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). In this study, seminal plasma levels of cytokines (tumor necrosis factor-a (TNF-a) and interleukin 1b (IL-1b)) 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). Significantly increased levels of cytokines (TNF-a and IL-1b) and HSP70 were observed in seminal plasmas from patients with chronic bacterial prostatitis compared with CP/CPPS patients and controls. However, only IL-1b 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. The results indicated that HSP70 and IL-1b appear to be the most reliable and predictive surrogate markers to diagnose chronic bacterial prostatitis and CP/CPPS, respectively. HSP70 has an important protective role in the regulation of cell functions in chronic bacterial prostatitis. CP/CPPS would probably be detrimental to the ability of T cells and consequently suppress the expression of HSP70.
BackgroundThis report describes one case of paravertebral haemorrhage after ultrasound-guided thoracic paravertebral block (TPVB) that may have been attributed to the inadvertent puncture of the posterior intercostal artery (PIA). This complication has never been reported in ultrasound-guided TPVB. Strategies to prevent this potentially serious complication are discussed.Case presentationA 52-year-old male underwent a video-assisted upper lobectomy. TPVB was performed under the guidance of ultrasound using the out-of-plane parasagittal approach. The transducer was placed 2.5 cm lateral to the midline area in a sagittal orientation. A needle was inserted at the lateral side of the transducer and advanced toward the T4 paravertebral space. During the final attempt, the needle tip was visualised in the middle area of the paravertebral space. Anterior displacement of the pleura was visualised upon injection of the saline. Aspiration of red blood was unfortunately identified. The block in this T4 level was discontinued. The patient was haemodynamically stable. When the chest cavity was entered, a bulging column-shaped haematoma was noted in the left paravertebral space extending from T1 to T12 with concomitant spread into the left T4–5 intercostal space. A postoperative neurological examination revealed intact sensory function in the T4 dermatome bilaterally. The patient fully recovered with no neurological sequelae.ConclusionsUltrasound-guided TPVB still bears the potential risk of inadvertent PIA injury. We recommend colour Doppler imaging to identify PIA prior to the TPVB.
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