Association Between Prostate Cancer and 25-Hydroxyvitamin D2 Levels: National Health and Nutrition Examination Survey 2007−2008 Results

Purpose@#To report an association between prostate cancer and vitamin D levels among different races in a single population in the United States. @*Materials and Methods@#We investigated whether there was an association between vitamin D level and prostate cancer in different races in the United States. We used data collected from 1,363 men during the National Health and Nutrition Examination Survey 2007–2008. Multivariate logistic regression analysis was used to evaluate the independent associations between vitamin D levels (not only 25-hydroxyvitamin D [25(OH)D], but also 25(OH)D2 and D3) and prostate cancer. Association between vitamin D levels and prostate specific antigen level was also analyzed in non-Hispanic white males without prostate cancer. @*Results@#Older age was significantly associated with prostate cancer in all races (p＜0.05), whereas vitamin D (p=0.024), especially 25(OH)D2 (p=0.027) was significantly higher only in non-Hispanic white males. There was no difference in vitamin D levels between non-Hispanic white males with a prostate specific antigen concentration ＞3 ng/mL and ≤3 ng/mL. @*Conclusions@#This study revealed a positive association between vitamin D, especially 25(OH)D2, and prostate cancer only in non-Hispanic white males. And vitamin D was not associated with prostate specific antigen level causing detection bias. (Korean J Urol Oncol 2020;18:32-39)

Neutrophil-to-Lymphocyte Ratio Predicts Pathological Renal Sinus Fat Invasion in Renal Cell Carcinomas of ≤7 cm with Presumed Renal Sinus Fat Invasion

PURPOSE: Computed tomography (CT) is the most useful diagnostic modality for staging renal cell carcinoma (RCC). However, CT is limited in its ability to predict renal sinus fat invasion (SFI). Here, we aimed to evaluate whether preoperative neutrophil-to-lymphocyte ratio (NLR) could predict pathological SFI in patients with RCC of ≤7 cm for whom preoperative imaging reveals potential renal SFI. MATERIALS AND METHODS: We reviewed the medical records of 1311 patients who underwent extirpative renal surgery for non-metastatic RCC of ≤7 cm between November 2005 and December 2014. After excluding patients with no SFI in preoperative imaging, unavailable preoperative data, and morbidity affecting inflammatory markers, a total of 476 patients were included in this study. Multivariate logistic regression analysis was used to evaluate predictors of pathological SFI. RESULTS: We implemented a cut-off value of 1.98, which was calculated by ROC analysis to obtain high (≥1.98) and low (<1.98) NLR groups. A total of 93 patients with pathological SFI had larger clinical tumor size, higher preoperative NLR, larger pathological tumor size, more frequent renal vein involvement, and higher Fuhrman nuclear grade. Multivariate analysis indicated that high NLR [odds ratio (OR) 2.032, p=0.004], clinical tumor size (OR 1.586, p<0.001), and collecting system involvement on preoperative imaging (OR 3.957, p=0.011) were significantly associated with pathological SFI in these tumors. CONCLUSION: Preoperative high NLR was associated with pathological SFI in patients with RCC of ≤7 cm and presumed SFI on preoperative imaging. Greater surgical attention is needed to obtain negative margins during partial nephrectomy in these patients.

Neurologic Mechanisms Underlying Voiding Dysfunction due to Prostatitis in a Rat Model of Nonbacterial Prostatic Inflammation / 대한배뇨장애요실금학회지

PURPOSE: The neurological molecular mechanisms underlying the voiding dysfunction associated with nonbacterial chronic prostatitis/chronic pelvic pain syndrome remain poorly understood. In this study, we assessed whether prostate inflammation activated bladder afferent neurons, leading to bladder dysfunction, and sought to elucidate the underlying mechanisms. METHODS: Thirty male Sprague-Dawley rats were divided into 3 groups: sham-saline, formalin-injected, and capsaicin-pretreated and formalin-injected. Chemical prostatitis was induced by 0.1 mL of 10% buffered formalin injected into the ventral prostate. Capsaicin was injected subcutaneously to desensitize capsaicin-sensitive nerves. In each group, conscious cystometry was performed, and c-fos expression within the spinal cord was determined immunocytochemically. Double immunofluorescent staining with c-fos and choline acetyltransferase (ChAT) was performed. On the third day after pseudorabies virus (PRV) infection, c-fos and PRV double-staining was performed. RESULTS: Intraprostatic formalin significantly increased the maximal voiding pressure and decreased the intercontraction interval, compared with controls. Pretreatment with capsaicin significantly reversed these effects. More c-fos-positive cells were observed in the sacral parasympathetic nucleus (SPN) and dorsal gray commissure (DCM) in the prostatitis group than in the sham group. c-fos-positive cells decreased in the capsaicin-pretreated group. Preganglionic neurons labeled by c-fos and ChAT were observed in the SPN in rats with prostatitis. Interneurons labeled by c-fos and PRV were identified in the DCM after PRV infection. CONCLUSIONS: Our results suggest that prostate inflammation activates afferent nerve fibers projecting to the lumbosacral spinal cord, producing reflex activation of spinal neurons innervating the bladder and bladder hyperreflexia. This is mediated by capsaicin-sensitive prostate afferent neurons.

Neonatal Bladder Irritation Is Associated With Vanilloid Receptor TRPV1 Expression in Adult Rats / 대한배뇨장애요실금학회지

PURPOSE: To evaluate whether mild chemical irritation of the bladder in neonatal rats is associated with persistent vanilloid receptor transient receptor potential vanilloid subfamily 1 (TRPV1) activity in adult rats. METHODS: Female Sprague-Dawley rats were used. Ten-day-old rat pups underwent bladder sensitization via intravesical infusion of 0.2% acetic acid in saline with or without prior bladder desensitization with capsaicin. After 8 weeks, 3 groups of rats (control [group 1], bladder sensitization [group 2], and bladder desensitization [group 3]) underwent cystometry. Inflammation of bladder tissue and the expression of TRPV1 in bladder tissue and dorsal root ganglia (DRG) were also evaluated. RESULTS: The bladder sensitization group showed more frequent voiding contractions. TRPV1 expression in adult bladder tissue was elevated in group 2. TRPV1 mRNA levels in the bladder and DRG were significantly higher in group 2 than in group 1. Moreover, group 2 had significantly more DRG neurons (identified by uptake of the retrograde label Fast Blue) that exhibited TRPV1 immunoreactivity. CONCLUSIONS: We found a significant association between neonatal bladder sensitization and persistent TRPV1 activity in adult rats. This is the first study to focus on the underlying pathogenesis of bladder overactivity from childhood to adulthood. Our findings could lead to the development of new strategies for the treatment and prevention of adult urinary symptoms arising from childhood urinary tract dysfunction.

Analysis of Age-Related Changes in Asian Facial Skeletons Using 3D Vector Mathematics on Picture Archiving and Communication System Computed Tomography

PURPOSE: There are marked differences in facial skeletal characteristics between Asian and Caucasian. However, ethnic differences in age-related facial skeletal changes have not yet been fully established. The aims of this study were to evaluate age-related changes in Asian midfacial skeletons and to explore ethnic differences in facial skeletal structures with aging between Caucasian and Asian. MATERIALS AND METHODS: The study included 108 men (aged 20-79 years) and 115 women (aged 20-81 years). Axial CT images with a gantry tilt angle of 0 were analyzed. We measured three-dimensional (3D) coordinates at each point with a pixel lens cursor in a picture archiving and communication system (PACS), and angles and widths between the points were calculated using 3D vector mathematics. We analyzed angular changes in 4 bony regions, including the glabellar, orbital, maxillary, and pyriform aperture regions, and changes in the orbital aperture width (distance from the posterior lacrimal crest to the frontozygomatic suture) and the pyriform width (between both upper margins of the pyriform aperture). RESULTS: All 4 midfacial angles in females and glabellar and maxillary angles in males showed statistically significant decreases with aging. On the other hand, the orbital and pyriform widths did not show statistically significant changes with aging. CONCLUSION: The results of this study suggest that Asian midfacial skeletons may change continuously throughout life, and that there may be significant differences in the midfacial skeleton between both sexes and between ethnic groups.

Complementation of Disability Rating System on Hearing Injury: Application of Linear Regression Analysis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: According to the correlation between hearing injury and McBride disability rating presented by previous studies, there are over/underestimated cases particularly in the 40 dB hearing range compared to other ranges. In this study, we reviewed the overestimated and underestimated data and propose a complementation scheme for a disability rating system by using the linear regression analysis. SUBJECTS AND METHOD: For the past 14 years, we have provided legal advisory for 121 cases of hearing injury, for which disability had to be rated. We reviewed all but excluded 11 cases for the aggravation of disability. A regression equation was produced from a linear regression analysis that used the percent of hearing handicap (AAO-HNS/AMA-1979 formula) as an independent variable (x) and McBride disability rating (%) as a dependent variable (y), following the Pearson correlation test. Iterative calculation was performed for overestimated (18) and underestimated (8) cases. RESULTS: Appropriate disability ratings were 14% for the cases overestimated to 20% and 11% for those underestimated to 5%. Appropriate disability ratings for the 20% of overestimated cases were changed to 14%, and for the 5% of the underestimated cases, the disability ratinb 11%. Iterative calculation showed that the Pearson correlation index was improved from 0.8866 to 0.9065 and the determination coefficient of regression analysis (adjusted R-square) was improved from 0.784 to 0.8202. CONCLUSION: The common range of hearing injury, which falls between 30-40 dB corresponds to the percentage of hearing handicap of 7.5-22.5%. A fairer assessment of ability rating would be possible by complementing some parts of this hearing range.

Hearing Injury Evaluation: Current Status and Medicolegal Considerations / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In disability rating of hearing injury, there are some medicolegal considerations, such as discrepancy in estimating values between McBride system and the American Medical Association system, and difficulties in judging the hearing level in boundary cases. We have therefore felt the need of complementary hearing disability evaluation methods that reflect reality. As a first step, we have pointed out current situation and problems in legal advisory cases of hearing injury. SUBJECTS AND METHOD: For the past 14 years, we have provided legal advisory on hearing injury for 121 cases for courts (group A) or insurance companies (group B). Eleven cases of 'aggravation of disability' were excluded. Data were summarized and tested statistically. We have used unpaired t-test for continuous variables such as age, hearing, hearing disability, disability rating, Fisher's exact test for dichotomous variable such as gender, group (A/B), and Pearson's correlation test for correlation coefficients between continuous variables. RESULTS: Subjects were more frequently males (3:1) and in the fifth decade of life. The averages of audiometry were around 40 dB. There were significant differences in hearing and disability rating between younger and older group. Group B is significantly older than group A. The type of disability or accident did not influence hearing and disability rating. CONCLUSION: This paper could help figure out the current situation with respect to medicolegal considerations of hearing injury discrepancies in disability rating and could also serve well to recognize the necessity for a complementary hearing disability evaluation method, especially for borderline hearing level.

Medicolegal Considerations in Hearing Injury with an Aggravation of Disability / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: When a disability is superimposed on a previous disability, the concept of aggravation of disability should be applied. In rating the disability for hearing loss, we focused on the aggravation of disability and the methods of assessment. SUBJECTS AND METHOD: For the past 12 years, we have provided legal advisory for 111 cases of hearing injury, for which disability had to be rated. In 11 of those 111 cases, disability was assessed in consideration of aggravation of disability. We assessed disability using three rating methods: they were based on 1) a change of hearing level from assumed normal, 2) apportionment of new hearing injury in final hearing, and 3) a change in disability rating. We evaluated for significant differences and correlations between the values obtained by each method. RESULTS: There was a significant difference between the results by the methods 1 and 2. The disability rating by the method 2 showed good correlations with those assessed by the methods 1 and 3. CONCLUSION: When considering aggravation of disability in hearing, the method 2 could be a good alternative when the standard method 3 is inappropriate.

Correlation Analysis of each variable of Fetal Heart Rate Observed through Computerized Monitoring / 대한산부인과학회잡지

OBJECTIVE: We aim to analyze each variable affecting FHR to build objective decision basis using canonical correlation analysis METHODS: The sixty four hundred and fifty five cases of NST from 1988 to 1997 at Hanyang University hospital were collected. We used FHR interpretation softwares, HYFM-I & II those were already developed by author, for extraction of each variable of FHR. We classified the variables into 2 groups, F.A.M(FHR, Amplitude, Mean minute range) and N.S.F(NST weeks, Signal loss, Fetal movement) groups. The Canonical correlation was compared between each variable and group. RESULTS: The canonical correlation between F.A.M & N.S.F are as follows; r=0.40 (p=0.001) in preterm, r=0.34 (p=0.001) in term, and r=0.41 (p=0.004) in postterm. The high linear dependency is shown as r=0.79 (p=0.013) before 23 weeks, the irregular changes shown from 23 weeks to 30 weeks (r=0.47 in 23-24 weeks, r=0.29 in 25-26 weeks, r=0.56 in 27-28 weeks, r=0.24 in 29-30 weeks) and the stable relative changes shown (about r=0.3-0.4) after 30 weeks (r=0.32 in 31-32 weeks, r=0.33 in 33-34 weeks, r=0.37 in 35-36, r=0.33 in 37-38 weeks, r=0.37 in 39-40 weeks, r=0.35 after 41 weeks) (p<0.02). In the linear correlation of FHR, two indicies of FHR variables, AMP and MMR pertaining to N.S.F., FHR(r) is 0.06, AMP and MMR seem to be identical as r=0.30 and then the canonization in term and postterm[FHR(r)=-0.27, AMR(r)=0.23, and MMR(r)=0.35]lies in the regular pattern. Moreover, there is rather a linear correlation between F.A.M and the gestational weeks in preterm and it is changed into linearity similar to zero in term and postterm pregnancies[term(r)=0.01, postterm(r)=0.06] CONCLUSIONS: This study shows the linearity of FHR and the variable which are based on the gestational weeks organically, comprehensibly, and quantitatively. It would be utilized as the fundamental standard of the linearity. The changes from the irregular linear correlation to the regular pattern according to advancing gestational weeks means the changes from the immature and transitional level to the mature level. The closer investigation of the linear and

Correlation Analysis of Each Variable of Fetal Heart Rate in Normal and Abnormal Pregnancies / 대한주산의학회잡지

No abstract available.

Statistical Investigation of Each Variable of Fetal Heart Rate According to Birth Weight / 대한주산의학회잡지

No abstract available.