Androgen Interaction with the Polyamine System of the Rat Prostate

The ventral and dorsal lobes of the rat prostate contain larger quantities of the aliphatic amines putrescine, spermidine and spermine and higher activities of the enzyme ornithine decarboxylase (ODC; EC 4.1.1.17) than other accessory sex glands. In contrast, the coagulating glands and the seminal vesicles contain only small quantities of the amines but the highest activities of the arginase (ARG; EC 3.5.3.1). Lineweaver-Burk plots indicated that the Km-values for ARG in the coagulating gland and ODC in the ventral prostate lobe were 20 mM and 0.2 mM, respectively. Castration decreased ODC and ARG activities to 3 and 50% of control levels, respectively, after 3 days, whilst the Km-values were unaffected. Daily administration of 3 mg dihydrotestosterone (DHT) prevented these castrational changes. Oestrogen treatment alone had no effect on the activities of the enzymes, but appeared to exert a synergistic effect with androgen on the ODC. Administration of androgen to intact rats for 7 days caused a dose-related alteration in the ratios of the various amines, particularly the spermine: putrescine ratio. A minor but significant decrease was also recorded in the activity of the ODC, which was mirrored by an increase in the levels of putrescine in the tissue. The data suggest that androgen control of the polyamine pathway is biphasic, first stimulatory and later inhibitory with lesions occurring at the ODC, possibly via short loop feedback of its product putrescine, but also at subsequent enzymic steps in spermidine and spermine biosynthesis.     

Anatomy of the prostate: An historical survey of divergent views

Historically, the study of the prostate anatomy has been characterized by a proliferation of contradictory findings. The major divergent views of prostate anatomy are here reviewed and compared in order to facilitate further study and the ultimate selection of the best anatomical model. The details of Lowsley's original concept of the prostate lobes and the subsequent evolution of this concept into several contradictory hypotheses are traced. Discrepancies between the findings of Lowsley, Franks, and McNeal are explained. Conclusions are drawn which may facilitate the further study of anatomy and disease in both the human animal prostate.     

Impact of the static prostatic urethral angle on men with lower urinary tract symptoms

ObjectiveThe purpose of this study was to investigate the relationship between the prostatic urethral angle (PUA) and the peak urinary flow rate (Q_max), as well as the severity of lower urinary tract symptoms (LUTS) in men with benign prostate hyperplasia.Materials and methodsThe records of first-visit male patients with LUTS in the outpatient department of our institution were obtained. A transrectal ultrasound was performed on these patients after a detailed physical examination and medical history taking were performed. The International Prostate Symptom Score (IPSS) of the patients, the prostate size, the length of intravesical prostatic protrusion (IPP), and the PUA were evaluated. The patients also underwent uroflowmetry and bladder scan for residual urine.ResultsA total of 227 patients were included in this study. The mean PUA was 44.58 ± 12.87°. The mean prostate volume was 39.39 ± 19.79 mL, and the mean IPP was 4.82 ± 6.82 mm. After utilizing multivariate linear regression analysis, PUA was independently associated with IPSS (p < 0.001) and Q_max (p < 0.001). However, prostate volume and IPP were not associated with the above clinical items. None of the prostatic parameters were associated with the amount of postvoiding residual urine.ConclusionPUA has a remarkable correlation with Q_max and IPSS in men with LUTS. As PUA increased, IPSS also increased, and urinary flow rate decreased, exhibiting an inverse relationship.     

Tissue type plasminogen activator as a marker for functional zones, within the human prostate gland

The cellular distribution of tissue plasminogen activator in the prostate central zone, prostate peripheral zone, and seminal vesicle was studied by using immunohistochemistry. Samples of these three regions were taken from 20 radical prostatectomy specimens. Sixteen of 18 central zone samples showed positive staining of 20-90% of the epithelial cells. All 15 peripheral zone samples were negative, and only three of 14 seminal vesicles showed positive staining, which was present in less than 5% of cells. The distribution of tissue plasminogen activator within the prostate was the same as that previously reported for pepsinogen II. This suggests that the central zone of the prostate may be the selective site of origin for proteolytic enzymes in seminal fluid.     

Course of localized adenocarcinoma of the prostate treated by radical prostatectomy

Among 562 patients with histologic stage B-1, B-2, or C adenocarcinoma of the prostate treated by radical prostatectomy and pelvic lymphadenectomy, analysis revealed that increasing histologic stage, tumor size, degree of capsular invasion, seminal vesicle involvement, and histologic grade all were highly correlated with both local and systemic progression (log-rank two-sided P less than or equal to 0.0001). No variable correlated with survival--a result that may reflect appropriate adjuvant therapy given at the time of progression. The death rate from prostatic cancer did appear to rise progressively with increase of stage. Overall, the projected 10-year survival was 76%.     

A form of basic fibroblast growth factor is secreted into the adluminal fluid of the rat coagulating gland

Rat coagulating gland and its secreted fluid contain a mitogenic substance that, by numerous criteria, appears to be similar to basic fibroblast growth factor (basic FGF). It is a potent competence factor in the BALB/c3T3 mouse embryo fibroblast assay, elutes from heparin-agarose at concentrations of NaCl greater than 1.0 M, and has an isoelectric point (pI) between 8 and 9. In coagulating gland fluid, its molecular weight was 20,000 +/- 5,000, as indicated by gel filtration on Sephadex G-200. Western blot analysis of purified factor from coagulating gland cytosol and fluid, respectively, revealed immunoreactive bands of 16,000 and 17,000 relative molecular weight similar to that of purified bovine basic FGF.     

超声引导下前列腺12针系统穿刺活检增加前列腺癌检出率的研究

目的:探讨不同年龄及前列腺特异性抗原(PSA)分组对12针穿刺活检前列腺癌检出率及肿瘤特征的影响。方法:临床表现怀疑前列腺癌患者210例,按照患者的年龄分为≤59岁组、60～69岁组、70～79岁组、≥80岁组,按照PSA水平分为0～4μg/L组、4.1～10μg/L组、10.1～20μg/L组、20.1～50μg/L组、>50μg/L组,记录患者临床资料及活检结果。提出不同的穿刺方案并计算其检出率。结果:210例怀疑为前列腺癌患者,检出前列腺癌91例,总的前列腺癌检出率为43.3%,随着年龄的增长,PSA水平的提高,检出率逐渐提高。年龄的增长、PSA水平的提高与体积较大、分级较高的肿瘤密切相关。外周带穿刺与旁正中矢状尖部穿刺有较高的前列腺癌检出率。当患者年龄<60岁,PSA水平<20μg/L时,12针穿刺活检为较佳方案。结论:12针穿刺活检可以弥补6针穿刺活检的缺陷,随着患者年龄的增长,PSA水平的提高,肿瘤的体积增大、病理分级较差。传统6针穿刺法与12针相比,受患者年龄、PSA水平的影响较大。     

前列腺体积及前列腺穿刺针数对前列腺癌诊断的影响

目的探讨前列腺体积及前列腺穿刺针数对前列腺癌诊断情况的影响并分析其原因。方法回顾性总结2002∽2009年间于我院行超声引导下经直肠前列腺系统12针穿刺292例患者的临床资料。患者PSA在o～20ng／mL之间。经直肠超声计算前列腺体积。将患者按照前列腺体积分为：〈30mL,30∽60mL,60∽90mL,〉90mL四组,比较各组前列腺穿刺6针、8针、10针、12针时前列腺癌诊断率。统计学Fisher’S检验比较各组间差异性。结果总体前列腺癌诊断率为25％（73／292）,在〈30mL组：6针、8针、10针、12针的前列腺癌诊断率相同,均为39．13％（21／54）;在30～60mL组：6针、8针、10针、12针的诊断率分别为：21．3％（23／108）、23．1％（25／108）、23．1％（25／108）、24．1％（26／108）,诊断率无显著差异（P〉0．05）。在60～90mL组：6针的诊断率为12．9％（12／93）,显著低于8针（19．4％（18／93）3、10针[20．4％（19／93）]、12针（20．4％（19／93）]的诊断率（Pd0．05）。在〉90mL组：6针、8针的诊断率均为8．1％（3／37）,显著低于10针、12针的诊断率C18．9％（7／37）,P〈0．053。黠论前列腺体积是选择前列腺穿刺针数时的一个重要的参考因素,在前列腺体积较大的情况下,可适当的增加前列腺穿刺针数,在前列腺体积较小的情况下,增加前列腺穿刺针数并不能提高前列腺癌的诊断率。     

Ultrastructure of the secretion of prostasomes from benign and malignant epithelial cells in the prostate

BACKGROUND: Prostate epithelial cells are producing, among other things, a fluid secretion containing small bodies, the prostasomes. The mechanism of synthesis of the prostasomes is not known in details, neither is it known whether the mode of prostasome production changes at a neoplastic transformation of the prostate cells. Due to the small size of the prostasomes, we have used electron microscopy for evaluating the production and distribution of prostasomes in benign and neoplastic cells of the prostate. METHODS: Benign and neoplastic areas in plastic embedded core biopsy specimens of prostate tissue were identified, and secreting cells were selected. The corresponding areas on the plastic blocks were further processed for examination in the electron microscope. RESULTS: The electron microscopical examination showed that the secretory machinery was similar in both types of tissue. Thus, in both benign and well-differentiated neoplastic cells studied, the formation of storage vesicles in the Golgi areas was similar, the content of the vesicles appeared similar, the structure and distribution of prostasomes were alike, and in both benign and malignant tissue, the secretion in the gland ducts showed the same appearance with many prostasomes. CONCLUSION: We conclude that cells in benign prostate tissue and cells in well-differentiated prostate carcinoma show great similarities in synthesis, storage, and release of prostasomes. However, this does not exclude the presence of other changes, for instance biochemical ones, in the prostasomes.     

剥离式经尿道前列腺切除术与经尿道前列腺电切术治疗良性前列腺增生的比较研究

目的:比较经尿道前列腺电切术(TURP)与使用专用前列腺增生腺体剥离器行剥离式经尿道前列腺切除术(剥离式TURP,TUERP)治疗良性前列腺增生(BPH)的疗效与安全性。方法:BPH患者630例,均具备手术指征,随机分为TURP组(305例)和剥离式TURP组(325例)。术前两组年龄、前列腺体积、国际前列腺症状评分(IPSS)、最大尿流率(Qmax)数值比较,差异无统计学意义(P均0.05)。记录两组手术时间、手术切除率、术后需要持续膀胱冲洗时间、术后生活质量评分(QOL)、手术并发症数据,进行统计学分析。结果:手术后的资料分析显示,TUERP手术切除率优于TURP组的手术切除率[(60.1±12.3)%vs(47.0±13.3)%,P0.05)];TUERP组平均手术时间比TURP组短[(40.4±14.2)min vs(57.9±15.9)min,P0.05];术后冲洗时间较短[(2.2±1.1)d vs(2.7±0.6)d,P0.05]。TUERP组手术前后血清Na+和血红蛋白浓度变化无统计学意义,TURP组血清Na+和血红蛋白浓度变化有统计学意义[血Na+:(141.2±3.5)mmol/L vs(136.9±4.7)mmol/L,P0.01,血红蛋白:(137.6±8.8)g/L vs(124.8±9.6)g/L,P0.01]。术后3个月,两组的IPSS评分、QOL评分、Qmax评分均较术前有显著改善(P均0.01),组间比较无显著性差异。(P0.05)。结论:剥离式TURP治疗BPH和TURP比较,具有手术时间短、手术切除率高、术中出血少、术后恢复快、并发症少等优点,在临床上有良好的应用前景。     

经尿道前列腺电气化术治疗前列腺增生症40例报告

目的：探讨经尿道前列腺电气化术治疗前列腺增生症的有效性。方法：采用ＴＵＶＰ治疗ＢＰＨ４０例，其中Ｉ度增生４例，Ⅱ度增生２５例，Ⅲ度增生１１例。结果：全部患者均获成功，术中经过平稳，无经尿道前列腺切除综合征；术后３－５ｄ拔除导管后均排尿通畅；随访１－１０个月，患者主，客观症状均有明显改善。     

Is chronic inflammatory change in the prostate the major cause of rising serum prostate‐specific antigen in patients with clinical suspicion of prostate cancer?

AIM: To evaluate the cause of elevated prostate-specific antigen (PSA) in patients with transrectal needle biopsy negative for prostate cancer. METHODS: Serum PSA concentration, prostate volume, and pathologic findings were examined in 223 patients with negative biopsy for prostate cancer. The degree of prostate inflammation was determined by the extent and degree of inflammation shown by biopsy specimens and is expressed as an inflammation score (range: 0-36). RESULTS: A significant correlation was found between PSA concentration and prostate total volume (P=0.0001). Prostate chronic inflammation showed no correlation with PSA concentration (P=0.485, F=0.488). After allocating patients to normal PSA (4 ng/mL) groups, we found that serum PSA concentrations in both groups were predominantly affected by prostate total volume. CONCLUSIONS: An increase in prostate volume appears to be the major contributor to a high serum PSA concentration in patients with negative biopsy for prostate cancer. However, in contrast to previous reports, there was no correlation between the degree of prostate chronic inflammation and serum PSA concentrations.     

老年男性静脉麻醉下经直肠超声引导无痛前列腺穿刺疼痛控制与并发症分析

目的：探讨前列腺特异抗原增高（PSA〉4/μg/L）老年男性静脉麻醉下经直肠超声引导无痛前列腺穿刺疼痛控制与并发症发生情况.方法：选取96例PSA增高老年男性患者（69±7岁）进行静脉麻醉下直肠超声引导无痛前列腺12针系统穿刺（静脉麻醉组）,并选取同期进行前列腺周围神经阻滞麻醉下直肠超声引导前列腺12针系统穿刺的51例PSA增高老年男性患者（67±6岁）为对照组.记录穿刺后30 min视觉模拟疼痛评分（VAS）、穿刺时间、麻醉不良事件和并发症发生情况.结果：静脉麻醉组90例（94%）为无疼痛（VAS=0）,6例（6%）为轻度疼痛 对照组21例（41%）为轻度疼痛,30例（59%）为中度疼痛.静脉麻醉组平均VAS评分和穿刺时间分别为（0.1±0.3）分和（5.1±1.3）min,显著低于对照组（3.85±1.2）分和（11.35±3.9）min.静脉麻醉组无一例发生麻醉不良事件.静脉麻醉组术后肉眼血尿、大便带血、发热和尿潴留的发生率分别为55%、15%、5%和3%,与对照组的差异无统计学意义（57%、18%、6%和4%）.结论：对于PSA增高老年男性患者,静脉麻醉直肠超声引导无痛前列腺穿刺具有无痛安全准确的优点.     

Regional variations in the testicular dependence of prolactin binding and its possible relationship to castration-induced involution in rat prostate gland

Prolactin binding sites of ventral, lateral, and dorsal lobes of rat prostate were examined immunohistochemically 1, 2, 4, and 8 days after castration or sham operation. In sham-operated rats each lobe exhibited a distinct pattern of intracellular and intraluminal prolactin binding. A loss in prolactin binding from epithelial cells of ventral prostate, which was visualized postcastration, was quantitated with the aid of an image analyzer and then statistically evaluated. The proportion of ventral prostate epithelial cells devoid of prolactin binding increased from approximately 13% in sham-operated rats to approximately 29% 1 day after castration, and reached a peak level of about 71% 4 days postcastration. No loss of prolactin binding was evident in either lateral or dorsal prostate up to 8 days postcastration. Direct measurement of epithelial cell heights and subsequent statistical evaluation revealed similar regional differences in the rates and extent of prostate involution. Eight days after castration ventral prostate epithelial cell heights decreased by 56% whereas lateral and dorsal lobe epithelial cells heights decreased about 25% and 14%, respectively. The apparent relationship between testicular dependence of prostatic prolactin binding and castration-induced prostatic involution are discussed in terms of possible regional variations in the prolactin-androgen interplay in prostate.     

Incidental prostate cancer revisited: Early outcomes after holmium laser enucleation of the prostate

Incidental prostate cancer (PCa) after treatment of benign prostate hyperplasia (BPH) is becoming less common. This is a result of the changing patterns of BPH treatment. The purpose of the present research was to re‐examine the clinical outcomes and importance of cT1a and cT1b PCa in a contemporary cohort after holmium laser enucleation of the prostate (HoLEP). All patients with newly diagnosed PCa after HoLEP were retrospectively identified. Pre‐ and postoperative prostate‐specific antigen (PSA), biopsy history, pathological features and disease progression were examined. Patients were matched to a control group with benign pathology for outcome comparisons. The database consisted of 240 consecutive patients, aged 52–90 years with prostate sizes from 25 to 375 cm³. A total of 28 patients were identified with incidental PCa (14 cT1a and 14 cT1b). Median follow up was 11 months and 13 months for cT1a and cT1b, respectively. Hospitalization time, catheterization time, complications and functional outcomes were similar. Three patients with cT1b required additional treatment as a result of PSA progression. All other cancers are being closely followed. The functional benefits of HoLEP are well established. The incidental PCa detection rate of 11.7% shows the potential benefit of pathological analysis. Just 10.7% of these patients received additional treatment, but this might be significant as these patients would otherwise go untreated. The impact on disease‐specific survival and progression requires a longer follow up.     

Comparison of the zones of the human prostate with the seminal vesicle: morphology, immunohistochemistry, and cell kinetics

BACKGROUND: The prostate contains three glandular zones (central, peripheral, transition) with widely differing susceptibilities to cancer and benign prostatic hyperplasia (BPH). Most of the prostate is derived from urogenital sinus, but the central zone may be derived from Wolffian duct, in common with the seminal vesicles (SV). The peripheral zone is the most frequent site of cancer and the transition zone is the almost exclusive site of BPH. METHOD: We compared the histology and immunohistochemistry of the SV with those of the prostate zones in order to identify differences associated with susceptibility to disease or different embryological origins. Sections from the prostates of nine organ donors (aged 15-36) were stained for tissue-specific markers, antigens previously shown to stain differentially between the zones and markers of cell proliferation and cell death. RESULTS: Neuroendocrine cells were absent from the SV and significantly fewer neuroendocrine cells were seen in the central zone compared to the peripheral zone. Most of the SV epithelium stained for lactoferrin, compared to approximately one-third of central zone and only 2% of peripheral zone epithelial cells. The proliferative index of the central zone was approximately 50% lower and the incidence of apoptotic cells approximately half that of the peripheral and transition zones. CONCLUSIONS: The central zone has features in common with both the SV and the other zones of the prostate. The higher incidence of proliferative diseases in the transition and peripheral zones may be associated with the higher rate of cell turnover observed in these zones.