Periprostatic adipose inflammation is associated with high-grade prostate cancer.

BACKGROUND: Obesity, a cause of subclinical inflammation, is associated with increased risk of high-grade prostate cancer (PC) and poor outcomes. Whether inflammation occurs in periprostatic white adipose tissue (WAT), and contributes to the negative impact of obesity on PC aggressiveness, is unknown. METHODS: In a single-center, cross-sectional design, men with newly diagnosed PC undergoing radical prostatectomy were eligible for study participation. The primary objective was to examine the prevalence of periprostatic WAT inflammation defined by the presence of crown-like structures (CLS-P) as detected by CD68 immunohistochemistry. Secondary objectives were to explore the clinical and systemic correlates of periprostatic WAT inflammation. Tumor characteristics and host factors including BMI, adipocyte diameter, and circulating levels of lipids, adipokines, and other metabolic factors were measured. Wilcoxon rank-sum, Chi-square, or Fisher's exact tests, and generalized linear regression were used to examine the association between WAT inflammation and tumor and host characteristics. RESULTS: Periprostatic fat was collected from 169 men (median age 62 years; median BMI 28.3). Periprostatic WAT inflammation was identified in 49.7% of patients and associated with higher BMI (P=0.02), larger adipocyte size (P=0.004) and Gleason grade groups IV/V tumors (P=0.02). The relationship between WAT inflammation and high Gleason grade remained significant after adjusting for BMI (P=0.04). WAT inflammation correlated with higher circulating levels of insulin, triglycerides, and leptin/adiponectin ratio, and lower high density lipoprotein cholesterol, compared to those without WAT inflammation (P's <0.05). CONCLUSION: Periprostatic WAT inflammation is common in this cohort of men with PC and is associated with high-grade PC.

[Pressure-dependent flow resistance in craniospinal cerebrospinal fluid dynamics: a calculation model for diagnosis of normal pressure hydrocephalus]. / Der druckabhängige Abflusswiderstand in der kraniospinalen Liquordynamik: ein Berechnungsmodell zur Diagnostik des Normaldruckhydrozephalus.

Computer-aided processing of the results obtained with the intrathecal infusion test using our newly developed mathematical model simplifies the investigation technique and thus the diagnosis of normal pressure hydrocephalus. Simultaneous determination of resistance and compliance in a single session markedly reduces the examination-related stress on the patient. In contrast to the classical methods, the new calculation does not require the ICP to reach a plateau. Unlike the static approach, our model describes the functional pressure-dependent course of the resistance. This means that account is taken of the non-linearity of the CSF dynamics during the processing of the biosignal. The intrathecal infusion test used to measure resistance and compliance is a reliable diagnostic method in patients with a normal pressure hydrocephalus.

[Diagnosis of normal pressure hydrocephalus. A calculation model for determining intracranial pressure-dependent resistance and compliance]. / Zur Diagnostik des Normaldruckhydrozephalus. Ein Berechnungsmodell zur Ermittlung der ICP-abhängigen Resistance und Compliance.

Computer-aided analysis of the results of the intrathecal infusion test using our mathematical computation leads to simplification of this investigation, and therefore normal pressure hydrocephalus is more easily diagnosed. Simultaneous measurement of resistance and compliance during a single investigation allows the exertion of the patients to be minimized. In contrast to classic methods it is not necessary that the ICP reaches a plateau. Our mathematical method diverges with the description of a pressure-dependent slope of the function for the resistance from the static examination models. For that we are able to take the non-linearity of the cerebrospinal fluid resorption into consideration. The intrathecal infusion tests is a reliable diagnostic method for measuring resistance and compliance in patients suspected of having normal pressure hydrocephalus.

[Indications for the intrathecal infusion test in disorders of cerebrospinal fluid dynamics]. / Indikationen zum intrathekalen Infusionstest bei Störungen der Liquordynamik.

Indications for and results of the intrathecal infusion test including 50 patients with chronic disturbances of the circulation of the cerebrospinal fluid are presented and discussed. The computer-aided infusion test permits in 93 per cent a reliable differentiation between patients with a normal-pressure hydrocephalus and those with cerebro-atrophic processes. Functional checking of the valve systems is a further indication for the intrathecal infusion test. In patients with a classical pressure hydrocephalus or subdural hygromas, however, we do not see an indication for this invasive examination procedure.

[Computer-assisted model trials of cerebrospinal fluid dynamics of the craniospinal system]. / Rechnergestützte Modellversuche zur Liquordynamik des kraniospinalen Systems.

Model-experiments demonstrated that the introduced computed method for simultaneous purpose of the parameter compliance C(p) and resistance to outflow of CSF R(p) by intrathecal infusion test produce equal results as conventional methods. By the calculation of the resistance to outflow of CSF R(p) no pressure plateau is necessary so that the injury of the patient is slightly. Conclusions of a standardized method for the intrathecal infusion test in clinical practice was made.

[The intrathecal infusion test in the study of craniospinal cerebrospinal fluid dynamics. A new assessment procedure]. / Der intrathekale Infusionstest zur Untersuchung der kraniospinalen Liquordynamik. Ein neues Auswerteverfahren.

A new mathematical method is presented for calculation of cerebrospinal fluid (CSF) parameters. Intrathecal lumbal infusion test with constant flow technique was used. Resistance to CSF outflow R(p) and compliance C(p) are computed by continuous comparing the change of pressure response dp/dt during infusion and--dp/dt after infusion. Using of this method, it is not necessary to determine the pressure plateau at the steady-state between artificial volume loading and the rate of CSF outflow. With that we were able to minimize the physical load on the patient. The expressiveness of investigation is increased by printing graphs of pressure-dependent resistance CSF outflow and compliance.