D.-S. Yu

INCREASING EXPRESSION OF GST-pi, MIF, AND ID1 GENES IN CHEMORESISTANT PROSTATE CANCER CELLS

The differential expression of genes and related proteins of multidrug resistance in chemoresistant prostate cancer cell lines were elucidated in this study. RNA extracted from doxorubicin-resistant rat prostate cancer (PCa) cells (AT3/ADR1000) and native PCa cells was hybridized to expression arrays containing cDNAs from 588 known genes. Differential expression of selected genes was confirmed by quantitative reverse-transcription polymerase chain reaction (RT-PCR) analysis. Protein contents were measured by fluorescent flow cytometry and immunoblotting. Localization of selected proteins in cells was observed by immunocytochemical staining. Up-regulation of eleven genes and down-regulation of one single gene were displayed in the chemoresistant prostate cancer cells. Overexpression of mRNAs in macrophage migration inhibitory factor (MIF), DNA binding protein inhibitor 1 (ID1), and glutathione S-transferase-pi (GST-pi) were confirmed by gene-specific RT-PCR. Protein over-expression of GST-pi, MIF, and ID1 in resistant cells were 3.3-, 1.5-, and 1.5-fold to native cells, respectively. Immunocytochemistry revealed that GST-pi, MIF, and ID1 were present primarily in the cytoplasm of tumor cells, but ID1 also could be found in the nucleus. AT3/ADR1000 drug-resistant PCa cells displayed significantly increased expression of GST-pi, MIF, and ID1 proteins when compared with native PCa cells. It indicates these genes may play a role in drug resistance of prostate cancer.

GIANT HYDRONEPHROSIS OF A DUPLEX SYSTEM ASSOCIATED WITH URETERAL ECTOPIA: A CAUSE OF RETROGRADE EJACULATION

Retrograde ejaculation is an extremely rare complication of the ectopic ureter or ectopic ureterocele. In the literature, only two cases have been reported worldwide. In this article the authors describe a patient who has a completely duplicated collecting system with massive dilatation of the upper pole system, which has manifested as a huge abdominal and retroperitoneal mass, complicated by retrograde ejaculation.Retrograde ejaculation is an extremely rare complication of the ectopic ureter or ectopic ureterocele. In the literature, only two cases have been reported worldwide. In this article the authors describe a patient who has a completely duplicated collecting system with massive dilatation of the upper pole system, which has manifested as a huge abdominal and retroperitoneal mass, complicated by retrograde ejaculation.

AGGRESSIVE ANGIOMYXOMA OF THE SCROTUM

Aggressive angiomyxoma is a rare and nonmetastasizing soft tissue tumor of the pelvis and perineum and occurs almost exclusively in adult females. It infiltrates locally and has a high risk of local recurrence. Recommended treatment of the symptomatic patient is wide excision with tumor-free margins and close postoperative monitoring. Herein, a case of aggressive angiomyxoma in an adult male is described, which arose in the scrotum over 12 months. The tumor showed an intermediate signal on T1-weighted MRI images. Contrast-enhanced T1-weighted images showed good enhancement. Wide excision of the tumor was performed. The surgical specimen measured 7 2 5 2 5 cm in size and weighed 80 g. The tumors surface was smooth and had a gelatinous cut surface. Grossly, it was encapsulated with a pleura-like membrane and had a finger-like projection. Microscopically, sections showed many walled vessels of various sizes, collagen fibrils, a loose myxoid background, and spindle stroma cells. MRI and CT showed the angiomatous and myxomatous nature of the tumor wall. To the authors knowledge, this is the first report to describe MRI findings in scrotal angiomyxoma.

Conjugation of maturation-related wheat-germ-lectin-binding proteins to caput epididymal sperm in co-cultures with corpus epididymal epithelial cells of BALB/C mouse

In BALB/c mice, two maturation-related wheat-germ-binding glycoproteins (GP-49 and GP-83) are synthesized and secreted by corpus and cauda epididymis. A co-culture technique was used to investigate these glycoproteins in principal cells of corpus epididymis and the conjugation of these molecules on caput sperm. The principal cells were recovered from corpus epididymides of 4-week-old mice and cultured in RPMI 1640 medium supplemented with 10% fetal calf serum. After culturing for 3-4 days, most cells revealed epithelial cell-specific keratins in immunofluorescent localization with monoclonal antibody. By electron microscopy, a prominent nucleolus with well-extended euchromatin was revealed in the nucleus and the cytoplasm contained multivesicular bodies, and a well-developed Golgi apparatus with endoplasmic reticulum. By SDS-PAGE, GP-83 and GP-49 were revealed in the cell extracts and cell culture supernatants after incubation with 35S-methionine. Radiolabeled binding sites were also found on the surface of caput sperm co-cultured with the principal cells for 4 h in the presence of 35S-methionine. WGA-binding glycoproteins may be synthesized and secreted by the principal cells of corpus epididymis and conjugated to caput sperm during the epididymal transit.

IDENTIFICATION OF MATURATION-RELATED WHEAT-GERM LECTIN-BINDING PROTEINS IN THE CULTURE OF HUMAN CORPUS EPIDIDYMAL EPITHELIAL CELLS

This study is designed to investigate the synthesis of maturation-related wheat germ agglutinin (WGA) binding glycoproteins in the human corpus epididymal epithelial cells by in vitro culture. Epithelial cells were isolated from the corpus of human epididymides and cultured with RPMI 1640 medium supplemented with 10% fetal calf serum in type IV collagen-coated dishes at 37 degrees C. The epithelial nature, presence of fibroblasts, WGA-binding sites, and existence of GP-83 were determined by an indirect immunocytochemical and histochemical staining technique. Proteins in the cultured cells were analyzed by SDS-PAGE and autoradiography. After culturing for 10 days, the cells were shown to be positive with epithelial cell-specific keratins but devoid of fibroblasts. WGA-binding granules and positive binding sites of GP-83 were also detected in the cytoplasm. Immunoblots of cell extracts probed with the anti-GP-83 antibody from seminal fluid revealed the sperm maturation-related glycoprotein GP-83. The results indicate that WGA-binding proteins may be synthesized by the corpus epididymal epithelial cells of human and GP-83 may play an important role in sperm maturation. This culture model may be suitable for the investigation on the biosynthesis and physiology of human epididymal principal cells in vitro.This study is designed to investigate the synthesis of maturation-related wheat germ agglutinin (WGA) binding glycoproteins in the human corpus epididymal epithelial cells by in vitro culture. Epithelial cells were isolated from the corpus of human epididymides and cultured with RPMI 1640 medium supplemented with 10% fetal calf serum in type IV collagen-coated dishes at 37°C. The epithelial nature, presence of fibroblasts, WGA-binding sites, and existence of GP-83 were determined by an indirect immunocytochemical and histochemical staining technique. Proteins in the cultured cells were analyzed by SDS-PAGE and autoradiography. After culturing for 10 days, the cells were shown to be positive with epithelial cell-specific keratins but devoid of fibroblasts. WGA-binding granules and positive binding sites of GP-83 were also detected in the cytoplasm. Immunoblots of cell extracts probed with the anti-GP-83 antibody from seminal fluid revealed the sperm maturation-related glycoprotein GP-83. The results indicate that WGA-binding proteins may be synthesized by the corpus epididymal epithelial cells of human and GP-83 may play an important role in sperm maturation. This culture model may be suitable for the investigation on the biosynthesis and physiology of human epididymal principal cells in vitro.

MODULATION OF MDR-1 GENE BY MIF AND GSTpi WITH DRUG RESISTANCE GENERATION IN HORMONE INDEPENDENT PROSTATE CANCER

The expression of MIF and GSTpi were upregulated in prostate cancer cells with mulitdrug resistant phenotype. The aim of this study is to determine the relationship between these genes and multidrug resistance (mdr-1) gene in acquired multidrug resistance of prostate cancer. The expression of MIF, GSTpi and gp-170 in multidrug resistant (MDR) subline or native cells were determined using flow cytometry and western blotting. The mRNA level of various genes was analyzed with RT-PCR method. The chemosensitivity of tumor cells and stable transfectants to paclitaxel was measured using MTT (tetrazolium bromide) assay. The protein levels of MIF, GSTpi and gp-170 increased in MDR sublines of prostate cancer when compared with their parental cells. The MIF and GSTpi stable transfectants expressed higher MIF and GSTpi protein levels than their parental cells in western blotting analysis, respectively. The expression of mdr-1 gene and the production of pg-170 were also increased in either MIF or GSTpi stable transfectants when compared with vector control by using RT-PCR and flow cytometric analysis. The MTT results demonstrated that the increased chemoresistance was correlated with the increased production of gp-170 protein in either MIF or GSTpi transfectants. The upregulation of MIF and GSTpi during the development of acquired drug resistance of hormone independent prostate cancer may simultaneously and partially modulate the activation of gp-170.

PENILE BLUNT TRAUMA INDUCED VENO-OCCLUSIVE ERECTILE DYSFUNCTION

Blunt trauma to the pelvic or perineal region of the corpora cavernosa is a risk factor for the subsequent development of persistent erectile dysfunction. The hemodynamic investigation of the integrity of the veno-occlusive mechanism has been rare in cases of traumatic impotence. We present two young men with erectile dysfunction following blunt penile or perineal trauma. Combined intracavernous injection and stimulation test, color duplex ultrasonography, and pharmacologic cavernosometry and cavernosography revealed normal arterial velocity and pulsation without cavernosal arterial fistula, but severe venous occlusion and site-specific abnormal veins were noted in both patients. They received penile vein ligation procedure and resulted in near-completely normal erectile function after a four-year followup. Penile venous ligation, especially on the site-specific veins, is still the choice of treatment for the trauma-induced penile veno-occlusive erectile dysfunction, and the result is satisfactory.

Successful treatment of azoospermia secondary to ejaculatory duct cyst.

Ejaculatory duct obstruction is considered a rare cause of infertility. Two cases are reported of an ejaculatory duct cyst with azoospermia preoperatively diagnosed by transrectal ultrasonography. The diagnosis of ejaculatory duct obstruction in one patient was confirmed by vasography with a combined iodinated contrast medium and methylene blue solution for radiological and direct visualization. Transrectal puncture and contrast filling of the cyst under the transrectal ultrasonographic guidance diagnosed the other patient. On the basis of these findings transurethral unroofing of the cyst was performed successfully. Transrectal ultrasonography facilitates evaluation and treatment of azoospermia caused by ejaculatory duct obstruction and may minimize the need for more invasive studies in such cases.Ejaculatory duct obstruction is considered a rare cause of infertility. Two cases are reported of an ejaculatory duct cyst with azoospermia preoperatively diagnosed by transrectal ultrasonography. The diagnosis of ejaculatory duct obstruction in one patient was confirmed by vasography with a combined iodinated contrast medium and methylene blue solution for radiological and direct visualization. Transrectal puncture and contrast filling of the cyst under the transrectal ultrasonographic guidance diagnosed the other patient. On the basis of these findings transurethral unroofing of the cyst was performed successfully. Transrectal ultrasonography facilitates evaluation and treatment of azoospermia caused by ejaculatory duct obstruction and may minimize the need for more invasive studies in such cases.

Value of prostate-specific antigen in the staging of Taiwanese patients with newly diagnosed prostate cancer.

Records of 71 patients diagnosed with prostate cancer were reviewed retrospectively regarding clinical stage, prostate-specific antigen (PSA), Gleason score, CT scan of pelvis, bone scan, and pelvic lymph node dissection. Fourteen patients had pelvic lymphadenopathy based on the CT scan. Of these, no patient had a PSA level <4 ng/mL, 1 patient had a PSA level between 4 and 10 ng/mL, and 3 had a PSA level between 10 and 20 ng/mL. Twelve of 13 patients with positive bone scan results had a PSA level >20 ng/mL, and 1 patient had a PSA level between 10 and 20 ng/mL. PSA can be cost-effective in selecting and identifying appropriate staging for patients with newly diagnosed prostate cancer. CT scans are not indicated in men with clinical localized prostate cancer when PSA levels are h 10 ng/mL. Bone scan is not required for staging asymptomatic men with PSA levels of h 20 ng/mL. Pelvic lymphadenectomy for localized prostate cancer may not be necessary if PSA levels is h 20 ng/mL and Gleason score is h 5.

CHANGE IN INTERNATIONAL PROSTATE SYMPTOM SCORE AFTER TRANSURETHRAL PROSTATECTOMY IN TAIWANESE MEN WITH BENIGN PROSTATE HYPERPLASIA: USE OF THESE CHANGES TO PREDICT THE OUTCOME

To investigate whether the pre- and postoperative International Prostate Symptom Score (IPSS) change predicts the outcome of transurethral prostatectomy in a Taiwanese population, 99 patients (transurethral prostatectomy candidates) were assessed with the IPSS before and 6-12 months after surgery. All symptoms improved significantly postoperatively. Patients with a greater preoperative IPSS benefited the most. Improvements in preoperative obstructive symptoms (incomplete emptying, intermittency, straining, and weak stream) were greater than those in irritable symptoms (urgency, frequency, and nocturia). A significant correlation was found between IPSS and quality of life (QOL) before and after transurethral prostatectomy. A change of 1 unit on the IPSS scale was found to decrease the QOL score 0.282 units. The positive predictive value of a ≥7-IPSS point decrease depended on the predictive IPSS criteria applied. When the preoperative IPSS was more than 17, the sensitivity was 83.5% and specificity was 30%. Postoperative improvement did not differ significantly between acute urinary retention (AUR) and non-AUR patients. Change in IPSS of more than 7 points predicted symptomatic improvement with high sensitivity. The predictive value depends on the definition of significant improvement (magnitude of IPSS change) and on the level of IPSS symptoms (sufficient to warrant transurethral prostatectomy).