The Clinical Usefulness of the Prostate-specific Antigen, Prostate- specific Antigen Density, Digital Rectal Examination, and Transrectal Ultrasonography in the Screening Test of Prostate Cancer in Koreans / 대한비뇨기과학회지

PURPOSE: The efficacy of the prostate-specific antigen (PSA), prostate-specific antigen density (PSAD), digital rectal examination (DRE) and transrectal ultrasonography (TRUS) for diagnosing prostate cancer in Koreans was investigated. MATERIALS AND METHODS: The medical records from a selected population of 346 patients (30 to 93 years old, mean age 66.0) who had visited the department of Urology in Seoul National University Hospital from January 1994 to December 2000 were reviewed retrospectively. All patients a transrectal ultrasonography-guided biopsy. The student's t test was used for statistical analysis. RESULTS: Prostate cancer was detected in 119 (34.4%) out of 346 patients. PSA, PSAD, TRUS, and DRE showed a sensitivity of 95.8%, 88.2%, 66.4% and 61.3%, a specificity of 26%, 49.3%, 66.5% and 55.9%, and a positive predictive value of 40.4%, 47.7%, 51% and 42.2%, respectively. The positive predictive value from the combination of PSAD and TRUS was 67%, which was the highest when two among the four methods were selected and combined. The detection rate for prostate cancer was 23% (31 out of 135 patients) when the PSA level was between 4 and 10ng/ml, and was 20.9% (18 out of 86 patients) when PSA level was between 4 and 10ng/ml and the DRE findings were negative. CONCLUSIONS: In detecting prostate cancer, PSA showed the highest sensitivity and TRUS showed the highest specificity and positive predictive value. PSAD might be a useful method for diagnosing prostate cancer when combined with TRUS. A TRUS-guided biopsy should be done in patients when the PSA level is between 4 and 10ng/ml in Korea.

The Value of Prostate Specific Antigen, Digital Rectal Examination, Transrectal Ultrasound, and Transrectal Ultrasound-Guided Biopsy in Prediction of Final Pathologic Diagnosis in Prostate Cancer / 대한비뇨기과학회지

PURPOSE: We evaluated the clinical utility of preoperative serum prostate specific antigen (PSA), digital rectal examination (DRE), transrectal ultrasound (TRUS), and findings of TRUS-guided biopsies in predicting the final pathologic diagnosis in patients who underwent radical prostatectomy. MATERIALS AND METHODS: The medical records of 53 patients with prostate cancer who underwent radical prostatectomy from september 1995 to June 2000 were reviewed. Pathologic variables evaluated on sextant biopsies included total length and percent of cancer on one core, number of cores involved and Gleason score. Clinical variables included PSA and PSA density (PSAD). Also subjects were divided into two groups; organ-confined group versus non organ-confined group. RESULTS: On final pathologic examination, 38 patients (72%) had organ-confined, 11 patients (21%) had margin positive, 6 patients (11%) had capsular penetration and 6 patients (11%) had seminal vesicle involvement. None had pelvic lymph node metastases. Chi-square analysis demonstrated significant correlations between PSA, PSAD, number of cores involved, total length of cancer on one core and organ-confined prostate cancer. When PSA level was 11 or more, PSAD was 0.34 or more, biopsies had Gleason scores of 7 or more, number of cores involved was two or more, and total length of cancer on one core was 0.4cm or more, possibility of cancer being non organ-confined increased CONCLUSIONS: This study demonstrates that PSA, PSAD, Gleason score in sextant biopsy, number of cores involved, total length of cancer on one core are clinically useful predictors of organ-confined disease. This may help both patients and clinician in selecting the most appropriate therapeutic approach.

Molecular Identification of Oxalobacter formigenes with Polymerase Chain Reaction: Fresh vs. Frozen Stool / 대한비뇨기과학회지

PURPOSE: Oxalobacter formigenes is an intestinal flora degrading oxalate in the gut. However, microbiological detection of this organism is quite difficult. We tried to develop a simple, rapid and cost-effective PCR method for detecting Oxalobacter formigenes from fecal specimens and to determine whether O. formigenes could be detected from frozen fecal specimens as well as fresh stool. MATERIALS AND METHODS: Whole bacterial DNA was isolated directly from fresh and frozen stool samples obtained from 30 healthy volunteers known to be free from urolithiasis and from fresh stool samples obtained from 38 patients with urolithiasis. Genus specific oligonucleotide sequences corresponding to homologous regions residing in the oxc gene that encodes for oxalyl-coenzyme A decarboxylase were designed. A PCR-based assay was done in both fresh and frozen stool samples and the nucleotide sequences were analyzed to determine the details of oxc. RESULTS: PCR product of 416-bp molecular size encoding oxc gene was detected in 23 (77%) of 30 healthy volunteers and in 14 (37%) of 38 patients with urolithiasis. In healthy volunteers, the results of PCR for the fresh and the frozen stool proved identical in each subject. The nucleotide sequence analysis revealed that the sequence of the amplified product was compatible with that of oxc gene. CONCLUSIONS: O. formigenes could be identified easily and efficiently by this PCR-based detection system. Furthermore, as the PCR-based assay results in the frozen fecal samples were identical as that of fresh stool, immediate processing of the fecal samples may not be necessary to detect O. formigenes in the clinical setting.

Molecular Epidemiology of Fecal Oxalobacter formigenes in Healthy Adults Living in Seoul, Using a Polymerase Chain Reaction-Based Detection System / 대한비뇨기과학회지

No abstract available.

The Effects of Oxalate on the DNA Synthesis in LLC-PK1 Cells / 대한비뇨기과학회지

No abstract available.

Laparoscopy-Assisted Extracorporeal Ureteral Anastomosis : a New Technique / 대한비뇨기과학회지

We investigated the feasibility of the extracorporeal suture technique in laparoscopic pyeloplasty and laparoscopic ipsilateral ureteroureterostomy in child with ureteropelvic junction obstruction or duplex kidney. Laparoscopic pyeloplasty and laparoscopic ureteroureterostomy were performed in a child with ureteropelvic junction obstruction and in a 3-year old child with duplex kidney, respectively. Ureteropelvic junction or ureters were dissected laparoscopically and were drawn out of the abdominal cavity through the 10mm trocar tracts and subsequently anastomosed extracorporeally. We were able to draw the ureteropelvic junction or the ureters out of the abdominal cavity without difficulty owing to the laxity and thin abdominal wall in children. Operating time was 120 minutes in both cases, and all anastomses between ureter and pelvis were completed without any intraoperative complication. There was no postoperative complication. Significant improvements in urinary drainage were shown in both children on postoperative intravenous pyelogram. These early results suggest that the extracorporeal suture technique in children is feasible and easy to perform. Therefore, the drawbacks of intracorporeal suture technique during the laparoscopic pyeloplasy or ureteroureterostomy could be overcome by using this novel teehnique.