Protein biomarker analysis of primary Peyronie's disease cells.

INTRODUCTION: The molecular pathogenesis of Peyronie's Disease (PD) remains unclear more than 250 years after its initial description. Because of this, no test is currently available to accurately predict PD progression among those affected. AIM: To investigate the expression of wound healing and fibrosis-associated proteins in primary cell cultures of PD fibroblasts to determine whether altered protein expression patterns can be used as predictors of clinical course and natural history. METHODS: Primary cell cultures derived from normal Tunica albuginea tissue and PD plaque tissue were examined by immuno-cytochemistry. Protein expression profiles were analyzed by Surface-Enhanced Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (SELDI-TOF-MS) and Western immunoblotting. MAIN OUTCOME MEASURES: Expression of wound healing and fibrosis-associated proteins and protein expression patterns were assessed. RESULTS: Statistically significant increases in smooth muscle alpha-actin, beta-catenin, and Heat shock proteins (Hsp47) were identified in cells derived from PD relative to cells derived from normal Tunica albuginea tissue. Changes in TGFbeta-1 receptor and Fibronectin were also observed. In addition, altered expression of additional as yet unidentified proteins at 4.7, 8.9, 10.8, 16.8, and 76.8 kDa were detected by complementary SELDI-TOF-MS approaches. CONCLUSIONS: Primary cells derived from PD plaques display up-regulated expression of several proteins that are established components of fibrosis and wound healing. In addition, changes in other, as yet unidentified proteins were measured. It will be of interest to conduct further studies to see whether these dysregulated protein peaks represent potential biological markers of disease progression.

A prospective randomized study comparing monopolar and bipolar transurethral resection of prostate using transurethral resection in saline (TURIS) system.

OBJECTIVES: To compare transurethral resection of prostate (TURP) using monopolar and bipolar transurethral resection in saline (TURIS) system. MATERIALS AND METHODS: A prospectively randomized study was conducted between January 2004 and January 2005. Patient demographics and indications for surgery were recorded. The safety end points studied were occurrence of complications and decline in postoperative serum sodium (Na(+)) and hemoglobin (Hb) levels. Efficacy end points were resection time, weight of resected prostate tissue, and improvement in International Prostate Symptoms Score (IPSS) and maximum flow rate (Q(max)) in patients' uroflow over 12 mo. RESULTS: One hundred consecutive patients were randomized and completed the study, with 52 patients in the monopolar TURP group and 48 in the TURIS group. At baseline, the two groups were comparable; they had at least 12 mo of follow-up. Mean resection time and mean weight of resected prostate tissue were comparable for both groups. Declines in the mean postoperative serum Na(+) for TURIS and monopolar TURP groups were 3.2 and 10.7 mmol/l, respectively (p<0.01). However, there was no statistical difference in the decline in postoperative Hb between the two groups. There were two cases of clinically significant transurethral resection syndrome in the monopolar group. Urethral strictures were observed in three cases of TURIS and one patient in the monopolar group. The IPSS and Q(max) improvements were comparable between the two groups at 12 mo of follow-up. CONCLUSIONS: Bipolar TURP using the TURIS system is clinically comparable to monopolar TURP at 1 yr with an improved safety profile.