Calcium channel blocker and renal mitochondrial function in warm renal ischemia

OBJECTIVE: Ions, particularly calcium ions, play an important role in ischemia-reperfusion cell injury. In this study, we investigated the action of verapamil on the mitochondrial function of kidneys submitted to ischemia without blood reperfusion in order to study isolated early and late ischemic effects. MATERIALS AND METHODS: 44 rats were submitted to bilateral warm renal ischemia for 30 minutes. The kidneys were then immediately reperfused with saline or Euro-Collins (EC) solution, with and without previous administration of 0.35 mg/kg of verapamil. Mitochondrial function was assessed at the end of renal perfusion and after 24 hours of cold preservation. RESULTS: In kidneys perfused with saline, verapamil allowed a significant early preservation of state III mitochondrial respiration, a result that was no longer evident after 24 hours. In kidneys perfused with EC solution, verapamil did not change state III for either early or late evaluations. Comparison of the groups showed that the results obtained for kidneys perfused with EC were always superior to those obtained for the saline group, except for the initial analysis of kidneys treated with saline and verapamil, which showed results similar to those obtained with EC perfusion alone. CONCLUSION: Administration of verapamil before warm ischemia provides partial and short-lasting functional protection of the mitochondrial function in kidneys perfused with sodium rich saline. With Euro-Collins solution, verapamil did not show any additional beneficial effect. This fact permits us to conclude that protective action is effective only under conditions that facilitate increased sodium uptake and/or potassium loss.

Performance of PSA and of PSA density in the diagnosis of prostate carcinoma

Objective: The aim of the study was to investigate the influence of the prostate volume and PSA density on the performance of total PSA to diagnosis of prostate carcinoma. Methods: We analyzed 217 patients(PSA 0-10ng/ml) submitted to transrectal sextant prostate biopsy. Criteria for biopsy indication was PSA >2ng/ml and/or digital rectal exam suspicious of prostate cancer. Results: Fifty five patients had prostate neoplasia (25.3 percent) and 8/55 (25.3 percent) the serum PSA was under 4ng/ml. The sensitivity and specificity of the test were respectively 98.2 percent /16.6 percent at a cut-off point of 2.5ng/ml and 85,4 percent /38.8 percent at cutt-off of 4ng/ml. The corresponding values for prostates >40ml or <40ml were: 96.2 percent /8.1 percent and 100 percent /27.7 percent at the cut-off point of 2.5ng/ml, and 92.5 percent /20 percent and 78.5 percent /62.3 percent at a cut-off level of 4ng/ml. For prostates <40ml a PSA cut-off point of 4ng/ml leads to a misdiagnosis in 21.4 percent of the malignant tumors. The median PSAD of benign prostates are different according to prostate volume (.40ml or <40ml). PSAD at cut-off of 0.08 increases the PSAspecificity at both PSA cut-off points. Conclusions: Prostate volume affects the sensitivity and specificity of PSA and the median values of PSAD. PSAD of 0.08 increases the PSA specificity specially at a cut-point of 2.5ng/ml in prostates smaller than 40ml.