Prostatic artery embolization for the management of benign prostatic hyperplasia/lower urinary tract symptoms in elderly patients unfit for surgery: Our initial experience.

Objective: To evaluate the safety and efficacy of prostatic artery embolization in the management of LUTS secondary to BPH in elderly patients unfit for surgery.

Materials And Methods: 17 elderly patients with moderate to severe LUTS/BPH were included in the study and treated with prostatic artery embolization. The patients were evaluated by transrectal ultrasonography (to assess prostate size), IPSS, and PVR urine volume preoperatively and 6 months after the procedure.

Antimicrobial activity of novel dendrimeric peptides obtained by phage display selection and rational modification.

A large 10-mer phage peptide library was panned against whole Escherichia coli cells, and an antimicrobial peptide (QEKIRVRLSA) was selected. The peptide was synthesized in monomeric and dendrimeric tetrabranched form (multiple antigen peptide [MAP]), which generally allows a dramatic increase of peptide stability to peptidases and proteases. The antibacterial activity of the dendrimeric peptide against E.

Detection of CTX-M-type beta-lactamase genes in fecal Escherichia coli isolates from healthy children in Bolivia and Peru.

A survey was carried out from August to November 2002 to evaluate the antimicrobial susceptibilities of fecal Escherichia coli isolates from 3,208 healthy children from four different urban areas of Latin America, two in Bolivia (Camiri and Villa Montes) and two in Peru (Yurimaguas and Moyobamba). Ceftriaxone-resistant E. coli isolates were detected in four children, one from each of the areas sampled.

[Pathogenesis of neoplasms].

The Authors discuss the aspect and the function of the Microcirculatory Unit and the chronic reduction of circulation in true capillaries and therefore of tissue perfusion increasingly evident with the advancement of age, the structural simplification of proteins, the instability of the cells' genome and the increasing remoteness of the immunity system's control. In view of these considerations, they propose the possibility that the onset of tumours may be due to the accentuation of mutageneous substances and the reduction of tissue perfusion with age. When perfusion is maintained of periodically resumed, hypoxy only determines hyperplasia but not cell degeneration or mutations.

[Compromised tissue perfusion for defective microcirculation in children].

After a brief review of the anatomic and physiological features of the microcirculatory system, the Authors describe a new interpretation of skin edema in acute diffuse infantile glomerulonephritis, in Henoch-Schönlein's purpura, in epidemic parotitis and in Kawasaki's disease. They attribute the cellular swelling typical of elastic oedema of these diseases to respiratory deficiency due to reduced tissue perfusion following insufficient circulation in real capillaries. The ensuring drop in energy is rapidly resolved by use of very small doses of a calcium antagonist, chloropromazine, which also affects hemorheology.

The impact of chronic reduced microcirculation on tissue function and on neoplastic promotion.

I hypothesize that chronic reduced microcirculation, even limited to micro areas of tissue, may lead to respiratory deficiencies, to a proliferation of simplified cells as a result of a lack of energy, and to defects in immune control. In these situations, reduce resistance and specific hypofunction might occur in organs (should the entire organ be involved) and cell alterations might come about, as several authors have described experiments in conditions of hypoanoxia. The mutated cells, possibly in these areas as well, could more easily emerge as neoplasia because they are removed from immune control and surrounded by a terrain of reduced resistance.

[A pathogenetic hypothesis based on the use of chlorpromazine of organic disorders probably due to microcirculatory changes].

In the introduction it is noted that, in the physiopathology, specific pathogenetic elements are missing concerning irritative stimulation, turbid fat pathosis, digital hippocratism of chronic affections (for example, pulmonary affections), the most frequent onset of telarche and of the swelling of the areola of the breast on the left hemithorax in the premenstrual syndrome, fibrosis, cyrrosis, certain types of insipid diabetes, etc. In the opinion of the author, the use of chloropromazine, in doses that have proved to be harmless, has contributed to the clearing up of some questions concerning a few pathologies of internal organs: the liver, the spleen, the brain-and enable us to pose some hypotheses about the swelling of the liver, the origin of scleroses and cirrhoses and some splenic and encephalic swellings. The author suggests that the fundamental reason is to be sought in changes in the microcirculation which are linked to insufficient capillary and sinusoidal circulation.

[Edema in acute diffuse glomerulonephritis, rheumatic peliosis and epidemic parotitis].

The Authors present a substantial series of infant APING in which the venous blood gas analysis shows poor use of oxygen, due to a probably reduced cellular combustion associated with low pCO2, high pH, which are characteristic of arterial blood travelling through anastomotic paths and preferential channels at the microcirculation level. They emphasize the contemporaneous increase in volemia, even with oedema present, and the poor permeation of the capillary wall found with the Landis test, contrary to what happens in glomerulonephrosis with minimal changes which features increased systematic capillary permeation with hypovolemia. The look of the oedema, together with the hypervolemia, led to the suspicion that the nephritic oedema was a sign of mainly intracellular oedema.

[Clinical course and therapy in 94 cases of rheumatic peliosis hospitalized at the Trento Pediatric Center from 1967 to 1986].

Therapy and clinical evolution are described in 94 cases of rheumatic peliosis accepted in about twenty years in the second division of the pediatric department. In 52 cases (55 per cent) at the first stage of the disease chlorpromazinic treatment only was performed and gradually replaced by prednisonich therapy; in other 36 lighter cases, (37 per cent) the treatment was prednisonic only. Other six cases were not treated at all.

[Microcirculatory changes in infancy and old age].

An account of the microcirculatory unit according to Zweifach is followed by an explanation of the marked differences in capillary and tissue perfusion in children and aged. Prolonged hypertonia of the metarteriolar smooth muscle cells of the precapillary sphincters depresses capillary perfusion, even though the preferential circulation remains, resulting in marked changes in cellular metabolism in the tissues. If the capillary circulation is excluded for a sufficiently long period, less oxygen and substrates will be transported to the tissues concerned, intravasal red cell clumping will exacerbate hypoxia, and drainage of metabolic residues will be reduced.

[Importance of microcirculation in the pathogenesis of various disease conditions, especially hyperplasia and neoplasms].

The possibility is considered that a contraction or an increase in the tone of the smooth muscular fibrocells of the vessels may direct the blood flow prevalently thorough preferential channels, with elusion of much of the capillary circulation. This event may lead to a slowdown or change in the function of organs and systems. The persistence of preferential route circulation leads to respiratory and metabolic trouble in the cells of tissues and basic and fibrillar substance of connectives.

Importance of microcirculatory alterations in the initial hypertensive, oligoanuric phase of acute post-infective glomerulonephritis in infancy.

By applying the blood gas analysis to the venous blood of 17 children affected by DPGN, the authors have observed an increase of the PvO2 and a reduction of the PvCO2 in the oligoanuric and hypertensive phase, which is attributed to a minor utilization of O2. The authors relate a probable cellular respiratory defect with the initial skin tumefaction in these cases. This respiratory dysfunction would be due to intravascular red cell aggregation, to the reduction of perfusion of the exchange vessels and to the passage of the blood through preferential circuits.