In the present review article, the penetration of antimicrobial agents into prostatic fluid and tissue was examined. Three major factors determining the diffusion and concentration of antimicrobial agents in prostatic fluid and tissue are the lipid solubility, dissociation constant (pKa) and protein binding. The normal pH of human prostatic fluid is 6.5–6.7, and it increases in chronic prostatitis, ranging from 7.0 to 8.3. A greater concentration of antimicrobial agents in the prostatic fluid occurs in the presence of a pH gradient across the membrane separating plasma from prostatic fluid. Of the available antimicrobial agents, β-lactam drugs have a low pKa and poor lipid solubility, and thus penetrate poorly into prostatic fluid, expect for some cephalosporins, which achieve greater than or equal to the inhibitory concentration. Good to excellent penetration into prostatic fluid and tissue has been demonstrated with many antimicrobial agents, including tobramycin, netilmicin, tetracyclines, macrolides, quinolones, sulfonamides and nitrofurantoin.

Trace element selenium (Se) is regarded to be a breast cancer preventive factor involved in multiple protective pathways. In all, 80 women with breast cancer who underwent a radical mastectomy were enrolled in the study. Serum Se and carcinoembryonic antigen levels were measured using a fluorometric and IRMA assay, respectively. Se tissue concentration was determined by a tissue extracting fluorometric assay. For statistical analysis purposes t -test was used and P -values <0.001 were regarded as statistically significant. Serum Se was 42.5±7.5 μ g l −1 in breast cancer patients and 67.6±5.36 μ g l −1 in the age-matched control group of healthy individuals. Serum carcinoembryonic antigen in patients was 10±1.7 U ml −1 (normal <2.5 U ml −1 in nonsmokers/<3.5 U ml −1 in smokers). A statistically significant difference was found for both serum Se and CEA between two groups studied ( P <0.001). Neoplastic tissue Se concentration was 2660±210 mg g −1 tissue; its concentration in the adjacent non-neoplastic tissue was 680±110 mg g −1 tissue ( P <0.001). An inverse relationship between Se and CEA serum levels was found in the two groups studied ( r =−0.794). There was no correlation between serum/tissue Se concentration and stage of the disease. The decrease in serum Se concentration as well as its increased concentration in the neoplastic breast tissue is of great significance. These alterations may reflect part of the defence mechanisms against the carcinogenetic process.

Intraoperative penile erection during endoscopic surgery, although an infrequent occurrence, is a troublesome complication and a challenge to the urologist. It is difficult to perform the procedure during penile erection, because various complications may occur. The etiology is unclear, and a number of pharmacological remedies have been discussed in the literature. Herein, we describe the treatment and outcomes for 3 patients with intraoperative penile erection and provide a brief review of the associated literature. Intraoperative penile erection is a rare event during transurethral procedures, with a frequency of approximately 0.1% in our institution.To our knowledge, no generally accepted protocols for the prevention or treatment of this phenomenon have been reported in the literature. We recommend intracorporeal injection of 250 mg of phenylephrine: detumescence occurred rapidly in all patients after a single injection. The mode of administration is simple, and no complications have been reported.Key words: Endoscopy, alpha-adrenergic agonists, phenylephrine, priapism.J Androl 2006;27:376-380 S ome degree of penile engorgement following epidural anesthesia is not uncommon because of vasodilatation and pooling of blood in the venous sinuses of the penis. However, penile tumescence resulting in partial or total erection at the time of cystoscopy or transurethral surgery is a relatively infrequent phenomenon (Walther et al, 1987). It is very troublesome to perform the procedure during penile erection because attempts to do so will lead to complications, such as excessive bleeding and urethral trauma, and surgery has to be delayed or postponed as a result. At our institution, during the last 16 years (1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004), of 2867 patients who received epidural anesthesia while undergoing different transurethral procedures, such as transurethral resection of the prostate (TUR-P), transurethral resection of bladder tumors, transurethral incision of the prostate, or optical internal urethrotomy, intraoperative penile erection was only encountered in 3. The management of these cases, along with a review of the literature, is presented. Materials and MethodsOver a 16-year period (1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004) at our institution, only 3 (approximately 0.1%) of 2867 patients had a penile erection while undergoing an endoscopic surgery procedure with epidural anesthesia. All 3 were successfully treated with an intracorporeal injection of 250 mg phenylephrine. Patient 1A 58-year-old man was admitted for transurethral resection of multiple superficial bladder carcinomas. He had a history of atrial fibrillation that was controlled with administration of digoxin. Results of routine laboratory analyses, including routine blood tests, prothrombin time, platelet count, fibrinogen time, and partial thromboplastin time, were within normal limits. He was given epidural...

Reduction/loss of E-cadherin is associated with the development and progression of many epithelial tumors, while in a limited number of neoplasms, E-cadherin is re-expressed in metastases. Dysadherin, recently characterized by members of our research team, has an anti-cell-cell adhesion function and downregulates E-cadherin in a posttranscriptional manner. Colorectal cancer (CRC) is one of the most common tumors in the developed world, and lymph node metastases are harbingers of aggressive behavior. The aim of the present study was to examine the dysadherin and E-cadherin expression patterns in lymph node metastases vs primary CRC. Dysadherin and E-cadherin expression was examined immunohistochemically in 78 patients with CRC, Dukes' stage C in the primary tumor and in one lymph node metastasis. Dysadherin was expressed in 42% while E-cadherin immunoreactivity was reduced in 45% of primary tumors. In lymph nodes, 33 and 81% of metastatic tumors were positive for dysadherin and E-cadherin, respectively. Dysadherin expression was not correlated with E-cadherin expression in the primary tumor with a reverse correlation evident in the lymph node metastases. Our results suggest that different mechanisms govern E-cadherin expression in the primary tumor and the corresponding lymph node metastases.