EAE in beta-2 microglobulin-deficient mice: axonal damage is not dependent on MHC-I restricted immune responses

There is accumulating evidence that CD8-positive (CD8+) T-cells and MHC-I expression may also play a role in neurodegeneration associated with multiple sclerosis (MS). We investigated the role of MHC-I and CD8+ T-cells by studying experimental autoimmune encephalomyelitis (EAE) in beta-2 microglobulin knockout mice induced by myelin oligodendrocyte glycoprotein (MOG) peptide 35-55 or whole rat myelin basic protein (rMBP). For both encephalitogens and even after reconstitution of the immune system with MHC-I-positive bone marrow and transfer of mature CD8+ T-cells (iMHC-I+ CD8+ beta2m-/- mice), the disease course in beta2m-/- mice was significantly more severe with a 10-fold increased mortality in the beta2m-/- mice as compared to wild-type C57BL/6 mice. EAE in beta2m-/- mice caused more severe demyelination after immunization with MOG than with rMBP and axonal damage was more marked with rMBP as well as MOG even in iMHC-I+ CD8+ beta2m-/- mice. Immunocytochemical analysis of spinal cord tissue revealed a significant increase in macrophage and microglia infiltration in beta2m-/- and iMHC-I+ CD8+ beta2m-/- mice. The different pattern of T-cell infiltration was underscored by a 2.5-fold increase in CD4-positive (CD4+) T-cells in beta2m-/- mice after induction of MOG 35-55 EAE. We conclude that lack of functional MHC-I molecules and CD8+ T-cells aggravates autoimmune tissue destruction in the CNS. Enhanced axonal damage speaks for pathways of tissue damage independent of CD8+ T-cells and neuronal MHC-I expression.     

Retropubic transvesical prostatectomy for significant prostatic enlargement must remain a standard part of urology training

OBJECTIVE: In recent years, open prostatectomy for benign enlargement has again become an issue of interest. We evaluated our experience with this procedure. Special attention was paid to the effect of the experience of the surgeon on operative outcome. MATERIAL AND METHODS: The patient files of 201 patients were evaluated retrospectively for operation outcome parameters. Statistical analysis was performed where appropriate. The different parameters were also analyzed separately for patients operated on by the head of the department and those operated on by residents. RESULTS: We found significant differences in pre- and postoperative median residual urine volume (85 vs 0.0 ml; p < 0.001) and pre- and postoperative median urinary flow (6.0 vs 20.8 ml/s; p < 0.001). There was a moderate correlation between preoperative determination of the prostate volume by means of transrectal ultrasound and postoperative histological weight. Patients operated on by the head of the department had a significantly shorter operation time. Postoperative complications were rarely seen in either group. The rates of postoperative complications were as follows: permanent incontinence, 0.5%; endoscopic revision (bleeding), 3%; open revision, 1%; urinary tract infection, 13%; and secondary wound healing, 5.5%. CONCLUSIONS: We feel that open prostatectomy remains an excellent technique for large prostate adenomas and should always be offered in such cases as a true alternative to endoscopic techniques. Having a well-trained urologist perform the procedure is the best guarantee of minimal blood loss and minimal complication rates. Therefore, open prostatectomy should be part of the education program of all prostate centers and urological departments.     

Photodynamic therapy of prostate cancer by means of 5-aminolevulinic acid-induced protoporphyrin IX - in vivo experiments on the dunning rat tumor model

OBJECTIVE: In order to expand the use of photodynamic therapy (PDT) in the treatment of prostate carcinoma (PCA), the aim of this study was to evaluate PDT by means of 5-aminolevulinic acid (5-ALA)-induced protoporphyrin IX (PPIX) in an in vivo tumor model. METHODS: The model used was the Dunning R3327 tumor. First of all, the pharmacokinetics and the localization of PPIX were obtained using fluorescence measurement techniques. Thereafter, PDT using 150 mg 5-ALA/kg b.w. i.v. was performed by homogenous irradiation of the photosensitized tumor (diode laser lambda = 633 nm). The tumors were resected 2 days post-PDT and the extent of the necrosis was determined histopathologically. RESULTS: The kinetics of PPIX fluorescence revealed a maximum intensity in the tumor tissue within 3 and 4.5 h post-application of 5-ALA. At this time, specific PPIX fluorescence could be localized selectively in the tumor cells. The PDT-induced necrosis (n = 18) was determined to be 94 +/- 12% (range 60-100%), while the necrosis of the controls (n = 12) differs significantly (p < 0.01), being less than 10%. CONCLUSION: These first in vivo results demonstrate the effective potential of 5-ALA-mediated PDT on PCA in an animal model.     

Ex-vivo comparison of the haemostatic properties of standard transurethral resection and transurethral vaporization resection of the prostate

OBJECTIVE: To compare the haemostatic properties of standard transurethral resection of the prostate (TURP) and transurethral vaporization resection of the prostate (TUVRP), as perioperative bleeding is still regarded as the major complication of prostate resection. MATERIALS AND METHODS: Isolated blood-perfused porcine kidneys were used to determine the haemostatic efficacy of TURP and TUVRP (using two different electrodes). Bleeding was quantified precisely in relation to tissue ablation for the two techniques, and specimens were evaluated histologically. RESULTS: Both TUVRP groups had significantly less bleeding (P = 0.005) than the TURP group for a standardized ablation volume of perfused kidney tissue (18.9, 19.5 and 24.1 mL/min, respectively). The different TUVRP electrodes had no significant haemostatic differences. The histology showed significantly (P = 0.03) larger coagulation zones for the TUVRP groups than for standard TURP. CONCLUSIONS: TUVRP ex-vivo was associated with significantly better haemostasis than TURP. The haemostatic properties of different active electrodes for TUVRP seem to be equivalent.     

表面带电脂质体载药及对小鼠体内弓形虫的作用

表面电性是脂质体重要性质之一,本文用1,8-ANS作为探剂,采用荧光法和电泳法测定脂质体的表面电位。离子性药物的包封率及渗漏速度受脂质体表面电性影响,实验表明,脂质体表面电性和药物离子电性相反时,包封率高,渗漏速度慢。以小鼠感染弓形虫做模型,进行体内试验,证明脂质体载药显著优于游离药物的治疗效果。因弓形虫是细胞内寄生的原虫,凡有利于药物入胞的方法,可提高其疗效。此种模型试验简便、准确,其结果对载抗癌药脂质体研究可以借鉴。     

Centrilobular emphysema: CT-pathologic correlation

Over a 5-year period, 25 patients who had undergone chest computed tomography (CT) died and were autopsied. Their lungs were fixed in the inflated state and were assessed for the presence and severity of centrilobular emphysema (CLE). Three radiologists independently evaluated the CT scans for nonperipheral low-attenuation areas, peripheral low-attenuation areas, pulmonary vascular pruning, pulmonary vascular distortion, and pulmonary density gradient. The CT criterion that best correlated with the presence and severity of CLE was the nonperipheral low-attenuation area. With this CT criterion, lung destruction was correctly identified in 13 of 15 cases. The absence of this criterion resulted in correct identification of eight of ten normal lungs. These preliminary data suggest that CLE can be reliably identified and quantified with current CT scanners.