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Objective: High concentrations of serum prostate-specific antigen (PSA) may be associated with the presence of benign prostatic hyperplasia or prostatitis. We investigated the serum-to-urinary PSA ratio in patients with or without prostate cancer to assess its efficacy in enhancing serum PSA specificity., Methods: Patients presenting abnormal findings in digital rectal examination or documented prostate carcinoma were prospectively included in the study. A control group, with no evidence of prostate disease, hospitalized in the same time interval was included. Serum and urine PSA levels were measured in our laboratory with the Tandem R assay (Hybritech). Samples were drawn twice at 2-month intervals (M1 and M3)., Results: Sixty-eight patients were included in the study divided into 27 cases of benign prostatic hyperplasia, 20 of prostate carcinoma, 10 of prostatitis and 11 patients in the control group. Serum and urine PSA levels were not correlated (r < or = 0.1). There was no significant difference in any group from M1 to M3 as regards urinary PSA (p > or = 0.15). Intergroup comparison showed significantly (p < or = 0.004) high urinary PSA (mean level +/- SEM 28.3 +/- 3.4 micrograms/mmol creatinine) only in the benign prostatic hyperplasia group, mean levels in the prostate carcinoma, prostatitis and control groups being 3.7 +/- 1.1, 11 +/- 2.9 and 5.2 +/- 0.9 micrograms/mmol creatinine, respectively. Differences in urinary PSA levels between the confined prostate carcinoma and benign prostatic hyperplasia groups (p = 0.0008) were further increased when considering the serum-to-urinary PSA ratio (p = 0.0003)., Conclusion: Our results suggest that the serum-to-urinary PSA ratio may be useful in distinguishing benign prostatic hyperplasia from prostate cancer.

Background: Cathepsin D is a widely distributed lysosomal acidic endopeptidase. It is an estrogen-regulated protein that is a prognostic factor in breast cancer. The aim of this study was to measure cathepsin D concentrations in thyroid tissues and to correlate these concentrations with clinical and pathologic parameters., Methods: Cathepsin D and thyroglobulin concentrations were measured in the cytosol of normal thyroid tissues (n = 14), benign nodules (n = 6), and thyroid carcinomas (n = 32) with an immunoradiometric assay. Statistical analysis was based on the Kruskal-Wallis and Wilcoxon tests and on the Spearman rank correlation coefficient., Results: The mean level of cathepsin D, expressed as picomoles per milligram protein minus thyroglobulin, was higher in the 32 carcinomas, 29.1 +/- 15.5, than in the 14 normal thyroid tissues, 8.4 +/- 2.5 (p < 0.001) or in the 6 benign nodules, 11.2 +/- 7.3 (p = 0.003). Cathepsin D concentrations correlated with tumor size; Spearman rank correlation coefficient was rs = 0.44 (p = 0.012). No significant difference was found regarding histologic type. Cathepsin D concentrations were inversely correlated with the thyroglobulin level in the tumor; Spearman rank correlation coefficient was rs = -0.60 (p < 0.001)., Conclusions: Cathepsin D concentration is higher in thyroid carcinoma than in normal thyroid tissue. Increased cathepsin D concentrations correlate with thyroid tumor size but not with histologic type. Further studies should be done to confirm the potential prognostic value of cathepsin D in patients with thyroid carcinomas.

The preceding discussion has profiled the three different types of knee braces which are available on today's market. It also has attempted to discuss the controversies surrounding these braces and to analyze the scientific data presented to date. Prophylactic braces have been shown to be ineffective in preventing knee injuries in its present day design. Evidence also has shown that their use may even lead to increased knee injuries. Rehabilitative braces, on the other hand, do serve a useful purpose in regard to the operative and non-operative treatment of ligamentous knee injuries. With their ease of application and control of joint motion, they are an important addition to the surgeon's armamentarium. One must keep in mind, however, that these braces provide little static anterior/posterior control and the hinge settings may not actually affect true joint motion. Functional knee braces may play a role in the treatment of patients with pathological laxity due to an injury of the anterior cruciate ligament. Combined with an adequate rehabilitation program and activity modification, these braces do limit excessive anterior tibial translation under low loading conditions. However, under conditions of high loading these braces provide little or no resistance to anterior translation. Therefore, in most sporting activities, their efficacy is questionable. Knee bracing continues to be a complex and controversial topic in the field of orthopedic surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

The preceding discussion has profiled the three different types of knee braces available on today's market. It has attempted to discuss the controversies surrounding these braces and to analyze the scientific data presented to date. Prophylactic braces have been shown to be ineffective in preventing knee injuries in their present-day design. Evidence has also shown that their use may even lead to increased knee injuries. On the other hand, rehabilitative braces do serve a useful purpose in regard to the operative and nonoperative treatment of ligamentous knee injuries. With their use in the application and control of joint motion, they are an important addition to the surgeon's armamentarium. One must keep in mind, however, that these braces provide little static anterior/posterior control and the hinge settings may not actually reflect true joint motion. Functional knee braces may play a role in the treatment of patients with pathologic laxity owing to an injury of the ACL. Combined with an adequate rehabilitation program and activity modification, these braces do limit excessive anterior tibial translation under low-loading conditions. However, under conditions of high loading these braces provide little or no resistance to anterior translation. Therefore, in most sporting activities, their efficacy is questionable. Knee bracing continues to be a complex and controversial topic in the field of orthopaedic surgery. The answers for the design of the "ideal" brace are being continually worked out and the need for more detailed, well-controlled studies continues to be great.(ABSTRACT TRUNCATED AT 250 WORDS)

Pseudohypoaldosteronism is a congenital disorder, with an as yet unclear pathophysiology, mode of inheritance and frequency. We have recently diagnosed 6 cases in a relatively short period of time, which suggests that the frequency of the disease may be underestimated. This may be due to a high variability in the clinical expression and to the existence of asymptomatic forms. Autosomal dominant and autosomal recessive modes of inheritance have been reported which probably correspond to different underlying mechanisms.

We demonstrate that the interactions between the uterine cytosol proteins of 24 day old Rats and estradiol-17 beta (E2) are significantly influenced by physiological concentrations of non esterified fatty acids (2. 10(-4)M). We show that the specific binding of the hormone to the 8S uterine receptor, is markedly inhibited (50-80%) by the unsaturated fatty acids. The observed inhibition is a function both of acid dose and acid unsaturation degree. The polyunsaturated arachidonic and docosahexaenoic acids are the strongest inhibitors, whereas the saturated palmitic and stearic acids do not displace the E2 from the 8S receptor.

The autonomic nervous system includes, side by side with the sympathetic and parasymathetic systems, a third, non-adrenergic and non-cholinergic system called NANC. The mediators in this system are peptides acting as neurotransmitters, i.e. neuropeptides. The NANC system has two components: bronchodilator and bronchoconstrictor. The bronchial relaxant system, called non-adrenergic inhibitory system, has several neurotransmitters, viz.: vasoactive intestinal peptide (VIP), isoleucine histidine peptide (IHP) and methionine histidine peptide (MPH), all derived from a common precursor: pre-pro VIP. MHP has been described in man and IHP in some animal species. VIP relaxes the bronchial smooth muscle, is vasodilator and exerts cellular effects in phagocytes, lymphocytes and mast cells. VIP receptors are present on cells. The other component, called non-cholinergic excitatory system, has tachykinins as neuromediators, including substance P, neurokinins A and B, neuropeptide K and calcitonin gene related peptide (CGRP). Substance P contracts the bronchi, increases mucus secretion, dilates vessels and also exerts cellular effects in lymphocytes and phagocytes. Tachykinins act through receptors 3 types of which are now known: NK 1, NK 2 and NK 3. Other neuropeptides have been isolated, including galanin, neuropeptide Y, bombesin, gastrin releasing peptide, enkephalins and katacalcin. The coexistence, in pre- and post-synaptic positions, of the conventional mediators (noradrenaline, acetylcholine) and neuropeptides leads to the concept of co-transmission and makes the notion of nerve impulse transmission more complex. The development of neuropeptide agonists and antagonists opens new therapeutic prospects in the management of asthma.

The characterisation of the "4 S-trypsin" form of the estradiol-receptor from calf uterus cytosol was carried out by polyacrylamide gel electrophoresis under non-denaturing conditions. In a multiphasic buffer system (upper buffer Tris-glycine pH25degrees C = 8,6, lower buffer Tris HCl pH25degrees C = 7,4), three radioactive estradiol peaks were observed. The first was free estradiol, the second estradiol initially complexed with a macromolecule and dissociated during electrophoresis, and the third the hormone-receptor complex. The sedimentation coefficient (4 S) of this complex was the same before and after electrophoresis. Its mean geometric radius is R = 2.53 + 0.08 nm and its molecular weight was estimated to be 55,000.

Estradiol-PAB-cellulose, an easily prepared adsorbent, has been proposed to purify the uterine estradiol receptor according to the principle of biospecific affinity chromatography. It apparently removes all hormone binding sites when cytosol preparations are incubated with it. A systematic study of this adsorbent was undertaken, including the synthesis and testing of the radioactive material. Two main results were obtained: 1) Estradiol-PAB-cellulose is heavily contaminated with free ligand and releases it during the normal chromatographic conditions. 2) Estradiol spacer derivatives (hydroxyethylphenyl-diazo (2 or 4)-estradiol) have a very low affinity for the receptor (Ki = 10 muM). The conclusion is that estradiol-PAB-cellulose is unsuitable for affinity chromatography of estradiol receptor.