Suppressive Effects of Eviprostat, a Phytotherapeutic Agent, on Lower Urinary Tract Symptoms in Prostate Cancer Patients Treated with Brachytherapy.

OBJECTIVES: Eviprostat is an anti-oxidant, anti-inflammatory phytotherapeutic agent that is commonly used to treat lower urinary tract symptoms (LUTS) in benign prostatic hyperplasia in Japan and Germany. Prostate cancer patients treated with brachytherapy generally have complaints of LUTS for several months postoperatively. METHODS: We investigated the protective effects of Eviprostat against the development of LUTS in 37 patients, who had received (125) I prostate brachytherapy as monotherapy. These patients were divided into two groups, an Eviprostat-treated group (n = 18) and an untreated control (n = 19), whose background had no significant difference. The group treated with Eviprostat was prophylactically medicated from 3 weeks preoperatively until 3 months postoperatively. Symptom scores and quality of life for urination were evaluated according to the International Prostate Symptom Score (IPSS) and Expanded Prostate Cancer Index Composite (EPIC) on preoperative day 1, and postoperative months 1, 3 and 6. RESULTS: Both the scores of IPSS and the levels of quality of life in EPIC were significantly worse at 1 month postoperatively compared to the pretreatment baseline, and thereafter progressively improved in both groups. Eviprostat-treated patients showed significantly better recovery compared to Eviprostat-untreated control at 6 months postoperatively, with respect to urinary summary score, urinary function and urinary irritation/obstruction subscales in EPIC. Moreover, the feeling of incomplete emptying in IPSS and the urinary irritation/obstruction subscale in EPIC were significantly improved at 3 months postoperatively compared to the peak impairment at 1 month in the Eviprostat-treated group. CONCLUSIONS: It is possible that Eviprostat has the potential to ameliorate postoperative LUTS caused by brachytherapy.

Treatment of bladder tumors and benign prostatic hyperplasia with a new TUR system using physiological saline as perfusate.

This article presents a new transurethral resection (TUR) system for use in endoscopic surgery. By using an electroconductive solution (physiological saline) as the perfusate in lieu of conventional non-electroconductive solution (Uromatic), additional anesthesia (e.g., obturator nerve blocking) is not required. The new TUR is carried out in an electroconductive solution such as saline, and because radiofrequency current flows from the resecting electrode through the perfusate to the outer sheath, no counter-electrode is needed. We have treated both bladder tumor and benign prostatic hyperplasia cases with this new system. Surgery was safely performed in all TUR-bt cases without requiring obturator nerve blocking. During both TUR-bt and transurethral resection of the prostate (TUR-P) using this system, tissue resection and coagulation equivalents were similar to the conventional TUR system. In previous TUR, preoperative obturator nerve blocking was necessary, and in some cases, incomplete blocking or complications occurred. When physiological saline is used as the perfusate, blood electrolyte levels are not greatly changed, even after extensive resection of the bladder wall; as a result, this new system is also cost effective because physiological saline is less expensive than non-electroconductive solutions and requires no counter-electrode. Thus, in comparison with conventional TUR, this new system is both significantly safer and more cost effective.

Copper chelation with tetrathiomolybdate suppresses adjuvant-induced arthritis and inflammation-associated cachexia in rats.

Tetrathiomolybdate (TM), a drug developed for Wilson's disease, produces an anti-angiogenic and anti-inflammatory effect by reducing systemic copper levels. TM therapy has proved effective in inhibiting the growth of tumors in animal tumor models and in cancer patients. We have hypothesized that TM may be used for the therapy of rheumatoid arthritis and have examined the efficacy of TM on adjuvant-induced arthritis in the rat, which is a model of acute inflammatory arthritis and inflammatory cachexia. TM delayed the onset of and suppressed the severity of clinical arthritis on both paw volume and the arthritis score. Histological examination demonstrated that TM significantly reduces the synovial hyperplasia and inflammatory cell invasion in joint tissues. Interestingly, TM can inhibit the expression of vascular endothelial growth factor in serum synovial tissues, especially in endothelial cells and macrophages. Moreover, the extent of pannus formation, which leads to bone destruction, is correlated with the content of vascular endothelial growth factor in the serum. There was no mortality in TM-treated rat abnormalities. TM also suppressed inflammatory cachexia. We suggest that copper deficiency induced by TM is a potent approach both to inhibit the progression of rheumatoid arthritis with minimal adverse effects and to improve the well-being of rheumatoid arthritis patients.

Study on autologous blood transfusion in hemodialysis patients.

The storage period of autologous blood of hemodialysis (HD) patients was investigated with focus on the red blood cell life span. Healthy subjects, HD patients administered recombinant human erythropoietin (rHuEPO) preparation at 4,500 units/week and at 9,000 units/week were classified into 3 groups, respectively. Blood cell system and biochemical parameters were investigated at the time of collection (week 0), and weeks 1, 2 and 3 (after 21 days) in the storage. There was no significant difference in serum potassium and total bilirubin between the groups. Compared with the status in week 0, erythrocyte creatine significantly increased in weeks 2 and 3 in the normal group and EPO 4,500 group. And a significant increase in this parameter was noted in the weeks 1 and 2 in the EPO 9,000 group. Furthermore, the value demonstrated by the EPO 4,500 group was significantly higher than that in the normal group at each time point. Compared with the normal group, the value was significantly higher in week 1 in the EPO 9,000 group. However, there was no significant difference between the EPO 4,500 and EPO 9,000 groups. Concerning the transfusion of autologous blood in HD patients, the degree of hemolysis was smaller than that in the normal group. However, in view of the life span of erythrocyte creatine obtained, the duration that is shorter than that in the normal group in the first place is expected to be further curtailed during the storage period. It is assumed that the generally accepted storage period of 21-35 days in the case of autologous blood is not applicable in the case of HD patients.