The Relationship Between Nocturia and Mortality: Data From the National Health and Nutrition Examination Survey / 대한배뇨장애요실금학회지

Purpose@#We investigated the relationship between nocturia and mortality risk in the United States. @*Methods@#Data were obtained from the National Health and Nutrition Examination Survey 2005–2010. Mortality data were obtained by linking the primary database to death certificate data found in the National Death Index with mortality follow-up up to December 31, 2015. Nocturia was defined based on symptoms reported in the symptom questionnaire. We categorized patients into 2 groups: mild nocturia (2–3 voidsight) and moderate-to severe nocturia (≥4 voidsight). Multiple Cox regression analyses were performed with adjustment for confounding variables at the baseline survey. @*Results@#This study included 9,892 adults (4,758 men, 5,134 women). Nocturia occurred in 3,314 individuals (33.5%). Nocturia was significantly associated with all-cause mortality (hazard ratio [HR], 1.23; 95% confidence interval [CI], 1.10–1.39) and cardiovascular disease (CVD) mortality (HR, 1.55; 95% CI, 1.19–2.01). Moreover, the mortality risk increased with increasing nocturia severity. Further analysis with propensity score matching showed that nocturia was still significantly associated with all-cause mortality and CVD mortality. In subgroup analysis according to sex, nocturia was significantly associated with allcause mortality and CVD mortality in men. In women, moderate-to-severe nocturia was significantly associated with allcause mortality and CVD mortality. In subgroup analysis according to cardio-metabolic diseases, nocturia was associated with CVD mortality in patients with diabetes mellitus, hypertension, dyslipidemia, or CVD at baseline. In subgroup analysis of patients without diabetes mellitus, hypertension or CVD, nocturia was significantly associated with all-cause mortality. @*Conclusions@#Nocturia was significantly associated with mortality in men and women after adjusting for major confounding factors.

Relevance of nationwide prostate specific antigen screening test for prostate cancer

The serum prostate specific antigen (PSA) screening test plays a pivotal role in the diagnosis of prostate cancer (PCa), especially for early detection, before symptoms of systemic spread. Even though clinical trials for the PSA screening test have demonstrated limited benefits with regard to patient survival, recent trends have shown a continuous decrease in the PCa mortality rate in Western countries. In many Asian countries where PSA screening has not yet been widely adopted, the screening strategy reduces the metastatic spread. While PCa became the 10th most common malignant disease in the Korean male population in 2000, recent national reports indicate that its increase in the last two decades have now made it the third most popular malignant condition. Due to the different epidemiologic background and limited social awareness of PCa compared to Western countries, the PSA screening test was not routinely performed in Korea, in contrast with other prevalent malignant diseases such as stomach, colon, and lung cancers. Therefore, only about a quarter of the patients newly diagnosed with PCa in Korea were found to have undergone repeated PSA screening. However, the screened population showed a higher probability of local rather than systemic treatment, which reflects an earlier disease stage at the time of diagnosis in comparison with their non-screened counterparts. Given the relatively high survival rate of PCa and the increasing lifespan of Korean males, the increase of PCa will accelerate, suggesting the clinical relevance of PSA screening as part of regular checkups for Korean males.

Recent Trends in Transurethral Surgeries and Urological Outpatient Procedures: a Nationwide Populationbased Cohort Study

Background@#Demographic change and advances in technology affect transurethral surgery and outpatient procedures in the urologic field. There are few population-based studies that accurately assess the trend of transurethral surgery and outpatient procedures including diagnostic tests. We investigated the recent epidemiologic trends in transurethral surgeries and urological outpatient procedures from 2009 to 2016 in Korea using the entire populationbased cohort. @*Methods@#We analyzed medical service claim data of transurethral surgery, urological outpatient procedures submitted by medical service providers from the Health Insurance Review and Assessment Service from 2009 to 2016. @*Results@#Transurethral ureter surgery increased by 134.9% from 14,635 in 2009 to 34,382 in 2016 (B = 2,698; R 2 = 0.98; P 2 = 0.97; P 2 = 0.04; P = 0.617) and urethral surgery (B = −12; R 2 = 0.18; P = 0.289). The significantly increasing trends in cystoscopy (B = 5,260; R 2 = 0.95; P 2 = 0.99; P 2 = 0.77; P = 0.003) and electrical stimulation treatment (EST: B = −1,034; R 2= 0.87; P < 0.001) significantly decreased. @*Conclusion@#In Korea, transurethral ureter surgery and transurethral bladder surgery have been continuously increasing. Transurethral prostate surgery and transurethral urethral surgery remained constant with no increase or decrease. Cystoscopy and uroflowmetry continue to increase, while UDS and EST continue to decrease.

The Association Between Obesity and the Nocturia in the U.S. Population / 대한배뇨장애요실금학회지

PURPOSE: We aimed to investigate the association of obesity with nocturia using a nationally representative sample of adults from the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2012. METHODS: A total of 14,135 participants were included in this study. We performed a multivariate logistic regression analysis to find the odds ratio (OR) of obesity for nocturia. Furthermore, the OR of BMI for nocturia was analyzed using restricted cubic splines (RCS) with five knots. We conducted subgroup analysis according to age, sex, hypertension, and diabetes mellitus (DM) and further analysis with 1:1 matching data with propensity score. RESULTS: The participants who had body mass index (BMI) above 30 kg/m² had a significantly higher OR for nocturia (OR, 1.39; 95% CI, 1.28–1.50) than those without obesity. RCS showed a dose-dependent relationship between BMI and OR for nocturia. Subgroup analysis by age, sex, hypertension, and DM showed similar results. Further analysis with 1:1 matching data showed a significant association of obesity with the prevalence of nocturia (OR, 1.25; 95% CI, 1.10–1.41). CONCLUSIONS: This study reported that obesity was significant association with the prevalence of nocturia with dose-dependent manner, regardless of age, sex, hypertension, and DM after taking major confounding factors into account.

Oncologic Outcomes and Predictive Factors for Recurrence Following Robot-Assisted Radical Cystectomy for Urothelial Carcinoma: Multicenter Study from Korea

The aim of our study was to evaluate intermediate-term oncologic outcomes, predictive factors for recurrence, and recurrence patterns in a multicenter series of patients treated with robot-assisted radical cystectomy (RARC) for urothelial carcinoma (UC) of the bladder. Between 2007 and 2015, 346 patients underwent RARC at multiple tertiary referral centers in Korea. Descriptive statistics were used for demographics and perioperative variables. Survival and recurrence were estimated with Kaplan-Meier analysis. Logistic regression models were used to determine predictors of recurrence. Median follow-up was 33 months (interquartile range [IQR], 7–50). The numbers of patients with organ-confined and lymph node (LN)-positive disease were 237 (68.4%) and 68 (19.7%), respectively. LN density (1–20 vs. > 20) was 13.6% and 6.1%, with a median of 17 nodes removed (IQR, 9–23). In logistic regression analysis, type of LN dissection, and pathologic tumor stage were significant predictors of cancer recurrence and death from cancer. Local, distal recurrence and secondary UC occurred in 7 (2.0%), 53 (15.3%), and 4 (1.2%) patients, respectively. The 5-year overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) were 78%, 84%, and 73%, respectively. At last follow-up, RFS for extended pelvic LN dissection vs. standard pelvic LN dissection was 70% and 47% (P = 0.038). In addition, at last follow-up, LN density (0 vs. 1–20 vs. over 20) was 67%, 41%, and 29%, respectively (P < 0.001). Patients undergoing RARC in this multi-institutional cohort demonstrated intermediate-term oncologic outcomes, predictive factors for recurrence, and recurrence patterns that were not unusual.

The association between an abnormal post-voiding urine volume and a lower estimated glomerular filtration rate in patients with type 2 diabetes with no voiding symptoms

BACKGROUND/AIMS: Diabetic cystopathy is a frequent complication of diabetes mellitus. This study assessed the association between the post-voiding residual (PVR) urine volume and diabetic nephropathy in type 2 diabetics with no voiding symptoms. METHODS: This study investigated 42 patients with type 2 diabetes who were followed regularly at our outpatient clinic between July 1, 2008 and June 30, 2009. No patient had voiding problems or International Prostate Symptom Scores (IPSSs) > or = 12. An urologist performed the urological evaluations and the PVR was measured using a bladder scan. A PVR > 50 mL on two consecutive voids was considered abnormal, which was the primary study outcome. RESULTS: The mean patient age was 60 +/- 10 years; the IPSS score was 3.7 +/- 3.3; and the diabetes duration was 11.9 +/- 7.8 years. Seven of the 42 patients (16.7%) had a PVR > 50 mL. The presence of overt proteinuria or microalbuminuria was associated with an increased risk of a PVR > 50 mL (p 50 mL had a significantly lower estimated glomerular filtration rate (eGFR) compared with those with a PVR 50 mL. CONCLUSIONS: Patients with diabetic nephropathy had a significantly higher PVR and a lower eGFR was associated with an abnormal PVR.

Primary Malignant Melanoma of the Female Urethra

We report here on a rare case of primary malignant melanoma of the female urethra. A 69-year-old female presented at our hospital with a several month history of dysuria, poor stream, gross hematuria, intermittent blood spots, and a painful mass at the external urethral meatus. The physical examination revealed a soft, small, chestnut-sized lesion through the urethral orifice. The mass was tan colored, ulcerated, covered with necrotic tissue, and protruded from the external urethral meatus. The mass was removed by wide local excision under spinal anesthesia. The pathological diagnosis was malignant melanoma of the urethra. Computed tomography of the abdomen as well as a whole-body bone scan showed no evidence of metastasis. The patient has been free of disease for 6 months postoperatively. We discuss the clinicopathologic features and treatment of this tumor.

Influence of Ureteral Stone Components on the Outcomes of Electrohydraulic Lithotripsy

PURPOSE: We evaluated the influence of urinary stone components on the outcomes of ureteroscopic removal of stones (URS) by electrohydraulic lithotripsy (EHL) in patients with distal ureteral stones. MATERIALS AND METHODS: Patients with a single distal ureteral stone with a stone size of 0.5 to 2.0 cm that was completely removed by use of EHL were included in the study. Operating time was defined as the time interval between ureteroscope insertion and complete removal of ureteral stones. Ureteral stones were classified into 5 categories on the basis of their main component (that accounting for 50% or more of the stone content) as follows: calcium oxalate monohydrate (COM), calcium oxalate dihydrate, carbonate apatite (CAP), uric acid (UA), and struvite (ST). RESULTS: A total of 193 patients (131 males and 62 females) underwent EHL. The mean operating time was 25.1+/-8.2 minutes and the mean stone size was 1.15+/-0.44 cm. Calcium oxalate stones accounted for 64.8% of all ureteral stones, followed by UA (19.7%), CAP (8.3%), and ST (7.2%) stones. The mean operating time was significantly longer in the UA group (28.6+/-8.3 minutes) than in the COM group (24.0+/-7.8 minutes, p=0.04). In multivariate analyses, the stone size was negatively associated with the odds ratio (OR) for successful fragmentation. UA as a main component (OR, 0.42; 95% confidence interval, 0.20 to 0.89; p=0.023) was also found to be significantly important as a negative predictive factor of successful fragmentation after adjustment for stone size. CONCLUSIONS: The results of the present study suggest that successful fragmentation by URS with EHL could be associated with the proportion of the UA component.

Hyaline Vascular Castleman Disease Involving Renal Parenchyma and a Lymph Node: A Case Report

Castleman disease is a rare lymphoproliferative lesion that is predominantly found in the mediastinum. Retroperitoneal and pararenal localizations are very rare. We describe a 36-year-old man with a hyaline vascular type of Castleman disease involving renal parenchyma and a paraaortic lymph node. Most reported renal Castleman disease was plasma cell type with systemic symptoms. Herein, we report the first Korean case of the hyaline vascular type of Castleman disease involving the renal parenchyma and the paraaortic lymph node simultaneously.

Our Experiences with Robot-Assisted Laparoscopic Radical Cystectomy: Orthotopic Neobladder by the Suprapubic Incision Method

PURPOSE: To report our technique for and experience with robot-assisted laparoscopic radical cystectomy (RARC) with orthotopic neobladder (ON) formation in a cohort of bladder cancer patients. MATERIALS AND METHODS: Between December 2007 and December 2011, a total of 35 patients underwent RARC. The patients' mean age was 63.3 years and their mean body mass index was 23.7 kg/m2. Thirty patients had a clinical stage of T2 or higher. Postoperative mean follow-up duration was 25.5 months. In 5 patients, a 4-cm midline infraumbilical skin incision was made for an ileal conduit (IC) and the stoma formation was similar to the open procedure. In 30 patients undergoing the ON procedure, the skin for specimen removal and extracorporeal enterocystoplasty was incised infraumbilically in the early 5 cases with redocking (ON-I) and suprapubically in the latter 25 cases without redocking (ON-S). RESULTS: The mean operative times of the IC, ON-I, and ON-S groups were 442.5, 646.0, and 531.3 minutes, respectively (p=0.001). Mean console and lymph node dissection time were not significantly different between the groups. Mean urinary diversion times in each group were 68.8, 125.0, and 118.8 minutes, respectively (p=0.001). In the comparison between the ON-I and ON-S group, only operative time was significant. Four patients required a blood transfusion. We had no cases of intraabdominal organ injury or open conversion. Thiry-three patients (94.2%) had a pathologic stage of T2 or higher. Two patients (5.7%) had lymph node-positive disease. Postoperative complications included ileus (n=4), stricture in the uretero-ileal junction (n=2), and vesicovaginal fistula (n=1). CONCLUSIONS: Our robotic neobladder-suprapubic incision without redocking procedure is easier and more rapid than that of infraumbilical incision with redocking.

Our Experiences with Robot-Assisted Laparoscopic Radical Cystectomy: Orthotopic Neobladder by the Suprapubic Incision Method

PURPOSE: To report our technique for and experience with robot-assisted laparoscopic radical cystectomy (RARC) with orthotopic neobladder (ON) formation in a cohort of bladder cancer patients. MATERIALS AND METHODS: Between December 2007 and December 2011, a total of 35 patients underwent RARC. The patients' mean age was 63.3 years and their mean body mass index was 23.7 kg/m2. Thirty patients had a clinical stage of T2 or higher. Postoperative mean follow-up duration was 25.5 months. In 5 patients, a 4-cm midline infraumbilical skin incision was made for an ileal conduit (IC) and the stoma formation was similar to the open procedure. In 30 patients undergoing the ON procedure, the skin for specimen removal and extracorporeal enterocystoplasty was incised infraumbilically in the early 5 cases with redocking (ON-I) and suprapubically in the latter 25 cases without redocking (ON-S). RESULTS: The mean operative times of the IC, ON-I, and ON-S groups were 442.5, 646.0, and 531.3 minutes, respectively (p=0.001). Mean console and lymph node dissection time were not significantly different between the groups. Mean urinary diversion times in each group were 68.8, 125.0, and 118.8 minutes, respectively (p=0.001). In the comparison between the ON-I and ON-S group, only operative time was significant. Four patients required a blood transfusion. We had no cases of intraabdominal organ injury or open conversion. Thiry-three patients (94.2%) had a pathologic stage of T2 or higher. Two patients (5.7%) had lymph node-positive disease. Postoperative complications included ileus (n=4), stricture in the uretero-ileal junction (n=2), and vesicovaginal fistula (n=1). CONCLUSIONS: Our robotic neobladder-suprapubic incision without redocking procedure is easier and more rapid than that of infraumbilical incision with redocking.

Predictors of Postoperative Voiding Dysfunction following Transobsturator Sling Procedures in Patients with Stress Urinary Incontinence / 대한배뇨장애요실금학회지

PURPOSE: We evaluated the influence of preoperative physical examination (PE) and urodynamic study (UDS) findings on objective postoperative bladder emptying, the subjective development of bladder storage symptoms, and patient-reported success of correction of stress urinary incontinence (SUI). MATERIALS AND METHODS: From January 2007 to August 2008, a total of 159 female patients with SUI underwent transobturator midurethral sling surgery (TOT). The patients were selected for SUI, with no overactive bladder (OAB) symptoms, no detrusor overactivity (DO) on UDS, no pelvic organ prolapse, and no history of prior anti-incontinence surgery. Of these patients, 128 patients (aged 38-74 years; mean age, 51.8+/-7.1 years) with follow-up of at least 12 months were included in the analysis. All patients had PE and UDS findings, including Q-tip testing, free maximal flow rates (Qmax), filling cystometry, Valsalva leak point pressure, detrusor pressure at maximal flow, and maximal urethral closing pressure. The primary outcome was postoperative voiding dysfunction, defined as the subjective feeling of not empting one's bladder completely and a postvoid residual > or =100 ml. A secondary outcome, "cure" of SUI, was defined as "a negative result on the cough stress test and no subjective complaint of urine leakage." We analyzed the preoperative parameters by univariate and multivariate regression for voiding dysfunction, de novo OAB, cure rate, and the patients' satisfaction. RESULTS: Patients with a preoperative Qmax < 15 ml/s (7 patients) had a tendency for postoperative voiding dysfunction compared with those with a Qmax 15 ml/s (15 patients) (35.0% vs. 13.9%, respectively; p=0.046). No other preoperative parameters had a statistically significant influence on postoperative voiding dysfunction. Receiver operating characteristic (ROC) analysis revealed that Qmax was a good predictor because the area under the ROC curve value of Qmax was 0.81 (95% CI: 0.73 to 0.89, p<0.001). The univariate and multivariate analysis of the preoperative PE and UDS parameters demonstrated that no significant differences and no independent risk factors were related to the postoperative de novo OAB, cure rate, or the patients' satisfaction. CONCLUSIONS: These findings suggest that preoperative UDS results, especially Qmax, could be used to predict postoperative voiding dysfunction after the TOT procedure.

A Penile Fracture with the Complete Urethral Rupture / 대한남성과학회지

A penile fracture is an injury caused by the rupture of the tunica albuginea. We report an uncommon case of penile fracture with the complete urethral rupture in a 48-year-old man who sustained the injury during the sexual intercourse. He presented with acute penile pain, swelling on the ventral aspect of the penile shaft and the inability to pass urine associated with urethral bleeding. Retrograde urethrography revealed the complete obstruction of the urethra. Exploration and repair of the penile fracture with the urethra rupture were performed. The patient recovered successfully with good erectile and voiding function.

Predictive Factors of the Long-term Medical Treatment Failure in Benign Prostatic Hyperplasia / 대한비뇨기과학회지

PURPOSE: The aim of this study was to identify the clinical baseline factors that affect failure of medical treatment(and especially surgical treatment) for benign prostatic hyperplasia(BPH) in spite of long-term medication. MATERIALS AND METHODS: 802 men who were over 50 years of age with BPH were enrolled for this study. Patients were allocated to a medication group and a surgical treatment group(after having at least a 12 month duration of medication). We compared the differences between the two groups for their initial International Prostate Symptom Score(IPSS), the uroflowmetry, the prostate volume, the postvoid residual urine and the serum prostate specific antigen(PSA). RESULTS: 397 patients had surgical treatment following medication due to BPH progression(acute urinary retention, aggravating LUTS) and 405 patients were given maintenance medical treatment during follow-up. Statistically significant differences were found in the IPSS(23.3+/-6.6 vs. 12.7+/-8.4), the prostate volume(53.5+/-28.1ml vs. 38.3+/-12.6ml), the maximal flow rate(7.8+/-4.7ml/sec vs. 12.7+/-5.4ml/sec), the postvoid residual urine volume(92.7+/-144.4cc vs. 36.5+/-147.1cc), and the PSA(6.1+/-7.6ng/ml vs. 2.8+/- 2.8ng/ml) between the surgical and medication groups. According to the area under the curve(AUC), the IPSS, prostate volume, maximal flow rate, postvoid residual urine volume and PSA are important in descending order. According to the receiver operating characteristic(ROC) curve- based prediction of the surgical intervention, the best cutoff value for the IPSS and prostate volume were 17(area under ROC curve: 0.83) and 40ml (area under ROC curve: 0.68), respectively. Conclusions: The results show that BPH patients with more severe IPSS (>or=17) and a larger prostate volume(>40ml) have a higher risk of surgical intervention, and this suggests that the IPSS and prostate volume may be useful predictors at the initial visit for surgical intervention.

Risk Factors of Ileus following Radical Cystectomy / 대한비뇨기과학회지

PURPOSE: Ileus is the most common complication following radical cystectomy. Ileus causes prolonged fasting, significant patient discomfort and prolongation of the hospital stay. We retrospectively examined the risk factors for ileus following radical cystectomy MATERIALS AND METHODS: Between January, 2000 and June, 2007, 59 patients underwent radical cystectomy with urinary diversion at our institution. 30 patients underwent creation of an ileal conduit and 29 patients underwent orthotopic bladder substitution with using ileum. Ileus was defined as the persistent absence of flatus on postoperative day 7 or the generalized findings of ileus on simple abdominal film. The potential risk factors were analyzed between the ileus and non ileus groups, including the patient's age and gender, the American Society of Anesthesiologists score, the preoperative serum albumin level, prior abdominal surgery, the operative time, combined operation, the estimated blood loss, the type of urinary diversion, use of N2O, use of intestinal stapler, complications, the ICU stay and the pathologic stage and grade. RESULTS: 24%(14/59) of patients had postoperative ileus. The difference of the ASA score between the two groups was statistically significant (p=0.03). Patients with ileus(67.5+/-7.2) were older than the non-ileus patients(63.0+/-9.4)(p=0.103). Ileus was more frequent in men(29.5%, 13/ 44) than in women(6.6%, 1/15)(p=0.09). CONCLUSIONS: Ileus following radical cystectomy was more frequent in patients with a high ASA score. Older aged men tend to have ileus after radical cystectomy.

Voiding Pattern and Incontinence after Orthotopic Ileal Neobladder in Male Patients / 대한비뇨기과학회지

PURPOSE: To report the voiding pattern and continence stati in male patients having undergone a radical cystectomy and orthotopic bladder substitution. MATERIALS AND MATHODS: Between March 2000 and June 2005, 20 men with advanced bladder cancer had a radical cystoprostatectomy and urinary diversion via an ileal orthotopic bladder substitution. The voiding pattern and continence stati were assessed using patient interviews, frequency- volume charts and pad tests at 1, 3, 6, 9 and 12 months after catheter removal. RESULTS: The mean age and follow-up were 60.5 years (41-72) and 34.1 months (12-69), respectively. Neobladder substitution was performed with an ileum in all patients. 17 patients had reconstruction with a Studer neobladder and 3 with a W-pouch Hautmann. All patients had transitional cell carcinoma (TCC) and their tumor stages ranged from T1G3 to T4aN1M0. The frequency of voiding ranged from 4 to 12 times during the day, and 0 to 5 times during the night, with a mean maximum neobladder capacity of 336ml (200-620) and maximum flow rate of 24.6ml/sec (12-46) 12 months after removal of the catheter. No patient required intermittent self-catheterization. All-time continence rates were 15, 30, 65 and 85%, and all-time incontinence rates were 55, 25, 10 and 5% at 1, 3, 6 and 9 months after catheter removal, respectively. CONCLUSIONS: Orthotopic bladder substitution has an excellent functional outcome over time, resulting in high daytime and nighttime continence rates within 9 months of catheter removal.

Segmental Testicular Infarction Masquerading as Testicular Neoplasm / 대한비뇨기과학회지

Segmental testicular infarction is an uncommon and usually idiopathic phenomenon. Some case reports have linked segmental infarction to sickle cell anemia, hypersensitivity angiitis, polycythemia, and an idiopathic cause. Magnetic resonance imaginge (MRI) might be of great diagnostic value as the ischemic lesions have a characteristic pattern. Nonetheless, as its clinical and radiological presentation may resemble testicular tumors, a definite diagnosis can only be established following surgery. We report a case of testicular infarction which presented as a malignancy even in the frozen biopsy.

Effect of Galectin-3 Gene Transfer for the Apoptosis and Cell Growth of the Prostate Cancer Cell Line (LNCaP Cells) / 대한비뇨기과학회지

PURPOSE: Galectin-3 is a member of a large family of beta-galactoside- binding animal lectins. It is thought that galectin-3 can be a suppressor of apoptosis because of its significant sequence similarity with Bcl-2. We examined the role of galectin-3 for the paclitaxel-induced apoptosis after transfection of the galectin-3 gene in LNCaP cells. MATERIALS AND METHODS: Galectin-3 cDNA was cloned into PcDNA 3.1(-) and transfected into LNCaP cells. Stable transfection of galectin-3 into the LNCaP cells was achieved. Growth of the transfectants was observed with performing MTT assay. Apoptosis was induced by 100nM paclitaxel and 2microM staurosporine, and this was observed by DNA fragmentation assay. The viable cell numbers(% of control) after induction of apoptosis were determined with performing MTT assay. RESULTS: The LNCaP subclone that expressed galectin-3(LNCaP-G3-PcDNA) grew faster than the control transfectant(LNCaP-PcDNA)(p<0.05). The DNA fragmentation bands were decreased in the LNCaP subclone expressing galectin-3(LNCaP-G3-PcDNA) as compared to the control transfectant(LNCaP-PcDNA) after induction of apoptosis by 100nM paclitaxel or 2iM staurosporine; this means that galectin-3 inhibits apoptosis. The viable cells (% of control) with LNCaP-G3-PcDNA after the induction of apoptosis by 100nM paclitaxel was 92+/-2% in 8 hours, 77.5+/-1.9% in 24 hours and 40.4+/-2.9% in 48 hours on average, respectively. In contrast, the viable cells(% of control) of the control transfectant were 84.5+/-2%, 46+/-2.5% and 19+/-2.6% on average, respectively. The viable cells(% of control) with the LNCaP-G3-PcDNA after the induction of apoptosis by 100nM paclitaxel was higher than that of the control transfectant(LNCaP- PcDNA cells)(p<0.05). CONCLUSIONS: Galectin-3 gene transfer stimulates the growth of LNCaP cells. The galectin-3 protects LNCaP cells from paclitaxel-induced apoptosis.

Intrauterine Device Migrating into the Bladder / 대한비뇨기과학회지

Migration of an intrauterine contraceptive device (IUD) into the urinary bladder is very rare. We experienced a case of a foreign-body migrating into the bladder of a 35-year-old women who has been suffering from frequency and dysuria for the recent 5 months. The IUD had originally been inserted 10 years ago. Removal of the IUD had been performed for achieving pregnancy, but the IUD was not detected at the correct site 7 years ago. One year later, the patient had given birth without complication. It is thought that it took less than 6 years for the IUD to invade the bladder wall.

Increased Expression of Hypoxia-Inducible Factor-1alpha in Castrated Rat Penile Tissue / 대한남성과학회지

PURPOSE: Hypoxia-inducible factor 1(HIF-1) is a transcriptional activator of genes whose products are involved in systemic, local, and cellular responses to hypoxia. We investigated the effect of androgen deprivation on the expression of HIF-1alpha and related proteins in the penile corpus cavernosum of castrated rat. MATERIALS AND METHODS: Thirty adult male Sprague-Dawley rats(250~350 gm) were divided into 3 groups of 10 each: sham operation(group 1), bilateral orchiectomy(group 2), and bilateral orchiectomy plus hormone replacement(group 3). Testosterone propionate(2 mg/day for 4 weeks) was used for hormone replacement. At 4 weeks after surgery, serum testosterone and erythropoietin were measured, and the expression of HIF-1alpha and VEGF were examined by immunohistochemical staining and Western blot of corpus cavernosum. RESULTS: There was no significant change in serum erythropoietin among the three groups. HIF-1alpha and VEGF immuno-positive cells were dense in vascular endothelium and cavernosal smooth muscle and showed more intense staining in the orchiectomy group compared with the control and sham operation groups. The amount of HIF-1alpha and VEGF proteins detected by Western blot were also increased in the orchiectomy group compared with the control and sham operation groups. CONCLUSIONS: These results suggest that increased HIF-1alpha expression in the penile tissue of castrated rat results from adaptive responses to hypoxia, and testosterone deprivation may contribute to hypoxic injury in the cavernosal microenvironment.