The goal of this study was to explore minimally invasive transurethral imaging and surgery for the treatment of severe, persistent hematospermia in cases that were refractory to conservative treatments. The study included 43 patients (aged 22-77 years; average, 44.6 years) with long-lasting, severe hematospermia, accompanied by discomfort or pain in the lumbosacral or perineal region, dysuria, frequent micturition, decreased semen volume, and/or azoospermia. Patient symptoms had persisted for 1 to 10 years (average, 5.3 years). Computed tomography or magnetic resonance imaging of each patient was evaluated, and transurethral surgery was performed. The causes of hematospermia were identified in all 43 patients, and their ejaculatory duct obstruction or seminal vesiculitis was successfully treated. No serious intraoperative or postoperative complications occurred. Pathologic analyses revealed that all of the resected or biopsied seminal vesicle tissues had chronic nonspecific inflammation in the seminal vesicle wall, and no tumors were identified. Preoperative symptomology of hematospermia disappeared in all patients followed up for 2 to 30 months (average, 16 months). A single patient experienced recurrence at 11 months and had a second minimally invasive surgery that was curative. A total of 95.3% (41 of 43) of the patients experienced normal orgasmic intensity after surgery. Magnetic resonance imaging is a valuable and accurate diagnostic method for the identification of causative factors underlying hematospermia. Transurethral dilation of ejaculatory ducts, incision of the verumontanum or the distal end of the ejaculatory ducts, and incision or resection of the relevant cysts represent simple, safe, and reliable approaches for the management of refractory cases of hematospermia that do not respond to conservative treatments.

No abstract

Although the critical role of complement component C3d as a molecular adjuvant in preventing virus infection is well established, its role in cancer prophylaxis and treatment is unclear. In this study, we constructed a recombinant plasmid encoding Flk-1 and C3d3 fusion proteins and investigated its transient expression in vitro in transfected eukaryotic cells and its antibody response in immunized mice. Subsequently, we investigated the vaccine's ability to elicit an immune response leading to suppression of angiogenesis and tumor growth in mice bearing bladder transitional cell carcinoma. Using Western blotting, immunocytochemistry, and flow cytometry, we detected the expression of Flk-1 and C3d3 fusion proteins in COS-7 cells transfected with these recombinant plasmids. Further binding experiment using CR2 (C3d receptor) positive Raji cells that were incubated with transfected COS-7 supernatant indicated that C3d was successfully fused to Flk-1. Although both vaccines elicited peak antibody levels at 5 weeks, Flk-1-specific antibody titer in pSG.SS.Flk-1(ECD).C3d3.YL-immunized mice was significantly higher when compared to pSG.SS.Flk-1(ECD).YL-immunized mice. The results of experiments with bladder tumor-bearing mice showed that the vaccine inhibited tumor growth significantly. These results suggest that C3d plays a critical role in tumor immunotherapy by promoting antibody response in Flk-1-based DNA vaccines. This approach may provide a new strategy for the rational design of anti-angiogenic therapies for the treatment of solid tumors and provide a basis for the further exploitation and application of the anti-angiogenesis DNA vaccines.

INTRODUCTION AND OBJECTIVES: The purpose of this study was to assess the diagnostic value and potentially protective capacity of heat-shock protein 70 (HSP70) in chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).METHODS: In this study, seminal plasma levels of cytokines (tumor necrosis factor-alpha (TNF-alpha) and interleukin 1beta (IL-1beta)) and HSP70 were evaluated by enzyme-linked immunosorbent assay in 80 men: 15 healthy controls, 16 men with chronic bacterial prostatitis, 23 men with CP/CPPS IIIA and 26 with CP/CPPS IIIB. The HSP70 levels in chronic bacterial prostatitis and CP/CPPS patients were correlated with chronic prostatitis symptom index (CPSI).RESULTS: Significantly increased levels of cytokines (TNFalpha and IL-1beta) and HSP70 were observed in seminal plasmas from patients with chronic bacterial prostatitis compared with CP/CPPS patients and controls. However, only IL-1beta was significantly elevated compared with CP/CPPS IIIB and controls in patients with CP/CPPS IIIA. HSP70 levels in CP/CPPS patients were significantly lower than that in controls. HSP70 concentration in seminal plasma was negatively correlated with CPSI in chronic bacterial prostatitis. Whereas,the expression of HSP70 did not correlate with the NIH-CPSI total scores in CP/CPPS patients.CONCLUSIONS: In conclusion, HSP70 and IL-1b are measurable in human semen plasma and they provide useful information in diagnosing prostatic inflammatory conditions and categorizing CPPS III subclasses, respectively. Levels of HSP70 expression are feasible to regard as diagnosis and prognostic indicators for chronic bacterial prostatitis. HSP70 levels may be suggested to assess the severity of prostatic inflammation in these patients.IL-1b appears to represent a useful biomarker in CP/CPPS and can be used to discriminate CP/ CPPS IIIA from IIIB. HSP70 provided cellular protection capacity that has pivotal roles in the regulation of cell functions in chronic bacterial prostatitis. CP/CPPS may disrupt the ability of T cells to suppress the immune system and consequently decrease HSP70 expression in these patients.It is further proved that the CP/CPPS is a kind of immune disease. Autoimmune may have a prominent role in the induction and progression of CP/CPPS. It should be novel treatments for chronic bacterial prostatitis and CP/CPPS and merit further study by enhancing HSP70 expression and exogenous HSP70 administration.