[Quality of life and impact of incontinence in male patients with prostate carcinoma after radical retropubic prostatectomy]. / Die Lebensqualität und die Bedeutung der Inkontinenz bei Männern mit Prostatakarzinom nach radikaler retropubischer Prostatektomie.

BACKGROUND: To explore the effect of an interdisciplinary training programme on quality of life and impact of incontinence in male patients with urinary incontinence after radical retropubic prostatectomy for cancer of the prostate. PATIENTS AND METHODS: We conducted a controlled trial with two intervention groups. Both groups received an interdisciplinary training programme, with the first group (n=87) receiving the standard version, and the second group (n=72) receiving an additional tool 'BBS-trainer' to improve the perception of the pelvic floor muscles. Primary outcomes were quality of life (EORTC questionnaires) and impact of incontinence (modified questionnaire) evaluated up to six months after the treatment. The relationship between certain parameters such as incontinence was investigated. RESULTS: Mean age was 64 years; most of the participants were married and pensioned. Both groups improved significantly and to a relevant extent in most of the quality of life and incontinence variables during the three weeks of treatment, after six months they further improved significantly. Quality of life improved first, continence and impact on daily life followed. Some differences found between both groups refer to the time course. CONCLUSIONS: There is strong interaction between quality of life, incontinence and impact of incontinence. The interdisciplinary training programme shows quickly strong effects on quality of life and impact factors. It therefore is advisable that men with incontinence symptoms after prostatectomy should be offered such a treatment in a specialized rehabilitation clinic.

Tissue-specific transcription profiles of sex steroid biosynthesis enzymes and the androgen receptor.

17beta-hydroxysteroid dehydrogenase (17beta-HSD) and 5alpha-reductase isoenzymes play a crucial role in the formation and metabolism of sex steroids. Not only the key androgens testosterone and dihydrotestosterone but also their precursors are potent activators of the androgen receptor and are, therefore, likely to act as determinants of male sexual differentiation and maturation in a differentially regulated way. The aim of the present study was to relatively quantify the expression of the mRNA of 17beta-HSD isoenzymes, namely, type 1, 2, 3, 4, 5, 7, and 10, together with the 5alpha-reductase type 1 and 2, and the androgen receptor in normal human males and females. RNA was isolated from peripheral blood cells of both sexes and from genital skin fibroblasts (GSFs) of two different localizations (foreskin and scrotal skin) obtained from phenotypically normal males. mRNA expression was semi-quantified by quantitative reverse-transcriptase polymerase chain reaction with the LightCycler Instrument (Roche). The examined enzymes show statistically significant differences in their transcription pattern between the blood and the GSF RNA samples. Within the GSF samples, there are also significant variations between the two examined localizations in the transcription of 17beta-HSD type 1, 2, 4, and 5 as well as for the androgen receptor. We found large interindividual variation of enzyme transcription patterns in all investigated tissues. In peripheral blood cells, no sex-specific differences were seen. We conclude that sex steroid enzymes are expressed not only in genital primary target tissues but also in peripheral blood. The expression in different target tissues may contribute to both the individual sexual and tissue-specific phenotype in humans.

Estimation of sex on the basis of radiographs of the calcaneus.

Lateral and anteroposterior radiographs of the ankles of 800 Central Europeans aged 20 to 79 were analyzed with regard to sexual dimorphism. All the distances, but not the angles, of the calcaneus were much larger in males than in females. Approximately 80% of the study sample could be sexed correctly by classifying all specimens greater than 86.0 mm in length as male and those less than 86.0 mm as female. The prevalence of os tibiale externum was 8.0 and 2.6% and the prevalence of plantar heel spur was 16.3 and 6.5% (increasing with age) for males and females, respectively, being significantly more frequent in females. On the other hand, the bone island frequencies were 9.1% in males and 4.8% in females. Our study suggests that radiographs of the ankle are a convenient, rapid, cheap and non-invasive means for estimating sex.

[The incidence, age dependence and sex distribution of the calcaneal spur. An analysis of its x-ray morphology in 1027 patients of the central European population]. / Häufigkeit, Altersabhängigkeit und Geschlechtsverteilung des Fersensporns. Analyse der Röntgenmorphologie bei 1027 Patienten der mitteleuropäischen Population.

In 1027 lateral radiograms of the ankle in a Caucasian population, 161 plantar and/or dorsal calcaneal spurs (15.7%) were diagnosed. Plantar spurs were more common than dorsal spurs (11.2 and 9.3% respectively). Prevalence of both spurs increases considerably with the rising age. Dorsal spurs appear slightly earlier than plantar spurs. The spur frequencies are similar in left and right feet. The plantar spurs were significantly (p < 0.0001) more common in women than in men in general, while dorsal spurs were more frequent in men than in women up to the age of 70. The previously reported higher frequencies of plantar and dorsal calcaneal spurs in women than in men are probably a result of a disproportionally higher number of women in higher age in the groups studied. In forensic medicine, calcaneal spurs provide evidence for identity and age of unknown corpses, and to certain extend their profession, physical activities and constitution during life.