The Changes of Psychometric Profiles after Medical Treatment of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia

OBJECTIVE: To investigate the relationship of somatization and depression with the degree of lower urinary tract symptoms suggestive of benign prostate hyperplasia (LUTS/BPH) and changes in psychometric profiles including somatization and depression after treatment of LUTS/BPH. METHODS: Subjects were evaluated at baseline and at week 12 following routine treatment for LUTS/BPH using the International Prostate Symptom Score (IPSS) to measure the severity of LUTS/BPH, the Overactive Bladder Symptom Score (OABSS) to measure the severity of OAB, the Patient Health Questionnaire-9 (PHQ-9) to assess depression, and the Patient Health Questionnaire-15 (PHQ-15) to evaluate somatization. The correlation of somatization and depression with the degree of LUTS/BPH symptoms at baseline and changes in somatization and depression after LUTS/BPH treatment were assessed using relevant statistical analyses. RESULTS: One hundred and twenty patients agreed to participate in this study, and 101 (84.2%) completed the 12-week trial and responded to the study questionnaires. At baseline, total IPSS score was correlated with PHQ-9 (r=0.475, p=0.005) and PHQ-15 (r=0.596, p<0.001) scores. The results after the 12-week treatment clearly show significant improvement in both PHQ-9 (p <0.001) and PHQ-15 (p=0.019) scores, and the PHQ-9 (r=0.509, p=0.048) and PHQ-15 (r=0.541, p=0.016) scores were positively correlated with total IPSS. CONCLUSION: Our preliminary results indicated that severity of LUTS is correlated with severity of somatization and depression. Further, the improvement of LUTS after treatment may have positive impacts on somatization and depression.

Antimicrobial Effect of Lactobacillus in a Rat Model of Escherichia coli Urinary Tract Infection: A Preliminary Study

PURPOSE: Urinary tract infection (UTI) is one of the most common infectious diseases. There are reports that loss or destruction of normal urinary flora such as Lactobacillus increases UTI, and in more recent reports, human urinary epithelial cells have been found to competitively block uropathogen conjugation. We investigated the blocking effect of the Lactobacillus rhamnosus in a rat model of UTI caused by Escherichia coli. MATERIALS AND METHODS: Thirty-two adult female Sprague-Dawley rats weighing 250 to 350 g (Samtako BioKorea, Osan, South Korea) were randomly divided into 4 groups (Group I, control group; Group II, Lactobacillus group; Group III, E. coli group; Group IV, E. coli and Lactobacillus group). After 3 weeks, the urine and bladder were cultured for microbiological study and the bladder was examined histopathologically. RESULTS: Microbiological culture of urine demonstrated no significant differences in the four groups, but there were significantly fewer bacteria in group IV than in group III (p<0.05). The bacterial growth of the bladder tissue showed the same result. Histological exam of the bladder of group IV showed decreased infiltration of leukocytes and less submucosal edema than in group III. CONCLUSIONS: We were able to confirm the blocking effect of L. rhamnosus on E. coli growth. More studies are needed to further identify the therapeutic effect of Lactobacillus and to determine the optimal lactobacilli species, dose, and method of administration.

Extrahepatic Metastasis of Peripheral Cholangiocarcinoma: CT Findings

PURPOSE: To evaluate the extrahepatic spread of peripheral cholangiocarcinoma with CT. MATERIALS AND METHODS: We retrospectively reviewed CT findings of extrahepatic spread in thirty-six patients with peripheral cholangiocarcinoma confirmed adenocarcinoma at surgery(n=5) or percutaneous biopsy(n--31) without primary leion in other organs, and analysed the frequency and distribution of enlarged lymph nodes, direct invasion of adjacent solid organs, and thrombosis of major vessels. RESULTS: Among the 36 cases, enlarged metastatic lymph node was noted in twenty-four(66.7%), direct invasion into adjacent organs in six(16.7%), portal and inferior vena caval thrombosis in five(13.9%). Enlarged lymph nodes were seen in hepatic nodes(n=16, 44.4%), portocaval nodes(n=15, 41.7%), interaortocaval nodes (n=10, 27.8) and celiac nodes in two(5.6%). Direct invasion was detected in the greater omentum(n=6), gallbladder(n:3) and stomach(n=2). Portal vein thrombosis(n:5) and thrombosis of inferior vena cava(n=2) were noted. CONCLUSION: Lymph node metastasis was seen in 67% in patients with peripheral cholangiocarcinoma. Direct invasion to adjacent organs and thrombosis in portal vein or inferior vena cava were occasionally associated.