Long-term results of arthroscopic repair of type II SLAP lesions in sports: assessment of return to pre-injury playing level and critical risk factors for complication.

PURPOSE: The management of isolated SLAP lesions is still debated especially in athletes. Aims of the study were: 1. to analyse our algorithm to treat SLAP lesions starting from the selection of patients for surgery and 2. to correlate the familiarity for diabetes and hypothyroid disorders with post-operative results. METHODS: Seventy-eight patients with isolated SLAP lesion were arthroscopically treated using knotless anchors and microfractures. All patients had a pre-operative and post-operative clinical examination according to Walch-Duplay, Constant, Rowe and Dash scores and interviewed for familiarity to diabetes and hypothyroid disorders. RESULTS: About 68.8% of patients solved pain with rehabilitation. About 29% of patients returned to the sports activities. About 32% of patients were no responder to physiotherapy and were arthroscopically treated. About 53.9% of patients responded excellent, 34.7% good, 3.8% medium and 7.6% poor results according to Walch-Duplay score. The Constant score increased from 64 to 95, the Rowe score from 48 to 96. The outcomes were significantly worse in patients with familiarity for diabetes. CONCLUSIONS: Microfractures and knotless anchor give long-term good results for the treatment of SLAP lesions in athletes. The familiarity for diabetes is an important risk factor that can lead to decreased outcomes.

The anti-proliferative effects of adiponectin on human lung adenocarcinoma A549 cells and oxidative stress involvement.

Adiponectin (Acrp30) plays an important role in energy metabolism and inflammation. Recently, in vivo serum Acrp30 levels have been reported to be correlated to risk of developing several types of cancers such as lung cancer, and in vitro studies have demonstrated a role for Acrp30 in the control of cell proliferation and survival. However, the molecular effects of Acrp30 on lung cancer have not yet been clearly defined. In the present study, we investigated the effects of different concentrations of Acrp30 on the A549 human alveolar epithelial cell line, an in vitro model of lung adenocarcinoma. A549 cells were exposed to various concentrations of Acrp30 and successively, proliferation, apoptosis and oxidative stress were evaluated by MTT test, caspase activity assay, flow-cytometry and western blotting analysis. Our results demonstrated that Acrp30 causes, in a time- and dose-dependent manner, a reduction of cell viability and duplication together with an increase in cell apoptosis rate. In addition, we found that Acrp30 induces an increase of lipid peroxidation evaluated by TBARS assay and a concomitant reduction of nitric oxide release, both markers of cellular oxidative stress. Taken together, our data on A549 cells provides new insight into potential involvement of Acrp30 on physio-pathologic mechanisms of lung diseases through interference with proliferation, apoptosis and oxidative status.

Adiponectin profile at baseline is correlated to progression and severity of multiple sclerosis.

BACKGROUND AND PURPOSE: Adiponectin is a cytokine linking energy metabolism and immune system. After being assembled, adiponectin circulates as oligomers of different molecular weight, i.e. low, medium and high (HMW) molecular weight. These have the most potent biological effects. Multiple sclerosis (MS) is an autoimmune disease of the human central nervous system. The aim of this study was to characterize the expression levels of both total adiponectin and its oligomerization state in the serum from 99 patients with MS at baseline (i.e. not influenced by therapies). We also investigated the potential relationships between adiponectin and disease progression and severity. METHODS: Adiponectin was quantified and visualized by enzyme-linked immunosorbent assay, western blotting and fast protein liquid chromatography. During the follow-up (3.6 ± 2.20 years), the patients were evaluated using total annualized relapse rate and Expanded Disability Status Scale score. RESULTS: Total adiponectin is statistically higher in patients with MS compared with matched controls (12.18 vs. 10.02 µg/mL, P = 0.001). Interestingly, the adiponectin oligomerization state is altered in MS, with an increase of HMW oligomers. In addition, patients with MS with higher levels of adiponectin at baseline have significantly higher risk of progression and severity (Multiple Sclerosis Severity Score, 3.84 vs. 2.44, P = 0.001). No statistical difference in adiponectin expression was found between active and inactive patients with MS and among the different forms of disease. CONCLUSIONS: This study demonstrated that adiponectin and its HMW oligomers are greatly involved in MS autoimmune disorder representing a potential biomarker to predict worse MS prognosis and severity. Further studies are required to clarify the molecular mechanisms underlying the properties of adiponectin and HMW oligomers in MS.

Adiponectin and colon cancer: evidence for inhibitory effects on viability and migration of human colorectal cell lines.

Adiponectin (Acrp30) is an adipokine widely studied for its beneficial metabolic and anti-inflammatory properties. Colorectal cancer is among the most common cancers worldwide. The aim of present study was to explore the effects of Acrp30 on both CaCo-2 and HCT116 colorectal cancer cells in terms of viability, oxidative stress, and apoptosis. In addition, since colorectal cancer represents a typical inflammation-related cancer, we investigated whether Acrp30 treatment modifies the migration and the expression of crucial proteins in the EMT transition. Finally, we analyzed the expression of cytokines in CaCo-2 cells. We found that Acrp30 reduces the survival rate of both CaCo-2 and HCT116 cells through induction of apoptosis and oxidative stress already after 24 h of treatment. In addition, wound-healing assay indicated that Acrp30 exposure statistically inhibits CaCo-2 and HCT116 cell migration. Western blot analysis performed on E-cadherin and vimentin, two EMT crucial markers in carcinogenesis, indicated that Acrp30 does not influence EMT transition. Finally, we found a reduction of mRNA levels corresponding to the anti-inflammatory IL-10 cytokine together with an increase of the pro-inflammatory IL-6 and IL-8 cytokines. This study provides new insight into Acrp30 molecular effects on colorectal cancer cells. Indeed, even if further studies are necessary to clarify the precise role of Acrp30 in colorectal cancer, our data strongly suggest that Acrp30 negatively regulates cell survival and migration in association with induction of oxidative stress and regulation of cytokines expression in both CaCo-2 and HCT116 colorectal cells.

AllergoOncology - the impact of allergy in oncology: EAACI position paper.

Th2 immunity and allergic immune surveillance play critical roles in host responses to pathogens, parasites and allergens. Numerous studies have reported significant links between Th2 responses and cancer, including insights into the functions of IgE antibodies and associated effector cells in both antitumour immune surveillance and therapy. The interdisciplinary field of AllergoOncology was given Task Force status by the European Academy of Allergy and Clinical Immunology in 2014. Affiliated expert groups focus on the interface between allergic responses and cancer, applied to immune surveillance, immunomodulation and the functions of IgE-mediated immune responses against cancer, to derive novel insights into more effective treatments. Coincident with rapid expansion in clinical application of cancer immunotherapies, here we review the current state-of-the-art and future translational opportunities, as well as challenges in this relatively new field. Recent developments include improved understanding of Th2 antibodies, intratumoral innate allergy effector cells and mediators, IgE-mediated tumour antigen cross-presentation by dendritic cells, as well as immunotherapeutic strategies such as vaccines and recombinant antibodies, and finally, the management of allergy in daily clinical oncology. Shedding light on the crosstalk between allergic response and cancer is paving the way for new avenues of treatment.

Differentially expressed and activated proteins associated with non small cell lung cancer tissues.

BACKGROUND: Lung cancer is a leading cause of mortality. The most common cancer subtype, non small cell lung cancer (NSCLC), accounts for 85-90% all cases and is mainly caused by environmental and genetic factors. Mechanisms involved in lung carcinogenesis include deregulation of several kinases and molecular pathways affecting cell proliferation, apoptosis and differentiation. Despite advances in lung cancer detection, diagnosis and staging, survival rate still remains poor and novel biomarkers for both diagnosis and therapy need to be identified. In the present study, we have explored the potential of novel specific biomarkers in the diagnosis of NSCLC, and the over-expression/activation of several kinases involved in disease development and progression. METHOD: Lung tumor tissue specimens and adjacent cancer-free tissues from 8 NSCLC patients undergoing surgery were collected. The differential activation status of ERK1/2, AKT and IKBα/NF-κß was analyzed. Subsequently, protein expression profile of NSCLC vs normal surrounding tissue was compared by a proteomic approach using LC-MS MS. Subsequently, MS/MS outputs were analyzed by the Protein Discoverer platform for label-free quantitation analysis. Finally, results were confirmed by western blotting analysis. RESULTS: This study confirms the involvement of ERK1/2, AKT, IKBα and NF-κß proteins in NSCLC demonstrating a significant over-activation of all tested proteins. Furthermore, we found significant differential expression of 20 proteins (Rsc ≥ 1.50 or ≤ -1.50) of which 7 are under-expressed and 13 over-expressed in NSCLC lung tissues. Finally, we validated, by western blotting, the two most under-expressed NSCLC tissue proteins, carbonic anhydrase I and II isoforms. CONCLUSION: Our data further support the possibility of developing both diagnostic tests and innovative targeted therapy in NSCLC. In addition to selective inhibitors of ERK1/2, AKT, IKBα and NF-κß, as therapeutic options, our data, for the first time, indicates carbonic anhydrase I and II as attractive targets for development of diagnostic tools enabling selection of patients for a more specific therapy in NSCLC.

Evaluation of salivary adiponectin profile in obese patients.

Obesity is a chronic inflammatory disease significantly risen worldwide, especially among children. Adipokines, secreted from adipose tissue, are hormones involved in various cellular processes such as energy metabolism and inflammation. Among the others, adiponectin is gaining increasing interest for its insulin-sentitizing, anti-atherogenic and anti-inflammatory properties. This adipokine undergoes different post-translational modifications, after which it circulates as oligomers of high, medium and low molecular weight (HMW, MMW, LMW); HMW are the most biologically active oligomers. Serum adiponectin levels as well as the amount of its oligomers are inversely correlated to BMI and closely associated with obesity and related diseases. In this study, we analyzed total adiponectin expression and its oligomeric profile in saliva samples from 27 obese compared to 27 age- and sex-matched controls. Moreover, we compared adiponectin oligomerization between serum and saliva samples. The analysis of the different adiponectin oligomers reveals a slightly higher expression of total, HMW and LMW salivary adiponectin in obese patients compared to controls. Finally, FPLC analysis evidenced that HMW oligomers in saliva have a higher molecular weight than in serum confirming the presence of more complex oligomers in saliva, previously identified as super HMW (S-HMW). Saliva is considered a potential source of novel biomarkers for the diagnosis of metabolic disorders. The assessment of total adiponectin and its oligomeric profiles in saliva samples may represent a promising biological marker for the analysis of metabolic diseases.

Tissue-specific downregulation of the adiponectin "system": possible implications for fat accumulation tendency in the pig.

Adiponectin's beneficial effects are mediated by the AdipoR1 and AdipoR2 receptors (AdipoRs). The pig is a good model to study complex disorders such as obesity. We analyzed the expression of adiponectin, AdipoRs and some key molecules of energy metabolism (AMP-activated protein kinase α [AMPKα], p38 mitogen-activated protein kinase [p38 MAPK], and PPARα) in 2 pig breeds that displayed an opposite genetic behavior for energy metabolism: Casertana (CE), a fat-type animal, and Large White (LW), a lean-type animal. Muscle, liver, visceral and subcutaneous adipose tissues, and brain tissues were examined. The AdipoRs cDNA sequences were identical in the 2 breeds. AdipoRs mRNA expression, measured in all tissues, was significantly lower only in the 2 adipose tissues of CE pigs (P < 0.05). The muscle expression of AdipoRs, AMPKα, p38 MAPK, and PPARα was lower in CE than in LW animals (P < 0.01, P < 0.05, P < 0.01, P < 0.01, respectively). In liver, no molecule differed between breeds. The expression of both AdipoRs in visceral and subcutaneous adipose tissues was lower in CE pigs (P < 0.01). In brain, AdipoR1 and AMPKα expression was lower in CE pigs (P < 0.01), whereas AdipoR2 tended to be lower in CE than LW pigs (P = 0.05). In conclusion, our results suggest that tissue-specific downregulation of Adiponectin, AdipoRs, and of the key molecules of energy metabolism may be associated with the tendency of CE pigs to accumulate fat.

[Health status of women at work: work risks and living conditions]. / La salute delle donne al lavoro: interferenze tra rischi lavorativi e condizioni di vita.

The increase of women at work calls for a new attention to a full health protection, besides the fertility and reproduction. Health Surveillance in workplaces can give much information about health state of women and men, when the evaluation takes into account physiological and social differences between the sexes. The study reports the health data from a working population, 675 women and 7991 men, employed in different work activities. The results showed no significant difference of health state between women and men, except a greater prevalence of the respiratory pathologies in men and psychosomatic disorders in women. Prevalence of muscle-skeletal diseases, psychosomatic disorders and recurring headache have been higher in married than in unmarried women. among married women, prevalence of pathologies have been related to number of children. No difference have been found between unmarried and married men, except a greater prevalence of psychic disorders in youngest. Results confirm the interaction between domestic and working load on health state of women. Under the same work conditions, women are subjected to a higher physical and mental load that reduces the endurance of strain and stress and increases the prevalence of some pathologies, as musculoskeletal chronic degenerative diseases and psychological disorders.

[Smoking habit among workers in Campania region]. / L'abitudine al fumo nei lavoratori Campani.

Smoking is still now the main avoidable cause of disease, disability and mortality in industrialized countries. This habit is still very common in workplaces, where anti-smoke efforts seem to be less incisive than among general populations. The study analyzed the diffusion of smoke habit in 8111 male workers in Campania region, employed in different work activities (white collars, blue collars, drivers, cleaning civil servants, porters), so as to evaluate work related features, affecting its assumption and maintenance. Among all workers, smokers prevalence (42.7%) was higher than national male population. Percentages of smokers were highest among drivers (60.7%) and civil servants (52.5%), slightly lower among industry workers (47.3%) and lower among white collars (36.4%). The highest prevalence were found in 41-50 years age group (46.8%), but only among white collars aging was associated with higher smokers prevalence. Lower education degrees and two working variables, shifts and handwork, have been related with significantly smoking habit assumption. Results emphasized that health promotional programs are necessary to reduce smoke habit among workers, particularly among professionally and culturally unqualified subgroups.

[Subjective perception of maladjustment risk factors]. / La percezione soggettiva dei fattori disadattanti al lavoro.

Maladjustment at work results from organizational and relational features of the work, the so-called fourth type factors; they include working hours, ways and contents of working activities, and horizontal and vertical business relations. The study reports the percentage of sensed disturbing factors in workers with maladjustment and disaffection at work. Data have been taken from 1382 white collars, 1117 males and 265 females, observed from January 2006 to June 2007 for Health Surveillance. Maladjustment prevalence was higher in females than in males. As individual variables, ageing and family care increased the prevalence of maladjustment among females, whilst a higher prevalence of maladjustment were found in youngest and unmarried males. A very different perception of work harmfulness were found between sexes. As risk factors, female have denounced more wear and tear and authoritarian management; male denounced physical strain.

T lymphocyte proliferative capability to defined stimuli and costimulatory CD28 pathway is not impaired in healthy centenarians.

It is generally assumed that T cell proliferation is impaired in aged individuals. We report data on the proliferative capability of peripheral blood mononuclear cells (PBMC) and T lymphocytes from 40 healthy people of different ages, (19-107 years), including 14 centenarians, to defined mitogenic stimuli. We observed no age-related proliferative impairment both in PBMC and in purified T cells stimulated by anti-CD3 mAb or phorbol myristate acetate (PMA). Furthermore, T cells stimulated by anti-CD3 mAb or PMA and costimulated by CD28 mAb did not proliferate differently among young, middle aged subjects and centenarians. Thus, short term T cell proliferation is not affected even at extreme age when well defined stimuli are used on cells deriving from carefully selected healthy subjects.

Compromiso nervio craneal en cáncer de próstata metastico / Craneal nerves compromised with metastasic prostate cancer

Es usual en el Cáncer de Próstata avanzado la metástasis ósea, pero no su localización en los huesos de la base del cráneo con compromiso de pares craneales. El propósito de este trabajo es presentar un caso clínico con afectación única del VI par craneal por invasión ósea metastásica con buena respuesta sintomático al tratamiento. Se trata de un paciente de 62 años con alteraciones del nervio motor ocular externo, debido a metástasis óseas de un cáncer de Próstata avanzado, diagnosticado 2 años antes. La sintomatología consistió en mareos, diplopia y cefalea. La TAC de Cráneo y el Centellograma Oseo demostraron metástasis en toda la calota y base del cráneo. Como tratamiento recibió radioterapia externa ( RTE) 4.000 cgy en los huesos de la base del cráneo. Se obtuvo la resolución completa del déficit neurológico, con el alivio de los síntomas concomitantes. Sin embargo a los 5 meses la enfermedad continuó su evolución hasta fallecer 2 meses después. La conclusión es que la aparición de la afectación neurológica descripta ensombrece el pronóstico, aunque el tratamiento radiante mejore transitoriamente los síntomas y la calidad de vida

Expansion of cytotoxic CD8+ CD28- T cells in healthy ageing people, including centenarians.

Ageing is associated with complex remodelling in the phenotypic and functional profiles of T lymphocytes. We investigated whether expression of CD28 antigen on T cells is conserved throughout adulthood and ageing in humans. For this purpose we analysed T cells obtained from peripheral blood of 102 healthy people of ages ranging from 20 to 105 years. We found an age-related increase of CD28- T cells in percentage and absolute number, predominantly among CD8+ T cells. CD28- T cells from aged donors analysed by flow cytometry appeared as resting cells (not expressing CD25, CD38, CD69, CD71, DR), bearing markers of cytotoxic activity (CD 11b and CD 57) and with a phenotype compatible with 'memory' cells (up-regulated CD2 and CD11a; CD62L absent). At the functional level, freshly isolated purified CD28- CD8+ T cells showed high anti-CD3 redirected cytotoxic activity against Fc-bearing P815 cells. The same activity tested on freshly isolated bulk T lymphocytes was significantly augmented with age. We found a positive correlation between age, number of CD8+ CD28- T cells and anti-CD3 redirected cytotoxicity by freshly isolated T cells. These data suggest that an activation of unknown nature within the cytotoxic arm of the immune system occurs with age. We speculate that these cytotoxic T lymphocytes (CTL) in vivo may constitute armed effector cells for immediate killing of targets bearing peptides from pathogens of intracellular origin.

Extensión del uso prenatal de corticoides para la inducción de la madurez pulmonar fetal / Extension of the prenatal use of corticoids for the fetal lung maturation

Al no hallar datos de nuestro país acerca de la extensión del uso prenatal de corticoides para la inducción de la madurez pulmonar fetal, nos propusimos efectuar una encuesta con un diseño de observación descriptiva, aprovechando las actividades docentes de nuestro grupo, tomando nota además, del nivel de capacitación de los profesionales consultados. Se interrogó acerca del uso rutinario o no de corticoides solos o asociados con TRH en 4 situaciones clínicas: amenaza de parto prematuro y rotura prematura de membranas antes de las 30 semanas de gestación y entre las 30 y 34 semanas. También se dieron 3 opciones para justificar el uso no rutinario. Fueron obtenidas 101 respuestas. En la amenaza de parto prematuro el uso rutinario alcanzó casi el 85 por ciento, mientras que en la rotura prematura de membranas varió entre el 58 por ciento y el 63 por ciento según la edad gestacional. Tanto en la amenaza de parto prematuro como en la rotura prematura de membranas la frecuencia de asociación corticoides-TRH fue significativamente mayor en el grupo menor de 30 semanas con respecto al grupo entre 30 y 34 semanas, siendo el principal argumento para no usarlo sistemáticamente la carencia de efecto beneficioso (AU)

Extensión del uso prenatal de corticoides para la inducción de la madurez pulmonar fetal / Extension of the prenatal use of corticoids for the fetal lung maturation

Al no hallar datos de nuestro país acerca de la extensión del uso prenatal de corticoides para la inducción de la madurez pulmonar fetal, nos propusimos efectuar una encuesta con un diseño de observación descriptiva, aprovechando las actividades docentes de nuestro grupo, tomando nota además, del nivel de capacitación de los profesionales consultados. Se interrogó acerca del uso rutinario o no de corticoides solos o asociados con TRH en 4 situaciones clínicas: amenaza de parto prematuro y rotura prematura de membranas antes de las 30 semanas de gestación y entre las 30 y 34 semanas. También se dieron 3 opciones para justificar el uso no rutinario. Fueron obtenidas 101 respuestas. En la amenaza de parto prematuro el uso rutinario alcanzó casi el 85 por ciento, mientras que en la rotura prematura de membranas varió entre el 58 por ciento y el 63 por ciento según la edad gestacional. Tanto en la amenaza de parto prematuro como en la rotura prematura de membranas la frecuencia de asociación corticoides-TRH fue significativamente mayor en el grupo menor de 30 semanas con respecto al grupo entre 30 y 34 semanas, siendo el principal argumento para no usarlo sistemáticamente la carencia de efecto beneficioso

[Epidemiologic study of femoral neck fractures in the province of Parma (1980-1992)]. / Indagine epidemiologica sulle fratture del collo del femore nella provincia di Parma (1980-1992).

Fractures of the femoral neck are one of the most important and severe complications of osteoporosis. To obtain up-to-date estimates on the frequency of these fractures in the province of Parma, a city of northern Italy, a retrospective study on the incidence of hip fractures has been carried out examining the operative records of all the orthopedic departments serving the whole province. Between January 1980 and December 1992, 3774 operations for hip fractures were performed, with a marked prevalence in women (2830 women and 944 men) and an exponential increase with age in both sexes. The incidence of extracapsular hip fractures was slightly higher and in women increased more rapidly with age than intracapsular fractures. Approximately 3 fractures out of 4 in women and 2 out of 3 in men occurred after the age of 75. Between 1980 and 1992, the age-adjusted annual incidence rose significantly by 7.1 cases per 100,000 per year in women and by 2.7 cases per 100,000 per year in men. When compared to other populations, these estimates indicate that the incidence of hip fractures in this province of Northern Italy is lower than that reported in other countries, especially in Northern Europe.

Different effects of delta-sleep-inducing peptide on arginine-vasopressin and ACTH secretion in normal men.

UNLABELLED: Delta-sleep-inducing peptide (DSIP) is a well-known inhibitor of pituitary ACTH secretion. In order to evaluate the possible influence of DSIP on basal arginine-vasopressin (AVP) secretion and/or on the AVP-response to osmotic and pressure/volumetric stimuli, DSIP (25 nmol/kg) was infused in 10 min to 8 normal men (23-34 years old) just before a 2-hour infusion of normal saline (NaCl 0.9%; DSIP test) or hypertonic saline (0.51 M NaCl; osmotic test) or before an orthostatic test (standing upright and maintaining an orthostatic position for 20 min). In different occasions, a 10-min infusion of normal saline (placebo) was given instead of DSIP. In an additional 7 subjects, DSIP or placebo was given 60 min before hypertonic saline or the orthostatic test. The results obtained after the administration of DSIP at time 0 and at -60 min were similar. RESULTS: The administration of DSIP or normal saline alone did not change the concentrations of circulating AVP. A slight physiological decline in ACTH levels was observed during saline infusion, whereas a significant decrease in ACTH levels was induced by DSIP administration. Osmotic stimulation of AVP secretion by hypertonic NaCl induced a significant increase in plasma AVP concentrations which was not modified by DSIP administration. The ACTH secretory patterns during hypertonic NaCl and hypertonic NaCl plus DSIP were similar to those observed during normal saline and normal saline plus DSIP, respectively. The orthostatic test provided similar plasma AVP increments, regardless of the previous treatment with DSIP.(ABSTRACT TRUNCATED AT 250 WORDS)

Transurethral radio frequency thermotherapy for symptomatic benign prostatic hyperplasia.

A total of 90 patients with symptomatic benign prostatic hyperplasia (BPH) were treated with transurethral radio frequency thermotherapy. The treatment consisted of one 180-min session at 48 degrees C. All patients were evaluated before treatment and 80 (10 with urinary retention) were reevaluated at 3 months for follow-up. The analysis of the results of this group of patients is the subject of this presentation. Results were defined according to the variation in three parameters: nocturia, symptomatic score (Madsen) and urinary peak flow. Improvement (defined as a change of 50% or more in any of the three measured parameters) was found in 78% of the patients. Improvement in all of the above-mentioned parameters was found in 34.08% of the patients. In 29.82% of the patients improvement was found in two parameters and 14.02% of the patients improvement was found in one parameter and none in 21.30%. The percent variations in each parameter before and after treatment were: nocturia and symptom score decreased by 33.33% and 50%, respectively, and urinary peak flow increased by 33.65%. Age was the most important predictive factor. Of the patients under 65 years of age, 85% showed very good and good results. In comparison, only 42% of the patients over 65 years showed similar results. Immediate complications were 4 cases of acute urinary retention (5.71%) and 4 cases of urinary infection (5.71%). Transurethral radio frequency thermotherapy, having a low toxicity and complication rate, has comparable results to other nonsurgical treatment modalities. It is a viable alternative treatment for symptomatic BPH.(ABSTRACT TRUNCATED AT 250 WORDS)