Resistance index in benign prostatic hyperplasia using power doppler imaging and clinical outcomes after transurethral vaporization of the prostate

BACKGROUND: Using power Doppler ultrasonography (PDUS), we investigate the change of resistance index (RI) before and after transurethral vaporization of the prostate (TUVP) in benign prostatic hyperplasia (BPH) patients. METHODS: In all, 49 patients underwent transrectal PDUS before receiving TUVP, three were excluded because of cancer and three could not be followed up. The remaining 43 were enrolled in the present study. Patients were assessed before and 1, 3 and 6 months after surgery, giving a mean duration of follow-up of 9.1 months. International prostate symptom scores (IPSS), quality of life (QOL) scores, postvoiding residual urine volumes (PVR) and maximum urinary flow rates (Qmax) were evaluated and total prostatic volume (TPV) and RI were measured using PDUS. RESULTS: Resistance index ranged from 0.64 to 0.91. The postoperative parameters except for RI, such as TPV, PVR, IPSS and QOL scores improved significantly at the follow-up assessment after surgery. The elevated RI decreased significantly 1, 3 and 6 months after the treatment. Resistance index significantly decreased after TUVP and IPSS and other urodymamics parameters improved. CONCLUSIONS: The present study suggested that RI could evaluate the severity of BPH and the degree of intraprostatic pressure or bladder outlet obstruction.     

HER-2 gene polymorphism at codon 655 in familial prostate cancer in a Japanese population

Background: The Ile to Val polymorphism at codon 655 of HER‐2 was reported to be associated with a risk of sporadic prostate cancer and breast cancer. In this study, we examined the association of the HER‐2 polymorphism with familial prostate cancer in a Japanese population. Materials and methods: We performed a case‐control study consisting of 144 familial prostate cancer cases and 119 normal control subjects. The genetic polymorphism was analyzed by the restriction fragment length polymorphism method. Results: There was no significant difference between the case group and the control group for the allele or genotype distribution. Conclusion: In the present study, we could not confirm any significant association between the HER‐2 polymorphism with familial prostate cancer risk in a Japanese population. Further large‐scale studies are warranted to confirm the association of the HER‐2 polymorphism with the risk of development of prostate cancer.     

Analysis of psychogeriatric patients in the psychiatric emergency system

Background: To date, there have been few studies about elderly psychiatric patients using psychiatric emergency services. In the present study, we analyze data from the Tokyo metropolitan psychiatric emergency system and the Tokyo Metropolitan Matsuzawa Hospital to examine the clinical features and social factors of elderly psychiatric patients hospitalized in psychiatric emergency units. Methods: Over a 4 year period, from April 1998 to March 2001, there were 7971 patients (4520 men, 3451 women) who used the Tokyo Metropolitan Government's psychiatric emergency system. Of these 584 patients (337 men, 247 women) were elderly, over 60 years. Of these geriatric patients, 72 (45 men, average age 74.4 years; 27 women, average age 76.0 years) were received at Tokyo Metropolitan Matsuzawa Hospital from January 1999 to December 2001. The present study examines the reasons for hospitalization, legally mandated admission, diagnosis, psychiatric symptoms at admission, inappropriate behaviors, family status and disease complications. Results: Epidemiological data showed that the number of geriatric patients has increased annually and the distribution of elderly patients’ diagnoses is entirely different from that of younger or middle‐aged patients’. Almost all geriatric patients were under mandatory hospitalization by Law Related to Mental Health and Welfare of the Person with Mental Disorder. Psychiatric symptoms and inappropriate behaviors were considered to be highly severe, like those of younger patients. Conclusion: The importance of psychiatric emergency care for geriatric patients is strongly recognized by the present study. It is necessary to improve the present psychiatric medical system to develop a suitable and desirable system to care for geriatric patients.     

Anti-tumor effect of an intratumoral administration of dendritic cells in combination with TS-1, an oral fluoropyrimidine anti-cancer drug, and OK-432, a streptococcal immunopotentiator: involvement of toll-like receptor 4

The authors investigated the in vivo anti-tumor effect of intratumoral administration of bone marrow-derived dendritic cells (DCs) after chemotherapy using an oral fluoropyrimidine anti-cancer drug TS-1, and followed by immunotherapeutic agent OK-432, in two syngeneic tumor-bearing mouse models. Both in Meth-A fibrosarcoma-bearing BALB/c mice and in SCCVII-bearing C3H/HeN mice, 1 week of oral administration of TS-1 effected partial eradication of established tumors. Intratumoral injection of DCs and OK-432 caused only slight inhibition of the tumor growth. However, TS-1 administration followed by DCs and OK-432 resulted in a marked inhibition in the tumor growth and also contributed to a greater prolongation of survival. By the injection of DCs and OK-432 after TS-1 administration, a significant infiltration of immune cells, especially CD8+ T cells, was observed. Furthermore, the cytotoxic activities of tumor-infiltrating lymphocytes and draining lymph node cells against inoculated tumor cells were significantly increased by the therapy, while activities against nonspecific target cells were not. Cytotoxic memory T cells were also induced; the main effectors were MHC class I-restricted, CD8+ T cells. The same therapy was also applied to SCCVII-bearing C3H/HeJ mice in which the Toll-like receptor (TLR) 4 is mutated and its function impaired; no immunotherapeutic effect was observed in the TLR4-deficient mouse model. These findings suggest that the local DC therapy in combination with TS-1 and OK-432 may be a useful strategy for the treatment of solid tumors, and that TLR4 signaling is involved in the success of this therapy.     

Post-prandial triglyceride-rich lipoprotein metabolism: possible role of sialilated apolipoprotein E isoproteins

Abstract. While serum concentrations of triglyceride (TG) and apolipoprotein (apo) E decreased significantly after 75 g glucose load, serum triglyceride concentration increased markedly and apoB concentration decreased significantly after 100 g fat load in 10 healthy men. Chylomicrons and very low density lipoproteins (VLDL) increased after the fat load but decreased after the glucose load. ApoB-100/B-48 ratio in VLDL fraction decreased slightly at 30 min and increased markedly at 60 min after the glucose load. On the other hand, the ratio decreased definitely at 30 min and then increased until 90 min after the fat load. Isoelectric focusing (IEF) and two-dimensional gel electrophoresis revealed that the relative concentration of sialilated apoE in VLDL fraction decreased after the glucose load and increased after the fat load. In hypertriglyceridaemic patients, apoE3_S1/E3 ratio in VLDL fraction was significantly higher than that in normal and hypercholesterolaemic patients. The results suggest that some structural changes in apoE, due probably to sialilation, may exert an influence on the hepatic uptake of the lipoproteins.     

Role of Vagal Control in Vasovagal Syncope

SUZUKI, M., et al .: Role of Vagal Control in Vasovagal Syncope. The vasovagal reaction is thought to be caused by sympathetic withdrawal and vagal augmentation. While measurements of muscle sympathetic nerve activity support sympathetic withdrawal in tilt induced syncope, the results of previous attempts to quantify vagal control using spectral analyses of heart rate variability (HRV) remain controversial. The sampling period used in the HRV studies is related to the discordant results. In the present study, HRV was computed every second using wavelet transformation to clarify the role of vagal control in tilt induced syncope during the 80-degree head-up tilt test (positive: 10 patients with vasovagal syncope; negative: 10 patients with vasovagal syncope, and 10 control subjects). Autonomic modulations were assessed using the absolute power of the low frequency (LF) (0.04–0.15 Hz) and high frequency (HF) (0.15–2.00 Hz) oscillatory components of R-R variability. Although the LF did not change during the tilt procedure, a decrease in the systolic arterial pressure (SAP) and increases in the R-R interval and HF were observed for the last 30 seconds before the tilt induced syncope in the tilt-positive group. Analyzing the hemodynamic measurements and spectral indices for the last 5 minutes preceding the tilt induced syncope, the study found that the SAP, R-R interval, and HF changed simultaneously during the 30-second period immediately before the tilt induced syncope. Further, the HF was positively correlated with the R-R interval and negatively correlated with the SAP. In conclusion, continuous spectral analysis of the R-R interval demonstrated increased vagal influence on the heart in tilt induced syncope. (PACE 2003; 26[Pt. I]:571–578)     

Anti-inflammatory effect of activated protein C in gastric epithelial cells

It has been previously demonstrated that activated protein C (APC) plays an important role in the inhibition of inflammation in the gastric mucosa from patients with Helicobacter pylori infection. However, the role of gastric epithelial cells in the anti-inflammatory activity of APC remains unknown. In the present study, we evaluated the anti-inflammatory activity of APC and the expression of thrombomodulin (TM) and endothelial protein C receptor (EPCR) in gastric epithelial cells. The gastric epithelial cell lines, MKN-1 and AGS, and gastric biopsy samples from patients with and without H. pylori infection were used in the experiments. Polymerase chain reaction showed that gastric epithelial cell lines express EPCR and TM. Flow cytometry analysis also showed EPCR expression in both cells. H. pylori infection significantly increased EPCR expression compared with non-infected cells. Similar results were observed in vivo when samples from patients with and without H. pylori infection were analyzed for EPCR protein expression. Significant TM activity was found on AGS and MKN-1 cells stimulated with LPS from Escherichia coli and VacA antigen. APC was able to significantly inhibit the secretion of MCP-1 and IL-1beta induced by H. pylori homogenate in AGS cells. APC also remarkably suppressed the mRNA expression and secretion of MCP-1 from AGS cells infected with H. pylori. These results demonstrated the expression of components of the protein C pathway on gastric epithelial cells and that APC may play a critical role in the protection against gastric mucosal inflammation.