- Email: [email protected]
A Comparative Study Between the Use of Isosmotic 5% Mannitol Solution and Water as an Irrigant in Transurethral Resection of the Prostate
Prostate 1066
1067
M~~ACHROMASIA IN THE PROSTATE, A HISTOCHEMICAL DIFFERENCE BETWEEN BENIGN PROSTATIC HYPERPLASIA AND PROSTATIC CANCER. John A. Arcadi, Whittier,CA
Extracellular Matrix Promotes Growth of Hormone-dependent, Benign, Prostate Epithelial Cells in Androgen-deficient Culture Medium. Mark J. Noble, Winston K. Mebust, Vicki Eddleman*, and Sharon Miller*, Kansas City, KS
(Presentation to be made by Dr. Arcaai) When using the stain Toluidine Blue, if a change of color from blue to red occurs in tissue sections, it is called "metachromasia. '.' Prostate tissue was obtained from open prostatectomies for benign enlargement and for localized carcinoma. The tissue had been fixed in several different solutions including 10% fonnalin, zenkers and Carney's. The type of fixative did not alter the ability of the tissue to .:itain metachromat.ically. Appropriate controls clarified this point. Thirty benign prostate adenomas and seven total prostates were stained with Toluidine Blue in a .5% solution buffered at a pH of 8.2, and another buffered at pH 3.8. In all of the benign prostates without carcinoma present, reddish-pink metachromasy was seen in the periacinar connective tissue (including, but not limited to, the basement membrane) of many, but not all, of the benign acini. The carcinomatous tissue, however had no metachromatic staining around the malignant acini. In addition benign acini near malignant acini had no reddish-pink metachroiiia'tic staining in its periacinar connective tissue. These observations suggest that the extracellular matrix of the benign tissue is in a different state of organization than that of the malignant tissue. It also suggests the possibility that the malignant cell secretes a substance that removes, dissolves, or alters the tissue adjacent to it. These studies add more evidence of the important role of the ECM on prostate growth.
(Presentation to be made by Dr. Noble) Human benign prostatic epithelial c~lls were plated as monolayer cultures in medium With defint~d fetal bovine serum (Hyclone) and examined for testosterone dependency. These cells represented subcultures of explant tissue
obtained from discarded prostate chips following transurethral resection to relieve obstruction in middle aged males. Isolates found to exhibit growth enhancement in the presence of increasiilg amounts of_ 5a-dihydrotestosterone were subcultured on extracellular matrix derived from monolayer cultures of human renal tubular cells grown with androgen supplementation. A plating efficiency assay was used to examine cell seeding
at low densities (1000 cells/25 cm T-flask). Cultures were performed in triplicate and resU~ts averaged. Prostate cells demonstrated mean plating efficiencies on bare plastic of 3% in androgen-poor medium and 32% with androgen
supplementation when examined after 4 weeks (p<0,001). Colony growth (defined as 1 mm or greater diameter) was less than 1% at one week irrespective of androgen supplementation. On ECM, equal seeding occurred for cells grown both with and without androgen added to medium, demonstrating enhanced plating and growth of prostate cells on ECM which was independent of androgen concentration. This suggests that the ECM of some tissues has growth-promoting substances which may regulate
proliferation of hormone-dependent cells (prostate) and compensate for deficient circulating hormones.
1068
1069
A COMPARATIVE STUDY BETWEEN THE USE OE' ISOSJVJOTIC 5% JVJANNITOL SOLUTION AND WATER AS AJII IR!UGANT IN TRANSURETHRAL RESECTION OF THE PROSTATE. *Ernesto V. Arada III, *Eduardo R. Gatchalian, *Romulo C. Gines Jr., *Josefine C, Castillo, *Guerilio U, Lim, -l<·Telesforo E. Gana Jr., *Genaro M. Yusi, *Januario Y. Estrada Jr., Angelita G. Reyes (Presentation to be made by Dr. Gatchalian) This study compares the occurence and amount of hemolysis during the different stages of and after completion of transurethral resection of the prostate (TURP), using 5% Mannitol solution as an irrigant and water irrigation as control. Thirty male patients necessitating TURP for obstructing enlargement of the prostate, benign or malignant, were studied. They were equally divided into two groups which were matched according to; age, clinical assessment, weight of the resected prostate, duration of resection, and the presence or absence of venous sinuses during resection. Using the osmotic fragility test of Hepler, percent hemolysis was determined at 15, 30, 60 and 120 minutes from start of resection. All resections were limited to one hour. Postoperatively, 100% patients in the rnanni tol group (JVJG) showed no hemolysis while only 20% in the water group (WG) was spared from hemolysis. Intraoperatively, 40% patients in MG revealed hemolysis at some point during the resection while 100% patients in WG revealed hemolysis at any point during the resection. All patients in MG with initial hemolysis at 15 minutes recovered to preoperative levels by 120 minutes; half of which recovered as early as 30 minutes. Our prospective study reveal the usefulness and safety of 5% Manni tol irrigant in TURP, especially for Urology residents-in-training in Third World countries.
INCIDENCE OF PULMONARY EMBOLIZATION AFTER PELVIC SURGERY. *Lee Goldman and Arthur Porter, Cleveland, OH (Presentation to be made by Dr. Goldman) The incidence of thrombophlehitis and pulmonary embolus in patients of the age grouP seen in most urologic practices
has been reported to be as high as 15-20% in some series. Other reports indicate an equally frequent incidence of pulmonary embolization after pelvic and prostatic surgery in all age groups in·the hands of most urological surgeons. In afl effort to determine the true occurrence rate and whether
the frequency has changed with the advent of early ambulation and modern regimens we have studied patients.who have
had retropubic prostatectomy, total and simple, Plus pelvic explorations, lymphadenectomy and the like over the last two decades. Our rate for embolization has not been anywhere near as high as that reported in the literature and may be well below 5%. The patient population, management of post-operative regimens and current,handling of thrombophlebitis, suspected and documented, will be reported as well. Initial preliminary evaluation suggest that the current surgical management has markedly reduced the incidence of these complications.
370A
1067
M~~ACHROMASIA IN THE PROSTATE, A HISTOCHEMICAL DIFFERENCE BETWEEN BENIGN PROSTATIC HYPERPLASIA AND PROSTATIC CANCER. John A. Arcadi, Whittier,CA
Extracellular Matrix Promotes Growth of Hormone-dependent, Benign, Prostate Epithelial Cells in Androgen-deficient Culture Medium. Mark J. Noble, Winston K. Mebust, Vicki Eddleman*, and Sharon Miller*, Kansas City, KS
(Presentation to be made by Dr. Arcaai) When using the stain Toluidine Blue, if a change of color from blue to red occurs in tissue sections, it is called "metachromasia. '.' Prostate tissue was obtained from open prostatectomies for benign enlargement and for localized carcinoma. The tissue had been fixed in several different solutions including 10% fonnalin, zenkers and Carney's. The type of fixative did not alter the ability of the tissue to .:itain metachromat.ically. Appropriate controls clarified this point. Thirty benign prostate adenomas and seven total prostates were stained with Toluidine Blue in a .5% solution buffered at a pH of 8.2, and another buffered at pH 3.8. In all of the benign prostates without carcinoma present, reddish-pink metachromasy was seen in the periacinar connective tissue (including, but not limited to, the basement membrane) of many, but not all, of the benign acini. The carcinomatous tissue, however had no metachromatic staining around the malignant acini. In addition benign acini near malignant acini had no reddish-pink metachroiiia'tic staining in its periacinar connective tissue. These observations suggest that the extracellular matrix of the benign tissue is in a different state of organization than that of the malignant tissue. It also suggests the possibility that the malignant cell secretes a substance that removes, dissolves, or alters the tissue adjacent to it. These studies add more evidence of the important role of the ECM on prostate growth.
(Presentation to be made by Dr. Noble) Human benign prostatic epithelial c~lls were plated as monolayer cultures in medium With defint~d fetal bovine serum (Hyclone) and examined for testosterone dependency. These cells represented subcultures of explant tissue
obtained from discarded prostate chips following transurethral resection to relieve obstruction in middle aged males. Isolates found to exhibit growth enhancement in the presence of increasiilg amounts of_ 5a-dihydrotestosterone were subcultured on extracellular matrix derived from monolayer cultures of human renal tubular cells grown with androgen supplementation. A plating efficiency assay was used to examine cell seeding
at low densities (1000 cells/25 cm T-flask). Cultures were performed in triplicate and resU~ts averaged. Prostate cells demonstrated mean plating efficiencies on bare plastic of 3% in androgen-poor medium and 32% with androgen
supplementation when examined after 4 weeks (p<0,001). Colony growth (defined as 1 mm or greater diameter) was less than 1% at one week irrespective of androgen supplementation. On ECM, equal seeding occurred for cells grown both with and without androgen added to medium, demonstrating enhanced plating and growth of prostate cells on ECM which was independent of androgen concentration. This suggests that the ECM of some tissues has growth-promoting substances which may regulate
proliferation of hormone-dependent cells (prostate) and compensate for deficient circulating hormones.
1068
1069
A COMPARATIVE STUDY BETWEEN THE USE OE' ISOSJVJOTIC 5% JVJANNITOL SOLUTION AND WATER AS AJII IR!UGANT IN TRANSURETHRAL RESECTION OF THE PROSTATE. *Ernesto V. Arada III, *Eduardo R. Gatchalian, *Romulo C. Gines Jr., *Josefine C, Castillo, *Guerilio U, Lim, -l<·Telesforo E. Gana Jr., *Genaro M. Yusi, *Januario Y. Estrada Jr., Angelita G. Reyes (Presentation to be made by Dr. Gatchalian) This study compares the occurence and amount of hemolysis during the different stages of and after completion of transurethral resection of the prostate (TURP), using 5% Mannitol solution as an irrigant and water irrigation as control. Thirty male patients necessitating TURP for obstructing enlargement of the prostate, benign or malignant, were studied. They were equally divided into two groups which were matched according to; age, clinical assessment, weight of the resected prostate, duration of resection, and the presence or absence of venous sinuses during resection. Using the osmotic fragility test of Hepler, percent hemolysis was determined at 15, 30, 60 and 120 minutes from start of resection. All resections were limited to one hour. Postoperatively, 100% patients in the rnanni tol group (JVJG) showed no hemolysis while only 20% in the water group (WG) was spared from hemolysis. Intraoperatively, 40% patients in MG revealed hemolysis at some point during the resection while 100% patients in WG revealed hemolysis at any point during the resection. All patients in MG with initial hemolysis at 15 minutes recovered to preoperative levels by 120 minutes; half of which recovered as early as 30 minutes. Our prospective study reveal the usefulness and safety of 5% Manni tol irrigant in TURP, especially for Urology residents-in-training in Third World countries.
INCIDENCE OF PULMONARY EMBOLIZATION AFTER PELVIC SURGERY. *Lee Goldman and Arthur Porter, Cleveland, OH (Presentation to be made by Dr. Goldman) The incidence of thrombophlehitis and pulmonary embolus in patients of the age grouP seen in most urologic practices
has been reported to be as high as 15-20% in some series. Other reports indicate an equally frequent incidence of pulmonary embolization after pelvic and prostatic surgery in all age groups in·the hands of most urological surgeons. In afl effort to determine the true occurrence rate and whether
the frequency has changed with the advent of early ambulation and modern regimens we have studied patients.who have
had retropubic prostatectomy, total and simple, Plus pelvic explorations, lymphadenectomy and the like over the last two decades. Our rate for embolization has not been anywhere near as high as that reported in the literature and may be well below 5%. The patient population, management of post-operative regimens and current,handling of thrombophlebitis, suspected and documented, will be reported as well. Initial preliminary evaluation suggest that the current surgical management has markedly reduced the incidence of these complications.
370A