Benign prostatic hyperplasia(BPH)is characterized by an enlarged prostate,lower urinary tract symptoms(LUTS),and a decreased urinary flow rate.Common in older men,BPH is a progressive disease that can eventually lead ...Benign prostatic hyperplasia(BPH)is characterized by an enlarged prostate,lower urinary tract symptoms(LUTS),and a decreased urinary flow rate.Common in older men,BPH is a progressive disease that can eventually lead to complications including acute urinary retention(AUR)and the need for BPH-related surgery.Both normal and abnormal prostate growth is driven by the androgen dihydrotestosterone(DHT),which is formed from testosterone under the influence of 5-alpha reductase.Thus,5-alpha reductase inhibitors(5-ARIs)effectively reduce the serum and intraprostatic concentration of DHT,causing an involution of prostate tissue.Two 5-ARIs are currently available for the treatment of BPHdfinasteride and dutasteride.Both have been demonstrated to decrease prostate volume,improve LUTS and urinary flow rates,which ultimately reduces the risk of AUR and BPH-related surgery.Therefore,either alone or in combination with other BPH medications,5-ARIs are a mainstay of BPH management.展开更多
The development of human benign or malignant prostatic diseases is closely associated with androgens, primarily testosterone （T） and dihydrotestosterone （DHT）. T is converted to DHT by 5-alpha reductase （5-AR） i...The development of human benign or malignant prostatic diseases is closely associated with androgens, primarily testosterone （T） and dihydrotestosterone （DHT）. T is converted to DHT by 5-alpha reductase （5-AR） isozymes. Differential expression of 5-AR isozymes is observed in both human benign and malignant prostatic tissues. 5-AR inhibitors （5-ARI） are commonly used for the treatment of benign prostatic hyperplasia （BPH） and were once promoted as chemopreventive agents for prostate cancer （PCa）. This review discusses the role of the differential expression of 5-AR in the normal development of the human prostate and in the pathogenesis and progression of BPH and PCa.展开更多
Objectives To study the expression pattern of 5α-reductase type 2 gene in human male reproductive organsMethods The expression level of 5α-reductase type 2 gene inhuman testis, epididymis and vas deferens tissues wa...Objectives To study the expression pattern of 5α-reductase type 2 gene in human male reproductive organsMethods The expression level of 5α-reductase type 2 gene inhuman testis, epididymis and vas deferens tissues was determined by in situ hybridization using Digoxin labeled 5α-reductase type 2 cRNA probe.Results The brown granules of hybridizing signals distributed in the cytoplasm of Sertoli and Leydig cells of the testis, the principle cells of epididymis and the epithelial cells of vas deferens, but there was no positive signal in the nuclei of above-mentioned cells. No positive signal was observed in germ cells, basement of the testis, interstium of epididymis and basement, as well as smooth muscle of vas deferens. Conclusion This study confirmed that the 5α-reductase type 2 gene expressed in Sertoli , Leydig cells of the testis, and the principle cells of epididymis. The expression pattern of the gene in these cells in human was similar to that of rat and monkey. The presence of 5α-reductase type 2 gene in epithelial cells of the vas deferens suggested it might possess an important physiological role in human reproduction.展开更多
Background: Patients with gross haematuria are sometimes found to have prostate cancer after clinical evaluation. The treatment of such haematuria could be very challenging. Use of a 5 alpha reductase inhibitor like d...Background: Patients with gross haematuria are sometimes found to have prostate cancer after clinical evaluation. The treatment of such haematuria could be very challenging. Use of a 5 alpha reductase inhibitor like dutasteride has been found helpful in bleeding prostate cancer patients if they have not undergone hormonal manipulation before they developed haematuria. Patients and Method: 26 patients with gross haematuria of prostatic origin who had histologic confirmation of adenocarcinoma of the prostate but who have not had chemical or surgical castration were randomized to receive daily dutasteride in addition to vigorous saline irrigation and antibiotics on one arm and vigorous saline irrigation and antibiotics only as control on the other arm. The time taken before haematuria resolved and the amount of irrigation fluid used were noted. Statistical analysis was done using SPSS. Student’s t-test and Kaplan Meier survival analysis were used to test various variables at 0.5 significant levels. Results: Of the 26 patients 12(46.2%) received 0.5 mg oral dutasteride in addition to saline irrigation while 14 (53.8%) received saline irrigation only. Haematuria stopped in all of 12 (100%) patients on dutasteride arm but on 12 (85.7%) of the 14 patients on the control arm. It took significantly shorter time and lesser volume of irrigation fluid before haematuria resolved in those treated with dutasteride than in those on the control arm. Conclusion: Dutasteride is effective in the control of acute haematuria in pre-androgen ablation prostate cancer patients.展开更多
Background: Acne vulgaris is a common skin disease. Its pathogenesis is multifactorial, and therapy can now be directed at many of these factors. Among these factors are androgen hormones which play an important role ...Background: Acne vulgaris is a common skin disease. Its pathogenesis is multifactorial, and therapy can now be directed at many of these factors. Among these factors are androgen hormones which play an important role in the pathogenesis of acne. Accordingly,many antiandrogens have been developed to treat acne by systemic and topical ways. Five-Alpha Avocuta 2% cream is a new topical 5-alpha reductase inhibitor extracted from the tropical fruit “avocado”. Objectives: To evaluate the effectiveness and safety of 5-Alpha Avocuta cream and compare it to tretinoin 0.025% cream, in the treatment of acne vulgaris. Patients& Methods: This single blinded comparative study was done in Department of Dermatology– Baghdad Teaching Hospital - from July 2009 through October 2010. All demographic points related to the disease were obtained from each patient to evaluate severity of acne. Sixty-eight patients with acne were divided into two groups and instructed to apply the drugs for three months. Group A uses 5-Alpha avocuta 2% (Teen-derm K) cream and Group B uses tretinoin (Acretin) 0.025% cream. Severe acne was excluded from the study. The clinical improvement was evaluated by counting the number of inflammatory lesions before and after treatment and compare between them by paired t-test. Results: Fifty-eight patients completed the study, their age ranged from 12 - 30 years with a mean of 18.21 ± 4.64 years. In Group A there was a significant reduction of the mean number of papules from 29.7 before treatment to 15.5 after treatment (p < 0.0001), while the mean number of pustules decreased from 4.9 to 0.6 (p = 0.019). In Group B the mean number of papules was reduced from 28.5 to 14.9 (p < 0.0001), while the mean number of pustules dropped from 5.3 before treatment to 0.7 after treatment (p = 0.009). The mean difference of papules after 14 weeks in Group A was 15.55 ± 6.95 while in Group B, the mean difference was 14.86 ± 6.99. This result was statistically not significant (p = 0.708, t-test). The difference in the mean展开更多
目的:对比研究120 W绿激光前列腺汽化术(PVP)在不同良性前列腺增生(BPH)患者群体中的疗效及安全性。方法:对2013年7月至2014年9月于我科诊断为BPH并行120 W PVP的患者,按前列腺体积(PV)(<80 ml和≥80 ml)、有无服用5-α还原酶抑制剂(...目的:对比研究120 W绿激光前列腺汽化术(PVP)在不同良性前列腺增生(BPH)患者群体中的疗效及安全性。方法:对2013年7月至2014年9月于我科诊断为BPH并行120 W PVP的患者,按前列腺体积(PV)(<80 ml和≥80 ml)、有无服用5-α还原酶抑制剂(5-ARIs)(持续时间>1个月)以及有无既往急性尿潴留史(AUR)进行分组对照研究,观察记录术前及围手术期情况,并于术后1、3个月随访。结果:共174例患者纳入研究,38例患者术中转为经尿道前列腺电切术(TURP),其余136例患者顺利完成手术并随访至术后3个月。患者年龄(69.4±7.7)岁,术前PV(67.9±29.8)ml,手术时间(49.4±16.3)min。术中无输血、电切综合征及前列腺包膜穿孔发生,术后2例患者发生尿道狭窄、2例患者出现膀胱颈口挛缩。各组患者的术后疗效指标均较术前显著提高,且各对照组间(大体积前列腺组与非大体积前列腺组、5-ARIs服用组与5-ARIs未服用组、AUR病史组与无AUR病史组)无统计学差异。结论:120 W PVP治疗BPH安全有效,且疗效不受PV、术前是否规律服用5-ARIs、既往有无AUR史影响,但术前留置导尿管可能增加手术难度及术中中转TURP的风险。展开更多
文摘Benign prostatic hyperplasia(BPH)is characterized by an enlarged prostate,lower urinary tract symptoms(LUTS),and a decreased urinary flow rate.Common in older men,BPH is a progressive disease that can eventually lead to complications including acute urinary retention(AUR)and the need for BPH-related surgery.Both normal and abnormal prostate growth is driven by the androgen dihydrotestosterone(DHT),which is formed from testosterone under the influence of 5-alpha reductase.Thus,5-alpha reductase inhibitors(5-ARIs)effectively reduce the serum and intraprostatic concentration of DHT,causing an involution of prostate tissue.Two 5-ARIs are currently available for the treatment of BPHdfinasteride and dutasteride.Both have been demonstrated to decrease prostate volume,improve LUTS and urinary flow rates,which ultimately reduces the risk of AUR and BPH-related surgery.Therefore,either alone or in combination with other BPH medications,5-ARIs are a mainstay of BPH management.
基金This work was supported by the National Natural Science Foundation of China （No. 30973015） and the Beijing Natural Science Foundation （No. 7122074） at Beijing Chaoyang Hospital, Capital Medical University to YNN.
文摘The development of human benign or malignant prostatic diseases is closely associated with androgens, primarily testosterone （T） and dihydrotestosterone （DHT）. T is converted to DHT by 5-alpha reductase （5-AR） isozymes. Differential expression of 5-AR isozymes is observed in both human benign and malignant prostatic tissues. 5-AR inhibitors （5-ARI） are commonly used for the treatment of benign prostatic hyperplasia （BPH） and were once promoted as chemopreventive agents for prostate cancer （PCa）. This review discusses the role of the differential expression of 5-AR in the normal development of the human prostate and in the pathogenesis and progression of BPH and PCa.
基金This study was supported by the State Family Planning Committee
文摘Objectives To study the expression pattern of 5α-reductase type 2 gene in human male reproductive organsMethods The expression level of 5α-reductase type 2 gene inhuman testis, epididymis and vas deferens tissues was determined by in situ hybridization using Digoxin labeled 5α-reductase type 2 cRNA probe.Results The brown granules of hybridizing signals distributed in the cytoplasm of Sertoli and Leydig cells of the testis, the principle cells of epididymis and the epithelial cells of vas deferens, but there was no positive signal in the nuclei of above-mentioned cells. No positive signal was observed in germ cells, basement of the testis, interstium of epididymis and basement, as well as smooth muscle of vas deferens. Conclusion This study confirmed that the 5α-reductase type 2 gene expressed in Sertoli , Leydig cells of the testis, and the principle cells of epididymis. The expression pattern of the gene in these cells in human was similar to that of rat and monkey. The presence of 5α-reductase type 2 gene in epithelial cells of the vas deferens suggested it might possess an important physiological role in human reproduction.
文摘Background: Patients with gross haematuria are sometimes found to have prostate cancer after clinical evaluation. The treatment of such haematuria could be very challenging. Use of a 5 alpha reductase inhibitor like dutasteride has been found helpful in bleeding prostate cancer patients if they have not undergone hormonal manipulation before they developed haematuria. Patients and Method: 26 patients with gross haematuria of prostatic origin who had histologic confirmation of adenocarcinoma of the prostate but who have not had chemical or surgical castration were randomized to receive daily dutasteride in addition to vigorous saline irrigation and antibiotics on one arm and vigorous saline irrigation and antibiotics only as control on the other arm. The time taken before haematuria resolved and the amount of irrigation fluid used were noted. Statistical analysis was done using SPSS. Student’s t-test and Kaplan Meier survival analysis were used to test various variables at 0.5 significant levels. Results: Of the 26 patients 12(46.2%) received 0.5 mg oral dutasteride in addition to saline irrigation while 14 (53.8%) received saline irrigation only. Haematuria stopped in all of 12 (100%) patients on dutasteride arm but on 12 (85.7%) of the 14 patients on the control arm. It took significantly shorter time and lesser volume of irrigation fluid before haematuria resolved in those treated with dutasteride than in those on the control arm. Conclusion: Dutasteride is effective in the control of acute haematuria in pre-androgen ablation prostate cancer patients.
文摘Background: Acne vulgaris is a common skin disease. Its pathogenesis is multifactorial, and therapy can now be directed at many of these factors. Among these factors are androgen hormones which play an important role in the pathogenesis of acne. Accordingly,many antiandrogens have been developed to treat acne by systemic and topical ways. Five-Alpha Avocuta 2% cream is a new topical 5-alpha reductase inhibitor extracted from the tropical fruit “avocado”. Objectives: To evaluate the effectiveness and safety of 5-Alpha Avocuta cream and compare it to tretinoin 0.025% cream, in the treatment of acne vulgaris. Patients& Methods: This single blinded comparative study was done in Department of Dermatology– Baghdad Teaching Hospital - from July 2009 through October 2010. All demographic points related to the disease were obtained from each patient to evaluate severity of acne. Sixty-eight patients with acne were divided into two groups and instructed to apply the drugs for three months. Group A uses 5-Alpha avocuta 2% (Teen-derm K) cream and Group B uses tretinoin (Acretin) 0.025% cream. Severe acne was excluded from the study. The clinical improvement was evaluated by counting the number of inflammatory lesions before and after treatment and compare between them by paired t-test. Results: Fifty-eight patients completed the study, their age ranged from 12 - 30 years with a mean of 18.21 ± 4.64 years. In Group A there was a significant reduction of the mean number of papules from 29.7 before treatment to 15.5 after treatment (p < 0.0001), while the mean number of pustules decreased from 4.9 to 0.6 (p = 0.019). In Group B the mean number of papules was reduced from 28.5 to 14.9 (p < 0.0001), while the mean number of pustules dropped from 5.3 before treatment to 0.7 after treatment (p = 0.009). The mean difference of papules after 14 weeks in Group A was 15.55 ± 6.95 while in Group B, the mean difference was 14.86 ± 6.99. This result was statistically not significant (p = 0.708, t-test). The difference in the mean
文摘目的:对比研究120 W绿激光前列腺汽化术(PVP)在不同良性前列腺增生(BPH)患者群体中的疗效及安全性。方法:对2013年7月至2014年9月于我科诊断为BPH并行120 W PVP的患者,按前列腺体积(PV)(<80 ml和≥80 ml)、有无服用5-α还原酶抑制剂(5-ARIs)(持续时间>1个月)以及有无既往急性尿潴留史(AUR)进行分组对照研究,观察记录术前及围手术期情况,并于术后1、3个月随访。结果:共174例患者纳入研究,38例患者术中转为经尿道前列腺电切术(TURP),其余136例患者顺利完成手术并随访至术后3个月。患者年龄(69.4±7.7)岁,术前PV(67.9±29.8)ml,手术时间(49.4±16.3)min。术中无输血、电切综合征及前列腺包膜穿孔发生,术后2例患者发生尿道狭窄、2例患者出现膀胱颈口挛缩。各组患者的术后疗效指标均较术前显著提高,且各对照组间(大体积前列腺组与非大体积前列腺组、5-ARIs服用组与5-ARIs未服用组、AUR病史组与无AUR病史组)无统计学差异。结论:120 W PVP治疗BPH安全有效,且疗效不受PV、术前是否规律服用5-ARIs、既往有无AUR史影响,但术前留置导尿管可能增加手术难度及术中中转TURP的风险。
