Stromal mesenchyme cell genes of the human prostate and bladder

Background

Stromal mesenchyme cells play an important role in epithelial differentiation and likely in cancer as well. Induction of epithelial differentiation is organ-specific, and the genes responsible could be identified through a comparative genomic analysis of the stromal cells from two different organs. These genes might be aberrantly expressed in cancer since cancer could be viewed as due to a defect in stromal signaling. We propose to identify the prostate stromal genes by analysis of differentially expressed genes between prostate and bladder stromal cells, and to examine their expression in prostate cancer.

Methods

Immunohistochemistry using antibodies to cluster designation (CD) cell surface antigens was first used to characterize the stromas of the prostate and bladder. Stromal cells were prepared from either prostate or bladder tissue for cell culture. RNA was isolated from the cultured cells and analyzed by DNA microarrays. Expression of candidate genes in normal prostate and prostate cancer was examined by RT-PCR.

Results

The bladder stroma was phenotypically different from that of the prostate. Most notable was the presence of a layer of CD13⁺ cells adjacent to the urothelium. This structural feature was also seen in the mouse bladder. The prostate stroma was uniformly CD13^-. A number of differentially expressed genes between prostate and bladder stromal cells were identified. One prostate gene, proenkephalin (PENK), was of interest because it encodes a hormone. Secreted proteins such as hormones and bioactive peptides are known to mediate cell-cell signaling. Prostate stromal expression of PENK was verified by an antibody raised against a PENK peptide, by RT-PCR analysis of laser-capture microdissected stromal cells, and by database analysis. Gene expression analysis showed that PENK expression was down-regulated in prostate cancer.

Conclusion

Our findings show that the histologically similar stromas of the prostate and bladder are phenotypically different, and express organ-specific genes. The importance of these genes in epithelial development is suggested by their abnormal expression in cancer. Among the candidates is the hormone PENK and the down-regulation of PENK expression in cancer suggests a possible association with cancer development.     

Absorbable cyanoacrylate as a vascular hemostatic sealant: a preliminary trial

No absorbable cyanoacrylate tissue adhesive for safe internal surgical use is available. This prospective multicenter preliminary study was designed to evaluate the safety and effectiveness of an investigational absorbable cyanoacrylate (IAC) as an adjunct to hemostasis in arteriovenous shunt (AVS) procedures for dialysis access. Consenting adults (10) underwent placement of expanded polytetrafluoroethylene (ePTFE) upper extremity vascular grafts for AVS access using continuous 5-0 or 6-0 polypropylene after heparinization (> or =3000 units i.v.). Arterial anastomoses were evaluated after sealing with IAC followed by 120 seconds of polymerization time. After vascular clamp removal, the mean time to hemostasis was 9.1 +/- 28.8 seconds. Additionally, 90 per cent (9/10) and 100 per cent (10/10) achieved hemostasis by 1 and 5 minutes, respectively. No patients required further adjunctive hemostatic measures. Adverse event safety data analysis through 12 weeks revealed occlusion of graft or vessel in four patients and graft thrombosis in one patient, all thought unrelated to sealant use. Other unrelated adverse events (bleeding, death, deep venous thrombosis, edema, erythema, hematoma, infection, and rash) occurred in single patients. Thus, IAC could be a useful sealant for vascular procedures with a potentially satisfactory safety profile. Larger, randomized, multicenter, prospective trials to further evaluate the use of this material are indicated and appropriate.     

Current Physiotherapy Practice of New Referrals to a Regional Paediatric Cystic Fibrosis Service

This paper reviews the physiotherapy practice and management of 85 cystic fibrosis patients referred to a Regional unit for comprehensive assessment. Following assessment, recommendations were made to the patients and referring units. Physiotherapy treatment was found to be sub-optimal in several areas. We suggest that, on the basis of our results, assessment/review at a Regional Cystic Fibrosis Centre would be beneficial to cystic fibrosis patients.     

Effectiveness of components of self-verbalization training for control of cold pressor pain

The increase of positive self-verbalizations (PSV), the decrease of negative self-verbalizations (NSV), their combination (PSV + NSV) and the use of an informational rationale that included a reconceptualization of pain were compared to a test-retest control group for ice water endurance. The Thought-Listing Questionnaire (TLQ) was used to assess participant thoughts. Sixty college women were pretested, given training, and posttested for ice water tolerance. Only the three self-talk treatments (PSV, NSV, PSV + NSV) produced greater pain tolerance. Analysis of TLQ data revealed a relationship between changes in thoughts and self-control of pain. Results suggest that, in contrast to some previous research, PSV and NSV were effective pain control techniques. Differences from other studies included using client-generated thoughts, examining client metacognitions, and promoting high compliance with training (tested by the TLQ). Client use of 'spontaneous' coping strategies was also discussed.