DβH-immunoreactive subepithelial nerves in the vas deferens of prostate cancer patients

We recently reported the results of applying immunohistochemical methods to examine the distribution of neuropeptides and neurotransmitter synthesising enzymes in the autonomic nerve fibres of specimens of human vas deferens obtained at vasectomy (Jen et al. 1999). As anticipated from previous neurohistochemical and electron microscopic studies (Baumgarten et al. 1971), the majority of nerves supplying the muscle coat are noradrenergic in type as demonstrated by the presence of tyrosine hydroxylase (TH) and dopamine beta hydroxylase (DbH) (Dixon et al. 1998), both of which are enzymes involved in the synthesis of noradrenaline.
In addition to the profuse intramuscular plexus of nerves, a second nerve plexus occurs at the base of the epithelium lining the vas deferens. These subepithelial nerves are immunopositive for vesicular acetylcholine transporter (VAChT) and therefore cholinergic in type, presumably serving a secretomotor function (Jen et al. 1999). Our immunohistochemical studies have also shown the presence of neuropeptide Y (NPY) in most of these subepithelial nerves in the human vas deferens with minor populations containing vasoactive intestinal peptide (VIP) and nitric oxide synthase (NOS), an enzyme involved in the formation of nitric oxide.     

Clinical, biochemical and pathological features of initial and repeat transrectal ultrasonography prostate biopsy positive patients

BACKGROUND: Using sextant biopsy, 16-41% of prostate cancers were diagnosed on repeat biopsy. The objective of the present study was to compare the differences in the clinical, biochemical and pathological features between patients with positive results on initial and repeat biopsies, with an aim to identify factors that can be used to improve the detection rate of transrectal ultrasound (TRUS) biopsy of the prostate. METHODS: Between February 2000 and April 2001, 222 patients with a mean age of 64 years (range 38-85) underwent TRUS-guided 10-core prostate biopsy for either abnormal prostate specific antigen (PSA) levels (>4 ng/mL) and/or abnormal digital rectal examination (DRE). Of this number, 165 patients underwent their first biopsy, whereas 45 and 12 patients had had one or two previous biopsies, respectively. RESULTS: Prostate cancer detection rates for the initial biopsy group (n = 165), second biopsy group (n = 45) and third biopsy group (n = 12) were 29.7, 23.0 and 41.7%, respectively. Six patients who had a negative first 10-core biopsy underwent a second 10-core biopsy and one patient (16%) was found to have cancer. Apart from total prostate volume, there were no significant statistical differences between the patient age, mean total PSA, PSA density, PSA-transition zone density, DRE and TRUS findings between the initial and repeat biopsy groups of subjects who had cancer. Those who had cancer detected only on repeat biopsies had larger prostate glands (P = 0.041). CONCLUSION: Patients who had cancer detected only on repeat biopsies had bigger prostate glands, supporting the hypothesis that TRUS sextant biopsy as a technique suffers the error of under-sampling in a bigger prostate.     

p38 MAPK对嗜酸性粒细胞和支气管上皮细胞共培养时细胞因子释放的调控作用

目的 了解嗜酸性粒细胞和支气管上皮细胞相互作用诱导细胞因子释放的p38 MAPK信号转导通路.方法 用CD16磁珠抗体分离外周血中嗜酸性粒细胞,以嗜酸性粒细胞和支气管上皮细胞(BEAS-2B)接触共培养为实验模型,观察SB 203580对细胞培养上清液中细胞因子浓度的影响.细胞因子浓度采用ELISA和流式细胞微珠方法测定.结果 SB 203580能够有效抑制BEAS-2B细胞释放IL-6、IL-8(P＜0.05)和嗜酸性粒细胞释放IL-8(P＜0.01).SB 203580对嗜酸性粒细胞与BEAS-2B细胞接触共培养诱导的IL-6、IL-8和IP-10释放具有显著抑制作用(P＜0.001).结论 嗜酸性粒细胞、BEAS-2B细胞单独或相互作用时均通过p38 MAPK信号转导通路释放细胞因子.     

The Clinico-pathologic Features of Hepatitis B Virus-associated Glomerulonephritis

The frequency of hepatitis B Surface antigen (HBsAg) was studiedin the sera of 311 patients with various forms of primary glomerulonephritisand 43 patients with lupus nephritis. HBs antigenaemia was detectedin 69 of the 311 patients (22 per cent) with primary glomerulonephritisand this prevalence of HBaAg carrier was significantly higherthan that in the general population (p<0. 001). These patientshad no clinical or biochemical findings to suggest acute orchronical liver disease. A higher HBs antigenaemia carrier ratewas not observed in patients with lupus nephritis. Three glomerulopathologicalentities, membranous nephropathy. IgA nephropathy, and mesangialproliferative glomerulonephrities, were found to be associatedwith a higher prevalence of HBs antigenaemia compared with thegeneral population (p<0. 001). Glomerular deposits of HBsAgand/or hepatitics core antigen (HBcAg) were detected in 41,61, and 60 per cent of renal biopsy specimens from patientswith membranous nephropathy, Iga nephropathy, and mesangialproliferative glomerulonephritis associated with persistentHBs antigenaemia respectively. During the mean study periodof 40 months (range 12–180), 14 per cent of these patientswith hepatitis-associated glomerulonephrities developed progressiverenal failure, althrough none required maintenanece dialysis.Our study suggests that hepatitis B virus antigenaemia may playa significant role in the developement of specific forms ofglomerulonephritis and that these hepatities B virus-associatedglomerulonephritides can run an indolent but relentless progressiveclinical course.     

Extension of Life-Table Methodology to Allow for Left-Censoring in Survival Studies of Pacing Devices Followed by Commercial Monitoring Services

The actuarial life-table is commonly used to describe lifetime data of living subjects and manufactured products. The life-table method allows subjects to come under observation at different times and, thus, to have differing lengths of follow-up, by assuming all subjects begin their lifetimes relative to the outcome of interest at some common point in time. As time progresses, subjects are withdrawn from the life-table when their period of observation has elapsed. This pattern of follow-up is often termed "right-censoring." An important feature of the classical life table approach is that the time at which the subject is placed at risk is known, and the status relative to the outcome of interest is known for the entire time at risk. Sometimes, however, subjects cannot be observed for some period after the beginning of their lifetimes. The example to be considered involves follow-up data collected by a commercial pacemaker monitoring service, to which patients subscribe, generally at some point following the actual implant of the pacemaker. Since the outcome of interest is device failure after implant, some means of dealing with the lack of information between implant and initiation of follow-up is needed. The extension of the actuarial life-table to accommodate this "left-censoring" will be described in this paper.     

Renal Kallikrein Excretion in Alcoholic Cirrhosis

Severe liver disease is often associated with renal hemodynamic changes, and these changes may involve vasoactive hormones. The vasodilatory renal kallikrein-kinin system has received little previous study in these patients. We measured urinary kallikrein in nine patients with alcoholic cirrhosis under rigid metabolic conditions and simultaneously evaluated renin, aldosterone and urinary prostaglandins. Plasma renin und aldosterone were generally increased as expected but urinary kallikrein was surprisingly diminished (13.3 ± 3.7 vs. 38.8 ± 11.1 SE, E.U./day. P < 0.05). despite adequate creatinine clearance (81 ± 9 ml./min.). Administration of prostaglandin inhibitors reduced urinary prostaglandin E by 72% and creatinine clearance by 56% but did not alter urinary kallikrein. Mineralocor-ticoid inhibition by spironolactone induced a natriuresis in four patients with ascites (from 1.4–140 mEq. Na⁺/day) but also failed to alter kallikrein. Thus, kallikrein excretion is paradoxically reduced and seemingly unresponsive to alterations in the prostaglandin and renin-aldosterone systems. If urinary kallikrein quantitatively reflects intrarenal kallikrein-kinin activity, the impairment in this vasodilatory system may mediate the altered renal hemodynamics of severe liver disease.     

Antigenic variation in Giardia lamblia: cellular and humoral immune response in a mouse model

Neonatal mice (CR:NIH:S) were infected with a cloned human isolate of Giardia lamblia (GS/M-83-H7) and the surface antigens of the intestinal trophozoites, as well as the cellular and humoral immune responses, were analysed during the course of infection. Infections in mice peaked 2-3 weeks after inoculation and were self-cured by day 42 post-infection (p.i.). The proportion of trophozoites expressing the Mr 72,000 surface antigen of the initial inoculum had decreased by day 12 and approached zero by day 22 p.i., similar to infections in humans. The predominant parasite-specific humoral response was an IgM- and IgG-isotype directed to the original Mr 72,000 surface antigen as well as other antigens. T-lymphocytes (predominantly LY4(CD4)+) isolated from Peyer's patches 12 days p.i. and later showed a significant proliferative response to Giardia lamblia antigens. Spleen and lymph node cells showed no lymphoproliferative response. T-cell blot analysis revealed the presence of dominant T-cell epitopes in the areas of Mr 200,000-75,000 and less than 50,000 polypeptides. No response was demonstrated in the Mr 72,000 region (migration site of the major surface antigen), suggesting T-cell dependent mechanisms are most likely not responsible for the surface antigen switch which occurred during the course of infection. This model infection can be used to study the role of immunological mechanisms in Giardia lamblia variant antigen switching and in the control of infections.     

COLON CANCER AND POLYPS IN ACROMEGALY: INCREASED RISK ASSOCIATED WITH FAMILY HISTORY OF COLON CANCER

A cohort of 52 subjects diagnosed with acromegaly in southeastern Michigan and northern Ohio between 1935 and 1985 were followed to determine the incidence of colon cancer and polyps. Medical records were reviewed, subjects or their next-of-kin were interviewed, and screening examinations of the colon were offered to the living patients who were located. Data on demographics, personal histories of cancer and colon polyps, family history of colon cancer, and cure from acromegaly were obtained for both living and deceased subjects. The risk for colon cancer compared to the general population was estimated using standardized incidence ratios (SIRs). The expected number of cases was determined utilizing age, sex and race-specific rates provided by the cancer registry in southeastern Michigan. Among the 52 subjects, one could not be located and nine were deceased, none from colon cancer, with one known to have a history of colon polyps. Of 13 (31%) who declined the screening physical, one had a history of polyps and none reported a history of colon cancer. Two of 29 screened patients were found to have right-sided adenocarcinoma of the colon. Of the entire cohort, eight people (including one deceased) had a current or previous diagnosis of polyps, with five known to be histologically adenomatous. The SIR for colon cancer was 4.7 (95% confidence interval 0.6-17.1). Seven subjects, including the two with detected adenocarcinoma and four of the six living subjects with polyps only, reported a family history of colon cancer. The SIR for the subset of subjects with a family history of colon cancer was 29.1 (95% confidence interval of 3.5-104.6).(ABSTRACT TRUNCATED AT 250 WORDS)     

Oral health-related quality of life in patients seeking care for dentin hypersensitivity

Summary  The aim of the present study was to evaluate oral health-related quality of life (OHRQoL) impairment in patients seeking care for their hypersensitive teeth in comparison with general population subjects and to investigate the influence of gender and age on OHRQoL in these populations. Study participants were 656 patients without removable prosthodontics who sought treatment for their hypersensitive teeth in German dental offices. These patients were asked to complete the German form of the Oral Health Impact Profile (OHIP-G) prior to treatment. The sum of OHIP-G item responses (OHIP-G49, 0–196) characterized the OHRQoL impairment. Patients' OHIP summary scores were compared with those in a sample of the German general population ( n  = 1541). The influence of population (patients vs. general population subjects), gender and age was investigated using a multivariable linear regression model. Age presented a curvilinear association with OHRQoL, with lower OHIP scores associated with younger and older adults and higher OHIP scores (indicating impaired OHRQoL) associated with middle-aged adults in both the patient and general populations. Gender influence depended on the population, i.e. female general population subjects had lower OHIP scores than male general population subjects and female patients had higher OHIP scores than male patients. Mean OHIP summary scores indicated that patients with hypersensitive teeth reported considerably more impaired OHRQoL (approximately 22 OHIP units) than subjects in the general population. The present study suggests that the oral condition of hypersensitive teeth is significantly associated with impaired OHRQoL.     

Joaquin Maria Albarran Y Dominguez: Microbiologist, histologist, and urologist–a lifetime from orphan in Cuba to Nobel nominee

Joaquin Albarran was an extraordinary late 19th century urologist. His early career was in the field of microbiology and histopathology in Paris at a time of great medical developments and innovations. His later contributions to urology included the Albarran lever, Albarrans sign, Albarran-Ormond syndrome and seminal works on testicular and renal tumors. He also wrote treatizes on the pathophysiology of acute urinary retention, nephritis and calculus ureteric obstruction. He died at the young age of 52 from the effects of tuberculosis and in this same year was nominated for the Nobel prize in medicine.