The effect of 5alpha-reductase inhibition with finasteride and dutasteride on bone mineral density in older men with benign prostatic hyperplasia.

Testosterone is converted to dihyrotestosterone by two isoenzymes of 5alpha-reductase. Finasteride and dutasteride are 5alpha-reductase inhibitors commonly used in the treatment of benign prostatic hyperplasia. We compared indices of bone mineral density in 50 men treated with finasteride, 50 men treated with dutasteride and 50 men as control. Bone mineral density of spine and hip were measured using dual energy X-ray absorptiometry. Bone formation was assessed by measuring serum osteocalcin and bone resorptionby measuring serum C-terminal telopeptide of collagen type 1. In addition serum total testosteron and estradiol were determined. The dutasteride group had significantly higher mean bone min- eral density, mean bone mineral content, mean T score, mean Z score at femoral neck and mean total hip Z score than control. Mean total testosterone and estradiol levels were higher in the dutasteride group. There were no significant dif- ferences between the groups in lumbar spine bone density parameters or bone turnover markers. Our results provide evidence that long-term 5alpha-reductase suppression does not adversely affect bone mineral density. Dutasteride therapy could have beneficial effect on bone density.

Importance of interincisal index for predicting mesiodistal crown diameters of canines and premolars.

The aim of this study was to examine the accuracy of regression equation for prediction of the mesiodistal diameter (MDD) of the crowns of canines and premolars (C, P1, P2), and to determine whether an incisal indexs can serve as a reliable predictor. MDD and vestibulooral diameter (VOD) of the crowns of central and lateral incisors (I1, I2), C, both P1, and P2, and first permanent molars (M1) in both jaws were measured on the plaster casts of 150 subjects (75 boys and 75 girls). The obtained measurements were compared and correlated with predicted values (by linear regression equation derived previously), with respect to gender, jaw side and value of the interincisal index. The correlation coefficients between measurements and predicted MDD of the C, P1, and P2 were calculated with respect to gender and jaw. The values varied from 0.62 to 0.81. It could be concluded that normal values of the interincisal index of the I1 and I2 are highly associated with measured and predicted MDD of the C, P1, and P2 crowns. Correlation coefficients ranged from 0.84 to 0.99.

The prevalence of supraventricular arrhythmias with regard to the type and degree of left ventricular hypertrophy in patients with hypertensive heart disease.

OBJECTIVES: We investigated the correlation between the type and degree of left ventricular hypertrophy and the prevalence of supraventricular arrhythmias in patients with hypertensive heart disease. METHODS: The study included 179 patients (79 men, 100 women, aged 43-80 years, median 68 years) with left ventricular hypertrophy. Patients were classified into three groups (concentric, eccentric and asymmetric types of hypertrophy) and into three subgroups (mild, moderate and severe hypertrophy). After discontinuation of all medication for 48 h, blood pressure was measured, electrocardiography and echocardiography performed and the prevalence of supraventricular arrhythmias assessed using Holter monitoring and bicycle ergometry. Antihypertensive drugs and duration of previous treatment were taken into consideration. RESULTS: Atrial fibrillation or paroxysmal supraventricular tachycardia were found in 43% of patients. The analysis showed no significant correlation between the prevalence of atrial fibrillation and/or paroxysmal supraventricular tachycardia and the degree (P = 0.607) and type of left ventricular hypertrophy (P = 0.455). However, the frequency of supraventricular premature beats was higher in the concentric and eccentric types than in the asymmetric type (P = 0.048) and increased with the degree of hypertrophy (significantly in men with the concentric type, P = 0.015). CONCLUSION: Concentric and eccentric types of left ventricular hypertrophy have a greater impact on the frequency of atrial arrhythmias. In the concentric type the prevalence of supraventricular premature beats correlates with the degree of left ventricular hypertrophy. Patients with moderate and severe concentric and eccentric left ventricular hypertrophy should be always tested using Holter monitoring and bicycle ergometry and treated with the maximum tolerable doses of antihypertensives, particularly with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers.

Strong nuclear EGFR expression in colorectal carcinomas is associated with cyclin-D1 but not with gene EGFR amplification.

BACKGROUND: Prognostic and predictive significance of epidermal growth factor receptor (EGFR) in colorectal carcinomas (CRCs) is still controversial. The aim of the present study was to explore and correlate membrane and nuclear EGFR and cyclin-D1 protein expression with EGFR gene status of tumor cells. METHODS: Immunohistochemical and FISH analysis was performed on 135 archival formalin fixed and paraffin embedded CRCs. RESULTS: Strong membrane and strong nuclear EGFR staining was detected in 16% and 57% of cases, respectively, and strong cyclin-D1 expression in 57% samples. Gene EGFR amplification was identified in 5.9% and polysomy in 7.4% of cases, while 87% showed no EGFR gene changes. A statistically significant difference was only found between tumor grade and expression of membrane EGFR, while nuclear EGFR and cyclin-D1 expression was not associated with the clinicopathologic characteristics analyzed. Tumor cells displaying gene amplification and strong protein membrane EGFR expression overlapped, while EGFR gene status showed no correlation with nuclear EGFR and cyclin-D1. There was no association between membrane EGFR and cyclin-D1, whereas nuclear EGFR expression was strongly related to cyclin-D1 expression. CONCLUSIONS: Study results revealed heterogeneity among CRCs, which could have a predictive value by identifying biologically and probably clinically different subsets of tumors with the possibly diverse response to anti-EGFR therapies.