Yttrium-90 Radioembolization to the Prostate Gland: Proof of Concept in a Canine Model and Clinical Translation

PurposeTo investigate the feasibility, safety, and absorbed-dose distribution of prostatic artery radioembolization (RE) in a canine model.Materials and MethodsFourteen male castrated beagles received dihydroandrosterone/estradiol to induce prostatic hyperplasia for the duration of the study. Each dog underwent fluoroscopic prostatic artery catheterization. Yttrium-90 (⁹⁰Y) microspheres (TheraSphere; Boston Scientific, Marlborough, Massachusetts) were delivered to 1 prostatic hemigland (dose escalation from 60 to 200 Gy), with the contralateral side serving as a control. Assessments for adverse events were performed throughout the follow-up (Common Terminology Criteria for Adverse Events v5.0). Positron emission tomography/magnetic resonance (MR) imaging provided a confirmation after the delivery of absorbed-dose distribution. MR imaging was performed before and 3, 20, and 40 days after RE. Tissue harvest of the prostate, rectum, bladder, urethra, penis, and neurovascular bundles was performed 60 days after RE.ResultsAll the animals successfully underwent RE. Positron emission tomography/MR imaging demonstrated localization to and good coverage of only the treated hemigland. No adverse events occurred. The MR imaging showed a significant dose-dependent decrease in the treated hemigland size at 40 days (25%–60%, P < .001). No extraprostatic radiographic changes were observed. Necropsy demonstrated no gross rectal, urethral, penile, or bladder changes. Histology revealed RE-induced changes in the treated prostatic tissues of the highest dose group, with gland atrophy and focal necrosis. No extraprostatic RE-related histologic findings were observed.ConclusionsProstate ⁹⁰Y RE is safe and feasible in a canine model and leads to focal dose-dependent changes in the gland without inducing unwanted extraprostatic effects. These results suggest that an investigation of nonoperative prostate cancer is warranted.     

Brenner tumors of the ovary: sonographic and computed tomographic imaging features.

OBJECTIVE: The purpose of this study was to describe the sonographic appearance of ovarian Brenner tumors with computed tomographic (CT) correlation. METHODS: Twenty-two female patients (age range, 32-78 years; mean, 58 years) with 25 ovarian Brenner tumors were identified from pathologic records from 1990 to 2005. Corresponding pathologic reports and images (17 sonographic and 14 CT) were reviewed independently. RESULTS: Tumors ranged in size from 0.3 to 12 cm (mean, 2.5 cm); all were benign. Sixteen (64%) of 25 were found incidentally. Eight (36%) of 22 patients had a total of 12 associated benign ovarian neoplasms (1 was contralateral); 3 patients had bilateral Brenner tumors. Eight (47%) of 17 tumors were not seen on sonography, and 5 (36%) of 14 were not seen on CT. Of the tumors seen on imaging, most were solid (67% on sonography and 78% on CT). Four tumors appeared at least partially cystic, of which 3 had coexistent cystic ovarian lesions. CONCLUSIONS: Brenner tumors are most often solid neoplasms found incidentally and frequently seen in association with other benign ovarian epithelial neoplasms.     

Inexpensive production of near‐native engineered stromas

Although the self‐assembly approach is an efficient method for the production of engineered physiological and pathological tissues, avoiding the use of exogenous materials, it nevertheless remains expensive and requires dexterity, which are features incompatible with large‐scale production. We propose a modification to this technique to make easier the production of mesenchymal compartment, to reduce the cost and to improve the histological quality of the self‐assembled tissues. The stroma produced by this novel approach allowed epithelial cell differentiation, resulting in a pseudostratified epithelium that shared several features with native tissues. The incorporation of endothelial cells in the reconstructed mesenchyme formed a three‐dimensional capillary‐like network, positive for CD31 and von Willebrand factor and surrounded by NG2 positive cells. It could limit self‐contraction of the resulting tissue by recruiting α‐Smooth Muscle Actin positive cells. With this new technique, which is relatively inexpensive and easy to use in a research laboratory set‐up, near‐native stromas can now be produced with minimal handling time. Copyright © 2015 John Wiley & Sons, Ltd.     

3764例女性泌尿生殖道支原体培养及药敏结果的分析

目的了解本地区女性生殖道疾病中支原体感染及常用药物体外药敏状况,为指导临床合理用药提供依据。方法应用珠海丽拓试剂公司提供的支原体鉴定药敏试剂盒对3764例门诊患者的泌尿生殖道分泌物进行支原体的培养、鉴定及药敏试验,并对12种抗菌药物对支原体的敏感性进行回顾性统计分析。结果 3764例门诊标本中,支原体检出阳性2041例,阳性率54.32%,其中解脲脲原体Uu阳性1655例（占43.97%）;人型支原体Mh阳性18例,（占0.48%）;Uu＋Mh混合感染阳性368例（占9.87%）。药敏试验显示药敏试验显示Uu、Uu＋Mh、Mh的耐药性存在一定差异,单纯Uu感染者对抗生素的敏感性明显高于混合感染者。交沙霉素、强力霉素、美满霉素对支原体敏感性最高。结论支原体感染以Uu感染为主,不同地区、不同支原体类型和是否混合感染对抗菌药物的敏感性存在差异,临床应根据感染类型及抗菌药物敏感性的不同选择有效的抗生素进行治疗。     

1652例泌尿生殖道感染患者支原体检测与药敏分析

目的:分析苏州市第五人民医院2009年泌尿生殖道感染患者支原体的检测及药敏情况,为临床治疗及合理用药提供依据.方法:采用法国梅里埃生物公司提供的1ST试剂盒做支原体培养鉴定和药敏试验,并对结果进行统计分析.结果:1 652例患者中分离出支原体5]1株,标本阳性率为30.93％,其中解脲支原体(Uu)阳性率为82％,人型支原体(Mh)阳性率为1.37％,Uu+Mh混合型阳性率为16.63％;药敏结果显示,支原体对普那霉素、多西环素、交沙霉素、四环素敏感率的平均值分别为100.00％,97.24％,95.75％,90.83％;对环丙沙星、氧氟沙星敏感率的平均值分别为10.54％,9.67％.结论:普那霉素、多西环素、交沙霉素、四环素可作为泌尿生殖道支原体感染的临床经验性选用的抗菌药物,同时应加强对支原体的耐药性的监测,指导临床合理使用抗菌药物.     

干细胞在组织工程技术修复重建下尿路疾病中的应用

应用组织工程技术进行泌尿系统重建的研究开展已有多年,但取材不便,细胞材源不足等问题始终未得以解决,从而限制了其进一步向临床推广。干细胞由于具备的自我更新及定向分化潜能,及对供区较小创伤等优势,为今后的研究工作提供了新的可能。研究者尝试以干细胞与脱细胞基质复合构建组织工程膀胱,适当诱导环境下,骨髓间充质干细胞能够向内胚层起源尿路上皮细胞分化。干细胞在尿道组织工程的研究中尚无相关动物模型的报道,但考虑到尿道与膀胱在组织结构及体内诱导环境上的相似性,推断干细胞在体内尿道组织中可能具有与膀胱间质中相似的分化能力。尿道超声引导下尿道周黏膜下层、横纹肌括约肌内注射自体肌源性干细胞、成纤维细胞是一种治疗压力性尿失禁的有效方法。间充质干细胞在海绵体组织中具有分化潜能外,还可促使一氧化氮分泌以改善勃起功能,并在内皮型一氧化氮合酶转染情况下,可通过进一步提高一氧化氮水平达到治疗勃起功能障碍的目的。     

Pyogenic Vertebral Osteomyelitis after Acute Bacterial Prostatitis: A Case Report

A case of pyogenic vertebral osteomyelitis after acute bacterial prostatitis in a 78-year-old man is reported. The rarity and subtle clinical presentation of this condition, and the delayed appearance of radiologic signs of progression to destructive osteomyelitis, contributed to a significant delay in diagnosis. An arterial blood culture positive for bacterial growth during the episode of acute prostatitis suggested that bacteremia might result from hematogenous spread of the infection to the vertebral column via the venous system. Since intensive antimicrobial therapy proved ineffective, debridement of the first and second lumbar vertebral bodies, and anterior spinal fusion from the twelfth thoracic to the third lumbar vertebrae were performed. The patient's high fever and severe lumbago subsided immediately after the surgery. The possibility of development to pyogenic vertebral osteomyelitis should be kept in mind when treating a serious genitourinary tract infection.