Can telomere alterations predict biochemical recurrence in prostate adenocarcinoma? A preliminary study.

Telomeres function in human somatic tissues to stabilize chromosome ends. Telomere shortening can be one of the ways that cause chromosomal instability in the pathogenesis of prostatic carcinoma. In the current study, we evaluated telomere length (TL) in normal and malignant prostate tissues, and its association with prognostic factors and with time to biochemical tumor recurrence. Tissue microarrays constructed from paraffin blocks from radical prostatectomy specimens containing 61 randomly selected cases were used. Sections were hybridized with a Cy3-labeled telomere-specific peptide nucleic acid probe. TL, proportional to probe fluorescence intensity, was visually evaluated. Statistical analysis was done to relate TL clinical and pathological prognostic variables. The majority (49/61) of prostate cancers displayed abnormally short telomeres. Univariate analysis revealed inverse correlation between telomere shortening in tumor and Gleason scores (p=0.017). Multivariate analyses pointed to TL as an independent predictor in addition to serum pre-operative PSA for reduced biochemical progression-free survival (p=0.035). Telomere shortening is a common alteration in prostatic adenocarcinoma. Normal or long telomeres are rarely seen and, when present, seem to provide a growth advantage for the tumor as being an advocate for poor differentiation.

Prognostic significance of lymphovascular invasion in clinically localized prostate cancer after radical prostatectomy.

Whether lymphovascular invasion (LVI) is an independent prognostic factor in prostate cancer is still controversial. We retrospectively investigated its predictive role in disease progression following radical prostatectomy. The histological sections of radical prostatectomies from 71 clinically localized, prostatic adenocarcinoma patients were reviewed for LVI. Pre- and postoperative follow-up data were collected. LVI was identified in 15.5% of cases. Univariate analysis showed a significant association between LVI and advanced pathological stage, higher Gleason score, positive surgical margins, extraprostatic extension, seminal vesicle invasion, and lymph node metastasis (each p < 0.05). Multivariate analyses pointed to vascular involvement as a strong and independent predictor for PSA failure (p = 0.023), and reduced biochemical progression-free survival (p = 0.019). LVI in radical prostatectomy is an adverse prognostic finding that must be recorded in the pathology report.

Preoperative ultrasonographic evaluation of testicular volume and blood flow in patients with inguinal hernias.

OBJECTIVE: The purpose of this study was to investigate whether an inguinal hernia would have an impact on the testicular volume and blood flow by scrotal ultrasonography. METHODS: Twenty-six male patients with unilateral inguinal hernias with a mean age of 48.1 years were included in the study. Testicular volumes were calculated, and spectral parameters such as the pulsatility index and resistive index of the testicular artery at supratesticular, subcapsular, and intratesticular levels on both the side with the inguinal hernia and the contralateral side were measured by a preoperative ultrasonographic examination. Comparisons between the dependent groups were performed by a Wilcoxon or paired samples t test where appropriate. RESULTS: The mean +/- SD testicular volume on the side with the inguinal hernia was significantly higher than that on the contralateral testis (15.46+/-4.49 versus 14.54+/-3.65 mL, respectively; P<.05, Student t test). In addition, the mean resistive index of the intratesticular arteries was significantly higher on the side with the hernia compared with the contralateral side (0.66+/-0.06 versus 0.63+/-0.05; P<.05, Student t test). CONCLUSIONS: These data indicate that an inguinal hernia may impair testicular blood flow, which may be attributable to an intermittent mechanical compression effect on the funiculus spermaticus in the inguinal canal.

Random urine protein-creatinine ratio to predict proteinuria in new-onset mild hypertension in late pregnancy.

OBJECTIVE: The aim of this study was to evaluate the diagnostic accuracy of random urine protein-creatinine ratio for prediction of significant proteinuria (> or = 300 mg/24 h) in patients with new-onset mild hypertension in late pregnancy. METHODS: Medical records of 185 consecutive pregnant patients with new onset of mild hypertension in late pregnancy were reviewed. Random urine samples were taken before 24-hour urine collection. The predictive values of the random urine protein-creatinine ratio for diagnosis of significant proteinuria were estimated by using at least a 300-mg protein level within the collected 24-hour urine as the gold standard. RESULTS: Thirty-nine patients (21%) had significant proteinuria. There was a significant association between 24-hour protein excretion and the random urine protein-creatinine ratio (rs = 0.56, P <.01). With a cutoff protein-creatinine ratio greater than 0.19 as a predictor of significant proteinuria, sensitivity and specificity were 85% and 73%, respectively. Positive and negative predictive values of the test were 46% and 95%, respectively. CONCLUSION: The random urine protein-creatinine ratio was a poor predictor for significant proteinuria in patients with new-onset mild hypertension in late pregnancy.

MR imaging determination of the normal level of conus medullaris.

The location of conus medullaris according to age and sex was retrospectively evaluated with a 0.5-T magnetic resonance (MR) imaging system. A total of 639 subjects without any conspicuous spinal canal pathology on the lumbar MR imaging examination were selected. The level of conus medullaris was most commonly located at the T(12)-L(1) intervertebral disc level in the whole population. Our results do not correlate with the previous studies. No significant difference in the conus level was found with increasing age.