Prostate Volume Measurement by Ultrasonography Over 40 Years Age of Bangladeshi Population

Background: Benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy, is a histologic diagnosis status characterized by proliferation of the ‘glandular elements’ of the prostate, which may lead to an enlarged prostate gland. In many studies, people over the age of 40 years found as the most vulnerable for BPH. Ultrasonography is a prominent method to determine prostate volume or size. Aim of the study: The aim of the present study was to evaluate the prostate volume measurement for the Bangladeshi population over the age of 40 years by ultrasonography.Methods:This prospective, observational study was conducted in the Department of Anatomy, Chattogram Medical College Hospital, Chattogram, Bangladesh during the period from January 2019 to December 2020. In total 157 suspected patients of benign prostatic hyperplasia were selected as the study population. All patients were clinically diagnosed for BPH, based on the present prostate symptoms and digital rectal examination. To measure the prostate volume, abdominal ultrasonography was performed for all the patients. After enucleation, another ultrasonogram was performed for all the patients to measure the existing sizes of the prostates of the patients. All the data were processed, analyzed, and disseminated by MS-word and SPSS programs as per need.Results:Finally, in this study in analyzing the volumes of the prostates of the participants according to the abdominal ultra-sonographic reports of pre-operative stage we observed, in 9%, 34%, 31%, 30%, 21% and 32% patients, the prostate sizes (In cc) were <20, 21-40, 41-60, 61-80, 81-100 and >100 cc respectively. On the other hand, after enucleation, in 11.46%, 24.20%, 28.66%, 27.39%, 7.01% and 1.27% patients, the prostate sizes (In cc) were found <20, 21-40, 41-60, 61-80, 81-100 and >100 cc respectively. The mean changes of prostate sizes between pre- and post-operative stages among the participant was not significant where the P value was found 0.464.Conclusion:The findings of this study support the applications of abdominal ultrasonographic evaluation for suspected benign prostatic hyperplasia patients to know about the exact volumes of their prostates for selecting the appropriate surgical approach.

Heat Shock Proteins in Benign Prostatic Hyperplasia and Prostate Cancer

Two out of three diseases of the prostate gland affect aging men worldwide. Benign prostatic hyperplasia (BPH) is a noncancerous enlargement affecting millions of men. Prostate cancer (PCa) in turn is the second leading cause of cancer death. The factors influencing the occurrence of BPH and PCa are different; however, in the course of these two diseases, the overexpression of heat shock proteins is observed. Heat shock proteins (HSPs), chaperone proteins, are known to be one of the main proteins playing a role in maintaining cell homeostasis. HSPs take part in the process of the proper folding of newly formed proteins, and participate in the renaturation of damaged proteins. In addition, they are involved in the transport of specific proteins to the appropriate cell organelles and directing damaged proteins to proteasomes or lysosomes. Their function is to protect the proteins against degradation factors that are produced during cellular stress. HSPs are also involved in modulating the immune response and the process of apoptosis. One well-known factor affecting HSPs is the androgen receptor (AR)—a main player involved in the development of BPH and the progression of prostate cancer. HSPs play a cytoprotective role and determine the survival of cancer cells. These chaperones are often upregulated in malignancies and play an indispensable role in tumor progression. Therefore, HSPs are considered as one of the therapeutic targets in anti-cancer therapies. In this review article, we discuss the role of different HSPs in prostate diseases, and their potential as therapeutic targets.

Explainable AI for CNN-based Prostate Tumor Segmentation in Multi-parametric MRI Correlated to Whole Mount Histopathology

Automatic prostate tumor segmentation is often unable to identify the lesion even if in multi-parametric MRI data is used as input, and the segmentation output is difficult to verify due to the lack of clinically established ground truth images. In this work we use an explainable deep learning model to interpret the predictions of a convolutional neural network (CNN) for prostate tumor segmentation. The CNN uses a U-Net architecture which was trained on multi-parametric MRI data from 122 patients to automatically segment the prostate gland and prostate tumor lesions. In addition, co-registered ground truth data from whole mount histopathology images were available in 15 patients that were used as a test set during CNN testing. To be able to interpret the segmentation results of the CNN, heat maps were generated using the Gradient Weighted Class Activation Map (Grad-CAM) method. With the CNN a mean Dice Sorensen Coefficient for the prostate gland and the tumor lesions of 0.62 and 0.31 with the radiologist drawn ground truth and 0.32 with wholemount histology ground truth for tumor lesions could be achieved. Dice Sorensen Coefficient between CNN predictions and manual segmentations from MRI and histology data were not significantly different. In the prostate the Grad-CAM heat maps could differentiate between tumor and healthy prostate tissue, which indicates that the image information in the tumor was essential for the CNN segmentation.

Biomarkers of tumor microenvironment of malignant neoplasms of kidneys, urinary bladder, and prostate gland (literature review)

The development of malignant tissue transformation is accompanied by the accumulation of immune system cells or tumor microenvironment cells (MCO) in it. Three variants of immune cell accumulation were identified: the ‘immune desert’ phenotype, ‘hot’ tumors, with a cytolytic T-cell response. The review presents immunotherapeutic strategies of exposure in order to enhance the ability of McO to initiate immune mechanisms capable of blocking the development of tumor tissue. The analysis of the presented data on the importance of immuno-oncological biomarkers as laboratory indicators of the therapeutic effectiveness of drug therapy aimed at restoring key immune defense pathways in oncourological diseases was carried out. The results of the study of the effectiveness of immuno-oncological biomarkers for assessing the state of antitumor immunity in malignant neoplasms of the bladder, kidneys, prostate gland are summarized.

Gyraulus marocana sp. nov., a new freshwater snail species (Mollusca, Gastropoda, Planorbidae) from Morocco

A new planorbid gastropod species is described: Gyraulus marocana sp. nov. It can be distinguished from other known species by its regularly striated ivory shell, with four whorls separated by a deep suture, prostate gland with 20 diverticula, phallotheca twice as long as the preputium and its orange stylet. The new species was found in the northern part of Morocco, in Lake Zerrouka, a Protected Area, being also a site of ecological and biological interest (known as SIBE). It is located in the Middle Atlas massif, which is a geographical barrier known for its other endemic molluscs.

On the role of diagnosis of prostate diseases at the outpatient appointment of a therapist

Злокачественные заболевания остаются важной проблемой медицины, при этом ее решение зависит от эффективности выявления ранних стадий онкозаболеваний на амбулаторном этапе, включая терапевтическое звено оказания медицинской помощи. Существующие в настоящее время подходы к пропаганде основ здорового образа жизни преимущественно направлены лишь на профилактику поведенческих факторов риска: табакокурения, нерационального питания, недостаточной физической активности и пагубного употребления алкоголя. При этом, по оценкам экспертов, даже воздействие только на них позволит предотвратить по меньшей мере 40% случаев развития злокачественных новообразований. В России организована 3-уровневая система оказания медицинской помощи. Именно первый уровень оказания первичной медико-санитарной помощи и должен обеспечивать профилактическую направленность здравоохранения: грамотная диспансеризация способна обеспечить существенный, до 30%, вклад в снижение общей смертности населения, в том числе и смертности от злокачественных новообразований. Первым звеном диагностики онкологического заболевания являются терапевты, к которым пациенты обращаются с жалобами общего характера (утомляемость, субфебрилитет, боли в суставах, дизурия и т. д.). Наиболее актуальными задачами в работе терапевта являются своевременное обнаружение опухолевого заболевания и направление больного на лечение к онкологу. Статья рассматривает возможности скрининговых мероприятий с участием терапевтов, врачей общей практики, предлагает специально разработанные алгоритмы диагностики доброкачественных и злокачественных новообразований предстательной железы. Формирование навыков онкологической настороженности у врача первичного амбулаторного звена необходимо для раннего выявления и снижения частоты продвинутых стадий опухолей и более раннего начала специализированного лечения. Выявление симптоматики, подозрительной на злокачественные новообразования, с помощью алгоритмизированных подходов и последующая консультация пациента урологом или онкологом должны улучшить результаты лечения. Malignant diseases remain an important problem in medicine, while its solution depends on the effectiveness of detecting the early stages of cancer at the outpatient stage, including the therapeutic link in the provision of medical care. Currently existing approaches to the promotion of the foundations of a healthy lifestyle are mainly aimed only at the prevention of behavioral risk factors: tobacco smoking, unhealthy diet, insufficient physical activity and harmful use of alcohol. At the same time, according to experts, even exposure only to them will prevent at least 40% of cases of the development of malignant ovariances. A 3-tier system of medical care has been organized in Russia. It is the first level of primary health care that should ensure the prophylactic focus of health care: competent clinical examination is able to provide a significant, up to 30%, contribution to reducing the overall mortality of the population, including mortality from malignant neoplasms. The first stage in the diagnosis of oncological disease are therapists, to whom patients come with general complaints (fatigue, low-grade fever, joint pain, dysuria, etc.). The most urgent task in the work of a general practitioner is the timely detection of a tumor disease and referral of a patient for treatment to an oncologist. The article considers the possibilities of screening measures with the participation of therapists, general practitioners, and offers specially developed algorithms for the diagnosis of benign and malignant neoplasms of the prostate gland. The formation of oncological alertness skills in a primary outpatient care physician is necessary for early detection and reduction of the incidence of advanced stages of tumors and earlier initiation of specialized treatment. Identification of symptoms suspicious of malignant neoplasms using algorithmic approaches and subsequent consultation with the patient by a specialist urologist or oncologist should improve treatment outcomes.

Results of endoscopic treatment of benign prostatic hyperplasia in patients with metabolic syndrome

The present paper is about the research conducted on the patients with metabolic syndrome and its results of endoscopic treatment of benign prostatic hyperplasia in these patients. It is generally accepted that the size and volume of the prostate gland is the main prognostic factor affecting the intraoperative and postoperative outcomes of endoscopic treatment of BPH. However, with the rapid development of endoscopic instruments and surgical techniques, the size of the prostate tends to have a lesser influence on the outcome of endoscopic BPH treatment. Currently, MS is becoming an increasingly common disease, which in most cases predicts a poor prognosis for treatment of patients with LUTS.

Deep Learning Enables Prostate MRI Segmentation: A Large Cohort Evaluation With Inter-Rater Variability Analysis

Whole-prostate gland (WPG) segmentation plays a significant role in prostate volume measurement, treatment, and biopsy planning. This study evaluated a previously developed automatic WPG segmentation, deep attentive neural network (DANN), on a large, continuous patient cohort to test its feasibility in a clinical setting. With IRB approval and HIPAA compliance, the study cohort included 3,698 3T MRI scans acquired between 2016 and 2020. In total, 335 MRI scans were used to train the model, and 3,210 and 100 were used to conduct the qualitative and quantitative evaluation of the model. In addition, the DANN-enabled prostate volume estimation was evaluated by using 50 MRI scans in comparison with manual prostate volume estimation. For qualitative evaluation, visual grading was used to evaluate the performance of WPG segmentation by two abdominal radiologists, and DANN demonstrated either acceptable or excellent performance in over 96% of the testing cohort on the WPG or each prostate sub-portion (apex, midgland, or base). Two radiologists reached a substantial agreement on WPG and midgland segmentation (κ = 0.75 and 0.63) and moderate agreement on apex and base segmentation (κ = 0.56 and 0.60). For quantitative evaluation, DANN demonstrated a dice similarity coefficient of 0.93 ± 0.02, significantly higher than other baseline methods, such as DeepLab v3+ and UNet (both p values &lt; 0.05). For the volume measurement, 96% of the evaluation cohort achieved differences between the DANN-enabled and manual volume measurement within 95% limits of agreement. In conclusion, the study showed that the DANN achieved sufficient and consistent WPG segmentation on a large, continuous study cohort, demonstrating its great potential to serve as a tool to measure prostate volume.

Extracellular Vesicle Proteome in Prostate Cancer: A Comparative Analysis of Mass Spectrometry Studies

Molecular diagnostics based on discovery research holds the promise of improving screening methods for prostate cancer (PCa). Furthermore, the congregated information prompts the question whether the urinary extracellular vesicles (uEV) proteome has been thoroughly explored, especially at the proteome level. In fact, most extracellular vesicles (EV) based biomarker studies have mainly targeted plasma or serum. Therefore, in this study, we aim to inquire about possible strategies for urinary biomarker discovery particularly focused on the proteome of urine EVs. Proteomics data deposited in the PRIDE archive were reanalyzed to target identifications of potential PCa markers. Network analysis of the markers proposed by different prostate cancer studies revealed moderate overlap. The recent throughput improvements in mass spectrometry together with the network analysis performed in this study, suggest that a larger standardized cohort may provide potential biomarkers that are able to fully characterize the heterogeneity of PCa. According to our analysis PCa studies based on urinary EV proteome presents higher protein coverage compared to plasma, plasma EV, and voided urine proteome. This together with a direct interaction of the prostate gland and urethra makes uEVs an attractive option for protein biomarker studies. In addition, urinary proteome based PCa studies must also evaluate samples from bladder and renal cancers to assess specificity for PCa.

Current MRI Methods for the Assessment of Pathologic Prostate: A Brief Review for Clinician

: The application of magnetic resonance imaging (MRI) have helped in different modalities for prostate cancer management, from early detection to treatment planning and follow-up, the evolution of MRI techniques allows to obtain not only anatomical but also functional information to take advantage of prostate cancer detection and staging while supplying prognostic and predictive biomarkers. This review presents conventional and advanced MRI techniques (known as multiparametric MRI) that allow functional and quantitative assessment of the normal prostate gland and its correlation with prostate cancer. Additional topics include the epidemiology of prostate cancer following the Global Burden Diseases Cancer Collaboration 2018, the clinical anatomy of the prostate gland, and the lower urinary tract; we also mention some aspects of the diagnosis performance in ultrasound. We end the review with a brief explanation about the anatomical foundation of external-beam planning radiotherapy.