Chemokines and chemokine receptors as promoters of prostate cancer growth and progression

Prostate cancer (CaP) is estimated to be first in incidence among cancers, with more than 240,000 new cases in 2012 in the United States. Chemokines and their receptors provide survival, proliferation, and invasion characteristics to CaP cells in both primary sites of cancer and metastatic locations. The emerging data demonstrate that many chemokines and their receptors are involved in the multistep process of CaP, leading to metastasis, and, further, that these factors act cooperatively to enhance other mechanisms of tumor cell survival, growth, and metastasis. Changes of chemokine receptor cohorts may be necessary to activate tumor-promoting signals. Chemokine receptors can activate downstream effectors, such as mitogen-activated protein kinases, by complex mechanisms of ligand-dependent activation of cryptic growth factors; guanosine triphosphate-binding, protein-coupled activation of survival kinases; or transactivation of other receptors such as ErbB family members. We describe vanguard research in which more than the classic view of chemokine receptor biology was clarified. Control of chemokines and inhibition of their receptor activation may add critical tools to reduce tumor growth, especially in chemo-hormonal refractory CaP that is both currently incurable and the most aggressive form of the disease, accounting for most of the more than 28,000 annual deaths.

Male genital self-amputation in the Middle East. A simple repair by anterior urethrostomy

Genital self-mutilation, whether partial or complete, is a rare condition, which usually occurs in psychotic patients and occasionally has a religious background. The initial management of complete genital self-mutilation usually involves a formation of perineal urethrostomy or a more complex procedure to form a short penile stump. Here, we present a case of complete genital self-mutilation in a psychotic male who was managed with simple urethral spatulation to form an anterior urethrostomy.

Self-bougienage: long-term relief of corrosive esophageal strictures

BACKGROUND

Corrosive esophageal strictures require dilatation at frequent intervals.

OBJECTIVE

To determine the efficacy of self-dilatation in treatment of corrosive esophageal strictures.

METHODS

Retrospective analysis of data from 51 patients with corrosive esophageal strictures seen in a surgical unit. Eighteen patients underwent per-oral antegrade dilatation of stricture using gum elastic bougies (Group I); 15 patients underwent retrograde dilatation with endless string using an India rubber dilator devised at the authors' institution, followed by per-oral antegrade dilatation (Group II); 15 patients underwent retrograde dilatation followed by antegrade dilatation with endless string through esophagostomy (Group III). In three patients with stricture of the entire esophagus, endless string could not be passed; they were subjected to esophagocoloplasty. All patients were taught self-dilatation with gum elastic bougies as the final step, and were put on a progressive, domiciliary, self-dilatation program. Quarterly follow up was done for one year, to ascertain whether self-bougienage was being performed properly.

RESULTS

All patients responded well to treatment, with significant relief of dysphagia and improvement in health and barium study findings. Six patients developed mediastinitis (3, 2 and 1 in Groups I, II and III, respectively) during initial dilatation; all improved with conservative management. Only one patient who failed to carry out self-bougienage had to be readmitted and retrained in the procedure, after which he remained asymptomatic.

CONCLUSIONS

Patients with corrosive esophageal strictures can be treated with a long-term self-bougienage program, which avoids the need for frequent hospital admissions for esophageal dilatation.