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1.
Cancer Res ; 53(15): 3585-90, 1993 Aug 01.
Article in English | MEDLINE | ID: mdl-8339265

ABSTRACT

The cadherins are a family of transmembrane glycoproteins responsible for calcium-dependent cell-cell adhesion. This adhesion is mediated by a group of cytoplasmic proteins, the catenins, which act inside the cell to couple the cadherin molecule to the microfilament cytoskeleton. Dysfunction of E-cadherin-dependent cell-cell adhesion has been demonstrated to contribute to the acquisition of invasive potential of malignant adenocarcinoma cells. The potential role of alterations of catenin expression in tumor cell invasion is largely unexplored. We have previously found that E-cadherin is frequently down-regulated in clinical samples of prostate cancer (Umbas, R., Schalken, J. A., Aalders, T. W., Carter, B. S., Karthaus, H. F. M., Schaafsma, H. E., Debruyne, F. M. J., and Isaacs, W. B. Cancer Res., 52: 5104-5109, 1992). In this study, we further investigate this adhesion system in both benign and malignant human prostate cells in culture. Using antibodies to E-cadherin and its cytoplasmic accessory protein, alpha-catenin, we find that 5 of 6 human prostate cancer cell lines have reduced or absent levels of one or the other or both of these molecules when compared to normal prostatic epithelial cells. Only the LNCaP prostate cancer cell line is indistinguishable from normal prostate epithelium with respect to its E-cadherin-alpha-catenin complement. Interestingly, the PC-3 line is characterized by the presence of E-cadherin, but the complete lack of alpha-catenin found at both the RNA and protein level. This lack of alpha-catenin gene expression is explained by Southern analysis, which reveals a homozygous deletion of a large portion of the alpha-catenin gene in PC-3 cells. This loss of alpha-catenin is functionally manifested by negligible Ca(2+)-dependent aggregation of these cells in vitro, when compared to LNCaP cells. These results confirm that E-cadherin-dependent cell-cell adhesion is frequently aberrant in prostate cancer cells, and suggest that in a subset of prostate cancers, this adhesion may be inactivated by loss of alpha-catenin rather than E-cadherin itself. Furthermore, these results demonstrate that mutational inactivation of the alpha-catenin gene is one mechanism responsible for the loss of normal cell-cell adhesion in prostate cancer.


Subject(s)
Cadherins/analysis , Cytoskeletal Proteins/genetics , Gene Deletion , Prostatic Neoplasms/metabolism , Cell Adhesion , Humans , Male , Molecular Weight , Precipitin Tests , Prostatic Neoplasms/genetics , RNA, Messenger/analysis , Tumor Cells, Cultured , alpha Catenin
2.
Cancer Res ; 60(11): 2840-4, 2000 Jun 01.
Article in English | MEDLINE | ID: mdl-10850425

ABSTRACT

Bone morphogenetic proteins (BMPs) are potential regulators of prostate cancer cell growth and metastasis that signal through an interaction with BMP membrane receptors (BMPRs) type I and type II. In the present study, Western blot and immunohistochemical analysis of BMPRs were carried out in benign and malignant human prostate tissues to explain the loss of BMP response in human prostate cancer cells. The results demonstrated that the benign prostate specimens expressed high levels of all three BMPRs. In normal prostate, BMPRs were localized predominantly to epithelial cells. Among prostate cancer specimens, well-differentiated cancers were positive for the expression of BMPR-II, BMPR-IA, and BMPR-IB, for the most part. In contrast, only 1 of 10 poorly differentiated prostate cancer cases was positive for each of the three BMPRs (P < 0.005 for all three receptors). Taken together, these results indicate that human prostate cancer cells frequently exhibit loss of expression of BMPRs and suggest that loss of BMPRs may play an important role during the progression of prostate cancer.


Subject(s)
Prostatic Neoplasms/metabolism , Protein Serine-Threonine Kinases/biosynthesis , Receptors, Growth Factor/biosynthesis , Blotting, Western , Bone Morphogenetic Protein Receptors, Type I , Bone Morphogenetic Protein Receptors, Type II , Disease Progression , Epithelial Cells/metabolism , Humans , Immunohistochemistry , Male , Prostate/metabolism , Prostatic Neoplasms/pathology , Transforming Growth Factors/metabolism
3.
Cancer Res ; 55(21): 4813-7, 1995 Nov 01.
Article in English | MEDLINE | ID: mdl-7585512

ABSTRACT

Considerable evidence now exists to support an important role for the E-cadherin-mediated cell-cell adhesion pathway as a suppressor of the invasive phenotype in adenocarcinoma cells. Previous studies have found that this pathway is frequently aberrant in prostate cancers, particularly those that are likely to metastasize. In this study, we report on the effects of re-establishment of this pathway in a prostate cancer cell line, PC-3, in which this adhesion system is dysfunctional by virtue of a deletion of the gene that codes for alpha-catenin, an E-cadherin-associated protein necessary for normal E-cadherin function. Re-expression of alpha-catenin was accomplished either by transfection of PC-3 cells with a copy of the alpha-catenin cDNA under the control of a heterologous promoter or by microcell-mediated transfer of chromosome 5, which contains the alpha-catenin gene and its normal regulatory elements. In both cases, re-expression of alpha-catenin is associated with a similar, dramatic alteration in cell morphology, whereby extensive cell-cell contact is observed. In the case of transfection of the cDNA, this expression is only transient, because the transfected cells either cease to proliferate or, more commonly, revert to the parental phenotype with concomitant cessation of alpha-catenin expression. In contrast, cells containing one or more copies of microcell-transferred chromosome 5 express alpha-catenin in a stable manner and continue to proliferate. Upon injection into nude mice, these latter cells are no longer tumorigenic, or form only slowly growing tumors with greatly extended doubling times when compared to the parental PC-3 cells. During passage in culture, clones that contain only one transferred copy of chromosome 5 reproducibly revert to the parental phenotype. This reversion is associated with loss of the chromosome 5 region containing the alpha-catenin gene and consequent loss of alpha-catenin expression, as well as re-emergence of tumorigenicity. Transfer of chromosome 5 into prostate cancer cells that are E-cadherin negative does not result in either morphological transformation or suppression of tumorigenicity, suggesting that these effects of alpha-catenin expression are dependent upon concomitant expression of E-cadherin. These data demonstrate the tumor suppressive ability of chromosome 5 in the PC-3 prostate cancer cells and suggest that re-expression of alpha-catenin with resultant restoration of E-cadherin function plays a critical role in this process.


Subject(s)
Cadherins/physiology , Chromosomes, Human, Pair 5 , Cytoskeletal Proteins/genetics , Prostatic Neoplasms/genetics , Prostatic Neoplasms/pathology , Animals , Cell Adhesion/physiology , Cell Communication/physiology , Cell Division/physiology , Cytoskeletal Proteins/physiology , DNA/genetics , Gene Expression , Humans , Male , Mice , Mice, Nude , Phenotype , Transfection , Tumor Cells, Cultured , alpha Catenin
4.
Cancer Res ; 56(18): 4096-102, 1996 Sep 15.
Article in English | MEDLINE | ID: mdl-8797572

ABSTRACT

We have previously reported the development of a transgenic mouse model for prostate cancer derived from PB-Tag transgenic line 8247, henceforth designated the TRAMP (transgenic adenocarcinoma mouse prostate) model. We now describe the temporal and spatial consequences of transgene expression and report the identification and characterization of metastatic disease in the TRAMP model. TRAMP mice characteristically express the T antigen oncoprotein by 8 weeks of age and develop distinct pathology in the epithelium of the dorsolateral prostate by 10 weeks of age. Distant site metastases can be detected as early as 12 weeks of age. The common sites of metastases are the periaortic lymph nodes and lungs, with occasional metastases to the kidney, adrenal gland, and bone. By 28 weeks of age, 100% harbor metastatic prostate cancer in the lymph nodes or lungs. We have also demonstrated the loss of normal E-cadherin expression, as observed in human prostate cancer, as primary tumors become less differentiated and metastasize. The TRAMP model provides a consistent source of primary and metastatic tumors for histopathobiological and molecular analysis to further define the earliest molecular events involved in the genesis, progression, and metastasis of prostate cancer.


Subject(s)
Adenocarcinoma/pathology , Antigens, Viral, Tumor/biosynthesis , Neoplasm Metastasis , Prostatic Neoplasms/pathology , Aging , Animals , Animals, Genetically Modified , Antigens, Viral, Tumor/analysis , Antigens, Viral, Tumor/genetics , Cell Line , Humans , Immunohistochemistry , Lymphatic Metastasis , Male , Mice , Mice, Inbred C57BL , Mice, Inbred Strains , Organ Specificity , Recombination, Genetic , Time Factors
5.
J Neurosci ; 21(13): 4691-8, 2001 Jul 01.
Article in English | MEDLINE | ID: mdl-11425896

ABSTRACT

We have studied synaptic function in a transgenic mouse strain relevant to Alzheimer's disease (AD), overexpressing the 695 amino acid isoform of human amyloid precursor protein with K670N and M671L mutations (APP(695)SWE mice), which is associated with early-onset familial AD. Aged-transgenic mice had substantially elevated levels of Abeta (up to 22 micromol/gm) and displayed characteristic Abeta plaques. Hippocampal slices from 12-month-old APP(695)SWE transgenic animals displayed reduced levels of synaptic transmission in the CA1 region when compared with wild-type littermate controls. Inclusion of the ionotropic glutamate receptor antagonist kynurenate during preparation of brain slices abolished this deficit. At 18 months of age, a selective deficit in basal synaptic transmission was observed in the CA1 region despite treatment with kynurenate. Paired-pulse facilitation and long-term potentiation (LTP) were normal in APP(695)SWE transgenic mice at both 12 and 18 months of age. Thus, although aged APP(695)SWE transgenic mice have greatly elevated levels of Abeta protein, increased numbers of plaques, and reduced basal synaptic transmission, LTP can still be induced and expressed normally. We conclude that increased susceptibility to excitotoxicity rather than a specific effect on LTP is the primary cause of cognitive deficits in APP(695)SWE mice.


Subject(s)
Aging/genetics , Alzheimer Disease/genetics , Amyloid beta-Protein Precursor/genetics , Long-Term Potentiation/genetics , Synaptic Transmission/genetics , Aging/metabolism , Alzheimer Disease/pathology , Amyloid beta-Protein Precursor/biosynthesis , Animals , Disease Models, Animal , Electric Stimulation , Excitatory Amino Acid Antagonists/pharmacology , Excitatory Postsynaptic Potentials/drug effects , Genetic Predisposition to Disease , Hippocampus/drug effects , Hippocampus/metabolism , Hippocampus/pathology , Humans , In Vitro Techniques , Kynurenic Acid/pharmacology , Mice , Mice, Transgenic , Mutation , Neuronal Plasticity , Plaque, Amyloid/pathology , Synaptic Transmission/drug effects
6.
Semin Oncol ; 21(5): 514-21, 1994 Oct.
Article in English | MEDLINE | ID: mdl-7939745

ABSTRACT

A number of genetic changes have been documented in prostate cancer, ranging from allelic loss to point mutations and changes in DNA methylation patterns (summarized in Fig 1). To date, the most consistent changes are those of allelic loss events, with the majority of tumors examined showing loss of alleles from at least one chromosomal arm. The short arm of chromosome 8, followed by the long arm of chromosome 16 appear to be the most frequent regions of loss, suggesting the presence of novel tumor suppressor genes. Deletions of one copy of the Rb and p53 genes are less frequent as are mutations of the p53 gene, and accumulating evidence suggests the presence of an additional tumor suppressor gene on chromosome 17p, which is frequently inactivated in prostate cancer. Alterations in the E-cadherin/alpha catenin mediated cell-cell adhesion mechanism appear to be present in almost half of all prostate cancers, and may be critical to the acquisition of metastatic potential of aggressive prostate cancers. Finally, altered DNA methylation patterns have been found in the majority of prostate cancers examined, suggesting widespread alterations in methylation-modulated gene expression. The presence of multiple changes in these tumors is consistent with the multistep nature of the transformation process. Finally, efforts to identify prostate cancer susceptibility loci are underway and will hopefully elucidate critical early events in prostatic carcinogenesis.


Subject(s)
Prostatic Neoplasms/genetics , Cadherins/genetics , Cadherins/physiology , Cell Line, Transformed , Cytoskeletal Proteins/genetics , Cytoskeletal Proteins/physiology , DNA, Neoplasm , Gene Expression , Genes, Retinoblastoma , Genes, p53 , Genes, ras , Heterozygote , Humans , Male , Methylation , Oncogenes , Prostatic Neoplasms/metabolism , Prostatic Neoplasms/pathology , alpha Catenin
7.
Neuropharmacology ; 41(5): 565-73, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11587711

ABSTRACT

A common feature of many synapses is their regulation by neurotransmitters other than those released from the presynaptic terminal. This aspect of synaptic transmission is often mediated by activation of G protein coupled receptors (GPCRs) and has been most extensively studied at amino acid-mediated synapses where ligand gated receptors mediate the postsynaptic signal. Here we have investigated how opioid receptors modulate synaptic transmission mediated by muscarinic acetylcholine receptors (mAChRs) in hippocampal CA1 pyramidal neurones. Using a cocktail of glutamate and gamma-amino-butyric acid (GABA) receptor antagonists a slow pirenzepine-sensitive excitatory postsynaptic potential (EPSP(M)) that was associated with a small increase in cell input resistance could be evoked in isolation. This response was enhanced by the acetylcholine (ACh) esterase inhibitor physostigmine (1 microM) and depressed by the vesicular ACh transport inhibitor vesamicol (50 microM). The mu-opioid receptor agonists DAMGO (1-5 microM) and etonitazene (100 nM), but not the delta- and kappa-opioid receptor selective agonists DTLET (1 microM) and U-50488 (1 microM), potentiated this EPSP(M) (up to 327%) without affecting cell membrane potential or input resistance; an effect that was totally reversed by naloxone (5 microM). In contrast, postsynaptic depolarizations and increases in cell input resistance evoked by carbachol (3 microM) were unaffected by DAMGO (1-5 microM) but were abolished by atropine (1 microM). Taken together these data provide good evidence for a mu-opioid receptor-mediated presynaptic enhancement of mAChR-mediated EPSPs in hippocampal CA1 pyramidal neurones.


Subject(s)
Hippocampus/physiology , Receptors, Muscarinic/physiology , Receptors, Opioid/physiology , Synapses/physiology , Synaptic Transmission/physiology , Animals , Excitatory Amino Acid Antagonists/pharmacology , Excitatory Postsynaptic Potentials/drug effects , Excitatory Postsynaptic Potentials/physiology , Female , GABA Antagonists/pharmacology , Hippocampus/drug effects , Rats , Rats, Wistar , Receptors, Opioid/agonists , Synapses/drug effects , Synaptic Transmission/drug effects
8.
Neuropharmacology ; 38(11): 1723-32, 1999 Nov.
Article in English | MEDLINE | ID: mdl-10587088

ABSTRACT

The role of GABA(B) autoreceptors in the regulation of GABA(A) and GABA(B) receptor-mediated inhibitory post-synaptic potentials (IPSPs) during repetitive synaptic activation has been established. In the present study the role of these receptors in the regulation of depolarising GABA(A) receptor-mediated synaptic potentials (DPSP(A)s) in the CA1 region of the hippocampus is documented. Following blockade of AMPA and NMDA receptor-mediated synaptic excitation, DPSP(A)s could be evoked by a single stimulus. The size of this response was enhanced by increasing the stimulus number (1-10 shocks) or stimulus frequency (10-100 Hz). Conversely, the amplitude of the DPSP(A) was dramatically reduced by a priming pulse (single shock) or priming burst (four shocks) delivered 200 ms beforehand. This activity-dependent depression was eliminated by the GABA(B) receptor antagonist CGP 35348 (1 mM). As such, GABA(B) autoreceptor-mediated regulation of DPSP(A)s prevented a pronounced, potentially epileptogenic, DPSP(A) from occurring during theta burst stimulation. Thus, during repetitive stimulation, activation of GABA(B) autoreceptors not only enables a transient reduction in GABA(A) receptor-mediated synaptic inhibition sufficient to enable NMDA receptor-dependent synaptic plasticity [Davies, C.H., Collingridge, G.L., 1996. J. Physiol. 496.2, 451-470] but also prevents the development of a potentially pathogenic depolarising GABA-mediated synaptic potential.


Subject(s)
Autoreceptors/physiology , Hippocampus/physiology , Receptors, GABA-A/physiology , Receptors, GABA-B/physiology , Synaptic Transmission/physiology , Animals , Autoreceptors/drug effects , Electric Stimulation , Excitatory Amino Acid Antagonists/pharmacology , Hippocampus/drug effects , Rats , Rats, Wistar , Receptors, GABA-A/drug effects , Receptors, GABA-B/drug effects , Synaptic Transmission/drug effects
9.
Neuropharmacology ; 38(3): 349-59, 1999 Mar.
Article in English | MEDLINE | ID: mdl-10219973

ABSTRACT

Abnormal processing of amyloid precursor protein (APP), in particular the generation of beta-amyloid (Abeta) peptides, has been implicated in the pathogenesis of Alzheimer's disease. This study examined the consequences of deleting the APP gene on hippocampal synaptic plasticity, and upon the biophysical properties of morphologically identified neurones in APP-null mice. The hippocampus of APP-null mice had a characteristic increase in gliosis throughout the CA1 region and a disruption of staining for the dendritic marker MAP2 and the presynaptic marker synaptophysin. The disruption of MAP2 staining was associated with a significant reduction in overall dendritic length and projection depth of biocytin labeled CA1 neurones. In two groups of APP-null mice that were examined at 8-12 months, and 20-24 months of age, there was an impairment in the formation of long-term potentiation (LTP) in the CA1 region compared to isogenic age matched controls. This LTP deficit was not associated with an alteration in the amplitude of EPSPs at low stimulus frequencies (0.033 Hz) or facilitation during a 100 Hz stimulus train, but was associated with a reduction in post-tetanic potentiation. Paired-pulse depression of GABA-mediated inhibitory post-synaptic currents was also attenuated in APP-null mice. These data demonstrate that the impaired synaptic plasticity in APP deficient mice is associated with abnormal neuronal morphology and synaptic function within the hippocampus.


Subject(s)
Aging/physiology , Amyloid beta-Protein Precursor/physiology , Hippocampus/physiology , Neuronal Plasticity/physiology , Synapses/physiology , Amyloid beta-Protein Precursor/deficiency , Amyloid beta-Protein Precursor/genetics , Animals , Dendrites/physiology , Dendrites/ultrastructure , Electric Stimulation , Excitatory Postsynaptic Potentials/physiology , Gliosis , Hippocampus/growth & development , Hippocampus/pathology , Long-Term Potentiation/physiology , Mice , Mice, Knockout , Microtubule-Associated Proteins/analysis , Neurons/physiology
10.
J Neurosci Methods ; 100(1-2): 117-22, 2000 Jul 31.
Article in English | MEDLINE | ID: mdl-11040373

ABSTRACT

Sucrose-based artificial cerebrospinal fluid (aCSF) is sometimes used to prepare brain slices for in vitro electrophysiological experiments. This study compared the effect of preparing brain slices using chilled sucrose-based aCSF versus the conventional method using chilled aCSF on hippocampal synaptic plasticity. Brain slices from each treatment group were transferred to normal aCSF before electrophysiological recordings were made. The stimulus-response relationship of field excitatory postsynaptic potentials (fEPSPs) in the CA1 region was indistinguishable between the two treatment groups. However, the amount of LTP induced by either a θ-burst (four stimuli at 100 Hz repeated ten times at 200 ms intervals) or tetanic stimulation (100 Hz for 1 s) was significantly reduced in slices that had been prepared using sucrose-based aCSF. This was associated with reduced facilitation of the fEPSPs during the high frequency stimulus, reduced post-tetanic potentiation and short-term potentiation. In sucrose-cut slices the fEPSPs were slightly shorter in duration (29%, P<0.01), and during paired-pulse stimulation the broadening of the second fEPSP was enhanced. The LTP deficit in sucrose-cut slices was reversed by blocking GABA(A) receptor function with picrotoxin. These data suggest that the use of sucrose based aCSF better preserves GABA-mediated synaptic transmission, which limits the induction of LTP in hippocampal brain slices.


Subject(s)
Cerebrospinal Fluid/metabolism , Hippocampus/drug effects , Long-Term Potentiation/drug effects , Sucrose/pharmacology , Action Potentials/drug effects , Action Potentials/physiology , Animals , Cerebrospinal Fluid/chemistry , Culture Techniques , Electric Stimulation/instrumentation , Electric Stimulation/methods , Excitatory Postsynaptic Potentials/drug effects , Excitatory Postsynaptic Potentials/physiology , Hippocampus/cytology , Hippocampus/metabolism , Long-Term Potentiation/physiology , Male , Mice , Mice, Inbred C57BL , Neural Inhibition/drug effects , Neural Inhibition/physiology , Picrotoxin/pharmacology , Pyramidal Cells/cytology , Pyramidal Cells/drug effects , Pyramidal Cells/metabolism , Sodium Chloride/metabolism , Sodium Chloride/pharmacology , Sucrose/metabolism , Synaptic Transmission/drug effects , Synaptic Transmission/physiology , gamma-Aminobutyric Acid/metabolism
11.
Urology ; 44(5): 637-45, 1994 Nov.
Article in English | MEDLINE | ID: mdl-7526522

ABSTRACT

Black men represent a particularly high risk group for the development of prostate cancer. Current recommendations are that all men over age 50 be screened for prostate cancer annually with a digital rectal examination (DRE) and PSA. Moreover, it has been recommended that men in high risk groups, including blacks and men with a family history of prostate cancer, be screened at an earlier age. At the present time, no adequately performed prospective study has demonstrated a reduction in mortality rate attributable to annual prostate cancer screening. Preliminary reports have suggested that the proportion of men with organ confined tumors increases with PSA based screening, and that a reduction in prostate cancer mortality via screening is feasible. In light of these preliminary studies, increased efforts toward patient awareness and PSA screening are certainly warranted in the black community. Hopefully the result of such programs would be to increase the percentage of black men diagnosed with organ confined prostate cancer. However, the etiology of these striking racial differences remains to be defined. To date no consistent data have been presented which can explain these observations. It is likely that multiple factors will be involved including socioeconomic, environmental, dietary, and genetic. Lastly, little is known of the molecular genetic factors, tumor suppressor genes and/or oncogenes, that play a role in prostate cancer in black men. Increased research efforts are needed in order to understand this problem at the molecular level.


Subject(s)
Adenocarcinoma , Black People , Prostatic Neoplasms , White People , Adenocarcinoma/blood , Adenocarcinoma/diagnosis , Adenocarcinoma/ethnology , Adenocarcinoma/etiology , Adenocarcinoma/mortality , Adenocarcinoma/prevention & control , Adult , Aged , Humans , Incidence , Male , Mass Screening , Medical History Taking , Middle Aged , Molecular Biology , North America/epidemiology , Nutritional Physiological Phenomena , Physical Examination , Prostate-Specific Antigen/blood , Prostatic Neoplasms/blood , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/ethnology , Prostatic Neoplasms/etiology , Prostatic Neoplasms/mortality , Prostatic Neoplasms/prevention & control , Research , Risk Factors , Testosterone/analysis , Vitamin D Deficiency/complications
12.
Neurosci Lett ; 288(1): 9-12, 2000 Jul 07.
Article in English | MEDLINE | ID: mdl-10869803

ABSTRACT

Although mutations in amyloid precursor protein (APP) are known to be involved in the development of Alzheimer's disease in some individuals, the role of this protein in normal brain function is poorly understood. We have reported previously that in APP-null mice long-term potentiation (LTP) in the CA1 region of the hippocampus is present but its magnitude is reduced compared to wild-type littermate controls. In the present study, we have confirmed this deficit using a different theta burst induction protocol. Significantly, however, we find that this deficit is no longer apparent when LTP experiments are performed following blockade of gamma-aminobutyric acid(A) receptors. These results suggest that the LTP process per se is not altered by the absence of APP. The deficit may therefore be an indirect consequence of other changes in the hippocampus that occur in the APP-null animal.


Subject(s)
Amyloid beta-Protein Precursor/genetics , Central Nervous System Stimulants/pharmacology , Hippocampus/physiology , Long-Term Potentiation/physiology , Picrotoxin/pharmacology , Alzheimer Disease/physiopathology , Animals , Electric Stimulation , Excitatory Postsynaptic Potentials/physiology , Hippocampus/chemistry , Mice , Mice, Knockout , Neural Inhibition/physiology , Organ Culture Techniques , gamma-Aminobutyric Acid/physiology
13.
Urol Clin North Am ; 18(4): 743-54, 1991 Nov.
Article in English | MEDLINE | ID: mdl-1949406

ABSTRACT

Almost all segments of the gastrointestinal tract have been used as urinary tract substitutes. The specific nutritional and gastrointestinal complications depend on the particular portion of bowel that is removed from the alimentary tract. The use of stomach theoretically may predispose the patient to hypergastrinemia and peptic ulcer disease, hypocalcemia, and iron deficiency or megaloblastic anemia. Resection of a large amount of jejunum causes malabsorption. Limited use of colon segments usually is well tolerated, but loss of large parts of the colon directly decreases available absorptive area, resulting in diarrhea. Resection of the ileum and ileocecal valve can lead to several disease states. One is mixed secretory-osmotic diarrhea. Decreased ileal reabsorption of bile salts results in fat malabsorption and steatorrhea. The presentation of increased amounts of bile salts and fatty acids to the colon decreases water absorption and stimulates active chloride and water secretion, producing a cholera-like high-volume secretory diarrhea. The loss of the ileocecal valve and ileum segment accelerates intestinal transit time, which does not allow for complete digestion and absorption of food. Water and electrolytes remain associated with undigested food particles and may overwhelm the absorptive capacity of the colon, resulting in an osmotic diarrhea. A second problem is vitamin B12 deficiency. Surgical reduction of sites in the terminal ileum for active and exclusive uptake of vitamin B12 might lead to hypovitaminosis. If this is unrecognized, patients may develop irreversible neurologic injury. A third problem is cholelithiasis. Derangements in bile salt metabolism can occur when as little as 10 cm of ileum is resected, and the propensity to form gallstones is increased. Pigment gallstones appear to be the predominant stone associated with ileal resections. The fourth possible problem is urolithiasis, the etiology of which is multifactorial in patients with ileal resections. With decreased availability of bile salts, fat malabsorption occurs. Fatty acids bind with calcium and magnesium to form soaps, resulting in increased levels of free oxalate available for absorption. Moreover, fatty acids directly increase colonic permeability to oxalate.(ABSTRACT TRUNCATED AT 400 WORDS)


Subject(s)
Gastrointestinal Diseases/etiology , Intestinal Mucosa/metabolism , Nutrition Disorders/etiology , Urinary Reservoirs, Continent/adverse effects , Gastrointestinal Diseases/metabolism , Humans , Intestinal Absorption , Intestines/surgery , Nutrition Disorders/metabolism , Urinary Reservoirs, Continent/methods
14.
Urol Clin North Am ; 28(3): 491-8, 2001 Aug.
Article in English | MEDLINE | ID: mdl-11590808

ABSTRACT

Clearly, pelvic lymphadenectomy can provide important staging information in the management of prostate cancer, but this benefit is counterbalanced by a modest increase in morbidity and the significant cost of the procedure. It is difficult to provide universal recommendations concerning the indications for pelvic lymphadenectomy. Part of the problem lies in the fact that urologists perform pelvic lymphadenectomy for several different reasons. Some surgeons perform pelvic lymphadenectomy to better counsel patients after radical prostatectomy about their risk for disease progression and for planning adjuvant radiotherapy or hormonal therapy. For these surgeons, preoperative clinical staging parameters do not exclude patients from pelvic lymphadenectomy, and frozen section analysis intraoperatively provides no useful information. Alternatively, the staging information from pelvic lymphadenectomy can be used to justify cancellation of the subsequent prostatectomy should regional spread of prostate cancer be identified, sparing the patient the morbidity of an unnecessary radical prostatectomy. With this approach, despite the false-negative rate of up to 30%, the expense of frozen section analysis seems justified. For this second group of surgeons, the problem becomes balancing the modest morbidity and cost of pelvic lymphadenectomy against the probability that nodal spread of prostate cancer will be missed if the procedure is omitted. The authors consider a greater than 4% risk for missing regional disease to be unacceptable in this setting. Following this assumption, Table 3 outlines parameters for clinical stage, Gleason score, and preoperative PSA within which pelvic lymphadenectomy is indicated. These recommendations are based on [table: see text] predictions from the Partin nomogram, which has been validated using a series of over 4000 patients. For the large number of patients with clinical T1c disease and a preoperative PSA less than 10 ng/mL, bilateral pelvic lymphadenectomy is indicated only if prostate biopsy identifies tumor of Gleason grade 4 or higher. For lower-grade tumors in this patient population, the risk for nodal metastasis was less than 5% in the Johns Hopkins and Mayo Clinic series of over 5800 patients with prostate cancer. For a large pool of patients, the several thousand dollar cost of pelvic lymphadenectomy and the risk for injury to the obturator nerves and vessels, the formation of lymphoceles, and chronic genital edema can be eliminated with low risk. A nomogram-based approach provides only a starting point for a decision analysis framework to determine whether the surgeon should perform lymphadenectomy at the time of radical prostatectomy because current nomograms predict only lymph node positivity. In a decision analysis framework, some patient and physician value is derived from a negative lymphadenectomy. Moreover, the morbidity associated with pelvic lymphadenectomy and the potential inconvenience associated with treating such morbidity also would be factored into the decision. Consequently, a decision analysis framework that takes into account prognostic value, costs, morbidity, and health state uses ultimately will provide the most informative method for determining when pelvic lymphadenectomy is indicated in patients with prostate cancer.


Subject(s)
Lymph Node Excision , Prostatic Neoplasms/pathology , Prostatic Neoplasms/surgery , Frozen Sections , Humans , Lymph Node Excision/adverse effects , Lymphatic Metastasis , Male , Neoplasm Staging , Pelvis , Preoperative Care , Prostate-Specific Antigen/blood , Prostatic Neoplasms/blood , Reproducibility of Results
15.
Urol Clin North Am ; 17(3): 679-84, 1990 Aug.
Article in English | MEDLINE | ID: mdl-2375065

ABSTRACT

The striated urethral sphincter is the predominant muscular structure divided posteriorly during the apical dissection in radical prostatectomy. The authors have long realized the value of this maneuver in obtaining excellent apical surgical margins and in identifying the correct plane on the anterior surface of the rectum. Recently, they also have recognized the importance of incorporating this musculature into the vesicourethral anastomosis to fix the bladder neck and thus re-establish anatomic continuity. Identification of the striated urethral sphincter ranks in importance with elucidation of the anatomy of the dorsal vein complex and the anatomic identification of the neurovascular bundle in improving the patient's quality of life postoperatively.


Subject(s)
Prostatectomy/methods , Urination , Anastomosis, Surgical , Follow-Up Studies , Humans , Male , Postoperative Period , Prostate/anatomy & histology
16.
Lipids ; 29(11): 753-8, 1994 Nov.
Article in English | MEDLINE | ID: mdl-7869855

ABSTRACT

Young adult obese Zucker rats have altered tissue fatty acid (FA) composition. The present study was aimed at determining whether such changes were seen in either liver, serum or adipose tissue obtained from 17-day-old obese (fafa) rats in comparison to both homozygous (FaFa) and heterozygous (Fafa) lean rats. Body weights of obese pups (30.3 g) were significantly greater than those of homozygous lean rats (25.2 g) (P < 0.05). Liver weight and lipid content were similar in all groups. Inguinal fat pad weight and lipid content were greatest in obese pups (573 mg) followed by heterozygous lean pups (303 mg); homozygous lean pups (146 mg) had the lowest values. There were no differences among the groups in hepatic FA composition in either triacylglycerol (TG) or phospholipid fractions. Serum TG was similar among the groups, while serum phospholipid was greater (P < 0.05) in obese (269 mg/dL) than in homozygous lean pups (184 mg/dL); heterozygous lean pups had an intermediate value not significantly different from either homozygous group. On a percent basis, there were no differences in FA composition in either serum lipid fraction among the three groups. There were a number of significant differences in adipose tissue FA composition between the groups on a percent basis. The adipose tissue FA composition on a percent basis reflected that of maternal milk. The results indicate that suckling obese Zucker rats do not have tissue FA profiles that are characteristic of essential FA deficiency.


Subject(s)
Adipose Tissue/chemistry , Animals, Suckling/genetics , Liver/chemistry , Phospholipids/blood , Rats, Zucker/genetics , Animals , Animals, Suckling/blood , Fatty Acids/analysis , Fatty Acids/blood , Female , Genotype , Male , Milk/chemistry , Obesity , Rats , Rats, Zucker/blood , Triglycerides/blood
17.
Yonsei Med J ; 40(2): 118-23, 1999 Apr.
Article in English | MEDLINE | ID: mdl-10333714

ABSTRACT

Transforming growth factor-beta (TGF-beta), a pleiotropic growth factor, is a potent inhibitor of cellular proliferation in cells of epithelial origin. Recently, it has been suggested that a loss of sensitivity to TGF-beta through a loss of expression of TGF-beta receptors T beta R-I and T beta R-II--is associated with tumor initiation and progression. Therefore, to investigate the relationship between TGF-beta receptors expression and carcinogenesis of bladder TCC, this study examined the expression of T beta R-I and T beta R-II in 46 bladder TCC patients using immunohistochemistry. Since histopathological grade is a widely accepted marker of prognosis, the results were compared in relation to the three grades of bladder TCC. The results demonstrated that the loss of TGF-beta receptors expression is associated with increasing histopathological grades of bladder TCC. Specifically, both T beta R-I and T beta R-II were readily detected in all 10 normal bladder mucosa specimens. Likewise, all 6 specimens of grade I TCC samples expressed high levels of both TGF-beta receptors. However, among grade II TCC samples, T beta R-I and T beta R-II were detected in 78% and 89%, respectively: among grade III TCC samples, T beta R-I and T beta R-II were detected in 45% and 41%, respectively. These results suggested that loss of sensitivity to TGF-beta may play a role in the progression of TCC from low to high grade disease.


Subject(s)
Carcinoma, Transitional Cell/metabolism , Carcinoma, Transitional Cell/pathology , Receptors, Transforming Growth Factor beta/metabolism , Urinary Bladder Neoplasms/metabolism , Urinary Bladder Neoplasms/pathology , Adult , Aged , Humans , Middle Aged , Reference Values
18.
Neuroscience ; 238: 59-70, 2013 May 15.
Article in English | MEDLINE | ID: mdl-23415785

ABSTRACT

Voltage-gated calcium channels (VGCCs) play a major role during the development of the central nervous system (CNS). Ca(2+) influx via VGCCs regulates axonal growth and neuronal migration as well as synaptic plasticity. Specifically, L-type VGCCs have been well characterized to be involved in the formation and refinement of the connections within the CA3 region of the hippocampus. The majority of the growth, formation, and refinement in the CNS occurs during the third trimester of human pregnancy. An equivalent developmental time period in rodents occurs during the first 2weeks of post-natal life, and the expression pattern of L-type VGCCs during this time period has not been well characterized. In this study, we show that Cav1.2 channels are more highly expressed during this developmental period compared to adolescence (post-natal day 30) and that L-type VGCCs significantly contribute to the overall Ca(2+) currents. These findings suggest that L-type VGCCs are functionally expressed during the crucial developmental period.


Subject(s)
CA3 Region, Hippocampal/physiology , Calcium Channels, L-Type/physiology , Calcium/metabolism , Pyramidal Cells/physiology , Animals , CA3 Region, Hippocampal/cytology , CA3 Region, Hippocampal/metabolism , Calcium Channels, L-Type/metabolism , Calcium Signaling/physiology , Cell Shape/physiology , Female , Male , Pyramidal Cells/cytology , Pyramidal Cells/metabolism , Rats , Rats, Sprague-Dawley
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