Increased peripheral CD4[+] CD25[high] Treg in prostate cancer patients is correlated with PSA

To determine peripheral frequencies of CD4[+]CD25[high]Foxp3[+] regulatory T cells [Treg] in prostate cancer [PCa] patients, and to investigate if there is a correlation between peripheral Treg and total serum prostate specific antigen [PSA] levels in PCa patients. Peripheral blood mononuclear cells from 56 subjects undergoing diagnostic prostate biopsies PSA >/= 2.5ng/ml were analyzed for Treg numbers. Association between the peripheral Treg and serum PSA values was first determined in the entire population, including people with no prostate pathology, PCa, and benign prostate hyperplasia [BPH] patients, and second, in 9 PCa patients before and after curative prostatectomy. In this study, the 3 groups were compared. This project was performed in the Akdeniz University Immunology laboratory, and the Urology outpatient clinic, Antalya, Turkey from December 2008 to January 2010. Peripheral Treg frequencies were significantly increased in the PCa patients [n=19, 3.23 +/- 1.59] compared with BPH patients [n=27, 1.66 +/- 0.80], and healthy subjects [n=10, 1.08 +/- 0.43] [p=0.007]. The percentage of Treg in BPH patients was also significantly higher than healthy subjects [p=0.007]. The increase of Treg in BPH and PCa patients was positively correlated with total serum PSA levels [r=0.75; p=0.007]. Peripheral Treg densities are correlated with PSA in BPH and PCa patients, suggesting that PSA may have a role in Treg induction and/or maintenance

Recent neuroanatomical studies on the neurovascular bundle of the prostate and cavernosal nerves: clinical reflections on radical prostatectomy / 亚洲男科学杂志(英文版)

The neurovascular bundle of the prostate and cavernosal nerves have been used to describe the same structure ever since the publication of the first studies on the neuroanatomy of the lower urogenital tract of men, studies that were prompted by postoperative complications arising from radical prostatectomy. In urological surgery every effort is made to preserve or restore the neurovascular bundle of the prostate to avoid erectile dysfunction (ED). However, the postoperative potency rates are yet to be satisfactory despite all advancements in radical prostatectomy technique. As the technology associated with urological surgery develops and topographical studies on neuroanatomy are cultivated, new observations seriously challenge the classical teachings on the topography of the neurovascular bundle of the prostate and the cavernosal nerves. The present review revisits the classical and most recent data on the topographical anatomy of the neurovascular bundle of the prostate and cavernosal nerves and their implications on radical prostatectomy techniques.

Intratunical bupivacaine and methylprednisolone instillation for scrotal pain after testicular sperm retrieval procedures / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To investigate the effect of intratunical instillation of bupivacaine and methylprednisolone for scrotal pain, swelling and peritesticular fibrosis due to testicular sperm retrieval procedures.</p><p><b>METHODS</b>A total of 65 patients were randomly divided into two groups. In the instillation group (GI), 34 patients were administered 2.5 mL of 0.5 % bupivacaine combined with 10 mg/ml methylprednisolone before closure of the tunica vaginalis. In the control group (GC), 31 patients only received analgesics postoperatively by intramuscular route. The pain (by visual analogue scale, VAS) and duration of pain-free period after surgery between the two groups were evaluated at 2 and 4 h and at days 2 and 7 postoperatively.</p><p><b>RESULTS</b>The mean pain scores were significantly lower in the GI than in the GC group at 2 and 4 h after surgery (P<0.05 and P<0.01, respectively). The mean duration of pain free interval after the procedure was 47.8 +/-16.9 (12-72) h in GI, which was significantly longer than that in GC [(9.9 +/-3.6; 4-20) h]. Besides, in the GI, 29 % of patients were completely free from pain and 67 % had no scrotal swelling, but in the GC, all the patients required additional NSAID injection due to pain and only 3 % had no scrotal swelling.</p><p><b>CONCLUSION</b>This study confirms that direct intratunical instillation of bupivacaine and methylprednisolone around the testis reduces the postoperative pain, scrotal swelling and peritesticular fibrosis.</p>

Expression of extracellular matrix proteins and vimentin in testes of azoospermic man: an immunohistochemical and morphometric study / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To investigate the changes in the extracellular matrix protein expression and the morphology of seminiferous tubules in the testis of 88 azoospermic men.</p><p><b>METHODS</b>The patients were of the following categories: (1) 22 cases of Sertoli-cell-only syndrome, (2) 20 cases of spermatogenic arrest, and (3) 46 cases with hypospermatogenesis. Testicular sections were immunohistochemically stained for fibronectin, vimentin, laminin and collagen type IV. The seminiferous tubular diameter and the connective matrix zone (CMZ, the acellular zone between the basement membrane [BM] and the peritubular cells) thickness were measured. Seminiferous tubules were typed according to the thickness of the connective matrix in the lamina propria. The predominant tubule type and the Johnsen and Silber scores were determined.</p><p><b>RESULTS</b>The mean tubular diameter were 119 +/- 27, 117 +/- 20, and 140 +/- 38 microm for Groups 1, 2, and 3, respectively. Both the laminin and the type IV collagen were localized to the epithelial BM and peritubular cells. In most of the tubules, BM and peritubular cells were separated by a homogenous acellular layer, the CMZ, in which laminin, type IV collagen, fibronectin and vimentin were not present. It is perceived that the worse the testicular histology, the higher the thickness of the CMZ.</p><p><b>CONCLUSION</b>In testis with no or low sperm production, the diameter of the seminiferous tubules is decreased, the thickness of the seminiferous tubular wall is increased and a CMZ is formed between the peritubular cells and the BM. The thickness of CMZ is increasing with the advancement of testiclar deterioration. The most important morphologic predictive factor for spermiogenesis is the predominant</p>

Evaluation of penile hemodynamic status and adjustment of treatment alternatives in Peyronie's disease / 亚洲男科学杂志(英文版)

<p><b>AIM</b>Erectile dysfunction may be observed in up to 80% of patients with Peyronie's disease. An objective evaluation of the erectile function is attempted to work out in patients with Peyronie's disease.</p><p><b>METHODS</b>Penile deformity, sexual function and penile vascular status were analyzed in 123 patients with Peyronie's disease, who had not received any pertinent treatment.</p><p><b>RESULTS</b>Penile deformity, palpable plaque and pain on erection were seen in 112 (91%), 97 (78.8%) and 27 (21.9%) of the 123 patients, respectively. Of the 76 patients evaluated by color Doppler ultrasounography, veno-occlusive dysfunction as the vascular component for erectile dysfunction was found in 17 (22.3%), arterial insufficiency in 10 (13.1%) and a mixed picture in 23 (30.2%).</p><p><b>CONCLUSION</b>The documentation of penile erectile function and the determination of the vascular status using color Doppler ultrasonography can guide the appropriate therapeutic choice.</p>