Factors Predicting the Prolonged Duration of Off-treatment in Intermittent Androgen Deprivation of Prostate Cancer Treatment / 대한비뇨기과학회지

PURPOSE: The goal of intermittent androgen deprivation (IAD) therapy in prostate cancer patients is to delay the disease progression and improve the survival rate. Therefore, the duration of off-treatment is very important for the effective treatment outcome of IAD. We analyzed factors that influence the duration of off-treatment in IAD. MATERIALS AND METHODS: We reviewed the medical records of 45 patients with prostate cancer who had completed at least 1 cycle of IAD. Uni- and multi-variate tests were used to determine the factors, which are predictive to the duration of off-treatment. These factors included: the patient's age, biopsy Gleasons score, initial PSA, presence of bone metastasis, PSA levels at 3 months following on-treatment and at 3 months following off-treatment, and the duration of on-treatment. RESULTS: The average follow up duration was 34 months (15-71 months). The average off-treatment duration of each cycle was 11.1 (4-40), 7.5 (4-14), and 5.6 (3-10) months for the 1st, 2nd and 3rd cycles, respectively. Independent factors associated with the extension of duration of off-treatment, by univariate tests, included: initial PSA value, PSA values at 3 months following on-treatment, PSA at 3 months following off- treatment, and duration of on-treatment. The duration of off-treatment was inversely related to the serum PSA level at the start, 3 months following on-treatment, and 3 months following off-treatment, while it was directly related to the duration of on- treatment by multivariate tests. CONCLUSIONS: The pretreatment serum PSA level and the serum PSA level at 3 months following on-treatment and off-treatment were valuable predictors for the duration of off-treatment in IAD.

Construction of a Short Form BPH Specific Health Related Quality of Life Scale: Reliablility and Validity Tests / 대한비뇨기과학회지

PURPOSE: To construct and validate the short-form benign prostatic hypertropy (BPH) health-related quality-of-life (HRQL) questionnaire which is more practical in use and as informative as the 35-item standard form questionnaire previously validated. MATERIALS AND METHODS: First the 9 items for the short form questionnaire were selected from the 35-item standard form questionnaire that includes lower urinary tract symptom (LUTS) related, physical, emotional, general helth percepton, sexual domains by the experts. The developed short form questions were divided into two domains; physical and emotional. This short form questionnaire was tested for reliablity, and validity in a total of 197 men who visited the urology clinics of the eight university medical centers in Korea with LUTS. RESULTS: The short form questionnaire was practical in use (completion rate; 98%, duration of completion at inclusion; 5.19min), and the level of comprehension was not affected by age or degree of education. On the test-retest reliability, high correlations (r=0.49-0.78) and high Cronbach's alpha (>0.745) of two domains were observed, supporting the satisfactory internal consistency, reliability. As the validity, the standard form and short form questionnaire were highly correlated (r=0.52-0.76) and the significant difference were noted in the domain sums and total sum regarding the LUTS severity (p<0.001). CONCLUSIONS: The newly constructed short form questionnaire is good for assessment BPH HRQL including patients' perceived physical, and emotional status easy to administer, accurate, reproducible and responsive to change according to symptom severity. This questionnaire can be used in patients with LUTS practically and offer the valuable clinical information to the physician.

Intratumoral Injection of 166Holmium-chitosan Complex to SmallRenal Cell Carcinoma: Preliminary Results / 대한비뇨기과학회지

No abstract available.

Clinical Characteristics in the 45XO/46XY Mosaicism and 45XO with SRY Gene Positive Patients / 대한비뇨기과학회지

PURPOSE: We investigated the clinical characteristics and relationship between chromosome and its phenotypic expression in patients with 45 XO/46XY mosaicism or 45 XO with SRY gene. MATERIALS AND METHODS: 11 patients with 45XO/46XY chromosomal abnormality and 4 patients with 45XO with SRY positive reaction admitted from 1990 to 1996 were evaluated. Patients were grouped according to chromosome and gonadal expression. Group A consisted of patients with 45XO/46XY chromosome and unilateral streak gonad, group B patients with 45XO chromosome, SRY positive reaction and unilateral streak gonad and group C patients with 45XO/46XY chromosome and bilateral streak gonads. RESULTS: Of the total 15 patients, the number of patients in group A, B, and C were 8, 4, and 3, respectively. SRY gene was positive in all group A and B patients but only one patient was positive in group C. Of the 8 patients in group A, 5 patients had a high XY mosaicism ratio compared to XO whereas an equal ratio was observed in the remaining 3 patients. Of the 4 male penotype patients only 1 patient had a high XY mosaicism ratio compared to XO while 3 patients displayed an equal ratio. There was no difference in associated anomaly and the degree of severity of ambiguity according to the mosaicism ratio in all patients. CONCLUSIONS: There was no definite correlation between the mosaicism ratio and phenotypic expression. Presence of SRY gene in 45XO patients may suggest MGD(mixed gonadal dysgenesis) and therefore, the evaluation SRY gene could be useful in the diagnosis of 45XO patients with ambiguous genitalia.

Expression of Cyclin D1 in Transitional Cell Carcinoma of the Urinary Bladder / 대한비뇨기과학회지

PURPOSE: Cyclin D1 plays critical roles in the progression of cells through the G1 phase of the cell cycle, which has been implicated as a putative protooncogene, while p53 protein affects different phase checkpoint pathways in the normal cell cycle, which mutations occur in poor prognosis of cancer. We attempted to determine their significance for tumor behavior and prognosis of transitional cell carcinoma(TCCa) of the bladder in human. MATERIALS AND METHODS: Formalin fixed-paraffin embedded tissue specimens from 102 patients with TCCa of the urinary bladder were examined. Nuclear expression was detected by immunohistochemical analysis with a standard avidin-biotin immunoperoxidase method, using the monoclonal antibody cyclin D1 and p53(DO7). RESULTS: Cyclin D1 and p53 protein immunostaining of the nucleus was observed in 49 tumors(48.0%) and 55 tumors(53.9%) respectively. Overexpression of cyclin D1 showed significant inverse correlation with the histological grade and significant correlation with recurrence. Overexpression of p53 protein showed a significant correlation with the histological grade and stage(p<0.01). 65.3% (32 out of 49 tumors), of the cyclin D1 positive tumors exhibited expression for p53 protein(p<0.05). Patients with TCCa coexpressing cyclin D1 and p53 protein had a significantly poorer prognosis than those expressing neither cyclin D1 nor p53 protein(p<0.001). CONCLUSIONS: Cyclin D1 in bladder TCCa is closely related to early tumor differentiation and associated with recurrence. Simultaneous overexpression of both cyclin D1 and p53 protein is related to more aggressive tumor behavior and poorer prognosis. This indicates that cyclin D1 evaluation may be a further useful element for selecting subgroup of patients who should be treated with more aggressive therapies.

Changes in Prostate Volume, Transitional Zone Volume and PSA after Cessation of the Finasteride / 대한비뇨기과학회지

PURPOSE: Finasteride is an inhibitor of human 5alpha-reductase, which results in a decrease in plasma and intraprostatic dihydrotestosterone(DHT) level. We investigated the changes of prostate volume(PV), transitional zone volume(TV), and PSA during and after administration of finasteride. MATERIALS AND METHODS: From 1995, 32 BPH patients treated with finasteride underwent surveillance after cessation of finasteride. Surveillance included measurements of PV, TV and PSA every 3 to 6 months. The mean age of the patients was 66.7 years(57-73). The mean duration of treatment and cessation were 8.6 months(6-12) and 8.0 months(6-12), respectively. The changes in PV, TV, and PSA were compared. RESULTS: The mean initial PV, TV, PSA were 45.7cc, 22.5cc, 2.72ng/ml, respectively. After treatment, PV, TV, PSA were reduced to 72.7%, 67.1%, 64.7% and 68.0%, 61.4%, 57.3% and 59.4%, 55.0%, 52.5% of the original values at 3, 6 and 12 months, respectively. The reduction rate was maximum after the first 3 months(p=0.001). After discontinuing finasteride, PV, TV, PSA recovered to 71.0%, 71.2% 63.9% and 84.0%, 82.3%, 67.6% and 90.4%, 85.1%, 74.1% at 3, 6 and 12 months, respectively. The recovery rates of PV and TV after 3 and 6 months were equal. However, recovery rate of PSA was maximum at 3 months and after then, constant until 12 months. CONCLUSIONS: During first 3 months` treatment, the decreasing rates of PV, TV and PSA were very considerable, after then, reduced. After cessation of medication the recovery rates of PV, TV were constant during first 6 months but PSA was maximum at first 3 months. The changes in clinical parameters during administration were fully recovered but it took slightly longer periods after cessation compared to those during of treatment. PSA is probably a predictor in the assessment of volume changes.