Autologous omentum transposition for regeneration of a renal injury model in rats.

BACKGROUND: After renal trauma, surgical treatment is vital, but sometimes there may be loss of function due to fibrosis. This study aimed to evaluate the effect of autologous omentum flaps on injured renal tissues in a rat model. METHODS: A total of 30 Wistar albino rats were included and randomly divided equally into a control group and four intervention groups. Iatrogenic renal injuries were repaired using a surgical technique (primary repair 1 group and primary repair 2 group) or transposition of the autologous omentum (omentum repair 1 group and omentum repair 2 group). Blood samples were taken preoperatively and on the 1st and 7th postoperative days in all groups and on the 18th postoperative day in the control and two intervention groups. All rats were sacrificed on the 7th or 18th day postoperatively, and their right kidneys were taken for histopathological evaluation. RESULTS: The mean urea level significantly decreased from day 1 to day 7 and from day 1 to day 18 in the omentum repair 2 group (P = 0.005 and P = 0.004, respectively). There were no other significant changes in urea or creatinine levels within the intervention groups (P > 0.05). There was no significant correlation between the urea and creatinine levels and the histological scores (P > 0.05). The primary repair 1 and 2 groups had significantly higher median granulation and inflammation scores in the kidney specimen than the control and omentum repair groups (P < 0.05). The omentum repair 2 group had significantly lower median granulation and inflammation scores in the surrounding tissues than the primary repair 2 group (P < 0.05). The completion score for the healing process in the kidney specimen was significantly higher in the omentum repair groups than in the primary repair groups (P < 0.05). The omentum repair 2 group had significantly lower median granulation and inflammation scores in the surrounding tissues than the primary repair 2 group (P < 0.05). Granulation degree in the kidney specimen was strongly and positively correlated with the inflammation degree (r = 0.824, P < 0.001) and foreign body reaction in the kidney specimen (r = 0.872, P < 0.001) and a strong and negative correlation with the healing process completion score in the kidney (r = - 0.627, P = 0.001). Inflammation degree in the kidney specimen was strongly and positively correlated with the foreign body reaction in the kidney specimen (r = 0.731, P = 0.001) and strongly and negatively correlated with the healing process completion score in the kidney specimen (r = - 0.608, P = 0.002). CONCLUSION: Autologous omentum tissue for kidney injury repair attenuated inflammation and granulation. Additionally, the use of omental tissue to facilitate healing of kidney injury may theoretically lead to a more effective healing process and reduced fibrosis and tissue and function loss.

Sextant Biopsy-Based Criteria for Clinically Insignificant Prostate Cancer Are Also Valid for the 12-Core Prostate Biopsy Scheme: A Multicenter Study of Urooncology Association, Turkey.

BACKGROUND: Epstein criteria based on sextant biopsy are assumed to be valid for 12-core biopsies. However, very scarce information is present in the current literature to support this view. OBJECTIVES: To investigate the validity of Epstein criteria for clinically insignificant prostate cancer (PCa) in a cohort of the currently utilized 12-core prostate biopsy (TRUS-Bx) scheme in patients with low-risk and intermediate-risk PCa. METHOD: Pathological findings were separately evaluated in the areas matching the sextant biopsy (6-core paramedian) scheme and in all 12-core schemes. Patients were divided into 2 groups according to the final pathology report of RP as true clinically significant PCa (sPCa) and insignificant PCa (insPCa) groups. Predictive factors (including Epstein criteria) and cutoff values for the presence of insPCa were separately evaluated for 6- and 12-core TRUS-Bx schemes. Then, different predictive models based on Epstein criteria with or without additional biopsy findings were created. RESULTS: A total of 442 patients were evaluated. PSA density, biopsy GS, percentage of tumor and number of positive cores, PNI, and HG-PIN were independent predictive factors for insPCa in both TRUS-Bx schemes. For the 12-core scheme, the best cutoff values of tumor percentage and number of positive cores were found to be ≤50% (OR: 3.662) and 1.5 cores (OR: 2.194), respectively. The best predictive model was found to be that which added 3 additional factors (PNI and HG-PIN absence and number of positive cores) to Epstein criteria (OR: 6.041). CONCLUSIONS: Using a cutoff value of "1" for the number of positive biopsy cores and absence of biopsy PNI and HG-PIN findings can be more useful for improving the prediction model of the Epstein criteria in the 12-core biopsy scheme.

Effects of pneumoperitoneum with carbon dioxide on renal and hepatic functions in rats.

INTRODUCTION: Laparoscopic surgery is a preferred method based on its many benefits. However, increasing abdominal pressure by CO2 insufflation during the implementation of this technique poses challenges. AIM: To determine the degree of renal and liver injury that occurs in a pneumoperitoneum (PP) model of prolonged CO2 insufflation. MATERIAL AND METHODS: Twenty-one female Sprague Dawley rats were separated randomly into three groups. Group 1 was the control group and given anesthesia for 3 h. In group 2, PP was administered under anesthesia for 1 h. In the last group, PP was administered under anesthesia to animals for 3 h. We measured renal and liver injury biomarkers and made a histopathological evaluation to estimate the degree of injury and assessed the correlation of biomarkers including kidney injury molecule-1 (KIM-1) with histopathological findings. RESULTS: Histopathological analysis according to the kidney ischemia tubular damage score showed a statistically significant difference between the 3 groups (p < 0.001). There was an increase in KIM-1 levels in the groups, although it was not statistically significant (p = 0.062, p = 0.156, p = 0.350 respectively). According to the correlation test in this research, KIM-1 results had a statistically significant association with creatinine, urea, aspartate aminotransferase and alanine aminotransferase levels in all control and study groups. CONCLUSIONS: According to our results, the increase in KIM-1 was correlated with Cr levels and compatible with histopathological analysis. Moreover, intra-abdominal pressure statistically significantly increased the degree of kidney injury and there was not a significant increase in the levels of KIM-1. There was no difference in liver damage between groups.

Correlation of Prostate-Imaging Reporting and Data Scoring System scoring on multiparametric prostate magnetic resonance imaging with histopathological factors in radical prostatectomy material in Turkish prostate cancer patients: a multicenter study of the Urooncology Association.

BACKGROUND: Histopathological features after radical prostatectomy (RP) provide important information for the prognosis of prostate cancer (PCa). The possible correlations between Prostate-Imaging Reporting and Data Scoring System (PIRADS) scores in multiparametric magnetic resonance imaging (mpMRI) may also be predictive for prognosis. In this study, we aimed to evaluate the correlation of PIRADS scores with histopathological data. METHODS: A total of 177 patients who underwent preoperative mpMRI and RP for PCa from eight institutions were included in the study. Correlation of PIRADS score in preoperative mpMRI with adverse histopathological factors in RP specimen was investigated using univariate and multivariate analyses. RESULTS: The relationship between PIRADS score and postoperative extracapsular extension, lymphovascular invasion, and seminal vesicle involvement was significant (P < 0.001, P = 0.032, and P = 0.007, respectively). Although the PIRADS score was significantly correlated with the number of dissected lymph nodes (p = 0.026), it had no significant correlation with the number of positive nodes (P = 0.611). Total Gleason score, extracapsular extension, seminal vesicle invasion, and number of lymph nodes were found to be independent factors, which correlated with high PIRADS scores in ordinal logistic regression analysis. CONCLUSION: PIRADS scoring system in mpMRI showed a statistically significant correlation with adverse histopathological factors in RP specimen. A higher PIRADS score may help to predict a higher Gleason score, indicating clinically important PCa as well as poor prognotic factors such as extracapsular extension, lymphovascular invasion, and seminal vesicle invasion that may indicate a higher risk of recurrence and the need for additional treatment.

Effect of endothelial dysfunction on the pathogenesis of urolithiasis in patients with metabolic syndrome.

OBJECTIVE: The aim of the present prospective clinical study was to investigate the possible effect of endothelial dysfunction in urolithiasis. METHODS: The study included 92 patients older than 18 years. The patients were divided into 4 groups with 23 patients each as group 1: metabolic sydrome (MetS) (-) stone disease (SD) (-), group 2: MetS (-) SD (+), group 3: MetS (+) SD (-) and group 4: MetS (+) SD (+). C-reactive protein, homocysteine, uric acid, and creatinine levels were evaluated between the groups. Endothelial (dys)function was evaluated based on the brachial artery flow-mediated dilation (FMD) measurement. RESULTS: The mean age was 41.9 ± 10.2 (range, 18-62) years. Mean FMD value was 15.9 ± 18.2% (range, 24.0-68.5%). A strong significant difference was found between group 1 and 2 (p < .001); group 1 and 3 (p < .001) and group 1 and 4 (p < .001) with regard to FMD. CONCLUSION: These results suggest that endothelial dysfunction plays an important role in the pathogenesis of urolithiasis in patients with MetS.

The role of an herbal agent in treatment for Escherichia coli induced bacterial cyctitis in rats.

OBJECTIVES: The aim of this study is to evaluate the effects of the herbal agent in the prevention and treatment of bacterial cystitis in a rat model. MATERIAL AND METHODS: A total of twenty-eight male Sprague- Dawley rats were divided into four groups. Group-1 constituted the control group (operated and normal saline injected into the bladder, received only drinking water for 7 days); Group-2 constituted the no-treatment group (operated, E.coli J96 strain injected into the bladder, received only drinking water for 7 days); Group-3 constituted the short-term treatment (operated, E.coli J96 strain injected into the bladder, received the herbal agent added into drinking water for 7 days) and Group-4 constituted the long-term treatment (operated, E. coli J96 strain injected into the bladder, received herbal agent added into drinking water for 14 days). At the end of the pre-defined treatment periods of duration, the rats were sacrificed, urine samples collected from the bladder for culture and bladders were harvested for histopathological evaluation. Urine culture results and histopathological findings were comparatively evaluated between the groups. RESULTS: Urine cultures were positive for implanted E. coli strains in 0%, 85.7%, 42.8% and 0% of rats in Group 1, Group 2, Group 3 and Group 4, respectively (p = 0.001). Although histopathological evaluation revealed increased vascular dilation in the bladder specimens obtained from Group 2 and Group 3 (p = 0.028) no significant difference was noticed in level of inflammation (p = 0.610), edema (p = 0.754) and thickness of uroepithelium (p = 0.138). CONCLUSION: While long term (14 days) treatment with an herbal agent added into the drinking water resulted in complete clearance of urine from E. coli; shorter application of the agent revealed partial clearance. Further clinical studies are needed to support our results.

Critical evaluation of the overactive bladder and urgency urinary incontinence association with obstructive sleep apnea syndrome in a relatively young adult male population.

AIMS: To evaluate the prevalence of Overactive Bladder (OAB) and Urgency Urinary Incontinence (UUI) in males with Obstructive Sleep Apnea Syndrome (OSAS) using the OSAS grading system. METHODS: A total of 194 patients who underwent Polysomnography (PSG) were included in our prospective cross sectional study. Patients were divided into four groups according to Apnea-Hypopnea Index (AHI). Group 1, 35 patients with normal AHI (<5) as a control group; Group 2, 47 patients with mild OSAS (AHI ≥5 and <15); Group 3, 51 patients with moderate OSAS (AHI ≥15 and <30); Group 4, 61 patients with severe OSAS (AHI ≥30). Over Active Bladder (OAB-V8), ICIQ-SF, and IPSS questionnaires were filled out for all patients. Prevalence of OAB, UUI, nocturia, and scores of OAB-V8, ICIQ-SF, IPSS were compared between the study groups. The statistical analysis was adjusted by the demographics of age and BMI. RESULTS: The mean age was 44.6 ± 11.2 years, and the mean BMI was 29.9 ± 4.9 within the whole study group, and both were statistically different between the groups. The scores of OAB-V8 (P = 0.298), ICIQ-SF (P = 0.392), IPSS total, IPSS storage, and IPSS voiding (P = 0.268, P = 0.380, P = 0.167, respectively), the prevalence of OAB (P = 0.078), UUI (P = 0.423), and nocturia (P = 0.096) were not statistically different between the study groups. CONCLUSIONS: Our findings demonstrated that there is no increase in prevalence of OAB and UUI in relatively young adult male with OSAS. Furthermore, analysis revealed that the higher OSAS grade does not mean the higher prevalence of OAB.

An integrated lab-on-a-chip-based electrochemical biosensor for rapid and sensitive detection of cancer biomarkers.

Recent advances in the area of biosensor technology and microfluidic applications have enabled the miniaturisation of the sensing platforms. Here we describe a new integrated and fully automated lab-on-a-chip-based biosensor device prototype (MiSens) that has potential to be used for point-of-care cancer biomarker testing. The key features of the device include a new biochip, a device integrated microfluidic system and real-time amperometric measurements during the flow of enzyme substrate. For ease of use, a new plug and play type sensor chip docking station has been designed. This system allows the formation of an ∼7 µL capacity flow cell on the electrode array with the necessary microfluidic and electronic connections with one move of a handle. As a case study, the developed prototype has been utilised for the detection of prostate-specific antigen (PSA) level in serum that is routinely used as a biomarker for the diagnosis of prostate cancer. The patient samples from a nearby hospital have been collected and tested using the MiSens device, and the results have been compared to the hospital results. The obtained results indicate the potential of the MiSens device as a useful tool for point-of-care testing. Graphical abstract Microfluidics integrated and automated electrochemical biosensor device "MiSens" has been designed and fabricated by a multidisciplinary team and utilised to detect PSA from clinical samples.

Hyperoxaluria-induced tubular ischemia: the effects of verapamil on the antioxidant capacity of the affected kidneys.

To evaluate the potential protective effects of a calcium channel blocker (Verapamil) on the oxidative stress related changes with an emphasis on the antioxidant capacity of the kidneys an experimental study in rats was performed. A total of 44 rats have been included. Hyperoxaluria was induced in Group 1 by continuous administration of ethylene glycol (EG). Animals in Group 2 received Verapamil in addition to EG. Animals in Group 3 constituted the control group. In addition to the evaluation of tissue and serum levels of three scavenging enzymes, NO, MDA and T-AOC; the presence and degree of crystal formation in renal parenchyma were evaluated in all animals after 7 and 28 days. Our data demonstrated that in addition to the lower level of all three scavenging enzymes (SOD, CAT and GSH) particularly during late phase evaluation (4 weeks); the total antioxidant capacity (T-AOC) of these kidneys were also higher when compared with the animals receiving EG only. Tissue and serum levels of both NO and MDA indicated the preventive effect of Verapamil on the oxidative stress induced changes. Very limited or no crystallization in the kidneys treated with verapamil during early and late phase examination was observed when compared with considerable crystal formation in Group 2 animals. Verapamil treatment may preserve the oxidant capacity of the kidneys and subsequently limit the crystal deposition induced by hyperoxaluria. Verapamil could therefore be considered in the management of kidney stone formation particularly in cases with recurrent kidney stone disease.

Management behaviors of the urology practitioners to the small lower calyceal stones: the results of a web-based survey.

Lower pole calyceal stones (LPS) represent lower spontaneous passage rates and, therefore, require several interventional treatment approaches. The aim of this survey study was to investigate the attitudes of the urology practitioners and the factors affecting their decision making in the management of small asymptomatic LPS. A total of 149 urologists participated to the study via email through the internet-based website. Participating urologists were asked to complete a 29-question survey including personal and academic data, level of surgical experience, available equipment for interventional approaches, which treatment do they prefer for small LPS (≥5 mm and <1 cm), and factors affecting their treatment decision. All data were analyzed to make inferences related with treatment decision and factors affecting decision-making. Mean participant age was 41.57 (26-62) years. The most preferred approach was observation/medical treatment option (52.3 %), subsequently SWL (25.5 %), RIRS (16.1 %), miniPNL (5.4 %) and standard PNL (0.7 %) were chosen by the participants. On the other side, SWL and medical treatment were at the forefront (52 and 16.1 %) among children. In the multivariate analysis of participants' age, academic status, surgical experience and institution, none was significantly associated with treatment decision-making (p > 0.05). The most important factors associated with decision making were calyceal dilatation (85.9 %) and patient preferences (81.2 %). The other factors effecting treatment decision were reported to be recurrent disease (70.5 %), the duration of the stone (74.5 %), patient age (95.3 %), current guidelines (87.9 %), stone density (50.3 %), body mass index (BMI) (73.8 %) and other morbid diseases (91.9 %). Our surveys' greatest value is in demonstrating the preferred treatment options and factors effecting decision-making in the treatment of LPS. The most preferred option in our population was follow-up and medical treatment. The most influencing factors on decision-making were age, patients' preferences, presence of calyceal dilatation, body mass index, comorbid conditions, available options for stone treatment and the surgeon's experience on the existing opportunities.

Impaction of ureteral stones into the ureteral wall: Is it possible to predict?

To determine the possible predictive value of certain acute phase reactants CRP and ESR as well as radiologic parameters on the degree of impaction in ureteral stones. A total of 80 adult patients with a single opaque proximal ureteral stone were evaluated. A non-contrast CT was performed in all cases and all possible radiologic predictive parameters calculated. Additionally, to outline the degree of impaction at the stone site, two serum acute phase reactants namely CRP and ESR levels were also assessed. Patients were divided into two groups as follows; Group 1 (n:42) patients with normal CRP levels and Group 2 (n:38) patients with elevated levels of CRP. The data obtained in the subgroups were first comparatively evaluated with radiological parameters and the possible correlation between CRP values and these parameters was well evaluated. While the serum CRP levels were normal in 42 cases, they were elevated in 38 cases. Evaluation of the data from CRP subgroups and radiologic parameters showed that elevated levels of serum CRP were closely related with mean values of ureteral wall thickness (UWT) as well as mean level of hydronephrosis with a statistically significant difference. Additionally, a correlation analysis between serum CRP levels and all other parameters mentioned above demonstrated a statistically significant correlation between UWT, degree of hydronephrosis and serum ESR values. Evaluation of serum CRP and ESR values could let us to predict the UWT, a parameter which is closely related with the degree of stone impaction.

Distribution of monocyte chemoattractant protein-1 (MCP-1 A-2518G) and chemokine receptor (CCR2-V64Ι) gene variants in hyperbilirubinemic newborns.

Hyperbilirubinemia is one of the most crucial syndromes, which is characterized by high levels of bilirubin, especially when it occurs in newborns. Bilirubin has cytoprotective properties with an antioxidant function and plays several major roles in the inflammation process with its members such as chemokines. The monocyte chemoattractant protein-1 (MCP-1) is a member of the C-C chemokine family and it has been associated with the inflammatory process. There are no data on the chemokine and its receptor genotypes in hyperbilirubinemic newborns to show their distribution. The aim of this study is to investigate the genotypic relationship of MCP-1 and its receptor CCR2-V64Ι with hyperbilirubinemia in Turkish newborns. A total of 85 newborns were included in the study: 20 infants with hyperbilirubinemia (hyperbilirubinemic group) and 65 infants without hyperbilirubinemia (non-hyperbilirubinemic group). Genotyping of MCP-1 A-2518G and CCR2-V64Ι gene polymorphisms were detected by PCR-RFLP, respectively. MCP-1 GG genotype in patients was higher than the controls and this genotype had 2.69 times higher risk for hyperbilirubinemic neonates (P: 0.20). The frequency of MCP-1 A-2518G G+ genotype in patients was higher than the controls (55.0% and 38.5%, respectively). The results of our preliminary study suggest that MCP-1 G+ genotype has the ability to increase the hyperbilirubinemia risk of newborns. These results should be focused on to research on a larger scale to confirm the findings.

Limitation of apoptotic changes and crystal deposition by Tutukon following hyperoxaluria-induced tubular cell injury in rat model.

This study aimed at evaluating the protective effects of a herbal medication (Tutukon) on the hyperoxaluria induced apoptotic changes and crystal deposition in renal tubular epithelium in rat model. 60 male wistar rats were divided into three different groups (each group n: 20). In Group I severe hyperoxaluria was induced by ethylene glycol (EG) (0.75%) administration for 28 days. In Group II, in addition to hyperoxaluria induction, animals were treated with Tutukon for 28 days. Group III animals constituted the controls without any specific medication and/or intervention. While the presence and degree of crystal deposition in the tubular lumen were examined histopathologically under light microscopy, tubular apoptotic changes were evaluated using immunohistochemical staining for cysteine-aspartic acid protease-3 (Caspase-3) and tumor necrosis factor alpha (TNF-α) positivity on days 14 and 28, respectively. Evaluation of apoptotic changes by Caspase-3 positivity showed that while the majority of animals undergoing EG only showed evident apoptotic changes (n: 9), Tutukon application demonstrated a significant limitation with limited or no apoptosis (n: 7) in these animals. Similar data were noted for TNF alpha expression; while apoptotic changes were evident in 8 (80%) in Group I animals, limited changes were noted in Tutukon Group (n: 2). Regarding crystal deposition despite evident changes in Group I (9 animals), like apoptotic alterations, it was again significantly limited in animals receiving Tutukon (4 animals). Renal tubular crystal deposition and apoptotic changes induced by hyperoxaluria play a role in the pathogenesis of urolithiasis and the limitation of these changes might be instituted by Tutukon as a result of its antioxidant and antiinflammatory effects.

Does metabolic syndrome increase the risk of infective complications after prostate biopsy? A critical evaluation.

PURPOSE: To evaluate the possible association between metabolic syndrome (MetS) and infectious complications after prostate biopsy. METHODS: A total of 480 men underwent prostatic biopsy due to elevated prostate-specific antigen levels and/or abnormal digital rectal examination. Patients were divided into two subgroups with respect to the presence or absence of MetS. Patients in both groups were closely followed with respect to infectious complications after biopsy and the possible effect of MetS as a certain risk factor on these complications was evaluated with a multivariate analysis. RESULTS: Infectious complications were observed in 33 cases (6.8%), while urinary tract infection (UTI) was detected in 30 (6.2%) cases, sepsis occurred in three (0.6%) cases. The percentage of the cases with infectious complications was 11.0 and 3.4% in men with and without MetS, respectively (p = 0.002). These rates were 3.7 versus 1.5%, respectively, for UTI (p < 0.003) and 0.9 versus 0.4%, respectively, for sepsis in both groups (p = 0.594). Multivariate analysis of the data confirmed that MetS was associated with an increased risk of infective complications (odds ratio 3.44 and 95% CI 1.56-7.58, p < 0.002) after this procedure. CONCLUSIONS: MetS could pose a certain increased risk for infectious complications after prostate biopsy. Patients with MetS should be considered as risk cases for this procedure, and they should be evaluated and followed in a very close manner with respect to these complications.

How do the residual fragments after SWL affect the health-related quality of life? A critical analysis in a size-based manner.

This study aimed at evaluating the possible effects of residual fragments (RF) after shockwave lithotripsy (SWL) on the health-related quality of life (QOL) of the patients on a size-related basis. Eighty six patients with RF after SWL were divided into three groups: Group 1 (n:30 with fragments ≤ 2 mm), Group 2 (n:21 2-≤ 4 mm) and Group 3 (n:35 > 4 mm). During a 3-month follow-up, spontaneous passage rates, emergency department visits, mean analgesic required, additional procedures and the QOL were all evaluated. QOL was evaluated using the Short Form-36 survey. Of the 30 patients with fragments ≤ 2 mm all cases passed the fragments spontaneously. Of the 21 cases with fragments 2-≤ 4, however, 76% were stone free. Last, of the 35 cases with fragments >4 mm, 52% passed them spontaneously in 3 months. While no patient with fragments ≤ 2 mm required emergency department visit, 19% of the cases with fragments 2-≤ 4 mm and 51.4 % with fragments >4 mm did require this visit. Mean analgesic need (mg) values were higher in cases with larger fragments. Evaluation of the QOL score data in a subgroup comparison base showed that cases with larger fragments had prominently lower scores during both 1- and 3-month evaluation. RF after SWL could pose an impact on the QOL of the cases in a size-related basis. While fragments ≤ 2 mm had nearly no impact on this aspect larger fragments could significantly affect the QOL.

Effects of the MTHFR C677T polymorphism on prostate specific antigen and prostate cancer.

Prostate cancer is the most common malignancy and the second leading cause of cancer related deaths among men in many countries. Serum levels of prostate-spesific antigen (PSA) have attracted attention for prediction purposes. The methylenetetrahydrofolate reductase (MTHFR) gene play a critical role in cancer development, but its potential impact on prostate cancer has not been well studied. The C677T variant lies in exon 4 at the folate binding site of the MTHFR gene and results in substitution of an alanine by a valine residue. The present study was carried out 55 cases with prostate cancer and 50 healthy men. Polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP), and agarose gel electrophoresis techniques were employed to determine MTHFR C677T mutation. The frequencies of the CT genotype (p= 0.025) and T allele (p= 0.023) was found to be higher in control subjects when compared with patients group. No statistical difference was found between the alleles of MTHFR and PSA levels after (PSA-BT)/ before (PSA-AT) antiandrogen treatment or tumor stages. We suggest that the heterozygote CT genotype and the 677T allele of the MTHFR polymorphism might be associated with an decreased prostate cancer risk.

ARE-I polymorphism on PSA gene in prostate cancer patients of a Turkish population.

BACKGROUND: The gene for kallikrein-like serin protease, prostate-specific antigen (PSA), has been a candidate gene in several studies. It is known that androgens are important in the proliferation and development of prostate gland and they are the main regulators of PSA expression. The polymorphism of the ARE-I locus on the PSA gene was studied in prostate cancer patients to determine a possible relationship of that locus to prostate cancer risk. PATIENTS AND METHODS: Forty-nine prostate cancer patients and forty-seven healthy control subjects were compared. Total and free PSA levels were measured by an enzymatic immunoassay method. PSA ARE-I polymorphism analyses were performed using a previously described PCR-restriction fragment length polymorphism (RFLP) method. RESULTS: There were no significant differences between the control and patient groups for any of the PSA-AREI genotypes, but the G allele carriers had a 2-fold higher risk of developing advanced prostate cancer. CONCLUSION: G allele carriers have a higher risk of developing advanced prostate cancer. With further research, such PSA-AREI polymorphism analyses may help in follow-up and in deciding the prognosis of prostate cancer patients.

Effects of ACE I/D polymorphism on prostate cancer risk, tumor grade and metastatis.

UNLABELLED: The aim was to substantiate the putative significance of angiotensin-converting enzyme (ACE) (insertion/deletion) I/D polymorphism on prostate cancer risk, BTPSA-A TPSA (before treatment-after treatment prostate-specific antigen) levels and tumor development. MATERIALS AND METHODS: 48 prostate cancer patients and 51 healthy volunteers were included. The ACE I/D genotypes were determined by PCR (polymerase chain reaction) and RFLP (restriction fragment length polymorphism) techniques. RESULTS: The DD genotype may have detrimental and the II genotype may have protective effect on prostate cancer (p = 0.03). The highest before treatment PSA (BTPSA) values were found in the patient group having the DD genotype (p = 0.017). PSA-AT levels were higher in homozygous mutant DD than homozygous II and the decrease in PSA-AT level was found to be statistically significant in each genotype (p = 0.000). Patients with the D allele showed a higher prevalence of late stage prostate carcinoma when compared to the patients with II genotype (p = 0.022) and the detrimental effects of the D allele, both in lymph node metastases and distant metastasis were observed. CONCLUSION: The risk of prostate cancer development, the PSA level and tumor metastasis may be associated with genetic variation in the ACE I/D genotypes which may be used as an important biomarker for further studies.

Effects of manganase superoxide dismutase Ala-9Val polymorphism on prostate cancer: a case-control study.

BACKGROUND: Manganese superoxide dismutase (MnSOD) is a major enzyme that is responsible for the detoxification of reactive oxygen species in the mitochondria. Mitochondrial DNA damage may contribute to carcinogenesis as an important risk factor. The aim of this study was to investigate the relationship between prostate cancer and MnSOD Ala-9Val polymorphism in Turkish men with prostate cancer. PATIENTS AND METHODS: Fifty patients with prostate cancer and 50 healthy controls were included in this study. Gene polymorphism was determined using a PCR-RFLP method. RESULTS: The Ala/Ala genotype and the Ala allele were found at statistically higher frequencies in patients with prostate cancer as compared to controls (p < 0.05). The patients suffering from prostate cancer were divided into two groups according to Gleason score: aggressive prostate cancer and non-aggressive prostate cancer. It was observed that carrying the Ala/Ala genotype or the Ala allele resulted in an insignificant increase in the frequency of aggressive prostate cancer compared to nonaggressive prostate cancer. It was concluded that MnSOD Ala allele might be the cause of prostate cancer risk among alcohol users. CONCLUSION: The results of our study of Turkish prostate cancer patients suggest that mutation of the MnSOD gene may be an important risk factor for prostate cancer.

Investigation of NAD(P)H:quinone oxidoreductase 1 (NQO1) C609T polymorphism in prostate cancer.

BACKGROUND: NAD(P)H:quinone oxidoreductase 1 (NQO1) is a part of the antioxidant defense system. NQO1 protects cells from oxidative stress by maintaining antioxidant forms of ubiquinone and vitamin E and this enzymatic activity can be sufficient to protect against carcinogenesis. Oxidative stress may contribute to carcinogenesis as an important risk factor. This study aimed to investigate the relationship between prostate cancer and NQO1 C609T polymorphism in a Turkish population. PATIENTS AND METHODS: Forty-five patients with prostate cancer and fifty healthy controls were included in this study. Gene polymorphism was determined by a restricted fragment length polymorphism-polymerase chain reaction (PCR-RFLP) method. RESULTS: The NQO1 TT genotype was demonstrated to be increased in patients, there were no significant differences between distributions of NQO1 C609T genotypes in the study groups. Serum PSA and alkaline phosphatase levels were elevated in patients carrying T alleles (TT > CT > CC). There were no correlations between tumor size, node classification, metastasis or stage and NQO1 genotypes. CONCLUSION: The results of our study of Turkish prostate cancer patients suggests that mutation of the NQO1 gene may effect the serum PSA and alkaline phosphatase levels. However there were no differences between the NQO1 genotypes in the study groups.