Predictive value of [-2]propsa (p2psa) and its derivatives for the prostate cancer detection in the 2. 0 to 10. 0ng/mL PSA range

ABSTRACT Introduction To assess predictive value of new tumor markers, precursor of prostate specific antigen (p2PSA) and its derivates-%p2PSA and prostate health index (PHI) in detection of patients with indolent and aggressive prostate cancer (PC) in a subcohort of man whose total PSA ranged from 2 to 10ng/mL. Materials and Methods This cross-sectional study included 129 consecutive male patients aged over 50 years, with no previous history of PC and with normal digital rectal examination findings, but with serum PSA in interval between 2 and 10ng/mL. All patients underwent standard transrectal ultrasonography guided prostate biopsy for the first time. For all patients, serum PSA, free PSA (fPSA) and p2PSA were measured and PHI and %p2PSA were calculated. Results PHI and %p2PSA levels were significanlty higher in patients with PC compared to those without this malignancy. The same findings have been observed in group of patients with Gleason score ≥7 compared to those with Gleason score <7. ROC analysis reveled the highest area under the curve with these two markers. Multivariate logistic regression showed significant improvement in PC detection and its agressive form (assumed as Gleason score ≥7). Conclusions New markers, derivates of p2PSA (especially %p2PSA and PHI), represente potentially very important clinical tool for predicting presence of PC, and even more important, to discriminate patients with Gleason score <7 from those with Gleason score ≥7 with total PSA in range from 2 to 10ng/mL.

Predictive value of [-2]propsa (p2psa) and its derivatives for the prostate cancer detection in the 2.0 to 10.0ng/mL PSA range.

INTRODUCTION: To assess predictive value of new tumor markers, precursor of prostate specific antigen (p2PSA) and its derivates-%p2PSA and prostate health index (PHI) in detection of patients with indolent and aggressive prostate cancer (PC) in a subcohort of man whose total PSA ranged from 2 to 10ng/mL. MATERIALS AND METHODS: This cross-sectional study included 129 consecutive male patients aged over 50 years, with no previous history of PC and with normal digital rectal examination findings, but with serum PSA in interval between 2 and 10ng/mL. All patients underwent standard transrectal ultrasonography guided prostate biopsy for the first time. For all patients, serum PSA, free PSA (fPSA) and p2PSA were measured and PHI and %p2PSA were calculated. RESULTS: PHI and %p2PSA levels were significanlty higher in patients with PC compared to those without this malignancy. The same findings have been observed in group of patients with Gleason score ≥7 compared to those with Gleason score <7. ROC analysis reveled the highest area under the curve with these two markers. Multivariate logistic regression showed significant improvement in PC detection and its agressive form (assumed as Gleason score ≥7). CONCLUSIONS: New markers, derivates of p2PSA (especially %p2PSA and PHI), represente potentially very important clinical tool for predicting presence of PC, and even more important, to discriminate patients with Gleason score <7 from those with Gleason score ≥7 with total PSA in range from 2 to 10ng/mL.

Changes in microbial food web structure in response to changed environmental trophic status: a case study of the Vranjic Basin (Adriatic Sea).

Vranjic Basin, in the eastern part of KastelaBay (middle Adriatic Sea), received municipal wastewater until offshore submarine outfalls were finished in November 2004. To identify the responses of the microbial community to changes in the trophic status of the marine environment, two 4-year periods were compared: a eutrophic period (2001-2004) when the sewage waters entered the Basin and an oligotrophic period (2005-2008) after the outfalls were completed. The switch from eutrophic to oligotrophic conditions was accompanied by decreases in bacterial abundance, bacterial production and chlorophyll a, and increase in heterotrophic nanoflagellate (HNF) abundance and bacterial specific growth rate. Qualitative changes in the phytoplankton community manifested through dramatically decreased abundance of the diatom species Skeletonema costatum and Euglenophyta Eutreptiella spp. during the oligotrophic period. Furthermore, the percent contribution of pico-nano phytoplankton chlorophyll to total chlorophyll increased from less than 40% during the eutrophic period to more than 60% during the oligotrophic period. Changes in seasonal patterns of phytoplankton, bacteria and HNF abundance were also observed, with summer maxima during the eutrophic period and spring and autumn maxima during the oligotrophic period. Significant changes in the microbial food web were also identified. During eutrophic conditions, bacteria were dominantly under the phytoplankton-mediated bottom-up control whereas HNF were dominantly controlled by ciliate grazing (top-down control). In contrast, during the oligotrophic period, predominantly top-down control of bacteria by strong HNF grazing was observed. At the same time, HNF were spared from strong ciliate predation pressure because the ciliates apparently switched their dominant prey from HNF to the pico-nano phytoplankton fraction during that period.

Isolation of a coronavirus from kidney biopsies of endemic Balkan nephropathy patients.

Endemic Balkan nephropathy (EBN) is a kidney disease of unknown etiology limited to Bulgaria, Rumania and former Yugoslavia. Primary kidney tissue cultures were established as explants from tissue obtained at operations from 5 EBN patients with urinary tract tumors. Four out of the five biopsy specimens on extended culture incubation at 33 degrees C yielded a coronavirus virus (EBNV) which was cytopathogenic for human fibroblast and Vero cells. In cells inoculated with EBNV, cytoplasmic immunofluorescence was found using antisera for human coronaviruses OC43 and 229E as well as the porcine transmissible gastroenteric virus and avian (chicken) bronchitis virus. In neutralization tests, EBNV failed to react with antisera to these viruses. Using hyperimmune serum raised with EBNV, positive cytoplasmic immunofluorescence was seen with cells infected with OC43, 229E, TGV and significantly with the kidney tissue of the biopsy specimens from the EBN patients. A screen for neutralizing antibody using the EBN virus revealed that 87.2% of EBN patients on dialysis were positive, also 74% of people from an endemic area were also positive, while only 13.5% from outside were positive. It is suggested that a coronavirus is involved in the etiology of the disease and that humans are an incidental host of a coronavirus zoonosis.

[The Camey enteroplasty after radical cystoprostatectomy: complications, results, quality of life]. / Eneteroplastika po Camey-u nakon radikalne cistoprostatektomije: komplikacije, rezultati, kvalitet zivota.

Removal of the urinary bladder-cystectomy--imposes the problem of urine derivation. The most sophisticated forms of urinary derivation imply those where the continent urinary reservoir is anastomosed to the urethra. One of these is Cameys enteroplasty. In our hospital this technique was applied on 52 patients. Postoperative complications and obtained results suggest that this form of urinary derivation is an important step nforward not only to incontinent forms of derivation, but to non-orthotopic continent urinary derivations, as well. All patients in our series were very successful in reintegration into the normal life, i.e. they were able to achieve a high a high quality of life after otherwise mutilating surgical procedure.

[Uretero-cutaneoustomy--indications and quality of life]. / Ureterokutaneostomija--indikacije i kvalitet zivota.

Ureterocutaneostomy, the anastomosis of the ureter to the skin, represents the most simple supravesical urinary derivation. It can be performed as unilateral, bilateral, bilateral with one orifice, or rarely as transuretero-ureterocutaneostomy. In period 1993-1998 on the Clinic of Urology, Clinical Center of Serbia, ureterocutaneostomy was performed in 155 patients as definitive type of urinary derivation. The most frequent indication for this type of derivation was the bladder tumor (130 out of 155 pts.). The rest of 25 pts. had carcinoma of vaginal portion of uterus, vesico-vaginal fistula (most frequently after irradiation), high ureteric lesions bladder neurogenic disfunction or rare bladder diseases. Having in mind short period of follow up two major complications were noticed: stenosis of uretero-cutaneostomy and retraction of anastomosis with consecutive formation of subcutaneous urinoma and abscesses formation. Although rarely used as definitive type of urinary anastomosis, ureterocutaneostomy has its place in wide spectrum of urinary derivations, since it is the only way to help those patients that have no other option of urinary derivation that might provide better way of social and professional rehabilitation.

Solitary kidney stone treatment by extracorporeal shock wave lithotripsy.

OBJECTIVES: To determine if solitary kidney stones can be successfully treated with ESWL. METHODS: 38 patients were examined, 34 stones were treated on a Dornier lithotripter HM-3, and 4 on a Siemens Lithostar. 17 stones were larger than 400 mm2, 11 were incomplete and 6 complete staghorn calculi. In 26 patients a catheter was placed before lithotripsy, double-J and ureteral stents in 14 and 12, respectively. RESULTS: Successful outcome of lithotripsy was achieved in 34 patients (89%). Complete fragment elimination was recorded in 23 patients (60%), and in 11 (29%) a negligible residuum was noticed. Treatment failure was recorded in 4 patients. In 3 patients fragment elimination was poor, and in 1 patient 3 ESWL sessions were not sufficient to commence stone destruction and we decided to operate on this patient. Anuria occurred in 4 patients (10%). CONCLUSIONS: Our results suggest that ESWL can be successfully used in the treatment of urolithiasis in a solitary kidney. Even in cases of staghorn stones, the obligatory placement of a double-J catheter, and strategic lithotripsy in several sessions result in a high success rate with a tolerable risk of complications.

Assessment of osteogenic potential of the natural origin bioceramics implanted into the human infrabony periodontal defects.

The osteogenic potential of natural origin bioceramics implanted in human periodontal infrabony defects was investigated Histologic and electron-microscopic analyses of implants 3 and 4.5 months after implantation were used for the estimation of osteogenic potential. Results show that the bioceramics of natural origin with a microstructure and canalicular system of the natural bone has a strong osteogenic potential. Results of histologic and electron-microscopic analyses, performed four and half months after implantation, show that new bone has been formed in the places of absorbed or partially absorbed implant granules as also in the pores of implant granules. Histological structure of the newly-formed bone correspond to the structure of the matured lamellated bone.

[Morphology of poststreptococcal glomerulonephritis in adults]. / Morfologija poststreptokoknog glomerulonefritisa kod odraslih.

The authors followed the evolution of morphologic changes in adult patients with poststreptococcal glomerulonephritis (PSGN). In all the patients the kidney biopsies repeated in the period of 2 to 5 years after the acute phase, showed certain histopathologic changes as follows: increased number of mesangial cells, increase of mesangial matrix with scattered axiation and lobulation, segmental thickening of Bowman's capsule, interstitial fibrosis along with preservation of capillary lumen and absence of changes in major blood vessels. According to severity of histopathologic changes, the patients were classified into 4 groups: moderate severe changes--2 patients, mild--15 patients, small--12 and minimal changes were seen in 5 patients. It was proved that after acute stage of PSGN, in which morphologic appearance was more or less typical but not pathognomonic as well, increased number of secretory active mesangial cells was kept, which lead to gradual increasing of mesangial matrix and in slowly evolutive process by the model of glomerulosclerosis lead to irreversible damage of glomerules and interstitial fibrosis.

[Acute renal insufficiency in poststreptococcal glomerulonephritis and its significance in evaluation of disease development in adults]. / Akutna bubrezna insuficijencija u poststreptokoknom glomerulonefritisu i njen znacaj za procenu evolucije bolesti u odraslih.

Importance of ARF occurring in the acute phase of PSGN in the disease evolution is still disputable because reported results are varying and even contradictory. Examination included 44 patients between 18 and 22 with the acute phase of PSGN. The serum creatinine levels over 124 mmol/l were found in 17 patients, while 27 of them were without ARF in the acute phase of the disease. The aim of the study was, after diagnosing APSGN, to form groups of patients according to the ARF presence and to examine its influence in the initial phase of PSGN on its evolution and prognosis. On the basis of clinical parameters, pH changes, renal rebiopsy and ARF associated with the type of evolution, severity of clinical presentation and pH changes it was shown that occurrence of ARF in the acute phase of PSGN was of no significant importance for clinical presentation of the disease, but it could have some influence on the degree of morphologic changes found by renal rebiopsy.

[Hypertension in patients with post-streptococcal glomerulonephritis]. / Hipertenzija kod bolesnika sa poststreptokoknim glomerulonefritisom.

Sixty two patients with poststreptococcal glomerulonephritis (PSGN), aged 18-22 (mean = 19 +/- 0.5 years) were examined and treated at the Clinic of Nephrology of the M.M.A. from the beginning of 1986 to the end of 1990. Hypertension (diastolic pressure over 13 kPa, that is, 97.5 mmHg) in the acute phase was found in 59 (95.16%) patients, being of milder degree and short-term course. Transient increase of blood pressure required sometimes a short therapy (with furosemide mainly). With normalization of the glomerular filtration rate, withdrawal of edema, and normalization of the plasma volume, the blood pressure has been also normalized in the majority of patients (within 3-5 days). Observing PSGN evolution in the period from 2 to 5 years, hypertension was found in 3 (6.8%) of 44 patients. All three patients had the clear clinical evolution (proteinuria and erythrocyturia) without signs of renal insufficiency. The rebiopsy of the kidneys showed milder morphologic changes which were more manifested compared to the group without hypertension. Hypertension was present in the majority of patients in acute phase of PSGN while it was rarely found during the evolution of the disease and its presence has been poor prognostic sign in evolution since it contributed to development of glomerulosclerosis and later on renal insufficiency.

[Morphologic characteristics of HBV markers and products of iron metabolism in liver tissue in patients with hepatitis B virus]. / Neke morfoloske karakteristike markera HBV i produkata metabolizma gvozda u tkivu jetre bolesnika sa B virusnim hepatitisom.

In the histomorphologic analysis of 126 liver biopsies with hepatitis B virus (HBV) infection the authors have met some difficulties in the interpretation of findings of three biopsies which showed the presence of hemosiderine and ferritin deposits in hepatocytes. The lack of cells with the appearance of "ground glass", that is, ground glass hepatocytes which are one of the important features of HBV infection and aberration from the standard features in some histochemical stainings are noticed in all three biopsies. Since only few authors have noticed the same problem, it is possible that these results open new ways in the study of pathogenesis of HBV infection in the liver and its relationship with iron metabolism.

[Morphologic changes in the valves in acquired heart defects]. / Morfoloske promene u zaliscima kod stecenih srcanih mana.

The histologic, histochemical and ultrastructural changes of the leaflet tissue of all four cardiac valves obtained by biopsy and autopsy have been studied in 50 patients with acquired valvular defects. The anamnesis confirmed the presence of rheumatic fever in 16 patients and negated it in 34 patients. In all analysed leaflets of all four cardiac valves organic changes were found which were the cause of their dysfunction. The analysis has shown that rheumatic fever does not play a dominant role in development of acquired valvular disease as it has been thought previously. However, degenerative changes were most commonly found being of unknown etiology up to now. The morphological changes of valvular tissue in the patients suffering from rheumatic fever differ from those who did not suffer from it. Vascularization, fibrosis and hyalinization of the connective tissue with fibroelastic densities predominated in patients suffering from rheumatic fever while myxomatous degeneration of valvular tissue predominated in those who did not suffer from it. Different morphological parameters indicate the different etiopathogenesis of these diseases.

[Morphologic characteristics of surgically removed menisci]. / Neke morfoloske osobenosti hirurski odstranjenih meniskusa.

The authors have analysed histologically and histochemically 88 surgically removed damaged menisci of which 8 were studied by the electron microscope. Of the total number of the analysed cases only 20 had the anamnesis specific for meniscus trauma while in the rest meniscus was damaged spontaneously. The age of the operated patients ranged from 16 to 50 years, the majority being from 20 to 25 years old. The authors have reported that the morphological examinations of the damaged menisci have shown that the main cause of the ruptured menisci was destruction of the collagenous fibres of the menisci and severe mucoid degeneration of their tissues with the increasing number of the elastic fibres at the site of the destructed collagenous fibres. The histochemical examinations have shown that the basic meniscus substance contains chodroitin sulfate mucopolysaccharides which, according to their opinion, were secreted by the choindroid cells.

[Ultrastructural changes in the hepatocytes in rats with dimethylaminoazobenzene poisoning]. / Ultrastrukturne izmene hepatocita pacova trovanih dimetil-amino-azo-benzenom.

Chemical induction of hepatocyte transformation induced by dimethylaminoazobenzene (DAB) effect has been followed up in the initial phases of this process. Of great importance has been early recognition of primary cell population, i.e. early detection of chemical carcinogenic effects.

[Histologic and electron microscopic analysis of experimentally transplanted CaM and MB16 tumors]. / Histoloska i elektronskomikroskopska analiza eksperimentalno transplantiranih tumora CaM i MB16.

Transplanted tumours (melanoma B16 and breast cancer) were analysed in different phases of development histologically and electronmicroscopically. The described specific ultrastructural changes of tumours cells in the course of neoplastic transformation have confirmed the supposition that the process of carcinogenesis is multiphasal and continuous.