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ANTI-AGING
BIOMEDICINE.
HIGH TECH BIO-MEDICAL TECHNOLOGIES FOR DISEASE TREATMENT
AND LIFE EXTENSION.
EXPERIMENTAL AND CLINICAL DATA.
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Department of Nuclear Medicine,
Inha University School of Medicine, Incheon 400103,
Korea.
AIM: To investigate the value
of Tc-99m ciprofloxacin imaging in the differential
diagnosis of chronic bacterial prostatitis. METHODS:
The study included 4 normal subjects as the negative
controls, 2 patients with acute prostatitis or cystourethritis
as the positive controls and 59 patients diagnosed
as chronic bacterial prostatitis or chronic pelvic
pain syndrome by traditional laboratory tests. In
every subject, the single photon emission computerized
tomography images were obtained 3 h after intravenous
injection of Tc-99m Ciprofloxacin. The results of
the imaging were compared with those of laboratory
tests. RESULTS: On the images, negative uptake was
observed in all normal subjects, while strong hot
uptake, in the whole prostate of acute prostatitis
patients and in the whole urethra of acute cystourethritis
patients. In 13 (68%) of 19 patients categorized as
chronic bacterial prostatitis by standard laboratory
tests, hot uptake with less intensity than that of
acute prostatitis was observed in the prostate area
around the prostatic urethra. Negative uptake in the
prostate was observed in 6 of 19 patients (32%) categorized
as chronic bacterial prostatitis. Interestingly, hot
uptake in the prostate was exhibited in 28 (70%) of
the 40 patients categorized as chronic pelvic pain
syndrome. CONCLUSION: Tc-99m ciprofloxacin imaging
is helpful in the differential diagnosis of prostatitis
syndrome.
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Institute of Family Planning
Research, Tongji Medical College, Huazhong University
of Science & Technology, Wuhan, Hubei 430030,
China.
OBJECTIVES: To evaluate the
diagnostic value of infrared image system for chronic
prostatitis(CP) and benign prostatic hyperplasia (BPH).
METHODS: Fifteen patients with CP, 17 patients with
BPH and 15 healthy volunteers were examined by infrared
image system. The infrared thermal images were analyzed.
RESULTS: Compared with healthy volunteers, CP and
BPH group had significantly different in infrared
thermal image of prostate, but there were no significant
differences between CP and BPH group. CONCLUSIONS:
Infrared image system is a useful tool to screen the
prostatic diseases.
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Department of Pathology, The
Johns Hopkins Medical Institutions, Baltimore, MD,
USA.
Pathologists frequently sign
out benign prostate needle biopsies as "benign
prostatic hyperplasia (BPH)". There are no data
indicating that a diagnosis of BPH on biopsy correlates
with either gland weight or with the International
Prostate Symptom Score (IPSS) used to measure urinary
obstructive symptoms. We examined biopsies for average
percentage of glands and average percentage of glands
with papillary infolding per case, maximum percentage
of glands and maximum percentage of glands with papillary
infolding per core per case, and presence of any stromal
nodules per case. BPH was measured in 2 ways: (1)
IPSS grouped into 3 categories (mild, moderate, severe)
and (2) prostate weight at radical prostatectomy in
men with limited cancer. IPSS was classified as follows:
mild (n = 12), moderate (n = 13), and severe (n =
10). There was no correlation with IPSS and any of
the histologic features measured. For the 41 radical
prostatectomy specimens, the average weight was 65.3
g (median, 56.0 g, range, 22 to 117 g). There was
no correlation between gland weight and the average
or maximum percentage of glands, or average or maximum
percentage of glands with papillary infolding. Stromal
nodules on biopsy correlated with gland weight. In
the 30 cases without stromal nodules on biopsy, the
mean gland weight was 51.4 g. In the 11 cases with
stromal nodules on biopsy, the mean gland weight was
77.4 g (P = 0.0125). However, stromal nodules were
not specific for a large prostate (i.e., a 15 g prostate
had stromal nodules on biopsy). With the exception
of stromal nodules found on biopsy, histologic findings
on biopsy are not specific for either clinical or
pathologic BPH. Thus benign prostate biopsies should
be signed out merely as "benign prostate tissue."
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Servicio de Analisis Clinicos.
Departamento de Ciencias Morfologicas y Cirugia. Hospital
Universitario Principe de Asturias. Alcala de Henares.
Madrid.
BACKGROUND: PSA (prostatic
specific antigen) is the most used tumor marker to
monitor prostate cancer (PC). It is an acceptably
sensitive test. Molecular forms of PSA give a chance
to improve its specificity. We have evaluated the
usefulness of the ratio free PSA/total PSA (f-PSA/t-PSA%)
to diagnose prostate cancer, in the range between
4 and 20 ng/ml; i.e. the interval in which values
overlap for patients with PC and benign prostatic
hyperplasia (BPH) in our environment. PATIENTS AND
METHODS: Prospective study on 269 patients, 73 with
PC and 196 with BPH. Both t-PSA and f-PSA were determined
using microparticles enzyme immune assay (MEIA) with
AXSYM (Abbott) analyzer. RESULTS: Statistically significant
differences were evidenced in f-PSA/t-PSA% for patients
with PC vs. BPH; but that did not happen for t-PSA
values. Sensitivity and specificity values were established
for different cut-off points. ROC curve analysis proved
diagnostic efficacy was better for f-PSA/t-PSA% than
for t-PSA. CONCLUSIONS: f-PSA/t-PSA percentage is
a useful tool for the differential diagnosis between
PC and BPH. A ratio lower than 12% selects a population
with high risk of cancer. A percentage over 18% is
useful to avoid or delay the indication of biopsy.
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The computer program "Prostate"
(Windows, 1.0 version) is designed to assist the urologist
in: objective assessment of the lower urinary tract
in benign prostatic hyperplasia (BPH), accumulation
and storage of information on the patients (data file),
comparison (text, graphics) with previous data to
control the course of the disease, treatment efficacy,
to refer to international recommendations and recent
advances in the treatment of both BPH and its complications.
The status of the lower urinary tract is to be described
basing on the IPSS and QOL tables, PSA findings, rhythm
of spontaneous uresis, uroflowmetry, residual urine,
prostate size, laboratory and microbiological urinalysis.
The program "Prostate" is a new step in
medical recording and efficacy of BPH treatment assessment
in urology.
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Arzt fur Allgemeinmedizin, Munchen.
Despite the availability of
modern urological methods, the diagnosis and therapy
of benign prostatic hypertrophy (BPH) continues to
present problems that are due in part to the discrepancy
between the patient's subjective symptoms and the
objective findings. With the aim of achieving a "clear"
picture of the actual indication or treatment, a differentiated
approach involving a careful waighing up of the patient's
history, symptoms, basic laboratory investigations
and the use of conventional sonography would be desirable
in the doctor's office. The present paper describes
a rational concept for the "interface" between
the general practitioner's office and that of the
specialist.
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