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We summarized and reviewed published reports, including our studies, on the reverse transcription-polymerase chain reaction (RT-PCR) detection of micrometastatic prostate cancer cells in lymph nodes, bone marrow and peripheral blood. Some published data preliminarily suggest that the RT-PCR assay of micrometastatic prostate cancer cells may allow a more accurate assessment of lymph node and bone metastases of prostate cancer, and offer a presurgical prediction of the pathological stage of clinically localized disease. In addition, the RT-PCR assay may have a unique prognostic value in prostate cancer. However, controversy remains over the clinical significance of the RT-PCR assay. This assay could potentially develop into a diagnostic procedure for the clinical decision making in patients with prostate cancer. To establish the clinical significance of the RT-PCR assay, further optimized and standardized RT-PCR assay studies are needed, investigating large populations and involving long-term follow-up for the determination of any association between the results of the RT-PCR assay and specific clinical outcome.

Cytochrome P 450s (P 450s) are a gene superfamily of heme enzymes involved in xeno-or endo-biotic metabolisms. They have approximately 500 isozymes via evolution, immense diversity in their functions and a broad range of substrate specificities. Thus, they are called diversozymes and their versatility is understood as a mechanism for living via detoxification of toxicants. However, some of the huge human-made chemicals are bioactivated by P 450s. To explain diversity of P 450s, further studies regarding relations between crystal structures and functions of P 450s are required. P 450s can be applied for exposure-biomarkers of environmental pollution, screening of drug metabolism and remedy for pollutants.

We detected micrometastatic prostate cancer cells in lymph nodes and bone marrow using reverse transcriptase-polymerase chain reaction (RT-PCT) specific for prostate-specific antigen (PSA). RT-PCR revealed PSA mRNA in two lymph nodes obtained from two patients with negative histological and immunohistochemical analyses for lymph node metastases. Of 26 patients with negative bone scan imaging, 7 had PSA mRNA detected in the bone marrow by RT-PCR. The RT-PCR will be a relevant tool to allow a more accurate clinical assessment of lymph node and bone metastases in patients with prostate cancer.

Secondary hyperparathyroidism following various causes except for end stage renal disease was reviewed. Chronic low serum ionic calcium status such as osteomalacia and ricket or its negative balance may cause the stimulation for the parathyroids glands, which results in over excretion of PTH. Serum calcium levels are compensated to normal and low phosphate is prominent because of phosphate diuresis by PTH. Vitamin D treatment may be effective. In autonomous (tertiary) hyperparathyroidism, the parathyroidectomy is necessary.