Nihon rinsho. Japanese journal of clinical medicine
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Preoperative neoadjuvant hormonal therapy is still controversial. This therapy's purpose is downstaging prostate cancer at radical prostatectomy and thereby improving the prognosis of prostate cancer. It has been repeatedly demonstrated that hormonal therapy causes significant alterations in the gross and microscopic appearance of the prostate. ⋯ However, it remains to be seen if the favorable findings lead to an improved outcome after radical prostatectomy. Our study showed 6-12 months neoadjuvant hormonal therapy with maximal androgen blockade did not lead to the improved result in long term follow-up. Because, PSA failure was observed 25% of the cases which received neoadjuvant hormonal therapy prior to radical prostatectomy.
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Clinical and laboratory experiments have demonstrated that arginine vasopressin (AVP), renin-aldosterone system and catecholamines play a crucial role in water and sodium retention in edematous diseases, including congestive heart failure, nephrotic syndrome and liver cirrhosis. These hormonal secretions are all increased mediated through baroreceptor mediated afferent pathway, in which the tonic inhibition of hormonal release is attenuated by decreased effective circulatory blood volume. ⋯ Aldosterone enhances sodium reabsorption in distal nephron. Also, norepinephrine increases sodium reabsorption in proximal tubules, and in part augments renin-aldosterone system that increases sodium reabsorption in distal nephron.