Shear wave elastography allows the identification of cancer foci based on shear wave elastography differences. Moreover, reliable cutoffs for this approach can be established, allowing examiner independent localization of prostate cancer foci.

Previously characterized mammalian soluble guanylyl cyclases form ␣/␤ heterodimers that can be activated by the gaseous messenger, nitric oxide, and the novel guanylyl cyclase modulator YC-1. Four mammalian subunits have been cloned named ␣ 1 , ␤ 1 , ␣ 2 , and ␤ 2 . The ␣ 1 /␤ 1 and ␣ 2 /␤ 1 heterodimeric enzyme isoforms have been rigorously characterized. The role of the ␤ 2 subunit has remained elusive. Here we isolate a novel variant of this subunit and show that the ␤ 2 subunit does not need to form heterodimers for catalytic activity because enzyme activity can be measured when it is expressed alone in Sf9 cells. In analogy to the ␤ 3 subunit recently isolated from the insect Manduca sexta, activity was dependent on the presence of 4 mM free Mn 2؉ . The EC 50 values for the NO-donor diethylamine/NO were shifted to the left by 1 order of magnitude as compared with the ␣ 1 /␤ 1 heterodimeric form. In the presence of the detergent Tween, NO sensitivity of ␤ 2 was abolished, but the enzyme could be activated by protoporphyrin IX, indicating removal of a prosthetic heme group and exchange for the heme precursor. We suggest that the ␤ 2 subunit is the first mammalian NO-sensitive guanylyl cyclase lacking a heterodimeric structure.

Objective• To address the biochemical and functional outcomes after radical prostatectomy (RP) of men aged <50 years in a large European population. Patients and Methods• Among 13 268 patients who underwent RP for clinically localised prostate cancer at our centre (1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011), 443 (3.3%) men aged <50 were identified. • Biochemical recurrence (BCR) and functional outcomes (International Index of Erectile Function , use of pads), were prospectively evaluated and compared between men aged <50 years and older patients. Results• Men aged <50 years were more likely to harbour D'Amico low-risk (49.4 vs 34.9%, P < 0.001), organ-confined (82.6 vs 69.4%, P < 0.001) and low-grade tumours (Gleason score <7: 33.1 vs 28.7%, P < 0.001).• Multivariate Cox regression analysis showed that age <50 years (hazard ratio 0.99; confidence interval 0.72-1.31; P = 0.9) was not a predictor of BCR.• Urinary continence was more favourable in younger patients, resulting in continence rates of 97.4% vs 91.6% in most recent years (2009)(2010)(2011) for patients aged <50 vs ≥50 years.• After RP, a median IIEF-5 drop of 4 points in younger men vs 8 points in older patients was recorded (P < 0.001).• Favourable recovery of urinary continence and erectile function in patients aged <50 years compared with their older counterparts was confirmed after multivariable adjustment. Conclusion• Men aged <50 years diagnosed with localised prostate cancer should not be discouraged from RP, as the postoperative rates of urinary incontinence and erectile dysfunction are low and probability of BCR-free survival at 2 and 5 years is high.