Primary melanoma of the prostate: case report and review of the literature

Background: Primary melanoma of the prostate has an extremely rare incidence. Only five cases have been reported in the literature and prognosis is poor. The most likely origin of prostatic melanoma is the transitional epithelium of the prostatic urethra. Surgical care for primary melanoma of mucosal sites is less well established than for primary cutaneous melanoma, but excision of the primary is recommended if the patient has no systemic disease. Case presentation: Here, we describe a case of primary malignant melanoma of the prostate. A 37-year-old male patient with history of both chemo- and radiation therapy for Hodgkin’s disease was admitted to the University Hospital Heidelberg on suspicion of pleomorphic sarcoma of the bladder. In-house diagnostic work-up revealed a malignant melanoma of the prostate. We then performed radical prostatectomy with extended lymphadenectomy. Despite presumably curative surgery, the patient suffered from early relapse of disease with pulmonary metastasis. Systemic chemotherapy and subsequent immuno-oncologic treatment was thereafter initiated. Conclusion: Since prostatic melanoma is a rare disease and a melanoma metastasis of unknown primary is the differential diagnosis, a multidisciplinary approach including early imaging to rule out possible metastases and to search for another potentially existing primary is advisable. To prevent complications related to local tumor progression and to receive tissue for mutational analysis, we recommend complete surgical resection to reduce the tumor mass. Novel immune and targeted oncologic therapies can lead to an improved survival in some cases and support of clinical trials is needed

Handling von Asthma bei Schülern der 7. Klasse im Kreis Aachen : eine Betrachtung unter Genderaspekten

With a prevalence of about 10% asthma is the most common chronic disease of the respiratory system. Resent studies underlined the influence of social status and lifestyle on the morbidity of asthma. The following study was conducted to investigate the handling of 7th year high school students with asthma in the area of Aachen. The investigated group of patients included 7th year high school students from all kind of educational levels („Gymnasien“, „Realschulen“, „Hauptschulen“ and „Gesamtschulen“). The investigation was conducted between November 2006 and August 2007, during which the patient’s data was collected by means of a written questionnaire. The following parameters with a potential influence on the course of the disease were determined for each patient and analysed:Asthma-specific anamnesis:• Occurrence of typical pathological respiratory sounds (rhonchus and grumble) within the last 12 months• Occurrence of dyspnea or chest pain within the last 12 months• Diagnosis of asthma made by a physician as opposed to typical asthma symptoms without the diagnosis of asthma by a physician• Current medical treatment• Measures of prevention taken by the patient• Self-assessment of general wellbeingSocial background and lifestyle:• Work of the parents• School education of the mother• Nationality of the patient and its parent• Nicotin consumption of the patient• Regular sport activity performed by the patientIn the interpretation of the obtained data special interest was put on gender-specific aspects. For statistical analysis the SAS Software was used. In order to insure the perception of the questionnaire it was tested in a small group of students and questions were modified for better understanding. 1950 questionnaires could be evaluated. This equals a response rate of 75,6%. 609 (31,82%) of the participants claimed to have asthmatic symptoms with equal rates in boys and girls. 178 (9,62%) of the student informed to have been diagnosed with asthma by a physician and 247 (13,15%) underwent medical treatment (some of which had not been diagnosed by a physician). In both of these groups boys formed the majority with 110 (61,8%) and 149 (60,32%) students respectively. In contrast to this data the percentage of girls claiming asthmatic symptoms without a diagnosis of asthma made by a physician was higher. The self-assessed general wellbeing was worse amongst girls as opposed to boys. A difference between students with a background of migration and students without a background of migration was statistically not significant. Boys were more commonly participated in prevention programmes as well as sport activities. 8% of the participants were smokers, with a majority of which were girls even though that difference did not prove to be significant (p=0,0895). The results of this study showed that the general wellbeing is highly influenced by gender aspects. The high rate of smokers amongst girls as well as lower rate of participation in sport activity and prevention programs makes girls vulnurable for asthmatic symptoms. Prevention programs should there for take focus on life style modifications of girl and gender-specific education

Role of Focal Therapy with High-Intensity Focused Ultrasound in the Management of Clinically Localized Prostate Cancer

Overtreatment of prostate cancer (PC) remains one of the main burdens in uro-oncology. Focal therapy may be a reasonable alternative with less side effects and morbidity. Application of high-intensity focused ultrasound (HIFU) induces immediate and irreversible coagulation. The treatment leads to consecutive necrosis with sharply delineated margins, making HIFU a promising tool for the focal therapy of localized PC. Unlike radiation, the treatment leaves no collateral damage outside of the heated tissue, allowing repeated use of HIFU, if necessary. In case of non-organ-confined relapse, additional radical salvage therapy can be performed. This review gives an overview of the existing evidence on focal HIFU. Today, 3 HIFU devices are approved for the treatment of localized PC: Sonablate (TM), AblathermTM and the FocalOne (TM) device. In summary, the first published results of focal HIFU are promising. The quality of life and potency of the patients are well preserved. Therefore, HIFU treatment, and especially focal ablation of tumor foci, seems to be a safe alternative to standard treatment, with low side effects. The oncologic results seem satisfactory but need further follow-up to validate this practice of PC control. (C) 2015 S. Karger GmbH, Freibur

Antioxidant Supplementation on Male Fertility—A Systematic Review

Our aim was to review the current literature regarding the effect of antioxidant supplementation (AS) on male fertility parameters, as AS is commonly used to treat male infertility due to the availability and affordability of antioxidants in many parts of the world. Materials and methods: PubMed, Medline, and Cochrane electronic bibliographies were searched using the modified Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) guidelines to evaluate studies on the benefit of antioxidant therapy on infertile men. Results were analyzed regarding the following aspects: (a) ingredient and dose; (b) potential mechanism of action and rationale for use; and (c) effect on various reported outcomes. Results: Thus, 29 studies found a substantial positive effect of AS on outcomes of assisted reproductive therapy (ART), WHO semen parameters, and live-birth rate. Carnitines, Vitamin E and C, N-acetyl cysteine, coenzyme Q10, selenium, zinc, folic acid, and lycopene were beneficial ingredients. Nevertheless, some studies did not show a substantial change in one or more factors. Conclusion: AS seems to have a positive effect on male fertility. Environmental factors may play an increasing role in fertility. Further studies are needed to determine the optimal AS combination and the influence of environmental factors

Vimentin 3 and endothelin in prostate cancer.

349 Background: An upregulation of vimentin 3, a truncated version of the full length vimentin, with an unknown function, was previously described by our group, in a direct dependency of increased ET-1 levels. We analyzed now vimentin 3 in further genitourinary cancers. Here, we describe our findings how vimentin 3 is part of the signaling pathways from Endothelin-1 (ET-1) and the Endothelin-A-Receptor (ETAR) and how it correlates with aggressive tumor behavior in a PCa cell culture and in human tissue and serum samples from PCa patients. Methods: DU145 cells were cultured. We stimulated with ET-1 with and without artificial downregulation of the ETAR, the ETBR or both receptors. A scratch assay was performed to demonstrate the influence of ET-1. Proteins were then extracted and WB for vimentin full length and vimentin 3 was performed. Additionally we analyzed ET-1 and vimentin 3 in serum from prostate cancer patients using ELISA and we did IF and IHC staining for vimentin 3 in human prostate cancer tissue. Results: Treatment with ET-1 and downregulation of the ETBR lead to a significant increased migration of DU145 cells after 3 and 6 h. The corresponding WB showed increased vimentin 3. ELISA showed increased levels of ET-1 in samples of prostate cancer patients compared to patients with no cancer history. ELISA could also demonstrate elevated levels of vimentin 3 in serum of patients with local disease and significantly elevated values in metastatic prostate cancer patients compared to patients with no cancer history. Conclusions: The data presented shows that ET-1 stimulation leads to overexpression of vimentin 3 in prostate cancer cell cultures and a concomitant aggressive biological behavior. Here we previously described the direct interaction of Vimentin 3 in prostate cancer and the activation mechanism via ET-1 and the ETAR. IHC, IF show an upregulation of the truncated variant Vimentin3 in tissue samples. In an Vimentin 3 ELISA we could show that this truncated variant is increased and therefore represents a potential biomarker. Highest values of vimentin 3 were measured using ELISA in serum of patients with recurrent and metastatic disease also suggesting that vimentin 3 correlates with aggressive tumor behavior. </jats:p