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Laparoscopic radical prostatectomy has evolved over the last decade to become a common treatment for clinically localized prostate cancer at specialized institutions. During that time, various technical modifications have been pioneered by groups throughout the world. We present our technique of transperitoneal laparoscopic radical prostatectomy through a descending approach. We believe that the transperitoneal approach affords better visual landmarks, a larger operative space, and a stable pneumoperitoneum. Our technique employs a five-trocar approach to the prostate. All dissection and suturing is performed intracorporeally. The perioperative morbidity and short-term efficacy are similar to those of the open procedure.

Purpose: We evaluate the efficacy of temperature based radio frequency ablation as a potential treatment modality for small (less than 3.5 cm.) renal tumors.Materials and Methods: We treated 15 patients with a total of 20 tumors with radio frequency ablation through an open surgical approach immediately before partial nephrectomy. All tumors were biopsied before radio frequency ablation treatment. Tumors were heated to 90 to 110C for 6 to 16 minutes (mean 9.1). Tumor ablation was monitored by direct vision and ultrasound. Partial nephrectomy was performed in standard fashion. All specimens were stained with hematoxylin and eosin, and 5 specimens were stained for nicotinamide adenine dinucleotide (NADH) diaphorase activity.Results: Tumors ranged from 1.5 to 3.5 cm. (mean 2.4) in greatest dimension. All 20 specimens had evidence of morphologically unchanged tumor and normal renal parenchyma on standard hematoxylin and eosin staining. Of the 5 specimens 4 stained positively for NADH in areas confirme...

Treatment of rat pituitary GH4C1 cells with estradiol, insulin, and epidermal growth factor induces secretory granule accumulation, PRL storage, and stabilization of ICA512, a membrane protein associated with secretory granules. In these investigations we found that the same treatment induced accumulation over 2-fold of other proteins in the secretory pathway, including synaptosomal-associated protein of 25 kDa (SNAP-25), synaptotagmin III, synaptobrevin, synaptophysin, and cyclophilin B, and did not affect accumulation of others, including synaptotagmin I, calnexin, and glucose-regulated protein 94. The induction of proteins was not a coordinate event, because epidermal growth factor alone maximally stimulated SNAP-25 accumulation, but not that of synaptotagmin III. Induction of SNAP-25 accumulation occurred without an increase in its synthesis, and induction of cyclophilin B occurred without an increase in its messenger RNA accumulation, suggesting that accumulation may be caused by stabilization of the proteins. SNAP-25 immunofluorescence was located in the cytoplasm and on the plasma membrane and sometimes was heavily concentrated in protrusions from the cell surface, especially in hormone-treated cells. Frequenin immunofluorescence was also sometimes concentrated in intense patches, but did not colocalize with SNAP-25. Growth hormone and prolactin immunofluorescence was not found in the protrusions and sometimes did not colocalize with each other when they were present in the same cell. Hormone treatment of GH4C1 cells therefore induces accumulation of specific proteins in all parts of the secretory pathway and causes morphological changes in addition to accumulating secretory granules.

We examined the biological activity and immunological reactivity of four mutants of human PRL. Two were mutants that changed the ability of human PRL to inhibit rat PRL storage when transfected into a rat pituitary cell line:mutations S34A and N31T. Two mutations were in regions of PRL that are highly conserved. One, des(3-11)-PRL, removed the N-terminal cystine loop that most PRLs, except those from certain fish, have, and no GHs have. The other, S90A, mutated a serine that is present in all PRLs but those from some fish and in all GHs. The immunological properties of des(3-11)-PRL were reduced 10-fold compared to those of wildtype human PRL in a RIA using NIH antihuman PRL-3, AFP C11580; the others were similar to those of wild-type PRL. The biological activity of des(3-11)-PRL was the most affected; activity was reduced about 8-fold compared to that of wild-type PRL in the Nb2 cell assay. The activities of the others were similar to that of the wild type. Serine 90 may be partially buried by loops connecting the alpha-helixes. The mutation of serine 90 did not affect the stability of the molecule in vitro, determined by comparing the red shift in tryptophan fluorescence that occurs with increasing concentrations of urea in S90A and wild-type PRL. The activity of S34A and N31T mutations indicates there is no correlation between biological activity and ability to affect storage. The N-terminal cystine loop may be conserved because it is needed for biological activity, but the conservation of serine 90 in GH and PRL must be determined by other properties, such as spacial requirements.

Human PRL binds Zn2+, but the function of the binding is not known. We investigated the effect on PRL production in pituitary cells by obtaining clones of GH4C1 cells stably transfected with human H27A-PRL, a mutant that does not bind Zn2+. Unexpectedly, clones transfected with the mutant human PRL made little rat PRL. Untransfected GH4C1 cells made between 0.5 to 10 μg rat PRL/105 cells in 24 h. Clones transfected with vector alone (four of four), wild type human PRL (six of six), or with human K69A-PRL (two of two) made amounts of rat PRL in the same range. Clones transfected with human H27A-PRL (five of five) made 0.003–0.1 μg rat PRL/105 cells in 24 h, and the production of rat PRL mRNA was reduced. Human H27A-PRL was not efficiently secreted; 20–40% newly synthesized H27A-PRL was degraded by 60 min, and there was usually a delay in release of newly synthesized H27A-PRL. Reduction of rat PRL production is not mediated through the PRL receptor, because no sequences for the receptor in GH4C1 cells were detected by RT-PCR. Proteins involved in folding, such as BiP, were not specifically elevated in the H27A-PRL clones. In transient transfections, in which cells have not undergone selection, we found no evidence for disulfide-bonded aggregates of the mutant protein. The results indicate that Zn2+ binding stabilizes PRL in the secretory pathway; the instablility of the mutant protein may trigger effects that suppress rat PRL production directly or that indirectly result in selection of clones with low rat PRL production.