ABSTRACT
The objective of this study was to test a novel technique of processing a prostate biopsy (PB) specimen by marking its peripheral end (PE) as a predictive tool for locally advanced prostate cancer (PC) or margin-positive resection (R1) after radical prostatectomy (RP). Prospective evaluation of a consecutive cohort of men who underwent PB and subsequent RP was carried out. Transrectal ultrasound-guided 10-20 core PB was performed according to a standardized protocol. Each biopsy core was inked at the PE and classified as PE positive or negative. The study cohort comprised 100 men with a mean age of 62.3 years (41-75 years). Overall, PE-positive cores were found in 71 men, postoperative tumour (pT)3/pT4 stages were diagnosed in 33 men and R1 status in 45 men after RP. In univariate analysis, the presence of at least one PE-positive core was correlated to an increased risk for pT3/pT4 stage (relative risk (RR): 3.15; 95% confidence interval (95% CI): 1.1-9.9; P = 0.03) and R1 status (RR: 2.9; 95% CI: 1.1-7.5; P = 0.03). In multivariate analysis including Gleason score, total number of positive cores, PE positivity and PSA, PE positivity was correlated to pT3/pT4 stage (P = 0.04). In conclusion, PC at the PE of a PB specimen predicts non-organ-confined tumour stage in subsequent prostatectomy. This simple, new technique may contribute to increasing the accuracy of risk stratification for curative treatment of PC.
Subject(s)
Biopsy/methods , Carcinoma/pathology , Neoplasm Recurrence, Local/pathology , Prostate/pathology , Prostatic Neoplasms/pathology , Tattooing/methods , Adult , Aged , Carcinoma/surgery , Humans , Male , Middle Aged , Neoplasm Staging , Predictive Value of Tests , Prospective Studies , Prostate-Specific Antigen/blood , Prostatectomy , Prostatic Neoplasms/surgery , Risk , Ultrasonography, InterventionalABSTRACT
Materno-fetal IgG transfer in the mature human placenta involves transport across the syncytiotrophoblast (STB) and fetal endothelial cell layer. The MHC class I-related Fc gamma-receptor (hFcRn) localized in STB as well as in endothelial cells is involved in overall IgG transfer from the maternal into the fetal circulation. Functional hFcRn is a heterodimer of a transmembrane alpha-chain and beta2-microglobulin. To establish the basis for future studies to unravel the mechanism of IgG transport in STB, we investigated hFcRn alpha-chain and beta2-microglobulin expression in cytotrophoblasts (CTB) isolated from human term placentae and cultured in vitro under conditions where differentiation into multinuclear STB takes place (>or=48 h). Northern blot analysis demonstrated up-regulation of alpha-chain mRNA after 48 h of in vitro cultivation. Likewise, hFcRn alpha-chain and beta2-microglobulin were at the limit of detection by immunofluorescence microscopy in CTB immediately after isolation, but their expression increased upon STB formation. hFcRn alpha-chain co-localized with beta2-microglobulin in multinuclear STB and formed a functional, i.e. low pH IgG binding, receptor as shown by affinity isolation. The in vitro differentiated STB exhibited specific, low pH-dependent IgG binding to the plasma membrane. In conclusion, these cultures can now be applied to study the role of hFcRn in IgG transport and trafficking in STB cultures in vitro.
Subject(s)
Histocompatibility Antigens Class I/genetics , Receptors, Fc/genetics , Trophoblasts/metabolism , Cell Differentiation/genetics , Cell Membrane/metabolism , Cell Separation , Cells, Cultured , Female , Gene Expression , Histocompatibility Antigens Class I/metabolism , Humans , Hydrogen-Ion Concentration , Immunoglobulin G/metabolism , Maternal-Fetal Exchange/immunology , Pregnancy , Protein Binding , Protein Transport/immunology , Receptors, Fc/metabolism , Trophoblasts/physiology , beta 2-Microglobulin/metabolismABSTRACT
Men perceive a bloody ejaculate as an alarming physical symptom and often seek the help of urologists for explanation and treatment. After a complete urological step-by-step examination including imaging studies and flexible cystoscopy, malignancy or another significant disease can be ruled out in the majority of cases. However, many of these cases of haematospermia may still remain idiopathic and thus unsatisfactory for both the patient and his physician. The following paper reviews the aetiology, the diagnostic work-up escalation and the treatment options of haematospermia.
Subject(s)
Hemospermia/diagnosis , Hemospermia/therapy , Cysts/complications , Ejaculation/physiology , Genital Diseases, Male/complications , Genital Neoplasms, Male/complications , Hemospermia/etiology , Humans , Inflammation/complications , MaleABSTRACT
Semen cryopreservation offers the possibility to maintain fertility over a long time period e.g. for male cancer patients. Although its use expands worldwide, there is no established method that can be referred to as an entrenched standard for routine laboratory use. Cryodamage is still a general phenomenon and the success of cryopreservation is affected on one side by the cryoprotective agent and on the other side by the technique of freezing. In this methodological study, we compared the newly offered SpermCryo (SC) with the standard used cryoprotectant Test yolk buffer (TYB). We could show that TYB is superior to SC. In addition, we compared the two mainly used techniques for cryopreservation: computerised slow-stage freezing versus nitrogen vapour fast freezing. Regarding the sperm post-thaw motility and viability, no significant difference was found between these two methods. In conclusion, TYB can be recommended as a cryomedium of first choice and the appropriate freezing technique can be selected according to the local facilities of the institution.
Subject(s)
Cryopreservation/methods , Cryoprotective Agents , Semen , Automation , Cell Survival/physiology , Humans , Male , Sperm Motility/physiology , Time FactorsABSTRACT
Human placental alkaline phosphatase (PLAP) was localized at the apical and basal plasma membrane of syncytiotrophoblasts and at the surface of cytotrophoblasts in term chorionic villi using immunoelectron microscopy. Similarly, apical and basolateral PLAP expression was found in polarized trophoblast-derived BeWo cells. Trophoblasts isolated from term placentas exhibited mainly vesicular PLAP immunofluorescence staining immediately after isolation. After in vitro differentiation into syncytia, PLAP plasma membrane expression was upregulated and exceeded that observed in mononuclear trophoblasts. These data call for caution in using PLAP as a morphological marker to differentiate syncytiotrophoblasts from cytotrophoblasts or as a marker enzyme for placental brush-border membranes. (J Histochem Cytochem 49:1155-1164, 2001)