The effect of alginate, hyaluronate and hyaluronate derivatives biomaterials on synthesis of non-articular chondrocyte extracellular matrix.

Cartilage engineering consists of re-constructing functional cartilage by seeding chondrocytes in suitable biomaterials in vitro. The characteristics of neocartilage differ upon the type of biomaterial chosen. This study aims at determining the appropriate scaffold material for articular cartilage reconstruction using non articular chondrocytes harvested from rat sternum. For this purpose, the use of polysaccharide hydrogels such as alginate (AA) and hyaluronic acid (HA) was investigated. Several ratios of AA/HA were used as well as three derivatives obtained by chemical modification of HA (HA-C18, HA-C12(2.3), HA-C12(2.5)-TEG0.5). Sternal chondrocytes were successfully cultured in 3D alginate and alginate/HA scaffolds. HA retention in alginate beads was found to be higher in beads seeded with cells than in beads without cells. HA-C18 improved HA retention in beads but inhibited the chondrocyte synthesis process. Cell proliferation and metabolism were enhanced in all biomaterials when beads were mechanically agitated. Preliminary results have shown that the chondrocyte neo-synthesised matrix had acquired articular characteristics after 21 days culture.

Peyronie's disease: prevalence and association with cigarette smoking. A multicenter population-based study in men aged 50-69 years.

OBJECTIVES: We present a multicenter, population-based epidemiological survey aimed at assessing the prevalence of Peyronie's disease (PD) and its potential risk factors in the general population. METHODS: In each of the ten centers throughout Italy, a uroandrologist contacted all the men in the age range 50-69 years registered with a general practitioner (GP). The subjects recruited were evaluated on the basis of their medical history, including alcohol consumption and cigarette smoking. The following questionnaires were administered: IIEF, IIPSS symptom score, premature ejaculation and PD. RESULTS: All the subjects registered with a GP were invited to participate in the study. Of the 1,180 subjects, 647 (53%) entered over survey. In this population, 46 cases of PD were identified, accounting for a prevalence of 7.1%. The prevalence rate increased with age even if the trend is not statistically significant. The multivariate analysis showed a significant correlation between cigarette smoking and PD, with an odds ratio (OR) of 4.6 (CL 95%) confidence limit 1.506- 14.287). Smoking as single variable had an OR of 7.2 (95% CL 2.34-24.93). No significant association was observed between PD and the other variables such as cardiovascular diseases, diabetes, hypertension and alcohol consumption. CONCLUSIONS: PD is a much more frequent condition in the general population than previously reported. According to our results, cigarette smoking may be considered a risk factor for developing PD. If further and more targeted studies confirm that giving up smoking may reduce the risk of developing PD, then there will be new prospects for primary and secondary prevention and for curbing the progression of the disease.

Life-style in patients with LUTS suggestive of BPH.

BACKGROUND: Owing to the existing controversy about the role of life-style in the pathogenesis of BPH, the possible associations of LUTS and prostate enlargement with alcohol intake, coffee consumption, smoking, physical activity, body mass index (BMI) and concomitant diseases were studied in the large series of patients of the QUIBUS study. RESULTS: Among concomitant diseases, essential hypertension was the most represented. However no apparent additive or synergistic influence on symptoms was recorded in this subset of the population. Coffee consumption was not associated with prostate volume or LUTS. Alcohol consumption was associated with urgency and intermittence and with an overall higher IPSS. No major influence on symptoms was found in smokers. Physical activity was associated with a lower frequency of incomplete bladder emptying, repeated urination, intermittence and urgency. The postulated existence of an association between BMI and BPH was not confirmed in this study. When a prediction of the IPSS scores was tempted by entering the life-style factors in a multiple regression model, they were able to explain at best 5% of the variance of the dependent variable. CONCLUSION: Life-style patterns bear a greater influence on individual symptoms than on total scores. This difference is sometimes high enough to recommend specific life-style measures to patients with LUTS and prostate enlargement.

Androstanolone treatment for congenital penile curvature.

OBJECTIVES: To test the etiological hypotheses of congenital penile curvature (CPC) and to infer the possible therapeutic approaches. MATERIALS AND METHODS: Seventy patients affected by CPC were enlisted for the present study: 37 with left curvature, 21 with ventral curvature, 11 with left ventral-lateral curvature, and 1 with right curvature. All patients under the age of 21 years were encouraged to take local medical therapy with alcohol androstanolone gel in a dosage of 0.15 mg/cm(2) of surface area. Group A (17-43 years of age) consisted of patients who refused medical therapy and decided to solve their problem with surgery. They underwent Nesbit's operation and were given a contralateral biopsy of the tunica albuginea at the same time. Cytoplasmic androgen receptors (CARs) were quantified in the tunica albuginea of both cavernous bodies (CBs). Group B consisted of 26 patients aged between 4 and 21 years who were given local medical therapy with androstanolone in alcohol gel. They underwent a maximum of 3 therapy cycles each lasting 2 months with a 1-month suspension between each. Group C consisted of 9 patients (27-53 years of age) who were fathers of 9 group B patients. These adults were also affected by penile curvature and taken into consideration as a control group because we have observed three spontaneous corrections of penile curvature in puberty. RESULTS: CARs research in group A and in 6 group B patients under the age of 20 revealed a 2-5 times reduction on the concave part of the cavernous body compared to the contralateral one. This difference progressively decreased in older patients. In group B, 14 patients aged between 4 and 15 years and 1 aged 17 (53.8%) were treated with a local androstanolone therapy and the result was a regression in the curvature between 30 and 100%. Another 9 patients aged between 17 and 21 years did not show any improvement despite androstanolone treatment. CONCLUSIONS: The results show a 2-5 times reduction in CARs on the hypoplastic cavernous body of young male patients. These differences progressively decreased in older patients. The positive results of the androstanolone therapy in patients under the age of 15 and the negative ones in older patients are certainly related to the quantity of CARs present on the tunica albuginea.

[Unusual ultrasonography of scrotal pathology]. / Rari quadri ecografici di patologia scrotale.

The potentialities of ultrasonography in scrotal diseases, with help of color-Doppler and angio-power, as well as their sensibility and specificity are discussed presenting three rather rare cases occurred with acute symptoms. It emphasises the utility of emergency scrotal scanning.

[Polyorchism: a case report]. / Poliorquidia: una aportación casuística.

A case of polyorchism is described and the literature reviewed, highlighting the rarity of this pathological condition. To our knowledge, only 70 cases have been reported in the world literature. Similarly, Nocks' embryological development theory is discussed herein. The present case was diagnosed intraoperatively. No further studies were warranted since the intraoperative findings were compatible with a more common pathological condition. Furthermore, the malformation was asymptomatic and was not associated with any other scrotal conditions, unlike most of the cases described in the literature. We discuss the therapeutic approach and underscore the need to remove the supernumerary testis encountered intraoperatively when the continuity of the seminal duct is uncompromised.