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Objectives To evaluate the short-and medium-term results of prostatic arterial embolisation (PAE) for benign prostatic hyperplasia (BPH). Methods This was a prospective non-randomised study including 255 patients diagnosed with BPH and moderate to severe lower urinary tract symptoms after failure of medical treatment for at least 6 months. The patients underwent PAE between March 2009 and April 2012. Technical success is when selective prostatic arterial embolisation is completed in at least one pelvic side. Clinical success was defined as improving symptoms and quality of life. Evaluation was performed before PAE and at 1, 3, 6 and every 6 months thereafter with the International Prostate Symptom Score (IPSS), quality of life (QoL), International Index of Erectile Function (IIEF), uroflowmetry, prostatic specific antigen (PSA) and volume. Non-spherical polyvinyl alcohol particles were used. Results PAE was technically successful in 250 patients (97.9 %). Mean follow-up, in 238 patients, was 10 months (range 1-36). Cumulative rates of clinical success were 81.9 %, 80.7 %, 77.9 %, 75.2 %, 72.0 %, 72.0 %, 72.0 % and 72.0 % at 1, 3, 6, 12, 18, 24, 30 and 36 months, respectively. There was one major complication. Conclusions PAE is a procedure with good results for BPH patients with moderate to severe LUTS after failure of medical therapy. Key Points • Prostatic artery embolisation offers minimally invasive therapy for benign prostatic hyperplasia.• Prostatic artery embolisation is a challenging procedure because of vascular anatomical variations.• PAE is a promising new technique that has shown good results.

Purpose: To describe the anatomy and imaging findings of the prostatic arteries (PAs) on multirow-detector pelvic computed tomographic (CT) angiography and digital subtraction angiography (DSA) before embolization for symptomatic benign prostatic hyperplasia (BPH). Materials and Methods:In a retrospective study from May 2010 to June 2011, 75 men (150 pelvic sides) underwent pelvic CT angiography and selective pelvic DSA before PA embolization for BPH. Each pelvic side was evaluated regarding the number of independent PAs and their origin, trajectory, termination, and anastomoses with adjacent arteries.

PAE is a safe and effective procedure, with low morbidity, no sexual dysfunction, and good short- and intermediate-term symptomatic control associated with prostate volume reduction.

PURPOSE:To evaluate whether prostatic arterial embolization (PAE) might be a feasible procedure to treat lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS:Fifteen patients (age range, 62-82 years; mean age, 74.1 y) with symptomatic BPH after failure of medical treatment were selected for PAE with nonspherical 200-m polyvinyl alcohol particles. The procedure was performed by a single femoral approach. Technical success was considered when selective prostatic arterial catheterization and embolization was achieved on at least one pelvic side. RESULTS:PAE was technically successful in 14 of the 15 patients (93.3%). There was a mean follow-up of 7.9 months (range, 3-12 months). International Prostate Symptom Score decreased a mean of 6.5 points (P ϭ .005), quality of life improved 1.14 points (P ϭ .065), International Index of Erectile Function increased 1.7 points (P ϭ .063), and peak urinary flow increased 3.85 mL/sec (P ϭ .015). There was a mean prostate-specific antigen reduction of 2.27 ng/mL (P ϭ .072) and a mean prostate volume decrease of 26.5 mL (P ϭ .0001) by ultrasound and 28.9 mL (P ϭ .008) by magnetic resonance imaging. There was one major complication (a 1.5-cm 2 ischemic area of the bladder wall) and four clinical failures (28.6%). CONCLUSIONS:In this small group of patients, PAE was a feasible procedure, with preliminary results and short-term follow-up suggesting good symptom control without sexual dysfunction in suitable candidates, associated with a reduction in prostate volume. ABBREVIATIONSBPH ϭ benign prostatic hyperplasia, IPSS ϭ international prostate symptom score, PAE ϭ prostatic arterial embolization, PSA ϭ prostate specific antigen, PVA ϭ polyvinyl alcohol, PVR ϭ postvoid residual volume, Q max ϭ peak urinary flow, QOL ϭ quality of life Benign prostatic hyperplasia (BPH) has a high prevalence rate in men aged 50 -79 years (1) and is ubiquitous with aging (2). BPH is a condition often associated with lower urinary tract symptoms (3), the most frequent of which are decreased urinary stream, greater frequency, and urgency (4).Surgery is performed less often now that effective pharmacotherapy is available, but it is an excellent option for improving symptoms and decreasing progression of disease in patients who develop complications or whose symptoms are inadequately controlled with medical treatment (5).Prostatectomy by open surgery or by transurethral resection of the prostate is still considered the gold standard of treatment. Alternative options include minimally invasive treatments and prostatic stent placement. Age, symptom scores, grade of obstruction, baseline prostate volume, peak urinary flow (Q max ), serum prostate specific antigen (PSA) value, and postvoid residual volume (PVR) are important predictors of clinical progression (6) and, along with individual anesthesiologist risk, are factors that should be taken into consideration when choosing an appropriate treatment (7).Urinary tract infection, strictures, postoperati...

The respiratory chain of the mitochondrial inner membrane includes a proton-pumping enzyme, complex I, which catalyses electron transfer from NADH to ubiquinone. This electron pathway occurs through a series of protein-bound prosthetic groups, FMN and around eight iron-sulfur clusters. The high number of polypeptide subunits of mitochondrial complex I, around 40, have a dual genetic origin. Neurospora crassa has been a useful genetic model to characterise complex I. The characterisation of mutants in specific proteins helped to understand the elaborate processes of the biogenesis, structure and function of the oligomeric enzyme. In the fungus, complex I seems to be dispensable for vegetative growth but required for sexual development. N. crassa mitochondria also contain three to four nonproton-pumping alternative NAD(P)H dehydrogenases. One of them is located in the outer face of the inner mitochondrial membrane, working as a calcium-dependent oxidase of cytosolic NADPH.

We have inactivated the nuclear gene coding for a putative NAD(P)H dehydrogenase from the inner membrane of Neurospora crassa mitochondria by repeat-induced point mutations. The respiratory rates of mitochondria from the resulting mutant (nde-1) were measured, using NADH or NADPH as substrates under different assay conditions. The results showed that the mutant lacks an external calcium-dependent NADPH dehydrogenase. The observation of NADH and NADPH oxidation by intact mitochondria from the nde-1 mutant suggests the existence of a second external NAD(P)H dehydrogenase. The topology of the NDE1 protein was further studied by protease accessibility, in vitro import experiments, and in silico analysis of the amino acid sequence. Taken together, it appears that most of the NDE1 protein extends into the intermembrane space in a tightly folded conformation and that it remains anchored to the inner mitochondrial membrane by an Nterminal transmembrane domain.In nonphotosynthetic eukaryotes, the mitochondrion is the cellular organelle responsible for producing most of the energy required for cellular metabolism. The process of oxidative phosphorylation takes place in the inner mitochondrial membrane, whereby the electrons produced by the oxidation of substrates like NAD(P)H are transported through the electron transport chain to oxygen, coupled to the generation of a transmembrane proton gradient that eventually leads to ATP synthesis (1). In contrast to mammals, the electron transport chains of plants and fungi possess several nonproton-pumping NAD(P)H dehydrogenases for transferring electrons to ubiquinone (2). In the case of potato tubers, four rotenone-insensitive NAD(P)H dehydrogenases have been identified in the inner mitochondrial membrane, two with the catalytic site facing the matrix (3, 4) and two facing the intermembrane space (5). In mitochondria from Saccharomyces cerevisiae, where the proton-pumping complex I is not present, the oxidation of NADH and NADPH is performed exclusively by three nonproton-pumping enzymes, one facing the matrix and two facing the intermembrane space (6 -8). In addition, the genome analysis of Synechocystis revealed three open reading frames that may code for such type II NAD(P)H dehydrogenases (9). On the other hand, only one external type II NADH dehydrogenase was reported for the fungus Yarrowia lipolytica (10). Although NAD(P)H dehydrogenases have been studied for a long time, our understanding of protein function at the molecular level is still very incomplete. The cloning of genes encoding several of these rotenoneinsensitive NAD(P)H dehydrogenases from mitochondria of different organisms (7, 10 -13) provides important tools for further research in this field. These enzymes might constitute a wasteful system acting to prevent the overreduction of the electron transport components and the production of reactive oxygen species, but their exact roles remain unclear.Both proton-pumping and nonproton-pumping NAD(P)H dehydrogenases have been described in Neurospora crassa mitochon...

Purpose To assess predictors of outcome after prostate artery embolization (PAE) for benign prostatic hyperplasia with spherical particle polyvinyl alcohol (sPVA) and compare outcomes with the use of nonspherical particle polyvinyl alcohol (nsPVA). Materials and Methods This was a single-center retrospective institutional review board-approved study conducted from 2009 to 2015 in patients undergoing PAE with sPVA (n = 186; mean age ± standard deviation, 65.5 years ± 7.7) and nsPVA (n = 300; mean age, 65.3 years ± 7.6). The two cohorts were compared and analyzed for predictors of outcome with a Cox proportional hazards model and linear regression. Post-PAE prostate ischemia was measured with contrast material-enhanced magnetic resonance (MR) imaging in 23 patients with nsPVA and 25 patients with sPVA. The 24-hour post-PAE prostate-specific antigen (PSA) level was registered in 133 patients with sPVA. Prognostic values of MR imaging and PSA levels 24 hours after PAE were assessed with Cox and random-effects regressions. Results Predictors of clinical failure were older age (age over 65 years, P = .002), unilateral procedure (P = .002), and higher baseline International Prostate Symptom Score (IPSS, P = .033). Adjusted hazard ratio for clinical failure of sPVA was 1.273 (P = .16). Acute urinary retention was a predictor of lower IPSS after PAE (P = .002). The mean proportion of prostate ischemia was 11% with sPVA and 10% with nsPVA (P = .65). Lower IPSS after PAE was associated with a higher proportion of prostate ischemia (P = .009). Patients with a PSA level of at least 75 ng/mL (75 μg/L) 24 hours after PAE had a greater decrease in IPSS (P = .01). Prostate ischemic volume and PSA level 24 hours after PAE were correlated (Pearson r = 0.64, P = .014). Conclusion Clinical outcome was similar after PAE with sPVA and nsPVA. Younger age (up to 65 years), bilateral PAE, lower baseline IPSS, and acute urinary retention were predictors of better clinical outcome. The PSA level 24 hours after PAE correlated with prostate ischemia, and both correlated with clinical outcome. (©) RSNA, 2016.