This review presents the current status of attempts to identify individuals with a high risk of carcinoma of the prostate by using biochemical, immunochemical, and immunologic studies of body fluids. Blood, urine, and prostatic fluid have been subjected to a variety of analyses in attempts to find alterations that are sufficiently specific and sensitive enough to be useful in the early recognition of patients with a high probability of localized or disseminated carcinoma of the prostate. A variety of immunologic and immunochemical techniques to identify and quantify acid phosphatase of prostatic origin in the serum are currently being explored for this purpose; as yet, none has achieved the specificity-sensitivity relationship necessary for widespread clinical application. Biochemical studies of prostatic fluid have disclosed a reversal of the lactic dehydrogenase (LDH) isoenzyme pattern with a predominance of LDH-V and increased levels of transferrin, complement C and possibly complement C in association with carcinoma of the prostate. The value of these non-specific changes is increased by the probable direct relationship between prostatic epithelial cell metabolism and changes in prostatic fluid composition. These approaches to identify individuals with a high risk of carcinoma of the prostate hold promise; they should be continued and expanded.
Although prolactin has a synergistic effect with testosterone in stimulating growth of the lateral lobe of the rat prostate, the role of prolactin in the absence of testosterone has not been well established. We studied the effect of prolactin on the rate of prostatic regression induced by castration in mature Sprague-Dawley rats. Anterior pituitaries from female rats were transplanted under the renal capsule in all rats. Castration and unilateral nephrectomy were carried out 1 week later. Half of the animals had the normal, non-grafted kidney removed and another half had the kidney bearing the pituitary grafts excised. Rats were sacrificed on days 0, 7, 10 and 14 and 3 lobes of the prostate were dissected separately. The lateral lobe showed a marked decrease in the rate of regression in the pituitary graft-bearing rats. In control animals, the relative weight of the lateral lobe on days 7, 10 and 14 was 38 +/- 2 per cent (mean +/- SE), 33 +/- 2 per cent and 26 +/- 2 per cent of the day 0 value, respectively; the respective relative weight in animals carrying pituitary grafts was 67 +/- 4 per cent, 51 +/- 5 per cent, and 38 +/- 3 per cent of the day 0 value. The difference in the weight of the lateral lobe between the 2 groups was significant on days 7 (p less than 0.001) and 10 (p less than 0.05) and was not significant on day 14. There was no difference in the mean body weight in graft bearing and non-graft bearing animals. Bilateral adrenalectomy at the time of castration did not influence the rate of prostatic regression in either group. Furthermore, pituitaries implanted in rats castrated for 3 weeks had no stimulatory effect of the prostates. These results indicate that increased endogenous prolactin, in the absence of testicular and adrenal secretion, delays the castration-induced regression of the lateral lobe of the prostate of Sprague-Dawley rats.
A case is reported of renal insufficiency in a solitary kidney secondary to hydronephrosis of pregnancy. Evidence supporting obstruction on a mechanical basis is presented. This entity should be considered when pursuing a correctable cause for functional renal deterioration in pregnant women. The clinical importance of this entity in the management of renal insufficiency in the pregnant woman is discussed.
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