Change of Therapeutic Response Classification According to Recombinant Human Thyrotropin‑Stimulated Thyroglobulin Measured at Different Time Points in Papillary Thyroid Carcinoma / 대한핵의학회잡지

Purpose@#We investigated whether response classification after total thyroidectomy and radioactive iodine (RAI) therapy could be affected by serum levels of recombinant human thyrotropin (rhTSH)-stimulated thyroglobulin (Tg) measured at different time points in a follow-up of patients with papillary thyroid carcinoma (PTC). @*Methods@#A total of 147 PTC patients underwent serum Tg measurement for response assessment 6 to 24 months after the first RAI therapy. Serum Tg levels were measured at 24 h (D1Tg) and 48–72 h (D2-3Tg) after the 2nd injection of rhTSH. Responses were classified into three categories based on serum Tg corresponding to the excellent response (ER-Tg), indeterminate response (IR-Tg), and biochemical incomplete response (BIR-Tg). The distribution pattern of response classification based on serum Tg at different time points (D1Tg vs. D2-3Tg) was compared. @*Results@#Serum D2-3Tg level was higher than D1Tg level (0.339 ng/mL vs. 0.239 ng/mL, P < 0.001). The distribution of response categories was not significantly different between D1Tg-based and D2-3Tg-based classification. However, 8 of 103 (7.8%) patients and 3 of 40 (7.5%) patients initially categorized as ER-Tg and IR-Tg based on D1Tg, respectively, were reclassified to IR-Tg and BIR-Tg based on D2-3Tg, respectively. The optimal cutoff values of D1Tg for the change of response categories were 0.557 ng/mL (from ER-Tg to IR-Tg) and 6.845 ng/mL (from IR-Tg to BIR-Tg). @*Conclusion@#D1Tg measurement was sufficient to assess the therapeutic response in most patients with low level of D1Tg. Nevertheless, D2-3Tg measurement was still necessary in the patients with D1Tg higher than a certain level as response classification based on D2-3Tg could change.

What Is Fecal Incontinence That Urologists Need to Know? / 대한배뇨장애요실금학회지

Fecal incontinence (FI) undoubtedly reduces quality of life and adversely affects the social life of the affected individual. FI has a higher prevalence with age and has an equivalent prevalence to urinary incontinence in patients with genitourinary disease, but is often not confirmed in these cases. A thorough investigation is needed to diagnose FI, with the common etiology of this condition in mind, and several questionnaires can be used to identify symptoms. The physical examination contains digital rectal examination carries out to identify the patient’s condition. Ultrasound, colonoscopy, and rectum pressure test can be performed. Patients educated in diet-related issues, bowel movements, and defecation mechanism. Nonoperative options such as diet control and Kegel exercise should be performed at first. Surgical treatment of FI is considered when conservative management and oral medications produce no improvement. Surgical options include less invasive procedures like bulking agent injections, and more involved approaches from sacral nerve stimulation to invasive direct sphincter repair and artificial bowel sphincter insertion. Good outcomes in FI cases have also recently been reported for barrier devices.

What Is Fecal Incontinence That Urologists Need to Know? / 대한배뇨장애요실금학회지

Fecal incontinence (FI) undoubtedly reduces quality of life and adversely affects the social life of the affected individual. FI has a higher prevalence with age and has an equivalent prevalence to urinary incontinence in patients with genitourinary disease, but is often not confirmed in these cases. A thorough investigation is needed to diagnose FI, with the common etiology of this condition in mind, and several questionnaires can be used to identify symptoms. The physical examination contains digital rectal examination carries out to identify the patient’s condition. Ultrasound, colonoscopy, and rectum pressure test can be performed. Patients educated in diet-related issues, bowel movements, and defecation mechanism. Nonoperative options such as diet control and Kegel exercise should be performed at first. Surgical treatment of FI is considered when conservative management and oral medications produce no improvement. Surgical options include less invasive procedures like bulking agent injections, and more involved approaches from sacral nerve stimulation to invasive direct sphincter repair and artificial bowel sphincter insertion. Good outcomes in FI cases have also recently been reported for barrier devices.

Clinical Impact of F-18 FDG PET-CT on Biopsy Site Selection in Patients with Suspected Bone Metastasis of Unknown Primary Site / 대한핵의학회잡지

Purpose@#We investigated the clinical role of F-18 fluorodeoxyglucose (FDG) positron emission tomography-computed tomography(PET-CT) in the identification of the primary site and the selection of the optimal biopsy site in patients with suspectedbone metastasis of unknown primary site. @*Methods@#The patients with suspected bone metastasis who underwent PET-CT for evaluation of primary site were enrolled inthis study. The primary sites were identified by the histopathologic or imaging studies and were classified according to the FDGuptake positivity of the primary site. To evaluate the guiding capability of PET-CT in biopsy site selection, we statisticallyanalyzed whether the biopsy site could be affected according to the presence of extra-skeletal FDG uptake. @*Results@#Among 74 enrolled patients, 51 patients had a metastatic bone disease. The primary site was identified in 48 of 51patients (94.1%). Forty-six patients were eligible to test the association of clinical choice of biopsy site with PET positivity ofextra-skeletal lesion. The extra-skeletal biopsies were done in 42 out of 43 patients with positive extra-skeletal uptake lesions.Bone biopsies were inevitably performed in the other three patients without extra-skeletal uptake lesions. The association cameout to be significant (Fisher’s exact test, P< 0.001). @*Conclusion@#F-18 FDG PET-CT significantly contributed not only to identify the primary site but also to suggest optimal biopsysites in patients with suspected bone metastasis.

Effects of Lonicera caerulea extract on adipocyte differentiation and adipogenesis in 3T3-L1 cells and mouse adipose-derived stem cells (MADSCs) / 한국영양학회지

PURPOSE: Obesity is a major health problem of global significance because it is clearly associated with an increased risk of health problems, such as nonalcoholic fatty liver disease (NAFLD), diabetes, cardiovascular diseases, and cancer. Lonicera caerulea (LC) originates from high mountains or wet areas and has been used as a traditional medicine in northern Russia, China, and Japan. LC contains a range of bioactive constituents, such as vitamins, minerals, and polyphenols. This study examined the anti-obesity effects of LC during differentiation in preadipocytes. METHODS: The cell viability assay was performed after the differentiation of 3T3-L1 cells for 7 days. Oil Red O staining was used to visualize the changes in lipid droplets in 3T3-L1 cells and mouse adipose-derived stem cells (MADSCs). The mRNA expression of obesity-related genes was determined by quantitative real-time PCR. RESULTS: According to the results of Oil Red O staining, the lipid levels and size of lipid droplets in the adipocytes were reduced and the LC extract (LCE, 0.25–1 mg/mL) markedly inhibited adipogenesis in a dose-dependent manner. The treatment of LCE also decreased the mRNA expression of peroxisome proliferator-activated receptor γ (PPARγ), CCAAT/enhancer binding protein-α (C/EBPα), and sterol regulatory element binding protein 1 (SREBP1) in 3T3-L1 cells. Western blot analysis showed that the PPARγ, C/EBPα, and SREBP1 protein levels in both 3T3-L1 and MADSC were reduced in a dose-dependent manner. CONCLUSION: These results suggest that LCE can inhibit adipogenic differentiation through the regulation of adipogenesis-related markers.

Erratum: Funding Acknowledgment Correction. Effects of Lonicera caerulea extract on adipocyte differentiation and adipogenesis in 3T3-L1 cells and mouse adipose-derived stem cells (MADSCs) / 한국영양학회지

The original version of this article contained an error in funding acknowledgment. The authors would like to apologize for any inconvenience caused.

Association between nutrient intakes and prevalence of depressive disorder in Korean adults: 2014 Korean National Health and Nutrition Examination Survey / 한국영양학회지

OBJECTIVE: Dietary nutrients may play a significant role in depressive disorders. However, sufficient evidences in epidemiological studies are limited. We investigated the cross-sectional association between dietary nutrients and the prevalence of depressive disorder in Korean adults using representative Korean data. METHODS: Participants were 2,938 adults aged 19 ~ 64 years from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted in 2014. Dietary intakes were assessed using 24-h recall method. Depressive disorder was assessed using Patients Health Questionnaire-9 (PHQ-9, self-depression test) as applied in 2014 KNHANES only. We defined depressive disorder as having a PHQ-9 score of ≥10, which was characterized as moderate depression and more. A multivariate logistic regression analysis was performed to estimate the adjusted odd ratios (ORs) and 95% confidence interval (CIs) of depressive disorder. RESULTS: Among the 2,938 subjects, 170 were identified as having depressive disorder. The multivariate-adjusted regression analysis demonstrated that the risk of depression was significantly associated with riboflavin (OR = 0.44, 95% CI: 0.24-0.85, p for trend = 0.018), thiamin (OR = 0.48, 95% CI: 0.23-0.99, p for trend = 0.045), and vitamin C (OR = 0.57, 95% CI: 0.34-0.95, p for trend = 0.025) in the highest versus lowest tertiles of intake. CONCLUSION: The high consumption of riboflavin, thiamin, and vitamin C was associated with the low prevalence of depressive disorder in Korean adults.

Altered Gene Expression Profile After Exposure to Transforming Growth Factor beta1 in the 253J Human Bladder Cancer Cell Line

PURPOSE: Transforming growth factor beta1 (TGF-beta1) inhibits the growth of bladder cancer cells and this effect is prominent and constant in 253J bladder cancer cells. We performed a microarray analysis to search for genes that were altered after TGF-beta1 treatment to understand the growth inhibitory action of TGF-beta1. MATERIALS AND METHODS: 253J bladder cancer cells were exposed to TGF-beta1 and total RNA was extracted at 6, 24, and 48 hours after exposure. The RNA was hybridized onto a human 22K oligonucleotide microarray and the data were analyzed by using GeneSpring 7.1. RESULTS: In the microarray analysis, a total of 1,974 genes showing changes of more than 2.0 fold were selected. The selected genes were further subdivided into five highly cohesive clusters with high probability according to the time-dependent expression pattern. A total of 310 genes showing changes of more than 2.0 fold in repeated arrays were identified by use of simple t-tests. Of these genes, those having a known function were listed according to clusters. Microarray analysis showed increased expression of molecules known to be related to Smad-dependent signal transduction, such as SARA and Smad4, and also those known to be related to the mitogen-activated protein kinase (MAPK) pathway, such as MAPKK1 and MAPKK4. CONCLUSIONS: A list of genes showing significantly altered expression profiles after TGF-beta1 treatment was made according to five highly cohesive clusters. The data suggest that the growth inhibitory effect of TGF-beta1 in bladder cancer may occur through the Smad-dependent pathway, possibly via activation of the extracellular signal-related kinase 1 and Jun amino-terminal kinases Mitogen-activated protein kinase pathway.

Urinary Retention Accompanied by Retroperitoneal Urine Leakage in Schizophrenia

We presented a case of a 46-year-old man who attended the emergency department with right flank pain. Abdominal computed tomography showed dilated renal pelvis, ureter and distended bladder. Fluid collection was seen in retroperitoneal space and pelvic cavity. He had renal insufficiency. When a urethral catheter was inserted, 1,200 mL urine was drained. He was diagnosed with schizophrenia more than 20 years prior, and had been taking anti-psychotics. He had been living in a sanatorium. He had nocturnal enuresis and had worn an incontinence pad nightly for the last 10 years. His fluid consumption was 10 L/day. After placement of an indwelling urethral catheter for relieving voiding problems and restriction of fluid intake, fluid collection in retroperitoneal spaces and pelvic cavity was removed and renal insufficiency was recovered. After training of self-clean intermittent catheterization, he was discharged.

The Effect of alpha-Blocker Treatment for Nocturia with Benign Prostatic Hyperplasia

OBJECTIVE: Nocturia is one of the most bothersome complaints in men with benign prostatic hyperplasia. It might be valuable to determine if alpha-blocker treatment for benigh prostatic hyperplasia can improve nocturia and the quality of life (QoL). The purpose of this study was to determine the efficacy of alpha blocker therapy in benigh prostatic hyperplasia patients with nocturia. METHODS: From January 2004 to June 2006, 68 men (> or =45 years) with lower urinary tract symptoms (LUTS: International Prostatic Symptom Score (IPSS)> or =12) and benign prostatic hyperplasia by transrectal ultrasonography (> or =25 mL) and a maximal urine flow rate (Qmax< or =12) were selected for this study. The efficacy of alpha blocker treatment was assessed by analyzing IPSS, QoL, Qmax, and postvoid residual urine (PVR). The data for these parameters was acquired at baseline and after short-term (range, 4-6 weeks) and long-term (range, 12-14 weeks) treatment. We analyzed the relationships between nocturia and other parameters, including age, prostate volume, Qmax, and PVR after alpha-blocker treatment. RESULTS: Overall, 47 of the 68 patients (69.1%) completed the study. IPSS, QoL, Qmax, and PVR showed significantly improvement after alpha blocker treatment. The nocturia score improved 23.8% after long-term alpha blocker treatment. However, nocturia improvement was lowest among the seven individual symptom scores. Other clinical parameters, including patient age, prostate volume, Qmax, and PVR, were not significantly associated with nocturia; only the LUTS severity was associated with nocturia. CONCLUSION: Treatment with alpha-blocker can reduce nocturia in benigh prostatic hyperplasia patients and can improve QoL.

Growth Inhibition After Exposure to Transforming Growth Factor-beta1 in Human Bladder Cancer Cell Lines

PURPOSE: Transforming growth factor-beta1 (TGF-beta1) plays a dual role in apoptosis and in proapoptotic responses in the support of survival in a variety of cells. The aim of this study was to determine the function of TGF-beta1 in bladder cancer cells. MATERIALS AND METHODS: The role of TGF-beta1 in bladder cancer cells was examined by observing cell viability by using the tetrazolium dye (MTT) assay after treating the bladder cancer cell lines 253J, 5637, T24, J82, HT1197, and HT1376 with TGF-beta1. Among these cell lines, the 253J and T24 cell lines were coincubated with TGF-beta1 and the pan anti-TGF-beta antibody. Fluorescence-activated cell sorter (FACS) analysis was performed to determine the mechanism involved after TGF-beta1 treatment in 253J cells. RESULTS: All six cell lines showed inhibited cellular growth after TGF-beta1 treatment. Although the T24 and J82 cell lines also showed inhibited cellular growth, the growth inhibition was less than that observed in the other 4 cell lines. The addition of pan anti-TGF-beta antibodies to the culture media restored the growth properties that had been inhibited by TGF-beta1. FACS analysis was performed in the 253J cells and the 253J cells with TGF-beta1. There were no significant differences in the cell cycle between the two treatments. However, there were more apoptotic cells in the TGF-beta1-treated 253J cells. CONCLUSIONS: TGF-beta1 did not stimulate cellular proliferation but was a growth inhibitory factor in bladder cancer cells. However, the pattern of its effects depended on the cell line. TGF-beta1 achieved growth inhibition by enhancing the level of apoptosis.

The Correlation between Transition Zone Index, versus IPSS and Peak Flow Rate after Transurethral Resection of Prostate in Benign Prostatic Hyperplasia / 대한비뇨기과학회지

PURPOSE: There is debate whether transition zone index is correlated with the parameters of benign prostatic hyperplasia. The purpose of this study was 3-fold: 1) to determine if transition zone index is correlated with the symptom score and peak flow rates of clinical benign prostatic hyperplasia, 2) to determine if transition zone index is correlated with the symptom score and peak flow rates of clinical benign prostatic hyperplasia after TURP, and lastly 3) to determine if the improvement of symptom score and peak flow rates after TURP is different according to transition zone index. MATERIALS AND METHODS: Fifty eight men, who underwent TURP, were measured total prostate volume and transition zone volume by trasnsrectal ultrasonography. All men were requested to undergo uroflowmetry and intermational prostate symptom score(IPSS), before and after TURP. RESULTS: The significant correlation between transition zone index and IPSS(p = 0.0001, R2 = 0.3652), and the relationships between transition zone index versus peak flow were not statistically significant(p = 0.79, R2 = 0.0015) before TURP. A weak relationship was observed between transition zone index versus IPSS(p = 0.0019, R2 = 0.16), peak flow rate(p = 0.022, R2 = 0.0811) after TURP. The improvement of IPSS and peak flow rate showed statistically significant difference according to transition zone index(p = 0.0001, 0.0787) CONCLUSIONS: The higher transition zone index, the more favorable outcome of transurethral resection of prostate was expected. On the contrary, the lower transition zone index, the less favorable outcome. So transition zone index can be used as a factor predicting the outcome of transurethral resection of prostate. The patient with lower transition zone index may have other factors affecting improvement of symptoms and peak flow rate in addition to obstruction.