Comparative study of the treatment of prostatic adenoma: laser photocoagulation versus endoscopic resection

OBJECTIVE: Resection of the prostate using a Nd YAG laser is designed to destroy benign prostatic hyperplasia responsible for bladder neck obstruction. This technique is currently under investigation. PATIENTS AND TECHNIQUE: A total of 56 patients, with a minimal follow-up of 6 months and presenting indications for endoscopic resection of the prostate were treated by TULIP [22] or VLAP [34] laser coagulation. The objective and subjective results were compared to a group of patients [30] treated by endoscopic resection during the same period. Results are expressed as the percentage of patient responding to treatment in terms of objective (peak flow rate > 15 ml/s with improvement > 30% or between 12 and 15 ml, but improvement > 50%) and subjective parameters (IPSS < 7 and improvement > 30% or between 7 and 10, but improvement < 50%). RESULTS: With a minimal follow-up of 6 months, the objective response rates were 55.5% (TULIP), 84.6% (VLAP) and 83.2% (TURP), while the subjective response rates were 55.5% (TULIP), 92.3% (VLAP) and 83.3% (TURP). The hospital stay was significantly shorter in the laser group (2.1 VLAP and 3.3 TULIP; 4.93 TURP). In the TULIP group, 3 patients were incontinent and 4 developed chronic prostatitis. At 6 months, 4 patients in the VLAP group and 6 patients in the TULIP group had to undergo a complementary TURP. CONCLUSION: These results indicate that laser photocoagulation is effective in the treatment of benign prostatic hyperplasia. The VLAP technique appears to be better adapted to this indication. The benefit of VLAP will be more clearly demonstrated by the randomized study currently underway, provided the length of hospital stay, postoperative complications and cost-effectiveness ratio are taken into account. In contrast, the TULIP system is associated with numerous complications which appear to be unacceptable.     

Results of the treatment of bladder tumors infiltrating the muscle

The results of PUVA treatment for severe alopecia areata (AA) were reviewed in 102 patients. Fifty-three per cent had greater than 90% regrowth of hair. Although these results appear to be encouraging, they differ little from what would be expected with no treatment. We consider that PUVA is not an effective treatment for AA.     

Shear wave velocity and geotechnical properties of tailings deposits

Bulletin of Engineering Geology and the Environment - This paper presents the results of subsurface shear wave velocity Vs measurement of tailings deposits (tailings sand and slime) at 4 tailings...     

Current state of knowledge concerning the mechanisms of action of BCG

OBJECTIVES: To report the safety and efficacy of the transurethral needle ablation (TUNA) procedure for the treatment of clinical benign prostatic hyperplasia (BPH). METHODS: One hundred thirty patients with BPH were enrolled in two identical protocols and treated by the TUNA procedure. Entry criteria included an American Urological Association symptom index (AUA SI) of 13 points or higher and a peak flow rate of 12 mL/s or less. Patients were followed up for 12 months. Efficacy parameters included the AUA SI, AUA problem index, BPH impact index (BPH II), quality of life (QOL) score, and peak flow rate. At each visit, side effects were elicited. Follow-up data are available for 93 patients at 12 months. All patients were given intraurethral lidocaine augmented by oral and/or parenteral sedation. No patient received spinal or general anesthesia. RESULTS: All patients tolerated the procedure well, and there were no deaths. Forty-one percent of patients (n = 53) had a catheter placed immediately after the procedure. At 12 months, the AUA SI had decreased from 23.7 to 11.9 (P < 0.0001) and the BPH II from 7.5 to 2.5 (P < 0.0001), whereas the peak flow rate had increased from 8.7 to 14.6 mL/s (P < 0.0001). Irritative voiding symptoms were noted in 20 patients (16%) at some point during follow-up. Two patients reported erectile dysfunction, and 1 reported retrograde ejaculation. CONCLUSIONS: In this prospective study of 130 patients with clinical BPH and lower urinary tract symptoms, TUNA provided substantive and lasting improvement according to AUA SI, BPH II, and QOL scores as well as peak flow rate over 1 year. The TUNA procedure was well tolerated, with few major side effects and complications noted. Longer follow-up is needed to document the maintenance of clinical benefit beyond 12 months.     

Distribution,sources, and behavior of trace elements in the Clinton River Watershed,Michigan

The Clinton River watershed near Detroit, Michigan, USA was separated in six different land uses: agricultural, residential, mixed industrial and residential, downstream industrial, Clinton River Spillway, and Lake St. Clair, utilizing As, Cd, Cu, Ni, Pb, and Zn contents of the sediment that has median values of 3, 0.3, 15, 14, 13, and 57 mg kg^− 1, respectively. However, trace element concentrations in the lower Clinton River rivaled those in the most contaminated watersheds of the world. Enrichment factors and principal component analysis (PCA) separated trace elements into 2 categories: anthropogenic (Cd, Cu, Ni, Pb, and Zn) and geogenic (Al, As, Ca, Fe, K, Mg, TOC) sources. PCA linked agricultural, residential, and mixed industrial and residential land uses to anthropogenic Cd, Cu, Ni, Pb, and Zn, and lake sediments to geogenic elements, organic matter and clay contents. The downstream industrial zone has a unique source signature. Trace element concentrations varied with land use. The upper Clinton River (> 20 km from mouth; residential land use; median concentrations up to 25 mg kg^− 1) appeared to meet delisting criteria. Partitioning was also land use and element specific with: (1) exchangeable fraction (up to 94% of total) related to road salt and mobile chloride complex formation; (2) carbonate-bound fraction (up to 100%) resulting from Ca substitution or adsorption; (3) presence of immobile (hydr)oxide-bound fraction (up to 90%) instead of potentially mobile organic matter and sulphide-bound fraction (up to 20%); and (4) residual fraction (up to 65%) originating from geogenic and/or anthropogenic sources.     

Zonal variation of apoptosis and proliferation in the normal prostate and in benign prostatic hyperplasia

OBJECTIVE: To determine whether benign prostatic hyperplasia (BPH) results from an imbalance between cell proliferation and apoptosis, and the extent to which the rates of these opposing processes are altered with the expression of the anti-death oncoprotein bcl-2. MATERIALS AND METHODS: Ten prostate glands from normal men (mean age 43.7 years) were sampled according to McNeal's zonal anatomy, in addition to 30 prostate adenomas obtained from prostatectomy specimens from symptomatic patients (mean age 61.4 years). Tissue samples were fixed in formalin and embedded in paraffin. Proliferation and bcl-2 expression were assessed by immunostaining using Mib-1 and anti-bcl-2 antibodies, while apoptotic bodies were specifically stained using in situ nick translation. The percentage of positive cells was determined by optical microscopy. RESULTS: In normal epithelium, the rates of proliferation and apoptosis were increased in the peripheral zone (Mib-1 1.7%, apoptotic bodies 3.3%) compared with the central (0.2% vs 1.4%) and transition (0.1% vs 1.8%) zones. Proliferation was significantly greater in BPH than in normal prostate tissue (3.7%), contrasting with a stable rate of apoptosis (1.4%). In the normal prostate, bcl-2 was expressed by glandular and basal cells in the peripheral zone. In the central zone, bcl-2 was overexpressed in basal cells and in most glandular cells of the intraluminal ridges. Bcl-2 expression in the transition zone was limited to dispersed basal cells. In BPH, bcl-2 was strongly expressed by basal cells in mature glandular formations and in most cells of young small nodules. CONCLUSION: BPH may result from both an increase of proliferation within the basal compartment and a failure of apoptosis to counterbalance basal cell proliferation. Increased expression of bcl-2 may participate in this process by blocking apoptosis.     

Molecular diversity and relationship within Lactococcus lactis, as revealed by randomly amplified polymorphic DNA (RAPD)

Lactococcus lactis strains are widely used in industrial dairy fermentations. Conventional phenotypic tests have been used for years to classify members of this species into two subspecies, lactis and cremoris, and play a key role in the choice of strains to be used in particular cheese fermentations. DNA hybridisation techniques have also been used for strain classification, giving rise to two genome homology groups. However, results showed discrepancies between the two methods of classification. We applied the randomly amplified polymorphic DNA fingerprinting (RAPD) technique to resolve previous contradictions in lactococcal classifications. Unlike usual RAPD methods, we use three primers to classify 113 strains and integrate the resulting information by a digitised programme used for this purpose. Our analysis revealed three major RAPD groups, designated G1, G2 and G3. G1 and G3 contain strains of the lactis subspecies, and G2 contains strains of the cremoris subspecies, as previously defined by phenotypic characteristics. Moreover, group G1 corresponds to one genome homology group, and groups G2 and G3 correspond to the second one. The taxonomic structure within L. lactis is therefore unusual: two distinct genetic groups of strains show indistinguishable phenotypes, while conversely, two phenotypically distinct groups are genetically homologous. We hypothesize that a subfamily of the subsp. lactis group gave rise to the cremoris subspecies.     

Monitoring of concrete homogenisation with the power consumption curve

Homogenisation time increases for superplasticized concrete slowing down their industrial production. Monitoring power consumption measurement capability to control concrete homogeneity during mixing is explored. Various High Performance Concrete and Self-Compacting Concrete was batched in a 1 m³ pan mixer, with increasing mixing time. Rheology and compressive strength were measured and compared for different mixing times. Correlations were established between power consumption and compressive strength evolutions. Also, power consumption for the longest mixing time and concrete rheological parameters (yield stress and plastic viscosity) are related. On the another hand, tests show that mixing difficulty for a given mix-design is reduced with increased mixer capacity and when fast planetary tools are implemented in the mixer. As a conclusion, the power consumption evolution can be very useful information to control concrete homogeneity during mixing, to control material flowability, and to compare the capability of different mixers.