A more advanced clinical stage is positively correlated with an increased prostate cancer detection rate.

Objectives: To determine whether an additional subclassification of the assessed clinical stage for prostate cancer before biopsy increases our ability to predict the biopsy outcome. A suspicious digital rectal examination (DRE) and/or a suspicious transrectal ultrasound (TRUS) investigation increases the likelihood of prostate cancer given a certain prostate-specific antigen level.

Methods: Biopsies done in 2199 men with suspicious DRE and/or TRUS findings were studied.

Analysis of TSC2 stop codon variants found in tuberous sclerosis patients.

Tuberous sclerosis complex (TSC) is an autosomal dominant disorder caused by mutations to the TSC1 and TSC2 tumour suppressor genes. We detected two sequence changes involving the TSC2 stop codon and investigated the effects of these changes on the expression of tuberin, the TSC2 gene product, and on the binding between tuberin and the TSC1 gene product, hamartin. While elongation of the tuberin open reading frame by 17 amino acids did not interfere with tuberin-hamartin binding, a longer extension prevented this interaction.

Shock wave lithotripsy treatment of radiolucent ureteric calculi with the help of contrast medium.

Objective: Extracorporeal shock wave lithotripsy (SWL) treatment of radiolucent ureteric calculi (UC) is hampered by the reduced visibility of the stone. Intravenous contrast medium (IV-CM) administration may overcome this problem by indirectly depicting the localisation of the stone. However, IV-CM administration bears known risks.

The use of carbon dioxide in magnetic resonance angiography: a new type of black blood imaging.

The injection of boluses of carbon dioxide (CO(2)) during T1-weighted magnetic resonance angiography (MRA) resulted in sharp depiction of the vascular lumen during the performance of in vitro and in vivo animal experiments. We propose the use of the low-cost, relatively safe CO(2) as a negative contrast agent for MRA and speculate on its use in future interventional MRA.

Predictors for biopsy outcome in the European Randomized Study of Screening for Prostate Cancer (Rotterdam region).

Background: In the European Randomized Study of Screening for Prostate Cancer (ERSPC, Rotterdam region), men aged 55-74 years are screened for prostate cancer by prostate-specific antigen (PSA) sampling, digital rectal examination (DRE), and transrectal ultrasound investigation (TRUS). All men with a PSA > or =4 ng/ml and/or a suspicious DRE and/or a suspicious TRUS are biopsied.

Methods: Logistic regression analysis was applied to derive a predictive index that equals the chance to find prostate cancer in a biopsy given the outcomes of the screening tests.

Increased loss of trabecular but not cortical bone density, 1 year after discontinuation of 2 years hormone replacement therapy with Tibolone.

Objective: Assessment of loss of bone density (BD) 1 year after a 2-year period of hormone replacement therapy (HRT) with two doses of Tibolone as compared to placebo in early post-menopausal women.

Methods: Sixty-four out of 84 women (1-3 years following spontaneous menopause) who completed a 2-year randomised, placebo controlled study to evaluate effects of Tibolone participated in this follow-up study. Quantitative computed tomography was used to exclusively measure trabecular BD, microdensitometry of the mid-phalangeal shaft was used for estimation of cortical BD and biochemical markers of bone metabolism were assessed, 1 year after discontinuation of Tibolone.

Developments in human recombinant follicle stimulating hormone technology: are we going in the right direction?

Recent developments in recombinant DNA technology have enabled the large scale production of human recombinant follicle stimulating hormone (rFSH); and this compound has recently been introduced to the market. Understanding of the structure-function relationship of FSH isohormones is crucial in understanding discussions on the standardization procedures of gonadotrophin preparations, potential differences in clinical efficacy of the various gonadotrophin preparations and in comprehending future developments (long-acting and short-acting forms, and rFSH preparations with altered isohormone profiles). Differences between immunoreactive and bioactive serum FSH concentrations have been observed following the administration of rFSH.

Lack of correlation between maximum early follicular phase serum follicle stimulating hormone concentrations and menstrual cycle characteristics in women under the age of 35 years.

The gradual increase in follicle stimulating hormone (FSH) concentrations in women approaching menopause results from the depletion of the ovarian follicular pool, a process referred to as 'ovarian ageing'. This study investigates whether variable endogenous FSH concentrations, as have been observed in normo-ovulatory young women, are related to menstrual cycle characteristics, including predictors of ovarian ageing. Serum concentrations of immunoreactive FSH, oestradiol, and inhibin-A and inhibin-B were measured, and follicular growth was assessed by transvaginal ultrasound throughout the follicular phase in 39 healthy volunteers (20-35 years) with regular menstrual cycles.

High dose gonadotrophin-releasing hormone antagonist (ganirelix) may prevent ovarian hyperstimulation syndrome caused by ovarian stimulation for in-vitro fertilization.

This case report describes the first attempt to treat imminent ovarian hyperstimulation syndrome (OHSS) by using a gonadotrophin-releasing hormone (GnRH) antagonist. A 33 year old, normo-ovulatory woman undergoing in-vitro fertilization received daily subcutaneous injections of 150 IU of recombinant follicle-stimulating hormone (recFSH) from cycle day 2, together with GnRH antagonist (ganirelix) 0.125 mg from cycle day 7 onwards.

The follicle-stimulating hormone (FSH) threshold/window concept examined by different interventions with exogenous FSH during the follicular phase of the normal menstrual cycle: duration, rather than magnitude, of FSH increase affects follicle development.

According to the threshold concept, FSH concentrations need to surpass a distinct level to stimulate ovarian follicle growth. The window concept stresses the significance of a limited duration of elevated FSH levels above the threshold for single dominant follicle selection. The aim of this study was to investigate effects on follicle growth of increased FSH levels, differing in duration and magnitude of elevation, during the follicular phase.

Fluoxetine and premature ejaculation: a double-blind, crossover, placebo-controlled study.

The purpose of this study was to investigate the effect of fluoxetine on sexual function in men with premature ejaculation and/or erectile dysfunction and control subjects in a prospective, double-blind, placebo-controlled, crossover study. There were four groups: (1) premature ejaculation (PE, N = 9); (2) premature ejaculation and erectile dysfunction (PE/ED, N = 9); (3) erectile dysfunction (ED, N = 7); and (4) healthy, sexually functional control subjects (N = 15). The study consisted of three 4-week periods: fluoxetine, washout, and placebo (or vice versa).

Urinary follicle-stimulating hormone for normogonadotropic clomiphene-resistant anovulatory infertility: prospective, randomized comparison between low dose step-up and step-down dose regimens.

A low dose step-up and step-down regimen for induction of ovulation using urinary FSH was compared in a prospective randomized fashion in 37 normogonadotropic clomiphene-resistant oligo- or amenorrheic infertile women. The objectives was to assess potential differences in duration of treatment, ovarian stimulation (serum FSH levels), and response [serum estradiol (E2) levels and number and size of follicles]. Monitoring (blood sampling and transvaginal sonography) took place on the day of initiation of treatment, the first day of ovarian response as assessed by ultrasound (i.

Flesinoxan: a prosexual drug for male rats.

Two tests were carried out to compare the stimulatory (i.e., prosexual) effects of the 5-HT1A receptor agonists flesinoxan and 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT) on sexual behavior in male Wistar rats.

Low levels of follicle-stimulating hormone receptor-activation inhibitors in serum and follicular fluid from normal controls and anovulatory patients with or without polycystic ovary syndrome.

In patients with normogonadotropic anovulation, either with or without polycystic ovary syndrome (PCOS), factors interfering with FSH action may be involved in arrested follicle development. The aim of this study is to assess whether factors inhibiting FSH receptor activation are elevated in serum or follicular fluid from anovulatory patients, as compared with regularly cycling women. For this purpose, a Chinese hamster ovary cell line, stably transfected with the human FSH receptor, has been applied.

Follicular development and oocyte maturation in hypogonadotrophic women employing recombinant follicle-stimulating hormone: the role of oestradiol.

Both luteinizing hormone (LH) and follicle-stimulating hormone (FSH) are required for follicle development and oestrogen production. Moreover, under normal conditions a close association between dominant follicle size and serum and intrafollicular oestradiol levels is observed. With the recent availability of human recombinant FSH (recFSH), it was possible for the first time to study effects of FSH alone, in the complete absence of endogenous or exogenous LH, on ovarian function.

Classification of normogonadotropic infertility: polycystic ovaries diagnosed by ultrasound versus endocrine characteristics of polycystic ovary syndrome.

Objective: To investigate the predictive value of polycystic ovaries for endocrine signs of polycystic ovary syndrome (PCOS).

Design: Controlled descriptive study.

Setting: Academic tertiary care fertility clinic.

Effects of two doses of tibolone on trabecular and cortical bone loss in early postmenopausal women: a two-year randomized, placebo-controlled study.

The present randomized, double-blind, placebo-controlled, 2-year study is the first to evaluate the effect of 1.25 and 2.5 mg tibolone daily oral administration on trabecular and cortical bone loss in early postmenopausal women.

Application of a CHO cell line transfected with the human FSH receptor for the measurement of specific FSH receptor activation inhibitors in human serum.

Effects of FSH on ovarian follicular development can be modulated by factors present in serum or by locally produced factors in follicular fluid. Some of these factors may act directly on the FSH receptor. A Chinese hamster ovary cell line (CHO-F3B4) stably transfected with the human FSH receptor has been used to measure the effects of these modulators on FSH-stimulated adenylate cyclase activity.

Interference with follicle stimulating hormone regulation of human ovarian function.

This review summarizes observations on the background and potential clinical significance of interference with follicle stimulating hormone (FSH) regulation of human ovarian function. This interference may occur at the level of the pituitary by the secretion of FSH isoforms with reduced or absent bioactivity. In addition, interference with FSH may occur in the circulation, or within the ovarian follicular compartment.

Circulating immunoreactive and bioactive follicle stimulating hormone concentrations in anovulatory infertile women and during gonadotrophin induction of ovulation using a decremental dose regimen.

Our purpose was to determine whether decreased follicle stimulating hormone (FSH) activity, either systemic or at the follicular level, is involved in impaired follicle growth associated with normogonadotrophic anovulation. To differentiate between the possible levels of disturbance, bioactive (BIO-FSH; using the in-vitro rat granulosa cell aromatase bioassay) and immunoreactive (IRMA-FSH) FSH serum concentrations of three groups of subjects were compared: (i) 172 normogonadotrophic anovulatory infertile women during baseline conditions, (ii) 22 clomiphene-resistant polycystic ovary syndrome patients undergoing ovulation induction by exogenous gonadotrophins using a decremental dose regimen, and (iii) nine regularly cycling controls. BIO-FSH [13.

Normal human follicle development: an evaluation of correlations with oestradiol, androstenedione and progesterone levels in individual follicles.

Objective: The mechanism of dominant follicle selection remains obscure. We have investigated the association between follicle diameter and follicular steroid levels in individual human ovarian follicles throughout the menstrual cycle.

Design: Fluid from ovarian follicles (n = 326) was obtained in vivo during surgery from 55 regularly cycling women with proven fertility.

Initial estradiol response predicts outcome of exogenous gonadotropins using a step-down dose regimen for induction of ovulation in polycystic ovary syndrome.

Objective: To study ovarian stimulation and response patterns during a gonadotropin step-down dose regimen for induction of ovulation by applying a decremental dose regimen in polycystic ovary syndrome (PCOS) patients.

Design: The present prospective study involves 28 infertile clomiphene citrate-resistant PCOS patients during gonadotropin-induced cycles using a modified step-down dose regimen (and adjuvant GnRH agonist medication). Applied gonadotropin doses included initial daily doses of 150 IU IM followed by two reducing steps (37.

Decremental follicle-stimulating hormone and dominant follicle development during the normal menstrual cycle.

Objective: To study the relationship between decreasing serum FSH levels in the follicular phase of the normal menstrual cycle and follicle development by means of transvaginal sonography and E2 production.

Design: Daily blood samples were taken and transvaginal sonography was performed every other day in 16 normal regularly cycling female volunteers.

Main Outcome Measure: Serum levels of FSH, LH, E2, and P and follicle diameter by transvaginal sonography.

Gonadotrophin induction of ovulation using a step-down dose regimen: single-centre clinical experience in 82 patients.

A total of 82 normogonadotrophic clomiphene-resistant anovulatory patients were treated with exogenous gonadotrophins according to a step-down dose regimen during 234 cycles. In 43 (18%) cycles co-treatment with gonadotrophin-releasing hormone analogues was applied. The initial dose was between 1.