Cell proliferation in dysplasia of the prostate: Analysis by PCNA immunostaining

Patterns of cell proliferation in the prostate were compared between benign epithelium and dysplasia. Proliferating cell nuclear antigen (PCNA) immunostaining was used to quantitate proliferation, and basal cells were tallied separately from secretory cells with the aid of keratin immunostaining. Using a novel technique, absolute cell densities (cells/mm) were determined and used to calculate growth fractions. In benign epithelium, 83% of PCNA⁺ cells were basal cells, while only 7% of PCNA⁺ cells in dysplasia were basal cells and there was a clear separation between groups. This dramatic shift of the proliferative compartment to the secretory cells in dysplasia was accompanied only by a moderate increase in overall secretory cell density and moderate reduction in basal cell density, but these ranges overlapped those of benign epithelium. The median PCNA⁺ secretory cell “growth fraction” was 0.12% in benign epithelium and 1.06% in dysplasia. The findings presented give further support to the concept that dysplasia represents an evolutionary stage in the malignant transformation of prostatic epithelium. The patterns of change in PCNA immunostaining may reflect certain aspects of the biologic nature of malignant transformation. © 1995 Wiley-Liss, Inc.     

Pica: a peculiar behavior with oral involvement

Pica is a behavior commonly displayed by children, pregnant females, and Individuals with mental retardation. A population of Institutionalized adults with mental retardation was assessed for pica. Of this population, 10.8% were identified with this behavior. Also, this article discusses aspects of pica and describes how this behavior can affect the mouth.     

Capsular penetration in prostate cancer. Significance for natural history and treatment

We established the location and extent of complete capsule penetration by prostate cancer in 176 radical prostatectomy specimens and related these findings to cancer volume, location of positive surgical margins, and presence of nodal metastases or seminal vesicle (SV) invasion. Extent of capsule penetration, cancer volume, and positive nodes/SV were strongly intercorrelated. It could not be shown that capsule penetration was related to prognosis independently of its correlation with cancer volume. Twelve cubic centimeters was a critical cancer volume; above that, combinations of extensive capsule penetration, positive surgical margins, and positive nodes/SV were almost universal. In cancers under 12 cc, positive surgical margins were only moderately correlated with cancer volume; they often represented surgical resection into the capsule rather than a complication of capsule penetration by tumor and were most common at the apex, where dissection is most difficult. In non-transition zone cancers (148 cases), capsule penetration was most common posterolaterally, where nerves penetrate the capsule. In transition zone cancers (28 cases), capsule penetration was much less common and was located more anteriorly. Apical positive margins were also relatively common in transition zone cancers, but seminal vesicle invasion was never seen.     

Oral converting enzyme inhibitor in malignant hypertension.

Malignant hypertension, which developed in a 9-year-old boy after an episode of haemolytic uraemic syndrome, could not be controlled with antihypertensive agents. However, treatment with oral converting enzyme inhibitor (captopril) was effective in controlling the blood pressure and it averted bilateral nephrectomy. No adverse effects from the drug were noted.