bluuebunny/crossref_metadata_2025 huggingface dataset:
Normalization of the Ovarian Cancer Microenvironment by SPARC
Authors: Said Neveen , Socha Matthew J. , Olearczyk Jeffrey J. , Elmarakby Ahmed A. , Imig John D. , Motamed Kouros
Published: October 2007

Malignant ascites is a major source of morbidity and mortality in ovarian cancer patients. It functions as a permissive reactive tumor-host microenvironment and provides sustenance for the floating tumor cells through a plethora of survival/metastasis-associated molecules. Using a syngeneic, immunocompetent model of peritoneal ovarian carcinomatosis in SP−/− mice, we investigated the molecular mechanisms implicated in the interplay between host secreted protein acidic and rich in cysteine (SPARC) and ascitic fluid prosurvival/prometastasis factors that result in the significantly augmented levels of vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMP). Ascitic fluid–enhanced ID8 invasiveness was mediated through VEGF via a positive feedback loop with MMP-2 and MMP-9 and through activation of αv and β1 integrins. Host SPARC down-regulated the VEGF-MMP axis at the transcriptional and posttranscriptional levels. In vitro, SPARC attenuated the basal as well as VEGF-induced integrin activation in tumor cells. SPARC inhibited the VEGF- and integrin-mediated ID8 proliferation in vitro and significantly suppressed their tumorigenicity in vivo. Relative to SP+/+, SP−/− ascitic fluid contained significantly higher levels of bioactive lipids and exerted stronger chemotactic, proinvasive, and mitogenic effects on ID8 cells in vitro. SP−/− ascites also contained high levels of interleukin-6, macrophage chemoattractant protein-1, and 8-isoprostane (prostaglandin F2α) that were positively correlated with extensive infiltration of SP−/− ovarian tumors and ascites with macrophages. In summary, our findings strongly suggest that host SPARC normalizes the microenvironment of ovarian cancer malignant ascites through down-regulation of the VEGF-integrin-MMP axis, decreases the levels and activity of bioactive lipids, and ameliorates downstream inflammation. (Mol Cancer Res 2007;5(10):1015–30)
Regulation of Docetaxel-Induced Apoptosis of Human Melanoma Cells by Different Isoforms of Protein Kinase C
Authors: Mhaidat Nizar M. , Thorne Rick F. , Zhang Xu Dong , Hersey Peter
Published: October 2007

Our previous studies showed that docetaxel-induced apoptosis of human melanoma cells was dependent on the activation of the c-jun NH2-terminal kinase (JNK) signaling pathway but was inhibited by the extracellular signal–regulated kinase (ERK)-1/2 pathway. However, the mechanisms by which these pathways were modulated by docetaxel were not clear. We report here that docetaxel induces activation of protein kinase C (PKC) signaling differentially through PKCε and PKCδ isoforms. Activation of PKCε was most marked in docetaxel-resistant cells and paralleled the activation of the ERK1/2 pathway. Inhibition of PKCε by small interfering RNA molecules resulted in down-regulation of phosphorylated ERK1/2 and sensitization of cells to docetaxel-induced apoptosis. Experiments also showed that β-tubulin class III, a molecular target of docetaxel, coimmunoprecipitated with PKCε and colocalized in confocal microscopic studies. In contrast to PKCε, high levels of activated PKCδ were associated with activation of the JNK pathway and sensitivity to docetaxel. Activation of PKCδ seemed to be upstream of JNK because inhibition of PKCδ by small interfering RNA abrogated activation of the JNK pathway. Although PKCδ could be activated in resistant cells, downstream activation of JNK and c-Jun did not occur. In summary, these results suggest that the outcome of docetaxel-induced apoptotic events in human melanoma cells depends on their PKC isoform content and signaling responses. PKCε was associated with prosurvival signaling through ERK, whereas PKCδ was associated with proapoptotic responses through JNK activation. (Mol Cancer Res 2007;5(10):1073–81)
Dysphotopsia after Cataract Surgery: Comparison of Four Different Intraocular Lenses
Authors: Bournas P. , Drazinos S. , Kanellas D. , Arvanitis M. , Vaikoussis E.
Published: October 2007

Aim: To assess the risk of dysphotopsia after phacoemulsification, with the use of four different intraocular lens (IOL) models. Methods: In this prospective randomized study, 600 patients underwent phacoemulsification surgery. Four study groups were formed, according to the type of the IOL implanted: Meridian HP60M [Bausch & Lomb, hydrogel, 6 mm, three piece (3P), square edge, refraction index (RI): 1.470], Acrysof MA60BM (Alcon, acrylic, 6 mm, 3P, square edge, RI: 1.550), Acrysof MA30BA (Alcon, acrylic, 5.5 mm, 3P, square edge, RI: 1.550) and Clariflex (AMO, silicone, 6 mm, 3P, anterior round and posterior square edge, RI: 1.460). Patients were examined for dysphotopsia symptoms after 1 week, 1, 3 and 6 months. Results: During the first follow-up visit, 117 patients (19.5%) reported dysphotopsia. During the next visits, the actual number of patients still reporting phenomena declined. Optic phenomena occurred less frequently in patients with AMO Clariflex lens, especially when compared to Acrysof (5.5 and 6 mm); IOL odds ratios ranged from 2.27 to 6.7, depending on follow-up time (p value < 0.05). IOL optic diameter was negatively but significantly associated with the risk of dysphotopsia. Conclusions: The design of the optic edge and the optic diameter of the IOL play an important role in the occurrence of dysphotopsia. AMO Clariflex, with round anterior and square posterior edge, overcomes the problem of dysphotopsia to a considerable extent.
Ocular Biometry in Acute and Chronic Angle-Closure Glaucoma
Authors: Lan Yu-Wen , Hsieh Jui-Wen , Hung Por-Tying
Published: October 2007

Aim: To evaluate the biometric difference between eyes with acute angle-closure (AAC) attack, their uninvolved fellow eyes and eyes with chronic angle-closure glaucoma (CACG). Methods: Patients with prior laser iridotomy on both eyes for unilateral AAC attack or CACG were recruited. We compared ocular biometric parameters by A-scan ultrasonography of the acutely affected eyes with those of the uninvolved fellow eyes and with eyes affected by CACG. Results: Thirty-three patients with unilateral AAC attack and 41 patients with CACG were included. The eyes with AAC attack had a significantly shallower anterior chamber depth (ACD), thicker lens, shorter axial length, higher lens/axial length factor and more anteriorly positioned lens than the eyes with CACG. The uninvolved fellow eyes had a significantly shallower ACD, shorter axial length and higher lens/axial length factor compared with the eyes with CACG. Acutely affected eyes had a shallower ACD and more anteriorly positioned lens than did the uninvolved fellow eyes. Conclusion: Eyes with AAC attack had a more crowded anterior segment compared with uninvolved fellow eyes and those affected by CACG. In addition to ACD, relative lens size, represented by the lens/axial length factor, and relative lens position appear to play important roles in the development of AAC attack.
Long-Term Intraocular Pressure Control of Trabeculectomy and Triple Procedure in Primary Open Angle Glaucoma and Chronic Primary Angle Closure Glaucoma
Authors: Hong Samin , Park Kyoungsoo , Ha Seung Joo , Yeom Ho Yeop , Seong Gong Je , Hong Young Jae
Published: October 2007

To evaluate the long-term intraocular pressure (IOP) control of trabeculectomy and triple procedure (cataract extraction by phacoemulsification, intraocular lens implantation and trabeculectomy), 1,542 eyes of 900 patients with primary open angle glaucoma (POAG) or chronic primary angle closure glaucoma (CPACG) were included. When success was defined as an IOP reduction of at least 30% from baseline, with or without antiglaucoma medications, the overall probability of success of trabeculectomy and triple procedure was 0.613 and 0.733 at 15 years, respectively. The success probability of trabeculectomy and triple procedure in reducing IOP below 18 mm Hg was 0.748 and 0.825 at 15 years, respectively. In POAG and CPACG patients, trabeculectomy and triple procedure were effective in reducing IOP for up to 15 years after surgery.
Changes in Intraocular Indocyanine Green Concentrations during Macular Hole Surgery
Authors: Ohguro Hiroshi , Ohguro Ikuyo , Ishikawa Futoshi , Hitoshi Yamazaki , Yokoi Yumiko , Nakazawa Mitsuru
Published: October 2007

Purpose: To report changes in intraocular indocyanine green (ICG) concentration which was used for visualization of the internal limiting membrane (ILM) during vitreous surgery on 3 eyes of 3 patients with full-thickness macular hole. Methods: During intraocular surgery with ICG-assisted ILM peeling, aliquots of intraocular fluid obtained at 1 min after ICG administration (0.5 ml of 5 mg/ml ICG solution), before and after ILM peeling, and before and after fluid/gas exchange were subjected to spectrophotometric analysis. Results: Intravitreous concentrations of ICG were dramatically reduced to approximately 0.4 µg/ml during the surgery for macular hole in all cases. Conclusion: The present study indicates that the levels of remaining intraocular ICG concentrations after macular hole surgery are much lower than the levels that induced retinal toxicity in experimental models.
Essential Hypertension and Hypermetropia: Is There Really an Association?
Authors: Gundogan Fatih C. , Mutlu Fatih M. , Bozoglu Ergun , Kilic Selim , Kerimoglu Hurkan , Deniz Devrim , Inal Satilmis , Sobaci Gungor
Published: October 2007

Aim: To investigate the relationship between hypermetropia and systemic hypertension. Methods: The study was performed on 2 groups of participants (a total of 1,162 participants). Group 1 comprised 370 patients with arterial hypertension and 205 age- and sex-matched normotensive subjects. Hypertension was defined as systolic blood pressure ≧140 mm Hg and/or diastolic blood pressure ≧90 mm Hg. Spherical equivalents between –0.50 and +0.50 dpt were regarded as emmetropia. Keratometry, anterior chamber depth (ACD) and axial length (AL) were measured with IOL Master (Zeiss, USA). Group 2 comprised 124 myopic, 206 emmetropic and 257 hypermetropic subjects. Differences for mean spherical equivalent, keratometry, ACD and AL measurements between hypertensive patients and control subjects (group 1) were compared using independent-sample t test and Mann-Whitney U test, and distributions of refractions were compared with the χ2 test. Distributions of hypertensive and normotensive subjects (group 2) among myopic, emmetropic and hypermetropic subjects were compared with the χ2 test. Results: Mean spherical equivalents of the patients with hypertension and of control subjects were –0.03 ± 1.63 and 0.22 ± 1.82 dpt, respectively (p = 0.182). The differences for keratometric values, ACD and AL were not significant (p = 0.151, 0.692 and 0.548, respectively). There was also no significant difference (p = 0.143) for hypertension ratios among myopic (66.1%), emmetropic (57.8%) and hypermetropic (55.6%) subjects. Conclusion: There is no association between systemic arterial hypertension and hypermetropia.
Inhibition of VEGF Expression by Targeting HIF-1α with Small Interference RNA in Human RPE Cells
Authors: Zhang Peng , Wang Yusheng , Hui Yannian , Hu Dan , Wang Haiyan , Zhou Jian , Du Hongjun
Published: October 2007

Background: Vascular endothelial growth factor (VEGF) is upregulated by hypoxia and is a major stimulatory factor for choroidal neovascularization. The upregulation of VEGF expression in response to hypoxia occurs through hypoxia-inducible factor 1 (HIF-1), which is a transcription factor that regulates genes involved in the response to hypoxia. HIF-1α is the inducible subunit of the HIF-1. Aims: To further define HIF-1 function in angiogenesis and to explore novel approaches to modulate choroidal neovascularization in age-related macular degeneration. Methods: In this study, we examined the response of human retinal pigment epithelium (RPE) cells to hypoxia and employed the small interference RNA technique to knock down gene expression of HIF-1α in RPE cells. Results: We found that both the mRNA and protein levels of HIF-1α in the RPE cells increased in response to hypoxia, followed by increasing expression of VEGF. Both the mRNA and protein levels of HIF-1α and VEGF in the RPE cells were decreased dramatically after transfection with a HIF-1α-specific small interference RNA vector. Conclusion: Our results suggest that HIF-1 may be involved in angiogenesis by controlling the expression of VEGF in vivo and provide a possible strategy for the treatment of angiogenesis by targeting the HIF-1α in ischemic retinopathies.
Effect of Thalidomide on Endostatin Levels in Retinal Ischemia/Reperfusion Injury
Authors: Aydoğan Semih , Türkçüoğlu Peykan , Çeliker Ülkü , İlhan Nevin
Published: October 2007

Aim: To evaluate the effects of thalidomide treatment on endostatin production in ischemia/reperfusion-injured guinea pigs retinas. Methods: Control, ischemia, thalidomide/ischemia groups including 7 animals in each were formed from pigmented male guinea pigs. Retinal ischemia was induced by cannulating anterior chambers and lifting the bottle to a height of 205 cm for 90 min in the ischemia and thalidomide/ischemia groups. The thalidomide/ischemia group received thalidomide (300 mg/kg/day) via nasogastric tube 24 h before ischemia and during 7 days of reperfusion. Guinea pigs were scarified for biochemical analysis of retinal endostatin level by ELISA. Results: The mean retinal endostatin levels of the control, ischemia and thalidomide/ischemia groups were 11.79 ± 7.36, 14.70 ± 4.88, 30.94 ± 15.59 ng/ml, respectively. The mean retinal endostatin level of the thalidomide/ischemia group was significantly higher than that of the control group (p = 0.011). The mean retinal endostatin level of the thalidomide/ischemia group was higher than that of the ischemia group, but there was no statistically significant difference (p = 0.073). No statistically significant difference in the mean retinal endostatin level was found between the control and ischemia groups (p = 0.165). Conclusion: Thalidomide treatment increased retinal endostatin level in ischemia/reperfusion-injured guinea pig retinas.
Effect of Melatonin and Zinc on the Immune Response in Experimental Toxoplasma Retinochoroiditis
Authors: Avunduk Avni Murat , Avunduk Mustafa Cihat , Baltacı Abdülkerim Kasım , Moğulkoç Rasim
Published: October 2007

Objectives: To investigate the possible effect of melatonin (MEL) and zinc on the immune response to Toxoplasma gondii retinochoroiditis in the rat model of infection and to establish the possible value of artificial MEL and/or zinc supplementation as adjunctive therapeutic agents in the treatment of T. gondii retinochoroiditis. Methods: Eighty-four Sprague-Dawley male rats were divided into 12 equal groups. All groups, except controls were infected with T. gondii parasite by intraperitoneal injection. Combinations of zinc-deficient diet, pinealectomy (Px), and artificial zinc and MEL were supplied during a 1-month period. At the end of the experiment, retinal and choroidal total lymphocytes, CD3+, CD4+, and CD8+ cell numbers were counted in histological sections. Results: The highest amount of cellular infiltration (lymphocytes, CD3+, CD4+, CD8+ cells) in the choroid and retina was detected in infected + MEL + zinc-treated rats, and the least amount of cellular infiltration was observed in Px + zinc-deficient diet-treated rats. Although single zinc or MEL supplementation had no significant impact on the cellular infiltration in the retina and choroid in Px rats, combined therapy significantly improved these responses. Conclusion: Artificial supplementation of MEL and zinc should be considered as an adjunctive therapy to classic treatment of Toxoplasma retinochoroiditis especially in immunosuppressed and elderly patients if our data are confirmed in a clinical setting.
The Effect of Intense, Short-Term Topical Dexamethasone Disodium Phosphate Eyedrops on Blood Glucose Level in Diabetic Patients
Authors: Kymionis George D. , Panagiotoglou Theoni , Tsilimbaris Miltiadis K.
Published: October 2007

Aim: To evaluate the influence of an intensive course of topical (ophthalmic drops) steroid (dexamethasone disodium phosphate) application on blood glucose levels in diabetic patients. Methods: Fifty-five diabetic (type 2) patients were randomly assigned to receive either corticosteroid (study group: 30 patients, 1 drop of 0.1% dexamethasone disodium phosphate) or balanced salt solution (BSS; control group: 25 patients) eyedrops, every 2 h for 7 days (8 drops/day). Blood glucose monitoring (venous blood sample) was performed at the same time every day (10:00 a.m.). Results: During the study no side effects (such as hypoglycemic/hyperglycemic crises) were observed in either study or control group. No statistically significant alterations in blood glucose levels were found (p = 0.19, paired t test) in either group. In the corticosteroid group, when we separately examined patients with controlled diabetes mellitus (initial glucose level ≤135 mg/dl), a statistically significant increase in blood glucose levels was found at the start of dexamethasone treatment (p = 0.003), but which returned to the pretreatment levels after discontinuation of dexamethasone drops. In contrast, similar results were not found for patients with uncontrolled diabetes mellitus (initial glucose level ≧135 mg/dl), while for control patients we did not find any statistically significant differences in any group. Conclusions: Intensive application of topical corticosteroids (drops) for a short period of time (7 days) seems to statistically raise the blood glucose levels in patients with controlled diabetes mellitus, which, however, return to pretreatment levels after discontinuation of eyedrops without any side effects.
Opinion of Headhunters about the Ability of Strabismic Subjects to Obtain Employment
Authors: Mojon-Azzi Stefania Margherita , Mojon Daniel Stéphane
Published: October 2007

Background: Through the opinion of Swiss headhunters, we wanted to determine the influence of strabismus on the ability to obtain employment. Methods:Out of 31 randomly selected Swiss headhunters, 20 could be interviewed using a validated questionnaire. Results: Forty-seven percent of the headhunters judged that strabismic subjects have more difficulties in obtaining a job. Gender has no influence on discrimination (p > 0.1). Asked about six facial disfigurements, strabismus was found to have the second largest negative impact on employment directly after acne. Strabismus was estimated to decrease the attractiveness of job applicants (p < 0.0001) and to have a negative impact on the overall judgment of a potential employer (p < 0.05). Conclusions:Visible strabismus influences negatively the ability to obtain a job. Because of its impact on the employability of a person, we believe that strabismus surgery in adults cannot be considered to be only a beautifying procedure.
Primary Invasive versus Progressive Invasive Transitional Cell Bladder Cancer: Multicentric Study of Overall Survival Rate
Authors: Ferreira Ubirajara , Matheus Wagner Eduardo , Nardi Pedro Renato , Levi D’Ancona Carlos Alturo , Reis Leonardo Oliveira , Stopiglia Rafael Mamprin , Denardi Fernandes , Rodrigues Netto, Jr. Nelson , de Cássio Zequi Stênio , da Fonseca Francisco Paulo , Lopes Ademar , Cardoso Guimarães Gustavo , de Carvalho Fernandes Roni , Cardenuto Perez Marjo Deninson
Published: October 2007

Introduction and Objective: When feasible, the treatment for all-invasive bladder cancer is radical cystectomy. The aim of the present study was to analyze the prognostic difference, disease-specific survival rate, of muscle-invasive transitional cell cancer of the bladder (TCCB) for progressive invasive TCCB. Patients and Methods: A retrospective multicentric analysis was performed studying a total of 242 patients who underwent radical cystectomy for invasive TCCB from 1993 to 2005. The patients were divided into two groups: group 1 included 57 patients with progressive invasive TCCB, and group 2 included 185 patients with primary invasive TCCB. Both groups were further divided according to the pathological findings in pT2/3 (muscle and/or perivesical fat invasion), pT4 (adjacent organs/structure invasion), N+ (positive lymphatic nodes) and M+ (distant organ metastasis). Several tests were employed for statistical analysis: χ2, Mann-Whitney, Kaplan-Meier method and Wilcoxon (Breslow) method were used to compare the possible survival curve differences of groups 1 and 2. Multivariated analysis determined by proportional risk regression excluded sex, age and disease stage interferences in the final results. Results: The average time for a superficial TCCB to become muscle-invasive was 37.4 months, and the average number of transurethral resections performed in each patient was 3. The average and median global survival rates were, respectively, 96 and 88 months in group 1 and 98 and 90 months in group 2, without a statistically significant difference (p = 0.0734). The 1-year survival rate was 84.32% in group 1 and 76.54% in group 2. After 3 years of follow-up the survival rate fell to 74.50% in group 1 and to 59.05% in group 2. Finally, the 5-year survival rate was 57.94% in group 1 and 52.24% in group 2. Conclusion: In the present study, patients with primary invasive and progressive invasive TCCB showed a similar 5-year disease-specific survival rate. Pathological stage (pTN, N and M) and patient demography did not interfere with the results.
Laparoscopic Radical Cystectomy with Extracorporeal Ileal Conduit Urinary Diversion for Treatment of Chinese Bladder Cancer Patients
Authors: Gao Zhen-Li , Fan Jie , Zhao Jun-Jie , Xia Shu-Jie , Shi Lei , Men Chang-Ping , Wang Hui , Wang Lin , Yang Dian-Dong , Sun De-Kang , Liu Qing-Zuo , Wu Ji-Tao , Zhang Peng , Liu Hai-Tao , Zhu Yi-Yong
Published: October 2007

Purpose: To present our experience in laparoscopic radical cystectomy with extracorporeal urinary diversion for treatment of Chinese bladder cancer patients. Methods: Between January 2003 and November 2005, 41 men and 5 women with organ-confined muscle-invasive transitional cell carcinoma of the bladder underwent laparoscopic radical cystectomy with the Bricker-type urinary diversion. The age range was 36–71 years. Laparoscopic radical cystectomy and bilateral pelvic lymphadenectomy were performed using five fan-shaped ports by a transperitoneal approach. An ileal conduit diversion was created through the site of specimen retrieval which was the second port at the region of the right pararectus. Results: 46 radical cystectomies with Bricker-type ileal conduits were performed. No conversion to open surgery was necessary. Mean operating time was 220 min (range 120–249 min) for laparoscopic radical cystectomy and 75 min (range 65–120 min) for creating the ileal conduits. Mean estimated blood loss was 276 ml (range 155–567 ml). Two of the 46 patients needed blood transfusion (400 ml each). Mean days to ambulation and oral intake was 4.1 (range 3–5 days) and 3.5 (range 3–6 days), respectively. Mean hospital stay was 17.6 days (range 12–35 days). Mean follow-up was 6.1 months (range 3–19 months). Histopathological examination of the specimens revealed stage T2N0M0 in 18 cases, T3aN0M0 in 14, T3bN0M0 in 9 and T3bN1M0 in 5 (TNM staging). WHO grading: G1 in 2 cases, G2 in 26 cases and G3 in 18 cases. Pelvic metastases appeared in one case and 44 patients are alive and free of disease. Intravenous pyelogram at 3 weeks postoperatively shows no evidence of upper urinary obstruction in 45 patients. Conclusion: Despite technical difficulties, laparoscopic radical cystectomy with Bricker-type urinary diversion is feasible. With more experience in the surgical technique, laparoscopic radical cystectomy with extracorporeal urinary diversion can become an alternative treatment of choice in the selected patients with organ- confined bladder cancer in China.
Does HER2 Immunoreactivity Provide Prognostic Information in Locally Advanced Urothelial Carcinoma Patients Receiving Adjuvant M-VEC Chemotherapy?
Authors: Tsai Yuh-Shyan , Tzai Tzong-Shin , Chow Nan-Hua
Published: October 2007

Introduction: To evaluate the impact of HER2 immunoreactivity on clinical outcome in locally advanced urothelial carcinoma patients who received surgery alone, or methotrexate, vinblastine, epirubicin, and cisplatin (M-VEC) as adjuvant chemotherapy. Materials and Methods: We studied 114 formalin-fixed paraffin-embedded specimens obtained from locally advanced urothelial carcinoma patients receiving surgery alone or adjuvant M-VEC. The authors evaluated HER2 immunoreactivity using immunohistochemical staining and explored the influence of pathological parameters and HER2 immunoreactivity on progression-free survival (PFS) and disease-specific overall survival (OS) using univariate and multivariate Cox’s analyses. Results: Urothelial carcinoma of the bladder had a significantly higher frequency of HER2 immunoreactivity than that of the upper urinary tract (60.7 vs. 20.7%, p < 0.0001). Overall, nodal status was a strong and independent prognostic indicator for clinical outcome. The HER2 immunoreactivity was significantly associated with PFS (p = 0.02) and disease-specific OS (p = 0.005) in advanced urothelial carcinoma patients. As for patients with adjuvant M-VEC, HER2 immunoreactivity was a significant prognostic factor for PFS (p = 0.03) and disease-specific OS (p = 0.02) using univariate analysis, but not multivariate analysis, and not for patients receiving watchful waiting. Conclusions: HER2 immunoreactivity might have a limited prognostic value for advanced urothelial carcinoma patients with adjuvant M-VEC.
Intraoperative and Early Postoperative Complications of Radical Retropubic Prostatectomy
Authors: Klevecka Virgilijus , Burmester Luise , Musch Michael , Roggenbuck Ulla , Kroepfl Darko
Published: October 2007

Introduction: To determine the perioperative complications and morbidity of radical retropubic prostatectomy (RRP) and to analyze risk factors for observed complications. Materials and Methods: Data of 1,000 patients undergoing RRP and pelvic lymphadenectomy (pLA) performed by different surgeons of the same hospital were collected. Uni- and multivariate analysis was performed to detect associations between intra- and postoperative complications and specific variables. Results: Relevant intraoperative complications were observed in 28 cases and relevant postoperative complications in 187 cases requiring reoperations in 46 patients. Diverse minor postoperative complications occurred in 75 cases. The surgeon’s experience and the operating time significantly influenced the incidence of intraoperative complications. Extended pLA was associated with significantly higher rates of lymphoceles and reoperations. The patients with lymphocele showed significantly higher rates of deep venous thrombosis (DVT), pulmonary embolism (PE) and reoperation and patients with DVT a higher incidence of PE and a higher rate of reoperations. The incidence of anastomotic strictures correlated significantly with postoperative urine retention. Conclusions: RRP is a safe surgical procedure. In the hands of experienced urologic surgeons it is associated with lower incidences of severe intraoperative complications. A substantial proportion of postoperative complications are associated with pLA and its extension.
Influence of Coping Styles on Quality of Life in Men with New and Increasing Lower Urinary Tract Symptoms
Authors: Kok Esther T. , Groeneveld Frans P.M.J. , Busschbach Jan J.V. , Hop Wim C.J. , Bosch J.L.H. Ruud , Thomas Siep , Bohnen Arthur M.
Published: October 2007

Objective: The present study aims to determine the influence of coping on quality of life (QOL) in elderly men developing lower urinary tract symptoms (LUTS). Materials and Methods: Longitudinal population-based study with a follow-up period of 6.5 years on 1,688 men aged 50–78 years. Data were collected through self-administered questionnaires, including the Sickness Impact Profile (SIP, three domains), Inventory of Subjective Health (ISH), International Prostate Symptom Score (IPSS), and the Utrecht Coping List (UCL). Various physical and urological measurements were completed. Multiple linear regressions were used to determine the change in QOL in men with incident LUTS in relation to coping behavior. Results: Overall no significant association is found between changes in LUTS with a change in QOL. However, a positive change in QOL is significantly associated with a change in LUTS when men use the coping style active problem solving and a negative relation exists with coping style reassuring thoughts. Conclusion: Different coping styles have a different impact on the relation between a change in LUTS and a change in generic QOL in community-dwelling elderly men. This makes a future exploration of the clinical treatment possibilities warranted.
Male Age and Sperm Necrosis in Assisted Reproductive Technologies
Authors: Siddighi Sam , Chan Christopher A. , Patton William C. , Jacobson John D. , Chan Philip J.
Published: October 2007

Introduction: Sperm apoptosis is well characterized but studies on the effect of male age and necrozoospermia are lacking. The objectives were: (a) to analyze percentages of apoptotic and necrotic sperm in ejaculates, and (b) to compare the results between younger and older age groups. Materials and Methods: Routine semen analyses were carried out (n = 189 males) and sperm cells were analyzed by dual fluorescence assay Hoechst 33342 and propidium iodide, and the acridine orange test. Results: The percentage of necrotic sperm in the ejaculate increased by 22% for males aged over 35. There was a positive correlation between age and necrosis (R = 0.30). Sperm apoptosis increased by 17% in males aged 45 and older. The population of DNA intact sperm declined in males aged 40 and over (R = –0.21). There were no age-related changes in strict normal morphology, sperm concentration and semen volume. A decrease in rapid progressive motility was correlated (R = –0.24) with male age and was significant after age 35. Conclusions: The study demonstrated increased necrosis, DNA damage and apoptosis while rapid progression and total motility declined with advancing age in the male beginning as early as age 35. The order of the observed changes was sequential, suggesting the involvement of different pathways in sperm necrosis after age 40.
Characterization of Primary Renal Carcinoma Cultures
Authors: Sievers Elisabeth , Dreimüller Patrick , Haferkamp Axel , Schmidt-Wolf Ingo G.H. , Büchler Markus W. , Schmidt Jan , Märten Angela
Published: October 2007

Purpose: For a better understanding of the factors contributing to tumor progression in metastatic renal cell carcinoma and to identify possible targets for immunotherapeutic approaches, we characterized several primary cultures from renal cell carcinoma. Materials and Methods: Cell cultures were tested for activity of telomerase, secretion of immunosuppressive cytokines and others. The induction of cytotoxic activity against the autologous tumor was tested in a cytotoxicity assay after coculture of immunological effector cells with antigen-pulsed dendritic cells. The data were tested for influence on survival. Results: We were able to establishprimary cell cultures from 58 patients with renal cell carcinoma and their metastasis. 48/58 were positive for telomerase activity and all secreted IL-6, TGF-β, VEGF and IL-8. High TGF-β secretion, the activity of telomerase and the induction of a telomerase-specific immune response against telomerase peptides in telomerase-positive tumors had a significant impact on survival. Conclusion: TGF-β secretion, activity of telomerase in telomerase-positive tumors and the ability to generate a telomerase-specific immune response might serve as a prognostic marker for RCC. New approaches might focus on attacking the TGF-β pathway and on induction of telomerase-specific immune cells.
Experience with Tube® (Promedon) Malleable Penile Implant
Authors: Fathy Ahmad , Shamloul Rany , AbdelRahim Amr , Zeidan Ashraf , El-Dakhly Refaat , Ghanem Hussein
Published: October 2007

Introduction: The main advantages of semirigid penile prosthesis are simple implantation, ease of use, very low risk of mechanical failure and more financial suitability for patients in developing countries. Aim: To evaluate reliability and safety of Tube® (Promedon, Cordoba, Argentina) penile prosthesis in the surgical treatment of erectile dysfunction. Patients and Methods: This retrospective case series was conducted on 83 patients who underwent Tube penile implant surgeries between 2001 and 2006. The choice of Promedon penile implant was determined by the patient himself. Strict infection control measures were applied. Patients were followed up for stability of vital signs and discharged within 72 h. Results: Successful sexual intercourse was possible for 75 (90.4%) of cases. Common postoperative complaintswere: prosthesis too short in 27 cases (32.5%), not happy with the appearance of the penis in 8 cases (9.6%), non-specific pain which subsided spontaneously in 20 cases (24%), in which no further intervention was done apart from reassurance. 79 (95.2%) patients were on regular follow-up for the first year and the rest dropped out. None of the patients experienced prosthetic infection postoperatively. Crural cross-perforation (4%) was managed intraoperatively. Hematomas (1.6%) were managed conservatively. Retarded ejaculation (10%) and penile hypothesia (0.8%) resolved spontaneously within 6 months in all cases. Conclusion: The Promedon malleable penile prosthesis is reliable and safe in the surgical treatment of erectile dysfunction.
Salutary Effects of N-Acetylcysteine on Apoptotic Damage in a Rat Model of Testicular Torsion
Authors: Payabvash Seyedmehdi , Salmasi Amirali Hassanzadeh , Kiumehr Saman , Tavangar Seyed Mohammad , Nourbakhsh Bardia , Faghihi Seyed Hamed , Dehpour Ahmad Reza
Published: October 2007

Introduction: Numerous studies performed in recent years have shown protective effects of N-acetylcysteine (NAC) on cardiac and renal tissue damage following ischemia/reperfusion injury. We assessed the effectiveness of systemic administration of NAC, at a therapeutic dose, in a rat model of a 1-hour 720-degree testicular torsion/detorsion. Materials and Methods: Sprague-Dawley rats were divided into five groups, 14 animals in each: group 1 animals underwent sham operation as the control group; group 2 rats underwent torsion/detorsion and received saline injection, and the animals in groups 3, 4, and 5 received intraperitoneal injections of 150 mg/kg NAC 30 min before torsion, after torsion, and after detorsion, respectively. Markers of oxidative stress as well as germ cell apoptosis indices were assessed 4 and 24 h after detorsion, respectively. Results: The apoptosis indices were significantly higher in group 2 as compared with the control group. Four hours after detorsion, the testicular level of lipid peroxidation was significantly increased, and antioxidant enzyme activities were significantly decreased in group 2 as compared with the controls. Administration of NAC either 30 min before or after torsion (groups 3 and 4) significantly improved the germ cell apoptosis indices and oxidant/antioxidant balance. Administration of NAC after detorsion had no significant effect on biochemical markers or germ cell apoptosis. Conclusion: Administration of NAC prior to torsion or detorsion, but not after detorsion, induces protective effects against ischemia/reperfusion injury in a rat model of testicular torsion.
Serotonin Induces a Biphasic Response in Rabbit Cavernosal Smooth Muscle: Relevance to the Erectile Process
Authors: Lau David H.W. , Thompson Cecil S. , Mumtaz Faiz H. , Morgan Robert J. , Mikhailidis Dimitri P.
Published: October 2007

Introduction: Serotonin (5-hydroxytryptamine; 5-HT) can cause contraction in cavernosal smooth muscle. We further evaluated this effect of 5-HT. Methods: Organ bath studies were used. Results: 5-HT induced a sustained contraction occasionally accompanied by a transient relaxation (in 30% of rabbit cavernosal tissues) that preceded the contraction. Ondansetron and Y-25130 (both 5-HT3 receptor antagonists) but not SB-269970 (a 5-HT7 receptor antagonist) significantly inhibited or abolished this transient relaxation. Doxazosin (dox, an α1-receptor antagonist) and ketanserin (ketan, a 5-HT2A receptor antagonist) significantly inhibited or abolished the sustained contraction. The effects of dox on 5-HT-mediated contraction were concentration-dependent. Conclusions: Our findings further confirm that the peripheral serotonergic pathway may play a part in the erectile process via 5-HT2A receptor-mediated contractile and 5-HT3 receptor-mediated relaxant activities. Our results also support the findings of human studies, which suggest that both ketan and dox may exert beneficial effects on the erectile process.
Segmental Testicular Infarction following Herniorrhaphy and Varicocelectomy
Authors: Calcagno Carlo , Gastaldi Franco
Published: October 2007

Segmental infarction of the testis is rare. To the best of our knowledge 36 cases have been reported in the literature. We report a case of focal infarction of the upper pole of the testis in a 23-year-old man following herniorrhaphy and varicocelectomy, treated with conservative surgery after intraoperative negative biopsy. The authors review the pertinent literature in terms of differential diagnosis, etiology and management.
CT Colonography (Virtual Colonoscopy): Technique, Indications and Performance
Authors: Blachar Arye , Sosna Jacob
Published: October 2007

Worldwide, colorectal cancer is the third most frequent cancer occurring in both sexes. Screening programs for early detection enable detection of tumors at an earlier stage and have been shown to reduce death rate. Currently, colonoscopy is the investigation of choice for colorectal cancer screening and for investigation of patients with suspected colorectal cancer. However, colonoscopy remains an invasive technique requiring anesthesia, with a risk of perforation and bleeding. In addition, even experienced colonoscopists may be unable to complete the colonoscopy due to multiple reasons such as severe diverticulosis, stricture, obstructing mass, or fixation of colonic loops. CT colonography, also known as virtual colonoscopy, is a relatively new technique that is becoming increasingly popular. The technical aspects, indications, advantages and diagnostic performance of this technique are briefly reviewed.
Chemoprevention of Colorectal Cancer
Authors: Das Debasish , Arber Nadir , Jankowski Janusz A.
Published: October 2007

Colorectal cancer is a major cause of mortality and treatment costs are considerable. Advocating lifestyle modification, faecal occult blood testing and surveillance colonoscopy in appropriate populations are already in practice. A developing concept is chemoprevention. Several models of carcinogenesis in colorectal cancer have been developed and there is an increasing database on the major molecular mechanisms involved in carcinogenesis mainly from preclinical experiments and phase I trials. There have been several large epidemiological and observational studies to evaluate possible protective effects of >200 agents. More recently, case-control and cohort studies and well-conceived, phase II/III clinical trials have been done or are under way to evaluate putative chemopreventive agents including established drugs like aspirin and non-steroidal anti-inflammatory drugs (NSAIDs), 5-aminosalicylates and statins; more controversial drugs like cyclo-oxygenase-2 (COX-2) inhibitors, ursodeoxycholic acid; various vitamins and micronutrients including calcium, selenium, folic acid, and dietary fibre, fat and protein content. Despite promising outcome in preclinical studies, there is currently very limited data from well-controlled and appropriately powered clinical studies. The most promising agents currently are aspirin, traditional NSAIDs and COX-2 inhibitors. The recent reports of cardiovascular risks of the COX-2 inhibitors and some traditional NSAIDs have resulted in stagnation of the field. Pending the expected release of results from several phase III trials in the near future, chemoprevention for colorectal cancer can only be practically considered in the very-high-risk population like those with familial adenomatous polyposis and ulcerative colitis, in conjunction with surveillance colonoscopy. This article reviews the major models of colorectal carcinogenesis, the concept of chemoprevention with special reference to colorectal cancer and the current state of clinical literature and the future direction of colorectal cancer chemoprevention for both researcher and clinician alike.
Rupture of Hepatocellular Carcinoma into the Biliary System with Resulting Bile Duct Thrombi: Report of Two Cases
Authors: Bigot P. , Buchanan G.M. , Hamy A. , Teyssedou C. , Pessaux P. , Arnaud J.P.
Published: October 2007

We report two cases of hepatocellular carcinoma revealed by jaundice and the presence of free-floating tumoural fragments within the biliary system. Two men (one of 64 and one of 73) presented with isolated jaundice. The results from ultrasound, CT and MRI were suggestive of a cholangiocarcinoma. Surgical intervention demonstrated bile duct thrombi from the primary tumour causing obstructive jaundice.
Intra Renal Arterial Injection of Autologous Mesenchymal Stem Cells in an Ovine Model in the Postischemic Kidney
Authors: Behr Luc , Hekmati Mehrak , Fromont Gaëlle , Borenstein Nicolas , Noel Laure-Hélène , Lelievre-Pegorier Martine , Laborde Kathleen
Published: October 2007

Background and Aims: Acute renal failure (ARF) remains a major healthcare problem. Although modern medical therapy has improved its outcome, the syndrome still has high mortality and morbidity rates [Xue et al.: J Am Soc Nephrol 2006;17:1135–1142]. Recently, stem cell (SC) therapies have been proposed as an alternative for the treatment of ARF on the basis of the damaged cells’ replacement or enhanced recovery or regeneration. The aims of this study were to investigate the engraftment of autologous mesenchymal stem cells (MSC) injected into the renal artery in an ovine model of ischemia reperfusion injury (IRI) and to assess the consequence of the delay between injury and cell transplantation on the engraftment. Material and Methods: MSC were transplanted in animals submitted to IRI or in healthy animals not submitted to IRI. Sheep with IRI were grafted at two different time points after injury. Unilateral renal IRI was performed by percutaneous transluminal placement of a balloon catheter in the renal artery. MSC were isolated from bone marrow, cultured, labeled and injected into the renal artery. Results: All ewes showed renal engraftment by MSC, both in tubules and glomeruli. MSC expressed tubular epithelial cell markers and podocyte phenotype. There was a significant increase of engraftment of tubules by MSC when cells were injected early after injury indicating that the delay for cell transplantation after ischemic insult should be short. Conclusions: This is the first report of intra-arterial autologous transplantation of MSC in the kidney, resulting in a successful engraftment into tubular and glomerular structures. The results strongly suggest that the optimal time window for stem cell therapy is during the early phase of the ischemic injury.
High Prevalence of Dementia in a Caribbean Population
Authors: Molero Aldrin E. , Pino-Ramírez Gloria , Maestre Gladys E.
Published: October 2007

Background/Aims: People in Caribbean countries are thought to be at particularly high risk for dementia. Basic descriptive epidemiology of dementia is required for populations in the region to determine the validity of this hypothesis. The main objectives of the study were to assess the prevalence, types and severity of dementia among elderly people (≥55 years old) in an urban area on the Caribbean coast of Venezuela, and to determine the gender and age distribution of affected people. Methods: The population-based Maracaibo Aging Study included 3,657 subjects, all of whom underwent a standardized, in-person interview. 2,438 of these subjects underwent neuropsychological, neuropsychiatric, cardiovascular and nutritional assessment. Results: The overall prevalence rate of dementia in elderly subjects was 8.04% and was not significantly different for women and men. Alzheimer’s disease was the most frequent type of dementia (50%), followed by vascular dementia (27%). Of all cases of dementia, 41.84% were ranked as mild, 30.10% as moderate and 28.06% as severe. Conclusion: The prevalence of dementia in elderly people from the Caribbean coast of Venezuela is much higher than frequencies previously reported for developing countries.
Attenuation of Glycerol-Induced Acute Kidney Injury by Previous Partial Hepatectomy: Role of Hepatocyte Growth Factor/c-met Axis in Tubular Protection
Authors: Homsi Eduardo , Janino Patricia , Biswas Subrata K. , Mizuno Shinya , Nakamura Toshikazu , Lopes de Faria Jose B.
Published: October 2007

Background/Aims: Previous partial hepatectomy (HPTX) can attenuate glycerol-induced acute kidney injury (Gly-AKI). The aim of this study was to explore the pathophysiological mechanisms and the role of hepatocyte growth factor (HGF) in kidney protection. Methods: Rats were subjected to HPTX 24 h before glycerol administration. Renal function, acute tubular necrosis, apoptosis, leukocyte infiltration, and the expression of HGF, c-met, monocyte chemoattractant protein-1, interleukin-1β, and heme oxygenase-1 were evaluated 24 h after glycerol injection. The regenerative response was analyzed from 6 to 72 h after glycerol injection (BrdU incorporation). In a separate series of experiments, Gly-AKI+HPTX rats were treated with anti-HGF antibody. Results: Gly-AKI+HPTX rats showed an increased expression of renal HGF and c-met as well as an improved creatinine clearance and reduced acute tubular necrosis and apoptosis, cytokine expression, and leukocyte infiltration. The regenerative response was less intense 24 and 72 h after glycerol administration in this group. The anti-HGF treatment disclosed an important role of HGF in the reduction of tubular injury, particularly apoptosis. Overexpression of heme oxygenase-1 was observed in Gly-AKI+HPTX rats, but was not associated with HPTX-induced renal protection. Conclusion: We conclude that Gly-AKI+HPTX rats have a reduced susceptibility to renal injury instead of an increased regenerative response and that endogenous HGF overexpression is responsible for suppression of tubular apoptosis.