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The Prostate: Part I – BNP What is situated below a body of water, has four zones and is commonly associated with venial pleasures. No it is not some romantic European city, but rather a walnut sized male organ that serves important procreative functions. It also happens to be an organ that plagues men as we age. This organ or gland is the prostate. This is the first of two articles on the male prostate. This article will focus on a disease process that affects older men, something we refer to as benign prostatic hyperplasia (BPH). BPH is a non-cancerous growth in the size of the prostate gland that impairs the flow of urine out of the bladder. The second article will focus of prostate cancer. But first a little about the small yet important male organ. The gland is located just below the bladder. It usually measures one inch by one-and-a-half inches (approximately the size of a walnut). It surrounds the urethra (the tube that takes urine out of the bladder). It is responsible for producing a fluid important in male sexual function. In the past the prostate was described as having “lobes”, but today we refer to it as having concentric zones. These zones are important both on an anatomical as well as histological level. We can separate pathology along these zones as well. For instance most all cancers occur in the peripheral zone while the benign process of enlargement occurs almost exclusively in the transitional zone (which only occupies about 5% of the total prostate volume). The prostate gland is also made up of different cell types. Cancer cells develop from the epithelial cells, but it is the interaction with stromal cells that is important in the behavior of the cancer. BPH develops from an interaction between these cells as well, but it is complex and poorly understood. Testosterone and other hormones and their interactions with this gland are hot topics of research in understanding prostate disease. The prostate gland produces most of what is found in the male ejaculate. The average volume is about 3 mL. This is less than a teaspoon and only 1% of it is sperm. The majority of the semen volume is made of products of the seminal vesicles and the prostate. The male ejaculate is very rich in potassium, zinc, citric acid and fructose. Along with these substances it also contains prostaglandins. There are many other unusual substances found in the semen. Not all is know about their function or purpose. This important male organ is a complex mix of anatomical structures and cell types that make it possible for human reproduction. However beyond the reproductive years of men, this organ becomes one of burden rather than usefulness. We will discuss the finer points of BPH and how to best avoid it and if plagued with it, treatment options. BPH typically affects men from their fourth to fifth decade of life and beyond. Several hormones come into play that have a drastic effect on the transitional zone (the zone that is most central and surrounding the urethra). Namely a metabolite of the male androgen Testosterone called Dihydrotestosterone (DHT) plays a big part on the enlargement of cells of the prostate and the encroachment on the urethra. There are several signs and symptoms that correlate with BPH and they are: slow urinary flow, the urge to urinate all the time, nighttime urination, enlargement and distension of the bladder with continuous urine leakage (incontinence) and urinary obstruction. Autopsies suggest that more than 90% of men older than 70 years have BPH. The average age for symptomatic development is about 65 years for white Americans and about 60 years for African-American men. Ways to prevent the effects of DHT on the prostate gland and the ensuing enlargement are via medications that block the enzyme 5-alpha-reductase, which converts Testosterone to DHT. Proscar is such a drug commercially available through a pharmaceutical company. Proscar works on blocking the effects of androgens on the epithelial cells and can actually shrink the size of the prostate making some of the symptoms of BPH resolve. Alternatively two FDA approved drugs that aid in symptoms of BPH (but act differently than Proscar) are Hytrin and Cardura. Both Hytrin and Cardura are drugs in the alpha1-blocker class. Originally researched as a centrally acting blood pressure reducer for patient with hypertension, it was discovered that this drug would actually relax the prostate tissue surrounding the urethra making symptoms of BPH resolve. Side effects generally include low blood pressure, dizziness, and nasal stuffiness. While neither of these two drugs will “cure” or reverse the process, they certainly do provide symptom relief for the patient plagued with BPH. Another way to treat this disease and a more natural approach is the use of herbs know for their anti-androgenic effects on the prostate. These include the well-studied Saw Palmetto herbal extract that blocks 5-alpha-reductase in the same manner as the prescription drug. Saw Palmetto taken in a standardized dose of 160mg twice daily has shown increased urine flow, with minimal side effects. Saw Palmetto is an herb indigenous to the Lowcountry of Georgia and South Carolina. Pygeum Africanum is shown to do the same yet it is not as effective and there is a fair degree of stomach symptoms. Pygeum is derived from an African evergreen tree. Stinging Nettles (Radix urticae) is another herb used widely in Europe for prostate health that has been shown to lower the residual urine volume in men with enlarged prostates. These phytotherapeutics (plant derived medicines), used and described by the Egyptians as far back as the 15 Century B.C., have a common compounds called phytosterols. The most effective phytosterol is beta sito sterol for BPH. None of the medications or herbs has been shown to prevent prostate cancer. These prescription medications and herbs are for the treatment, reduction in size or prevention of the benign process of enlargement of the prostate. Prostate cancer prevention and treatment is by other means and the subject of the next article. Besides the herbal and drug therapies there are a few surgical therapies worth mentioning. These include the most common transurethral resection of the prostate or TURP. This is where under the care of an urologist the constricted urethra within the prostate gland is “reamed out” thus mechanically or surgically widened the opening. A variant of this is the transurethral incision of the prostate (TUIP) where an incision rather than resection of the tissue is performed. A suitable procedure for patients with prostates 100 mL in volume. This involves an abdominal operation and removal of the whole prostate. Of course symptoms mentioned above for TURP are of greater frequency with this more radical procedure. There is also thermotherapy (a type of microwave treatment) that alleviates irritative symptoms, but not much is available in long-term results in the medical literature. And finally stent placement is an option. This can be used in selected cases of patients with a poor general condition and in the non-operative candidate. Symptoms of BPH include: Obstructive symptoms: Hesitancy in initiating voiding (trouble getting started) Weak urinary stream, prolonged voiding Post-voiding dribbling (mild incontinence) Sensation of incomplete emptying Nocturia (night time urination) Overflow incontinence Acute urinary retention (very painful condition) Irritative symptoms: Dysuria (discomfort in urination) Frequency Urgency Scoring BPH: The American Urological Association Symptom Index (AUASI) and International Prostate Symptom Score (IPSS) are now considered the gold standard measurement tools for the assessment of BPH symptoms and response to treatment. Both questionnaires can be used by a physician in a clinical practice to quantify the subjective symptoms of BPH and monitor therapies. Part II in this series will cover annual examination of the prostate, blood testing, prostate cancer. It will also cover prevention and treatment of prostate cancer. Reference: http://www.prostatehealth.com Lowe, FC. Et al, Phytotherapy in treatment of benign prostatic hyperplasia: a critical review. Urology 48:12-19, 1996 Dreikorn, K. et al, Stellenwert von Phytotherapeutica dei der Behandulng der benighnen Prostatahyperplasia. Urologe (A)34:119-129, 1995 Fitzpatrick, J.M. et al, Phytotherapeutic Agents in Management of Symptomatic Benign Prostatic Hyperplasia. Urological Clinics of North America. 22:407-412, 1995 Wilt T, Ishani A, Mac Donald R.. Serenoa repens for benign prostatic hyperplasia. The Cochrane Database of Systematic Reviews 2002, Issue 3. Art. No.: CD001423. DOI: 10.1002/14651858.CD001423. [Research by Sagalowski and Wilson, 1998] © 2005 pnis enlargement technique guide to pennis enlargement penis enargement supplement enlargement manhattan penile natural pennis enlargement cheap vigrx pill penis elargement excersizes vimax penis enlargement picture pnis enlargement drug

Franchising Trade Journals do not do well, because today with all the industry regulations only about 1800 active franchise actually exist in the US. Down sharply over the past five years. Why? Over-regulation. Now you have a Bank Cooperative, which owns a company that collect data, FranData of Uniform Franchise Offering Circulars, which are the industries required disclosure documents to new franchise buyers. The company sells it to attorneys and to competitors of which many probably are financed through that bank. My God can this be real. Then they work with industry Trade Journals to do Top 50 franchises lists, but to be qualified to be reviewed they of course wish to see your UFOC; Uniform Franchise Offering Circular. So what is the deal with this purported 50 Fastest New Franchise List? Is it real? Does it matter if it is? After all once a Franchisor decides to participate they have just given their life's work to someone who will sell the data including the names addresses and phone numbers of each and every one of your franchisees to your competitors or to franchise industry salesmen who will never stop harassing you or your company and to the over seas competitors who want to come into this country and take you customers and end use customers of your franchise families income. You think this is acceptable? It is unbelievable to think that this is acceptable, in a time when Accounting Firms and Agencies cannot advise and audit or a time when the NYSE is splitting up it's executive and regulating boards. This whole thing smells of Conflict of interest, anti-trust laws, misrepresentation of intent. Meanwhile the SBA, a government agency, paid by us is paying this company or has given them an exclusive to collect this data for their SBA registry of franchising companies to streamline loan application process times? Holly conflict of interest; can you believe that the industry has there penis so far up the regulating agencies rear end that they allow this? Then a lady who called our company had the nerve to ask us to participate with them in a survey, so she can help us get more publicity? No; so their company can give away our information to those companies who cannot compete with us head on in the market place, because they are either to incompetent or too lazy to offer better service and lower prices to the consumer. Instead they are willing to pay for all our secrets via a group financed by government contracts at the SBA, which is really involved in industry spying? Wow, for an agency like the SBA which is suppose to help people in achieving their American Dream, they have allowed and exclusive contract to a company that wants to put the screws to the next Ray Kroc, up and coming franchise concept? Pathetic, typical Washington, "It's who you know and who you BLOW" attitude, literally. You can bet that http://www.Franchising.org is going to get to the bottom of this, meanwhile if you are an up and coming franchisor and you want to succeed, then realize who you are dealing with before you allow the important data that makes your business possible out of your sight. Franchise Buyers must be screened carefully, do not hand over your information, data, financial audit, or profile without weighing the benefits first. Be sure to ask questions of these companies who claim to be helping you in some way? Yah sure, they are going out of their way to help you? Since when has anyone besides a new franchisor; ever done that in your life? Since when has someone gone out of their way to assist you in building your franchise company? What we see here is an undermining of the entire Friedman Economic Model, which dictates free markets, which is run by a company which profits from screwing over the little guy. Last time I checked it was new smaller businesses and expanding businesses, which provided jobs. Not the government or attorneys, speaking of which wasn’t it great watching that lawyer hide behind the tree the other day trying not to be shot buy a guy he ripped off; I think that happened at a California court house last year? In my opinion FranData a subsidiary of the National Bank Cooperative is violating the intent if not the letter of the law as it relates to anti-trust. And it is our opinion that only a D.C. Company could get way with such a conflict of interest working in cahoots with a government agency, which literally gives out money. Have you seen the fall out rates of SBA loans? It is also our opinion that we were lied to by FranData for them to secure more information from our company to give, actually sell, to our competitors. What started out as a nice contract for a Black African American businessman has been manipulated and then sold to a Bank Cooperative, which uses this data through a subsidiary to profit of the sale of said data to competitors. Does this affect our team? Our Company, the franchise business I have been working on for 27 years? Well, it could if we give our data to these people to sell online. But still these companies buying the data will see we do not take prisoners in the marketplace. However for a small franchisor starting out, it could spell disaster. Every time we see these things, we are more resolved to get out there and kick ass against those who manipulate the system, break the law or think they can take the easy way out to compete with us. 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Since the release of the erectile dysfunction drug Viagra onto the market in the mid-1990’s, there have been a number of clinical reports regarding the complications associated with the erectile dysfunction drug. Viagra users report adverse side-effects to the drug, including cardiovascular and ocular complications. Yet, despite reports of such serious side effects, men of a variety of ages still choose to use Viagra as a catch-all cure for erectile dysfunction. Viagra works at treating erectile dysfunction in the first place, by blocking two specific enzymes in the body, known as PDE5 and PDE6, which exist throughout the body, but in higher concentrations in the penis. The problem here: PDE6 also plays an important role in the processes that make vision possible. Thus, blocking the enzyme causes complications with the vision of some Viagra users. Proponents of Viagra argue that the reports of Viagra's complications can be explained away by aging—that the trouble with vision typically reported by Viagra users are mere results of the aging process. But, considering that the side effects occurred even in Viagra’s youngest users, we know this cannot explain every instance of the adverse side effect. In truth, we can determine that in many cases, Viagra causes men to go blind. This isn’t to say that Viagra isn’t without its positive attributes. Viagra users certainly seem to profess gratefulness to the erectile dysfunction drug, for its effects on their sexual relationships. But is the cost of sexual satisfaction too high for men? Men seem willing to risk life and limb for the opportunity to have somewhat normal penis function in the form of an easy-to-swallow little blue caplet, but with such great risks as cardiovascular and ocular complications, we have to wonder if the risk balances with the reward. For men who wish to avoid the complications associated with Viagra, there are other , more natural options for the temporary cure of erectile dysfunction, Following the popularity of Viagra in the mid-1990’s, many companies began marketing natural male enhancement alternatives to the popular drug. Yet, Viagra users still continue using Viagra, despite the risk of blindness and other obvious and prevalent complications associated with the manufactured drug. More public awareness about dangerous complications associated with Viagra is necessary, as well as more public awareness about the natural male enhancement alternatives to the erecticle dysfunction drug. By educating Viagra users, we can ensure that fewer men lose their vision due to this very dangerous erectile dysfunction drug. Men shouldn’t have to choose between their vision and their sex lives, and the many natural male enhancement alternatives to Viagra make this choice unnecessary.