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PubMed1996

Non-gay-identifying men who have sex with men: formative research results from Seattle, Washington.

Non-gay-identifying men who have sex with men are at risk for human immunodeficiency virus (HIV) infection. To understand these men and to develop interventions to reduce their HIV risks, the authors interviewed staff at agencies that serve non-gay-identifying men who have sex with men, business people who interact with them, and the men themselves. Interviews were augmented with focus groups of non-gay-identifying men who have sex with men and field observations at sites identified as places where they meet to negotiate or have sex. These qualitative data suggested 73 possible groups, which were consolidated into 16 broader "sectors," and then formally ranked by level of HIV risk, ease of access to the sector, psychosocial risks, and influence of other local interventions or research activities. The authors identified six priority groups of non-gay-identifying men who have sex with men (and sites where members of these groups could be approached): hustlers, closeted men, experimenters, incarcerated or formerly incarcerated men, men of color, and heterosexually identified bisexuals. Masturbation and oral sex were reportedly common, but anal and vaginal sex were also noted; condom use was rarely reported. Risk behaviors among non-gay-identifying men who have sex with men persist for a variety of reasons and may require a variety of intervention approaches.

Adolescent↗

PubMed2006

African-American men with nonpalpable prostate cancer exhibit greater tumor volume than matched white men.

BACKGROUND: Although prostate cancer (PC) mortality disproportionately affects African-American (AA) men, limited data exist comparing the pathologic characteristics of white and AA patients with nonpalpable PC (clinical stage T1c). METHODS: The authors reviewed the radical prostatectomy (RP) specimens from 37 consecutive AA men with clinical stage T1c PC and 35 white men who were matched for age, clinical stage, serum prostate-specific antigen (PSA) level, year of surgery, prostate weight, and prostate biopsy strategy. Pathologic characteristics were compared after mapping tumor foci and calculating tumor volumes by using computer software. RESULTS: For AA men, the median age (57.7 years), mean serum PSA level (9.3 ng/mL), mean prostate weight (43 g), and biopsy strategy (73% sextant) were matched with the cohort of 35 white men (median age, 57.1 years; mean PSA, 9.3 ng/mL;, mean prostate weight, 43 g; biopsy strategy, 66% sextant). Despite similar biopsy characteristics between the 2 groups (Gleason score > or =7 in 43% of AA men vs. 37% of white men), AA men exhibited significantly higher prostatectomy Gleason scores (> or =7 in 76% of AA men vs. 34% of white men; P = .01). AA men also had a higher mean tumor volume (1.82 cm3 vs. 0.72 cm3; P = .001) and had 2.8 times more tumor per ng/mL of serum PSA (0.22 cm3 per ng/mL vs. 0.079 cm3 per ng/mL; P = .001). CONCLUSIONS: Compared with a cohort of white men with similar clinical features at the time of biopsy, AA men with nonpalpable PC had higher prostatectomy Gleason scores, greater cancer volume, and greater tumor volume per ng/mL of serum PSA. These data provide additional support for the concept of early PC detection using a serum PSA threshold of 2.5 ng/mL for biopsy among AA men.

Black or African American↗

PubMed2005

Racial differences in the prevalence of vertebral fractures in older men: the Baltimore Men's Osteoporosis Study.

Older black men have higher adjusted bone mineral density (BMD) and a lower adjusted rate of decline in hip BMD than older white men. There are few published data on the prevalence of morphometric vertebral fractures in older white men and no published data for older black men. The study's objective was to estimate the prevalence of vertebral fractures in older men and explore differences in prevalence between older white and black men. Subjects included five hundred forty-two men (415 white and 127 black) aged 65 and above (mean age of 74.0+/-5.7 years) participating in the longitudinal component of the Baltimore Men's Osteoporosis Study. Radiographs of the thoracic and lumbar spine were obtained using standard protocols and read for the presence of vertebral deformities using binary semiquantitative techniques. Quantitative morphometry was performed and vertebral fractures were defined using the Melton-Eastell method. BMD was measured at the femoral neck, total hip and lumbar spine. Participants also completed self- and interviewer-administered questionnaires and underwent standardized clinical examinations. One or more vertebral fractures were present in 30 of 514 men with available radiographs: estimated prevalence 5.8% (95% confidence intervals [CI]: 4.0, 8.3%). Prevalence was significantly higher in white than black men, 7.3% vs 0.9% (Fishers' exact p =0.01): age-adjusted odds ratio=8.3 (95% CI: 1.1, 62.5). Among white men, there was no significant difference in age-adjusted femoral neck or total hip BMD or frequency or severity of back pain between men with and without vertebral fractures. In conclusion, older white men have a higher prevalence of vertebral fractures than older black men. This may be related to differences in BMD between these groups.

Black or African American↗

PubMed2000

Criteria for mutation analysis in MEN 1-suspected patients: MEN 1 case-finding.

BACKGROUND: Multiple endocrine neoplasia type 1 (MEN 1) is an autosomal, dominantly inherited cancer syndrome, with tumours in various endocrine glands. In 1997 the responsible tumour suppressor gene was identified. MEN1 gene germ-line mutations are detected in the vast majority of MEN 1 patients, however, with regard to case-finding, unfortunately only at a very low frequency in patients with apparently sporadic MEN 1-related tumours. In order to increase the detection rate of disease gene carriers among patients with apparently sporadic MEN 1-related tumours, clinical criteria were needed. DESIGN AND RESULTS: In this study MEN1 gene germ-line mutations were revealed in 16/16 MEN 1 patients/families (100%). Based on our clinical experience with MEN 1 patients/families we formulated clinical criteria to identify disease gene carriers among patients with apparently sporadic MEN 1-related tumours. The criteria for MEN 1-suspected patients are: young age at onset (< 35 years) and/or multiple MEN 1-related lesions in a single organ or two distinct organs affected. Application of these criteria yielded MEN1 gene germ-line mutations in nine of 15 MEN 1-suspected patients (60%), thus identifying novel MEN 1 families. Follow up was also guaranteed for patients not fulfilling these criteria. CONCLUSIONS: The clinical criteria for MEN 1-suspected patients increase the detection rate of germ-line MEN1 gene mutations among patients with apparently sporadic MEN 1-related tumours. These criteria may be used for (presymptomatic) identification of MEN 1 disease gene-carriers, thus enabling early detection of tumour development and timely treatment, as well as genetic counselling.

Adult↗

PubMed1999

Prevalence of APC resistance and its relationship to arterial and venous thromboembolism in a general population sample of elderly Swedish men: The Study of Men Born in 1913.

BACKGROUND: Most studies of hereditary resistance to activated protein C (APC resistance) as a risk factor for venous thromboembolism are derived from case-control studies of hospitalized patients, whilst the importance of this condition in the general population has been only sparsely investigated. OBJECTIVE: To study the prevalence of APC resistance and its relationship to morbidity and mortality in a general population sample of elderly men. DESIGN: Cross-sectional and prospective follow-up study. SETTING: General community: The Study of Men Born in 1913. SUBJECTS: A random population sample of 404 men, all 75 years of age. MAIN OUTCOME MEASURES: Four hundred and four men participated in a screening examination in 1988. The APC ratio was analysed in 382 of them. All the men were followed up for 5 years. Medical records were reviewed for all the men with a history of deep vein thrombosis, pulmonary embolism, myocardial infarction or stroke. RESULTS: Twenty-five men (6.5%) were found to have APC resistance. The incidence of venous thromboembolism, myocardial infarction or stroke did not differ between men with or without APC resistance, either retrospectively or during follow-up. Only two men experienced a deep vein thrombosis before the age of 80 and there was no case of pulmonary embolism. Mortality during 5 years of follow-up did not differ between men with and without APC resistance. CONCLUSION: The prevalence of APC resistance was 6.5% in this study of Swedish men. Although the size of the population sample is somewhat small, the study shows that, amongst elderly men, the association between APC resistance and venous thromboembolic disease was weak and men with this hereditary condition did not have any increase in morbidity or mortality compared with men without APC resistance.

Aged↗

PubMed2002

HIV infection in men who have sex with men, New York City Department of Health sexually transmitted disease clinics, 1990-1999: a decade of serosurveillance finds that racial disparities and associations between HIV and gonorrhea persist.

BACKGROUND: Previous data indicating wide racial disparities in HIV seroprevalence, associations between sentinel sexually transmitted diseases (STDs) and HIV infection, and recent reports of STD outbreaks among men who have sex with men (MSM) have raised concerns that HIV may be resurgent among MSM. GOAL: To measure trends in HIV seroprevalence and describe racial disparities among MSM presenting to New York City Department of Health STD clinics, 1990-1999 (n = 4076). STUDY DESIGN: This blinded HIV-1 serosurvey used remnant serum originally drawn for routine serologic tests for syphilis. Demographic, risk factor, clinical and laboratory data were abstracted from clinic charts of patients whose medical records documented sexual contact with men or with both men and women ("bisexual" men). Data were matched to the specimens, and all personal identifiers were removed before testing. Patients were not interviewed. RESULTS: The sample was 41% black, 20% Hispanic, 31% white, and 9% of other or mixed race/ethnicity. Sixty-one percent of the patients were >30 years of age; 21% were > or = 40 years of age. One-third had sex with women as well as men. For 60%, laboratory-confirmed STD diagnosis was made on the serosurvey visit. Overall, HIV seroprevalence declined from 47% in 1990 to 18% in 1999 (P < 0.01). Seroprevalence declined from 34% to 11% among white men (n = 1250), from 47% to 19% among Hispanic men (n = 795), from 56% to 28% among black men (n = 1656), and from 43% to 14% among men who had sex with both men and women (n = 1447). Seroprevalence among MSM with gonorrhea (n = 507) declined but remained high (57-34%; P < 0.05). In contrast, seroprevalence among MSM with nongonococcal urethritis (n = 953) declined from 36% to 16% (P < 0.01), and seroprevalence among MSM who had no STD (n = 1650) dropped from 48% to 12% (P < 0.01). Gonorrhea was diagnosed almost twice as frequently among seropositive versus seronegative MSM (19% versus 10%; P < 0.05). Black MSM were not more or less likely to have been tested for HIV or to be diagnosed with acute STD than were MSM in the other-race/ethnicity group. Positive serostatus was associated with black race/ethnicity (odds ratio [OR], 2.5; 95% CI, 2.1-2.9), age >25 years (OR, 2.5; 95% CI, 1.9-3.1), and a diagnosis of gonorrhea (OR, 2.4; 95% CI, 2.0-2.8). Sixty percent of seropositive MSM knew their serostatus from confidential or anonymous HIV testing at this or a previous visit. Two thirds of the known seropositive men had a new STD diagnosed at the serosurvey visit. CONCLUSION: Seroprevalence in this racially diverse sample of MSM declined significantly during the study period. However, wide racial disparities in seroprevalence were observed that were not attributable to disparities in risk factors such as STD, bisexuality, or acceptance of HIV testing. This finding suggests that the observed differences may reflect racial differences in the background seroprevalences, such as those seen in all New York City serosurvey samples and the population-based AIDS case rates. High prevalence associated with gonorrhea and new STD in known seropositive men of any race suggests that continued efforts to control the incidence of STD, increased encouragement of MSM to accept HIV counseling and testing, and prevention-focused counseling of seropositive men are needed.

Adult↗

PubMed2001

The Gay Men's Task Force: the impact of peer education on the sexual health behaviour of homosexual men in Glasgow.

OBJECTIVE: To assess the impact of a peer education intervention, based in the "gay" bars of Glasgow, which sought to reduce sexual risk behaviours for HIV infection and increase use of a dedicated homosexual men's sexual health service, and in particular increase the uptake of hepatitis B vaccination. DESIGN: Self completed questionnaires administered to men who have sex with men (MSM) in Glasgow's gay bars. SUBJECTS: 1442 men completed questionnaires in January 1999, 7 months after the end of the 9 month sexual health intervention. MAIN OUTCOME MEASURES: Self reported contact with the peer education intervention, reported behaviour change, and reported sexual health service use. RESULTS: The Gay Men's Task Force (GMTF) symbol was recognised by 42% of the men surveyed. Among men who reported speaking with peer educators 49% reported thinking about their sexual behaviour and 26% reported changing their sexual behaviour. Logistic regressions demonstrated higher levels of HIV testing, hepatitis B vaccination, and use of sexual health services among men who reported contact with the intervention. These men were more likely to have used the homosexual specific sexual health service. Peer education dose effects were suggested, with the likelihood of HIV testing, hepatitis B vaccination, and use of sexual health services being greater among men who reported talking to peer educators more than once. CONCLUSION: The intervention had a direct impact on Glasgow's homosexual men and reached men of all ages and social classes. Higher levels of sexual health service use and uptake of specific services among men who had contact with the intervention are suggestive of an intervention effect. Peer education, as a form of health outreach, appears to be an effective intervention tool in terms of the uptake of sexual health services, but is less effective in achieving actual sexual behaviour change among homosexual men.

Adolescent↗

PubMed2001

High prevalence of anal squamous intraepithelial lesions and squamous-cell carcinoma in men who have sex with men as seen in a surgical practice.

INTRODUCTION: Anal high-grade squamous intraepithelial lesions are probable invasive anal squamous-cell cancer precursors, and although unproved, treatment of high-grade squamous intraepithelial lesions may prevent progression to anal squamous-cell cancer. Men who have sex with men are often treated for benign anorectal disorders without consideration given to the possibility of concurrent high-grade squamous intraepithelial lesions or anal squamous-cell cancer. We determined the prevalence of anal high-grade squamous intraepithelial lesions and anal squamous-cell cancer in an urban surgical practice of men who have sex with men referred for treatment of anal condyloma and other benign noncondylomatous anal disorders. METHODS: One hundred thirty-one HIV-positive and 69 HIV-negative men who have sex with men referred for surgical treatment of presumed benign anorectal disease were evaluated by anal cytology, high-resolution anoscopy, and biopsy. Anal cytology and histology were reported with a modified Bethesda classification. RESULTS: One hundred fifty-seven patients (79 percent) were referred for condyloma, 4 (2 percent) for anal squamous intraepithelial lesions (anal high-grade squamous intraepithelial lesions) diagnosed by primary care providers, and 39 (19 percent) for other benign anorectal disorders. One hundred forty-three patients (93 percent) had abnormal anal cytology, with 107 (54 percent) having high-grade squamous intraepithelial lesions on cytology. Biopsy results revealed 120 patients (60.0 percent) with high-grade squamous intraepithelial lesions and 5 patients (3 percent) with invasive squamous-cell carcinoma. Four of five men with anal squamous-cell cancer were HIV positive. Fourteen men (36 percent) who have sex with men referred for noncondylomatous benign anal disorders had high-grade squamous intraepithelial lesions, and three (8 percent) had anal squamous-cell cancer. High-grade squamous intraepithelial lesions and anal squamous-cell cancer were seen most often at the squamocolumnar junction. CONCLUSIONS: Men who have sex with men referred for treatment of either condyloma or noncondylomatous benign anorectal disease had a high prevalence of anal high-grade squamous intraepithelial lesions and anal squamous-cell cancer. All men who have sex with men referred for treatment of benign anorectal disease should have high-resolution anoscopy and aggressive biopsy of all abnormal areas. Treatment of external lesions alone could miss high-grade squamous intraepithelial lesions or anal squamous-cell cancer.

Adult↗

PubMed1995

Association between history of childhood sexual abuse and adult HIV-risk sexual behavior in Puerto Rican men who have sex with men.

This study explored whether homosexually active men who were sexually abused in childhood were more likely to engage in HIV-risk sexual behavior than men who were not sexually abused. Participants were 182 adult men of Puerto Rican ancestry living in New York City who had had sex with other men or with men and women. Quantitative and qualitative methods of exploration were used. Three groups were determined: (a) Abuse group (AB), formed by men who before age 13, had sex with a partner at least 4 years their senior and who felt hurt by the experience and/or were unwilling to participate in it; (b) Willing/not hurt group (W), consisting of men who had an older sexual partner before age 13 but did not feel hurt by the experience and were willing to participate; and (c) No-older-partner group (NOP). The results showed that men in the AB group were significantly more likely than men in the NOP group to engage in receptive anal sex and to do so without protection. Men in the W group were ranked between the other two groups in terms of their unsafe behavior. Age and education were cofactors both for receptive anal sex and for unprotected receptive anal sex. It is concluded that given the need to improve HIV prevention among Puerto Rican men who have sex with men, sexual abuse in childhood may constitute a marker to identify men at increased risk.

Adolescent↗

PubMed1993

MEN 10,573 and MEN 10,612, novel cyclic pseudopeptides which are potent tachykinin NK-2 receptor antagonists.

The activity and selectivity of MEN 10,573 and MEN 10,612, novel cyclic pseudopeptides which are selective tachykinin NK-2 receptor antagonists is described, as compared to that of previously characterized linear and cyclic compounds. For the NK-2 receptor, the activity of test compounds was investigated in the hamster isolated trachea (HT) and the endothelium-deprived rabbit isolated pulmonary artery (RPA), two preparations which are endowed with pharmacologically distinct forms of the NK-2 receptor. The novel cyclic pseudopeptides, MEN 10,573 and MEN 10,612 displayed very high affinity for the NK-2 receptor in the HT (pA2 8.66 and 9.06, respectively) which is higher than that observed in the RPA (pA2 7.31 and 7.41 for MEN 10,573 and MEN 10,612, respectively). The antagonism exerted by MEN 10,573 and MEN 10,612 was of competitive nature in both preparations. MEN 10,573 and MEN 10,612 also displayed competitive antagonism for NK-2 receptor-mediated responses in the rabbit bronchus (RB), rat vas deferens (RVD), circular muscle of the human colon (HUC) and ileum (HUI). In the RB, HUC and HUI, the potency of the novel cyclic pseudopeptides was comparable to that of MDL 29,913 and about 10-fold greater than that of L659,877. In the RVD however, the potency of MEN 10,573 MEN 10,612 or MDL 29,913 was similar to that of L659,877. In anaesthetized rats, i.v. injection of MEN 10,612 produced a selective and long-lasting blockade of the urinary bladder contraction produced by the i.v. injection of the NK-2 receptor selective agonist [beta Ala8]neurokinin A(4-10), without affecting the response to the NK-1 receptor selective agonist [Sar9]substance P sulfone.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acid Sequence↗

PubMed2003

Safety and acceptability of penile application of 2 candidate topical microbicides: BufferGel and PRO 2000 Gel: 3 randomized trials in healthy low-risk men and HIV-positive men.

OBJECTIVES: To assess safety and acceptability of penile application of BufferGel (ReProtect, Baltimore, MD) and PRO 2000 Gel (Indevus Pharmaceuticals, Lexington, MA)compared with placebo among low-risk sexually abstinent men and HIV-positive sexually abstinent men. DESIGN: Seventy-two healthy low-risk men (36 uncircumcised) and 25 HIV-positive men (12 uncircumcised) were enrolled in 3 double-blind, single-center studies as follows: 36 low-risk men in a study of BufferGel and K-Y Jelly (McNeil-PPC, Skillman, NJ) placebo; 36 low-risk men in a study of PRO 2000 Gel and vehicle placebo; and 25 HIV-positive men in a crossover study of BufferGel, PRO 2000 Gel, and K-Y Jelly placebo. METHODS: Participants applied product to the penis on 7 consecutive nights, kept study diaries, and were then interviewed and examined. Urine was tested for inflammation by leukocyte esterase. RESULTS: No serious adverse events (AEs) or urethral inflammation was detected. During use of BufferGel, 3 low-risk men (13%) reported 6 AEs and 2 HIV-positive men (8%) reported 3 AEs. During use of PRO 2000 Gel, 4 low-risk men (17%) reported 6 AEs and 1 HIV-positive participant (4%) had 1 AE. AE rates during use of BufferGel and PRO 2000 Gel use were not significantly different from rates observed during placebo. One low-risk man (4%) would object to his partners using BufferGel and 3 (13%) to PRO 2000 Gel. Two HIV-positive men (8%) reported they would object to partners using either BufferGel or PRO 2000 Gel. CONCLUSIONS: Daily application of BufferGel and PRO 2000 Gel directly to the penis consecutively for 7 days was generally safe and well tolerated among healthy low-risk men and HIV-positive men. These microbicides have acceptable safety profiles to proceed with planned phase 3 vaginal microbicide trials.

Acrylic Resins↗

PubMed2002

Quantitative detection of Mycoplasma genitalium from first-pass urine of men with urethritis and asymptomatic men by real-time PCR.

We developed a TaqMan-based real-time PCR assay for quantifying Mycoplasma genitalium. This assay is able to specifically quantify concentrations of the M. genitalium 16S rRNA gene ranging from 10(7) to 10 copies/reaction. Using the TaqMan assay, we quantified the M. genitalium 16S rRNA gene in first-pass urine of men with urethritis and asymptomatic men who were positive for M. genitalium by PCR- and phylogeny-based assay. Of 130 men with gonococcal urethritis (GU), five were positive for M. genitalium. The mycoplasma load for each specimen was <5 x 10 copies/ml. Of 84 men with chlamydial non-GU (CNGU), seven were positive for M. genitalium. One man had an M. genitalium load of <5 x 10 copies/ml, and six men had loads ranging from 1.1 x 10(7) to 2.7 x 10(2) copies/ml. Of 86 men with nonchlamydial NGU (NCNGU), 17 were positive for M. genitalium. The mycoplasma loads for these men ranged from 3.3 x 10(6) to 2.3 x 10(2) copies/ml. Of 76 asymptomatic men, only two were positive for M. genitalium. For these men, the loads were 2 x 10(2) and <5 x 10 copies/ml. The patients with NGU had significantly higher concentrations of M. genitalium in their first-pass urine than did men with GU (P < 0.01) or asymptomatic men (P < 0.05). In addition, M. genitalium loads were significantly higher in men with NCNGU than those in asymptomatic men (P < 0.05). The quantitative assessment of M. genitalium loads by the TaqMan assay will provide useful information for understanding the pathogenicity of this mycoplasma in the urogenital tract.

DNA, Bacterial↗

PubMed2004

Cardiovascular disease incidence and mortality in older men with diabetes and in men with coronary heart disease.

OBJECTIVE: To examine the relation of diabetes and coronary heart disease (CHD; myocardial infarction (MI) or angina) to the incidence of major CHD and stroke events and total mortality. METHODS: Prospective study of 5934 men aged 52-74 years followed up for 10 years. The men were divided into five groups according to their diabetes and CHD status. RESULTS: During the follow up there were 662 major CHD events, 305 major stroke events, and 1357 deaths from all causes (637 cardiovascular disease (CVD) deaths, 417 CHD deaths). Men with diabetes had significantly increased cardiovascular and total mortality risk compared with non-diabetic men with no CHD but lower risk than men with prior MI only. The adjusted relative risk for CHD deaths was 2.82 (95% confidence interval (CI) 1.85 to 4.28) in men with diabetes only, 2.12 (95% CI 1.53 to 2.93) in men with angina only, 3.91 (95% CI 3.07 to 4.99) in men with MI, and 8.93 (95% CI 6.13 to 12.99) in men with both diabetes and CHD. Case fatality among men with diabetes only was similar to those with prior MI only. CHD and CVD mortality increased with increasing duration of diabetes with risk eventually approaching that of patients with MI without diabetes. CONCLUSION: Men with diabetes only have a CVD risk intermediate between men with angina and men with prior MI. Their absolute risk is high and the prognosis for diabetic patients who develop CHD is extremely poor.

Aged↗

PubMed1979

Diet and urinary steroids in black and white North American men and black South African men.

Urinary steroid hormone content was determined in Black and White North American men and in rural Black South African men between 40 and 55 years of age and in Black South African men over 60 years of age when maintained on their customary diets or when transferred to a vegetarian or Western diet, respectively. When eating their customary diets, Black South African men had lower levels of urinary estrogens and androgens than did Black and White North American men. The total androgen content decreased significantly in Black North American men on the vegetarian diet and increased in Black South African men fed a Western diet. Urinary excretion of estrogens was higher in older than in younger rural Black South African men. Data indicated that a vegetarian diet modified androgen and estrogen metabolism in North American men and that a Western diet was associated with higher levels of urinary steroid hormones in young Black South African men. Diet-related changes in steroid metabolism in rural Black South African men were age dependent. The relationship of the increased urinary excretion of steroid hormones in Black South African men, a low-risk group fed a Western diet, and the decreased excretion in Black and White North American men, high-risk groups fed a vegetarian diet, to the development of prostatic cancer remains to be clarified.

Adult↗

PubMed2003

Trends in prostate cancer mortality among black men and white men in the United States.

BACKGROUND: Prostate cancer mortality rates in the United States declined sharply after 1991 in white men and declined after 1992 in black men. The current study was conducted to investigate possible mechanisms for the declining prostate cancer mortality rates in the United States. METHODS: The authors examined and compared patterns of prostate cancer incidence, survival rates, and mortality rates among black men and white men in the United States using the 1969-1999 U.S. prostate cancer mortality rates and the 1975-1999 prostate cancer incidence, survival, and incidence-based mortality rates from the Surveillance, Epidemiology, and End Results (SEER) Program for the U.S. population. The SEER data represent approximately 10% of the U.S. population. RESULTS: Prostate cancer incidence and mortality rates showed transient increases after 1986, when the U.S. Food and Drug Administration approved the use of prostate specific antigen (PSA) testing. The age-adjusted prostate cancer mortality rates for men age 50-84 years, however, have dropped below the rate in 1986 since 1995 for white men and since 1997 for black men. In fact, for white men ages 50-79 years, the 1998 and 1999 rates were the lowest observed since 1950. Incidence-based mortality rates by disease stage revealed that the recent declines were due to declines in distant disease mortality. Moreover, the decrease in distant disease mortality was due to a decline in distant disease incidence, and not to improved survival of patients with distant disease. CONCLUSIONS: Similar incidence, survival, and mortality rate patterns are seen in black men and white men in the United States, although with differences in the timing and magnitude of recent rate decreases. Increased detection of prostate cancer before it becomes metastatic, possibly reflecting increased use of PSA testing after 1986, may explain much of the recent mortality decrease in both white men and black men.

Aged↗

PubMed2004

Longitudinal changes in lower urinary tract symptoms among a cohort of black American men: the Flint Men's Health Study.

OBJECTIVES: To examine the progression of lower urinary tract symptoms in a longitudinal population-based cohort of black men. Population-based studies of prostatism and longitudinal data regarding changes in lower urinary tract symptom severity have largely focused on white men, with little attention directed toward black men. METHODS: In 1996, a probability sample of 369 black men, aged 40 to 79 years, residing in Genesee County, Michigan, and without a prior history of prostate cancer/surgery participated in a prostate cancer screening protocol that included completing the American Urological Association Symptom Index (AUASI). Four years after baseline, 175 of the 369 men agreed to participate in the follow-up protocol. Of the 175 men, 149 had not reported undergoing treatment for benign prostatic hyperplasia and had complete symptom data. These men were included in this study. Differences between baseline and follow-up AUASI scores were examined. RESULTS: The mean and standard deviation AUASI scores at baseline and follow-up were 7.1 (6.4) and 7.0 (6.8), respectively. Although overall no statistically significant change was found in the mean AUASI during the 4 years of follow-up (-0.11; SD 6.2; P = 0.7), the average change in the symptom score and the variability in the change increased with patient age at baseline from a mean of -0.42 (SD 5.0) among men in their 40s to 2.1 (SD 6.6) among men in their 70s. Of the 91 men (61.1%) who reported mild to no symptoms (AUASI score 7 or less) at baseline, 24 (26.4%) reported moderate to severe symptoms (AUASI score 8 or more) at follow-up. This progression of symptom severity was observed across all ages. CONCLUSIONS: In this population-based study of longitudinal changes in urinary symptoms in black men, we found a substantial percentage of men demonstrated a measurable progression in urinary symptom severity over time. Additional studies are needed to examine critically any racial differences in lower urinary tract symptom progression.

Adult↗

PubMed1997

Distinct biological properties of two RET isoforms activated by MEN 2A and MEN 2B mutations.

Germline mutations of the RET proto-oncogene, which codes for a receptor tyrosine kinase, cause multiple endocrine neoplasia type 2A (MEN 2A) and 2B (MEN 2B) and familial medullary thyroid carcinoma (FMTC). MEN 2 mutations have been shown to result in RET oncogenic activation. The RET gene encodes several isoforms whose biological properties, when altered by MEN 2 mutations, have not been thoroughly addressed yet. In this study, we have introduced a MEN 2A mutation (Cys634-->Arg) and the unique MEN 2B mutation (Met918-->Thr) in two RET isoforms of 1114 and 1072 amino acids which differ in the carboxy-terminus part. Herein, we report that each RET isoform activated by MEN 2A or MEN 2B mutation was transforming in fibroblasts and induced neuronal differentiation of pheochromocytoma PC12 cells. However, among the different RET-MEN 2 mutants, the long RET isoform activated by the MEN 2B mutation stimulated the most prominent neurite outgrowth in PC12 cells, while the short RET isoform counterpart elicited a very weak differentiation effect in PC12 cells. We further demonstrate that the morphological changes of PC12 cells caused by constitutively activated RET oncoproteins involved the engagement of a Ras-dependent pathway. These findings provide evidence that the biological properties of RET-MEN 2 mutants depend on the interplay between the RET isoforms and the nature of the activating MEN 2 mutation.

Animals↗

PubMed2002

Perception of men with androgenetic alopecia by women and nonbalding men in Korea: how the nonbald regard the bald.

BACKGROUND: Baldness has significant negative psychosocial effects. It has been asserted that the negative effects of baldness are often trivialized by the nonbald. Most studies concerning the perception of baldness have focused on the perceptions of the bald by themselves. In this study, we assessed the perception of baldness by the nonbald in Korea. METHOD: A questionnaire on the perception of balding men was answered by 130 women (age range 15-58 years), 90 nonbalding men (age range 18-72 years) and 30 balding men (age range 20-63 years). RESULTS: Balding men were perceived as being older and less attractive by over 90% of respondents. A perception that balding men are less confident, duller, and less potent was reported by less than half of respondents. A perception that balding men are less attractive was significantly more common among women than among nonbalding men (P < 0.05). A perception that balding men appear less confident was significantly more common among balding men than among nonbalding men (P < 0.05). CONCLUSION: In this study of Koreans, the perception of balding men by others was similar to the perception of balding men by themselves. It is likely that androgenetic alopecia adversely influences social interactions of those who are subject to it.

Adolescent↗