Prostate artery embolization for the treatment of urinary retention caused by large (>80 ​mL) benign prostatic hyperplasia: Results of 21 patients

ObjectiveA large prostate size (>80 ​mL) of benign prostatic hyperplasia (BPH) is technically challenging to treat surgically. This study aimed to investigate the safety and efficacy of super-selective prostatic artery embolization (PAE) for the treatment of urinary retention caused by large BPH.MethodsA total of 21 patients with urinary retention, indwelling urinary catheter, or suprapubic cystostomy as a consequence of giant BPH (prostate volume [PV] ​> ​80 ​mL) who sought treatment between January 2013 and December 2017 were enrolled. A microcatheter (1.9–2.7 Fr) and a “two-step embolization” combining 50-μm and 100-μm polyvinyl alcohol embolization particles were used in all patients. International Prostate Symptom Score (IPSS), quality of life (QoL), PV, and prostate-specific antigen (PSA) were evaluated at 3, 6, and 12 months post-PAE. Clinical success was defined as removal of urinary catheter or suprapubic cystostomy and ability to void spontaneously.ResultsThe clinical success rate was 95.2% (20/21). Compared with pre-procedural values, IPSS, QoL, PV, and PSA showed statistically significant differences at 3, 6, and 12 months post-PAE (P ​< ​0.05). There were no serious complications after PAE.ConclusionsPAE was safe and effective for the treatment of urinary retention caused by large BPH in patients without surgical treatment options.     

Genetics and susceptibility to toxic chemicals: do you (or should you) know your genetic profile?

This review is based on a symposium/roundtable session, sponsored by the Division of Toxicology of the American Society for Pharmacology and Experimental Therapeutics, that was held at the 2002 Experimental Biology meeting in New Orleans, LA. The focus is on the role of pharmacogenomics in determining individual susceptibility to chemically induced toxicity. An individual's risk of disease from exposure to toxic chemicals is determined by a complex interplay between genetics, physiology, and concurrent or prior exposures to drugs and other chemicals. The first section of the review defines the basics of pharmacogenetics and pharmacogenomics and assesses the current state of the science. Selected applications to specific enzyme systems are summarized by way of example. New, state-of-the-art approaches to studying genetic determinants of susceptibility, including analytical methods and transgenic technology, are then discussed. Finally, ethical and legal concerns with the application of this knowledge and methodology to human health will be discussed.     

Antifungal susceptibility of 262 bloodstream yeast isolates from a mixed cancer and non-cancer patient population: is there a correlation between in-vitro resistance to fluconazole and the outcome of fungemia?

The aim of this study was to test the antifungal susceptibility of 262 bloodstream yeast isolates (164 Candida albicans strain, 88 non-albicans Candida spp. and 10 non-Candida yeasts) recovered from 169 surgical, neonatal, critically ill intensive care unit patients (ICU), and cancer patients (mixed patient population) to amphotericin B (AmB), fluconazole (FLU), 5-flucytosine (5-FC), itraconazole (ITRA), ketoconazole (KETO), miconazole (MICO), and nystatin (NYS), in order to correlate in-vitro resistance to fluconazole with the outcome of fungemia. The agar disk diffusion test was used to assess the susceptibility of the 262 bloodstream yeasts isolates. In addition, 78 strains isolated from cancer patients were also tested with the E-test. There were no differences in the susceptibility of the various C. albicans strains tested, except in 40 isolates from surgery patients, which showed a somewhat lower susceptibility to KETO and MICO to (3.7–5.5% resistance). There were no C. albicans strains resistant to AmB, NYS, or FLU. There were slight differences in the susceptibility patterns of the 88 non-albicans Candida spp. (NAC) isolates. Resistance to AmB and NYS appeared in 1 strain of C. guillermondii (minimum inhibitory concentration; MIC to AmB; 4 μg/ml) and in 1 strain of C. parapsilosis (MIC to NYS, 8 μg/ml and MIC to AmB, 2 μg/ml). All other NACs were susceptible to both polyenes (AmB and NYS). Nine of the 11 strains of C. krusei were resistant to FLU (MIC ≥ 64 μg/ml), the 2 exceptions showed, respectively, MICs for FLU of 6 and 32 μg/ml ("dose-dependent" susceptibility). However, only 2 of 29 C. glabrata strains were fully FLU-resistant (MIC ≥ 64 μg/ml), 27 being susceptible with MIC values of 0.5–8 μg/ml. Apart from 9 C. krusei and 2 C. glabrata strains, 2 C. parapsilosis strains and 1 strain of C. tropicalis were also FLU-resistant. Among the 88 NACs, 17.04% were FLU-resistant and 3.7% were KETO- and ITRA-resistant. Resistance to 5-FC and AmB was minimal. We compared the outcomes of patients infected with FLU-resistant vs FLU-susceptible yeasts in 161 evaluable patients treated with FLU. Attributable mortality was significantly higher (19.0% vs 8.6%; P < 0.01) in patients infected with the FLU-resistant yeasts. Received: March 27, 2000 / Accepted: September 11, 2000     

RANK ligand inhibition in bone metastatic cancer and risk of osteonecrosis of the jaw (ONJ): non bis in idem?

Purpose  

The purpose of this study was to assess the necessity of post-marketing safety monitoring focused on osteonecrosis of the jaw (ONJ) in patients with bone metastatic cancer treated with denosumab (AMG162).     

Examination of couples�� attachment security in relation to depression and hopelessness in maritally distressed patients facing end-stage cancer and their spouse caregivers: a buffer or facilitator of psychosocial distress?

Purpose  

The purpose of this study is to determine levels of depression and hopelessness and to explore the relationship between attachment security and psychosocial distress in patients with metastatic/recurrent cancer and spouse-caregivers, experiencing marital distress.     

Volumes of normal ovaries,ovaries with benign lesions,and ovaries with cancer in menopausal women: Is there an optimal cut‐off value to predict malignancy?

PURPOSE: To evaluate different ovarian volume cut-off values to distinguish between normal ovaries, benign lesions, and malignant lesions in menopausal women. METHODS: Transvaginal sonographic ovarian volume measurements were performed in 362 menopausal patients prior to gynecologic surgery. Based on the histopathologic results, a total of 466 ovaries were divided into 3 groups: normal ovary, benign lesion, and malignant tumor. Different ovarian volume cut-off values were analyzed via receiver operating characteristic curves to determine the optimal cut-off value. RESULTS: The mean ovarian volumes in the normal ovary, benign lesion, and malignant tumor groups were 3.4 +/- 2.2 cm3 (range, 0.6-9.6 cm3), 102 +/- 308 cm3 (range, 0.3-3543 cm3), and 368 +/- 1176 cm3 (range, 8.1-9908) cm3, respectively. Cut-off values of 8 cm3 and 10 cm3 to distinguish between malignant and nonmalignant lesions had a sensitivity of 100% and 97% and a specificity of 39% and 45%, respectively. CONCLUSION: In menopausal patients, any ovary with a volume >8 cm3 can potentially harbor a cancer.     

Reactive oxygen species (ROS): pathogens or sources of vital energy? Part 2. Bioenergetic and bioinformational functions of ROS

In Part 1 of the review of experimental data concerning reactive oxygen species (ROS) production and use, their indispensable role in regulation of multiple physiologic processes is examined. Part 2 considers the unique property of reactions in which ROS participates, the generation of energy of electronic excitation (EEE). Because of incessant ROS cycling, EEE is continuously produced in aerobic organisms. It may be used as an energy activator for multiple biochemical reactions and also may function as a specific signaling factor. This approach allows the perception of the beneficial effects of hydrogen peroxide, ozone, other ROS therapy, and foods rich in antioxidants. Both insufficient production of ROS and distortions in their use may cause anomalies in coordination of ROS generation and use, resulting in the deranged operation of biochemical and physiologic processes and the development of pathology.