Weekly ascorbic acid infusion in castration-resistant prostate cancer patients: a single-arm phase II trial.

Background: Ascorbic acid (AA) has cytotoxic properties at concentrations that can only be achieved through intravenous (IV) administration in humans. Treatment with intravenous AA is widely and increasingly used in complementary medicine despite a lack of clinical evidence for the efficacy of this treatment.

Methods: This non-comparative, single-center, phase II trial included patients with chemotherapy-naïve, metastatic castration-resistant prostate cancer (mCRPC) from an outpatient clinic to evaluate the efficacy and safety of IV AA therapy.

Prostate cancer staging with extracapsular extension risk scoring using multiparametric MRI: a correlation with histopathology.

Objectives: To evaluate the diagnostic performance of preoperative multiparametric MRI with extracapsular extension (ECE) risk-scoring in the assessment of prostate cancer tumour stage (T-stage) and prediction of ECE at final pathology.

Materials And Methods: Eighty-seven patients with clinically localised prostate cancer scheduled for radical prostatectomy were prospectively enrolled. Multiparametric MRI was performed prior to prostatectomy, and evaluated according to the ESUR MR prostate guidelines by two different readers.

[The Danish introductory position provides a qualified choice of specialty].

The Danish introductory position is unique. It is placed between internship and the main part of specialist education. Workplace-based assessment according to central objectives is central.

Elimination of ascorbic acid after high-dose infusion in prostate cancer patients: a pharmacokinetic evaluation.

Treatment with high-dose intravenous (IV) ascorbic acid (AA) is used in complementary and alternative medicine for various conditions including cancer. Cytotoxicity to cancer cell lines has been observed with millimolar concentrations of AA. Little is known about the pharmacokinetics of high-dose IV AA.

Early experience with multiparametric magnetic resonance imaging-targeted biopsies under visual transrectal ultrasound guidance in patients suspicious for prostate cancer undergoing repeated biopsy.

Objectives: The purpose of this study was to investigate the detection rate of prostate cancer (PCa) by multiparametric magnetic resonance imaging-targeted biopsies (mp-MRI-bx) in patients with prior negative transrectal ultrasound biopsy (TRUS-bx) sessions without previous experience of this.

Material And Methods: Eighty-three patients with prior negative TRUS-bx scheduled for repeated biopsies due to persistent suspicion of PCa were prospectively enrolled. mp-MRI was performed before biopsy and all lesions were scored according to the Prostate Imaging Reporting and Data System (PI-RADS) and Likert classification.

[The seven CanMEDS roles in postgraduate medical education should be revised].

The seven CanMEDS roles were adopted by the Danish reform in postgraduate medical education in 2004. The roles have become a natural part of defining specialist competence. However, the definition of the seven roles from 2000 might not be aligned with the perception of good medical practice anno 2013.

Inoculation of Sphingobacterium multivorum in the prostate by prostate biopsy.

This report describes three cases of infection with Sphingobacterium multivorum after transrectal ultrasound-guided prostate biopsy. The pathogen is ubiquitous in water and soil but has been described fewer than 10 times causing infections in humans. An infection hygiene evaluation identified and changed a step in the biopsy process in order to reduce the risk of inoculating the patient with environmental microorganisms.

Endurance training improves insulin sensitivity and body composition in prostate cancer patients treated with androgen deprivation therapy.

Insulin resistance and changes in body composition are side effects of androgen deprivation therapy (ADT) given to prostate cancer patients. The present study investigated whether endurance training improves insulin sensitivity and body composition in ADT-treated prostate cancer patients. Nine men undergoing ADT for prostate cancer and ten healthy men with normal testosterone levels underwent 12 weeks of endurance training.

Mitochondrial respiration in subcutaneous and visceral adipose tissue from patients with morbid obesity.

Adipose tissue exerts important endocrine and metabolic functions in health and disease. Yet the bioenergetics of this tissue is not characterized in humans and possible regional differences are not elucidated. Using high resolution respirometry, mitochondrial respiration was quantified in human abdominal subcutaneous and intra-abdominal visceral (omentum majus) adipose tissue from biopsies obtained in 20 obese patients undergoing bariatric surgery.

Ureteral injuries during photoselective vaporization of the prostate.

Photoselective vaporization of the prostate is a relatively new surgical modality for male lower urinary tract symptoms. The method has a risk of tissue damage if laser pulses miss the prostatic adenoma and travel through the irrigation fluid in the bladder. Five cases of damage to the ureteral orifices are described, with hidden orifices, intravesical prostatic adenomas and prior prostatectomy as risk factors for laser-related injuries to ureteral orifices.

[Recurrence of varicocele caused by renal tumour].

A 31-year-old man referred with six to seven years' history of a left-side WHO grade III varicocele and normal palpatory abdominal findings underwent microsurgical subinguinal varicocelectomy. At 3-month follow-up there was complete remission. The varicocele recurred after one year and abdominal ultrasound demonstrated a solid mass in the left kidney.

[Microsurgical varicocele operation: a retrospective statement of Danish results].

Introduction: Varicoceles are present in about 15% of the male population. The treatment is surgical and internationally there has been an increase in the use of a subinguinal microsurgical approach in which the veins of the spermatic cord are ligated. The purpose of this paper is to evaluate the results of the first microsurgical varicocelectomies performed in Denmark.

[Treatment of localised prostate cancer].

The incidence of prostate cancer is increasing sharply in Denmark and an increasing proportion of patients have clinically localised disease at diagnosis. The therapeutic strategy encompasses intended curative therapy: radical prostatectomy with complete removal of the prostate gland and seminal vesicles performed as an open procedure or laparoscopically, external beam radiation therapy, or implantation of radioactive seeds into the prostate (brachytherapy). In older patients with good prognostic factors, active surveillance should be considered.

[Occupationally conditioned bladder cancer--are the patients identified?].

Introduction: A minor percentage of bladder cancer cases in Denmark are caused by occupational exposure to carcinogens. The disease is therefore also present on the National Board of Industrial Injuries' list of occupational diseases, and reporting of these is compulsory for Danish physicians. In spite of this, only very few cases are reported annually.

[HCG in the treatment of cryptorchidism. The effect of age and position of the testis].

In a recent study, the effect of human chorionic gonadotropin (HCG) in the treatment of children with cryptorchidism aged less than four years was questioned. The purpose of the present study was to determine, on the basis of a retrospective examination of patients' records, the effect of HCG treatment, whether outcomes are age-dependent and whether the effects of treatment are related to the position of the testis. Patients diagnosed with undescended testis who had been treated at the Department of Urology at Gentofte Hospital (Copenhagen) in the period from 1 November 1998 to 31 May 2003 were identified.

Physical training may enhance beta-cell function in type 2 diabetes.

In healthy young subjects, training increases insulin sensitivity but decreases the capacity to secrete insulin. We studied whether training changes beta-cell function in type 2 diabetic patients. Patients, stratified into "moderate" and "low" secretors according to individual C-peptide responses to an intravenous glucagon test, were randomly assigned to a training program [ergometer cycling 30-40 min/day, including at least 20 min at 75% maximum oxygen consumption (Vo(2 max)), 5 days/wk for 3 mo] or a sedentary schedule.

Effect of training on insulin sensitivity of glucose uptake and lipolysis in human adipose tissue.

Training increases insulin sensitivity of both whole body and muscle in humans. To investigate whether training also increases insulin sensitivity of adipose tissue, we performed a three-step hyperinsulinemic, euglycemic clamp in eight endurance-trained (T) and eight sedentary (S) young men [insulin infusion rates: 10,000 (step I), 20,000 (step II), and 150,000 (step III) microU x min(-1) x m(-2)]. Glucose and glycerol concentrations were measured in arterial blood and also by microdialysis in interstitial fluid in periumbilical, subcutaneous adipose tissue and in quadriceps femoris muscle (glucose only).

Glucose clearance in aged trained skeletal muscle during maximal insulin with superimposed exercise.

Insulin and muscle contractions are major stimuli for glucose uptake in skeletal muscle and have in young healthy people been shown to be additive. We studied the effect of superimposed exercise during a maximal insulin stimulus on glucose uptake and clearance in trained (T) (1-legged bicycle training, 30 min/day, 6 days/wk for 10 wk at approximately 70% of maximal O(2) uptake) and untrained (UT) legs of healthy men (H) [n = 6, age 60 +/- 2 (SE) yr] and patients with Type 2 diabetes mellitus (DM) (n = 4, age 56 +/- 3 yr) during a hyperinsulinemic ( approximately 16,000 pmol/l), isoglycemic clamp with a final 30 min of superimposed two-legged exercise at 70% of individual maximal heart rate. With superimposed exercise, leg glucose extraction decreased (P < 0.

[Munchausen syndrome].

The case of 43 year old man who had numerous contacts with the health care system is reported. Since 1984 he had been treated 95 times for testicular problems at 45 different hospitals including 36 operations for torsion. Computer record systems had only once stopped the patient from going through another unnecessary operation.

Training-induced enhancement of insulin action in human skeletal muscle: the influence of aging.

Age-induced reduction of whole body insulin action has been attributed to decreased insulin action in skeletal muscle. Physical training improves insulin action, but the effect has never been investigated specifically in aged human skeletal muscle. Seven young men [age: 23 +/- 1 yr (mean +/- SE; range, 21-24 yr); weight: 70 +/- 1 kg; body fat: 8 +/- 1%] and eight aged men [59 +/- 1 yr (range, 58-64 yr); 83 +/- 2 kg; 20 +/- 2%] performed one-legged bicycle training on a modified ergometer cycle for 10 weeks, 6 days/week, at 70% of VO2 peak.

Insulin-stimulated muscle glucose clearance in patients with NIDDM. Effects of one-legged physical training.

Physical training increases insulin action in skeletal muscle in healthy men. In non-insulin-dependent diabetes mellitus (NIDDM), only minor improvements in whole-body insulin action are seen. We studied the effect of training on insulin-mediated glucose clearance rates (GCRs) in the whole body and in leg muscle in seven patients with NIDDM and in eight healthy control subjects.

Paradoxical inhibition of insulin secretion by glucose in non-insulin-dependent diabetic patients.

In young healthy individuals, an i.v. glucose bolus leads to an immediate increase in plasma insulin, whereas in non-insulin-dependent diabetic patients this early response is diminished, lacking or even negative.

Normal effect of insulin to stimulate leg blood flow in NIDDM.

In patients with non-insulin-dependent diabetes mellitus (NIDDM), a decreased effect of insulin in stimulating leg blood flow (LBF) has been reported. We reinvestigated the effect of insulin on LBF and validated our data by use of other measures. Eight healthy men (control group) and seven men with NIDDM were studied (age 59 +/- 1 and 58 +/- 3 years, weight 83 +/- 3 and 86 +/- 6 kg, fat-free mass 66 +/- 1 and 64 +/- 3 kg, respectively [mean +/- SE, all P > 0.