Surgical pathology examination of radical prostatectomy specimens. Updated protocol based on the Italian TAP study.

Between January 1996 and June 2000, 192 men with prostate cancer underwent radical retropubic prostatectomy (RP) and bilateral pelvic node dissection in 26 centers participating in the Italian randomized prospective TAP study. The reviewing pathologist evaluated 145 RP specimens. Seventy-five cases had not been treated with total androgen ablation before RP was performed, whereas 70 had been treated for three months. Whole-mount sectioning of the complete radical prostatectomy specimens was adopted in each center for accurately evaluating the pathological stage of prostate cancer and resection limit status. The results of this study suggest that total androgen ablation before RP is beneficial in men with clinical stage T2 because of the significant pathological down-staging and decrease in the number of positive margins in the RP specimens. On the basis of the experience acquired through the Italian TAP study and recent publications on prognostic factors in prostate cancer, the original practice protocol for examination of RP specimens removed from patients with carcinoma of the prostate glands was updated.

Gas chromatographic assay for estazolam in human plasma and results of a bioequivalence study.

This paper describes a new sensitive gas chromatographic method with electron capture detector to assay estazolam in human plasma, which has been developed and validated for pharmacokinetic purposes. The drug and the internal standard (triazolam) were extracted from plasma buffered at pH 9.0 into toluene and analysed on a widebore DB 17 column. The calibration curve covered the 1.0-200 ng ml-1 range with a mean determination coefficient of 0.9996. The quantification limit was 1.0 ng ml-1. This method was used to investigate the bioequivalence of a new formulation of estazolam in drops (test) and the formulation in tablets (reference, ESILGAN). Both formulations were administered at a single dose of 2 mg in a clinical trial carried out on 24 healthy volunteers consisting of 12 males and 12 females, following a crossover randomised design in two periods with wash-out. The test and the reference formulations proved to be fully bioequivalent according to operating guidelines, namely through 90% confidence intervals in the 0.80-1.25 range.

Phagocytosis and killing of A-protein positive Staphylococcus aureus in the presence of low doses of antibiotics.

An A-protein positive strain of Staphylococcus aureus was grown in varying concentrations of erythromycin, clindamycin and miocamycin at sub-MIC levels and incubated in purified human polymorphonuclear leukocytes (PMNs). The presence of A-protein produced resistance of the above strain to phagocytosis and killing by PMNs and a slight resistance to opsonization by normal serum. The addition of antibiotics, which inhibit protein biosynthesis, caused significant changes in the ability of this bacterium to resist opsonization by serum complement. The antimicrobial agents produced a significant enhancement of bacterial killing and phagocytosis. In particular, clindamycin and erythromycin, at sub-MIC concentrations, modified the hair-like structure of S. aureus, which contains A-protein, and were able to affect the interaction of the strain with phagocytic cells.

Erythromycin, miocamycin and clindamycin towards adhesivity and phagocytosis of gram-positive bacteria.

To estimate the antibacterial activity of sub-MIC concentrations of Erythromycin and Miocamycin in the mucosal surfaces, we studied the adhesivity of Gram-positive pathogenic strains (S. pyogenes, S. aureus) towards oral and urinary epithelial cells. Erythromycin strongly inhibits the adhesivity of Staphylococci to oral cells (50% of inhibition) and to a lesser extent the adhesivity of Streptococci (21%), while Miocamycin reduced the adhesivity of Staphylococci by about 16%. In some cases, an increase in the adhesivity on urinary cells was found mainly for Miocamycin. Therefore Erythromycin, at sub-MIC concentrations, is able to induce a marked reduction in the adhesivity of Staphylococci and Streptococci; this may interfere with the invasivity and subsequent pathogenicity of these bacteria. As far as phagocytosis is concerned, one strain of enterotoxic coagulase + S. aureus bearing A-protein on its surface but lacking the capsule was taken into consideration. The presence of A-protein induces resistance to phagocytosis and opsonization by normal serum. The addition of antibiotics which inhibit protein biosynthesis, such as Clindamycin, Miocamycin and Erythromycin, increases either uptake of this strain or intracellular killing. In particular Clindamycin and Erythromycin, at sub-MIC concentrations, are able to affect the interaction of Staphylococcus with phagocytic cells.