Context Serum testosterone levels decline significantly with aging.
 Testosterone supplementation to older men might beneficially affect the aging processes.
 ObjectiveTo investigate the effect of testosterone supplementation on functional mobility, cognitive function, bone mineral density, body composition, plasma lipids, quality of life, and safety parameters in older men with low normal testosterone levels.Design, Setting, and ParticipantsDouble-blind, randomized, placebo-controlled trial of 237 healthy men between the ages of 60 and 80 years with a testosterone level lower than 13.7 nmol/L conducted from January 2004 to April 2005 at a university medical center in the Netherlands.InterventionParticipants were randomly assigned to receive 80 mg of testosterone undecenoate or a matching placebo twice daily for 6 months.Main Outcome Measures
 Functional mobility (Stanford Health Assessment Questionnaire,
 timed get up and go test, isometric handgrip strength, isometric leg extensor strength), cognitive function (8 different cognitive instruments),
 bone mineral density of the hip and lumbar spine (dual-energy x-ray absorptiometry scanning), body composition (total body dual-energy x-ray absorptiometry and abdominal ultrasound of fat mass), metabolic risk factors (fasting plasma lipids, glucose, and insulin), quality of life (Short-Form Health 36 Survey and the Questions on Life Satisfaction Modules), and safety parameters (serum prostate-specific antigen level,
 ultrasonographic prostate volume, International Prostate Symptom score,
 serum levels of creatinine, aspartate aminotransferase, alanine aminotransferase, γ-glutamyltransferase,
 hemoglobin, and hematocrit).
 Results
 A total of 207 men completed the study. During the study, lean body mass increased and fat mass decreased in the testosterone group compared with the placebo group but these factors were not accompanied by an increase of functional mobility or muscle strength. Cognitive function and bone mineral density did not change. Insulin sensitivity improved but high-density lipoprotein cholesterol decreased; by the end of the study, 47.8% in the testosterone group vs 35.5% in the placebo group had the metabolic syndrome (P = .07).
 Quality-of-life measures were no different except for one hormone-related quality-of-life measure that improved. No negative effects on prostate safety were detected.
 ConclusionTestosterone supplementation during 6 months to older men with a low normal testosterone concentration did not affect functional status or cognition but increased lean body mass and had mixed metabolic effects.Trial Registration
 isrctn.org Identifier: ISRCTN23688581

/pdf/effect-of-testosterone-supplementation-on-functional-12leh6ckii.pdf

Effect of testosterone supplementation on functional mobility, cognition, and other parameters in older men - A randomized controlled trial

Cancers of the prostate have traditionally been detected by digital palpation which identifies increased stiffness (modulus of elasticity, hardness) of the abnormal tissue. Gray-scale ultrasound is insensitive to stiffness as an imaging parameter and often fails to reveal the extent or existence of a prostate cancer. Recent developments in technology and understanding have improved the diagnostic efficacy of transrectal ultrasound for detection of early prostate cancer, but even when coupled with digital rectal examination, a significant percentage of existing carcinomas may not be recognized. This statement is based on the lower detection rates for transrectal ultrasound and digital rectal examination in screening populations (0.1-4%) as compared to autopsy series prevalance rates of approximately 30%. Recent reports suggest that early cancers of the prostate may be characterized as hypoechoic areas in the peripheral zone of the prostate (1). Others suggest that the more advanced lesions have varied appearances ranging from hypo to hyperechoic with some even showing combinations of both (2,3). Our transrectal ultrasound experience from patients with palpable cancers (which include moderately to advanced disease), suggests a varied non-specific gray-scale appearance as well, despite the uniform impression that they are all firm on digital palpation.

Sono-Elasticity: Medical Elasticity Images Derived from Ultrasound Signals in Mechanically Vibrated Targets

Diagnosis of Prostatic Carcinoma: The Yield of Serum Prostate Specific Antigen, Digital Rectal Examination and Transrectal Ultrasonography

Economics of screening for carcinoma of the prostate

Magnetic resonance (MR) imaging–guided prostate biopsy in a 0.5-T open imager is described, validated in phantom studies, and performed in two patients. The needles are guided by using fast gradient-recalled echo and T2-weighted fast spin-echo images. Surgical navigation software provided T2-weighted images critical to targeting the peripheral zone and the tumor. MR imaging can be used to guide prostate biopsy.

MR imaging-guided prostate biopsy with surgical navigation software: device validation and feasibility.

Over a 7-month period, from a total of 417 transrectal ultrasound (US) studies, 45 transperineal biopsies of the prostate were performed in the radiology department. Transrectal US guidance and local anesthesia were used. Twenty-two of 32 hypoechoic lesions, located within the peripheral zone tissue of the gland, were proved by histologic study to be cancerous. Hyperechoic lesions were all histologically benign hyperplasias. The patients experienced no major complications necessitating hospitalization or increased length of hospital stay as a result of the procedure.

Prostatic evaluation by transrectal sonography: criteria for diagnosis of early carcinoma.

Transrectal Ultrasound in the Diagnosis of Prostate Cancer: Location, Echogenicity, Histopathology, and Staging

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Prostatic evaluation by transrectal sonography: criteria for diagnosis of early carcinoma.

Transrectal Ultrasound in the Diagnosis of Prostate Cancer: Location, Echogenicity, Histopathology, and Staging