Risk Factors for Ciprofloxacin-Resistant Escherichia coli Strains in Pediatric Patients with Acute Urinary Tract Infection

PURPOSE: Previous exposure to fluoroquinolone is an important risk factor for acquiring resistant strains of microorganisms. However, the mechanisms of fluoroquinolone resistance in Escherichia coli from pediatric patients with urinary tract infection (UTI) are not well defined because fluoroquinolone prescription for children is not permitted around the world. We investigated the risk factors for ciprofloxacin-resistant E. coli isolates from the urine of pediatric patients with UTI. MATERIALS AND METHODS: Data from 72 patients who showed > or =10(5) E. coli colony-forming units in urine culture were retrospectively collected from a university hospital between June 2006 and June 2009. The minimum inhibitory concentration of ciprofloxacin resistance was determined by the agar dilution method on Mueller-Hinton agar. RESULTS: The rates of E. coli resistance to ciprofloxacin, cefazolin, ampicillin, co-trimoxazole, and fosfomycin were 8.3%, 20.8%, 77.7%, 25%, and 0%, respectively. Differences in sex, age intervals, and previous antimicrobial use in recent years were significantly associated with ciprofloxacin resistance, whereas admission level, the presence of fever, and the type of UTI were not. In addition, female gender, previous antimicrobial use, and older age significantly increased the risk for ciprofloxacin resistance in a univariate analysis. Only co-trimoxazole resistance was positively associated with ciprofloxacin resistance, whereas resistance to other antimicrobials was not. CONCLUSIONS: Even though the incidence was not high, ciprofloxacin resistance was found in E. coli from pediatric UTIs. Because the characteristics of ciprofloxacin resistance in pediatric patients are not well defined, further study of the mechanism of acquiring ciprofloxacin resistance in children is needed.

The Effect of Dutasteride on Serum Prostate-specific Antigen (PSA) in Patients with Benign Prostate Hypertrophy

PURPOSE: 5alpha reductase, dutasteride, has widely used to treat enlarged prostate (BPH). By suppressing the conversion of testosterone to dihydrotestosterone it decreases serum prostate-specific antigen (PSA) which is very important screening marker for prostate cancer. We evaluate the early serum PSA changes after dutasteride treatment to Korean BPH patients. MATERIALS AND METHODS: A total 159 men with a clinical diagnosis of BPH and no evidence of prostate cancer were enrolled. They were treated with dutasteride 0.5mg daily for 12 months. Serum PSA was evaluated at 2, 6, and 12 months after the medication. RESULT: Dutasteride statistically significantly reduced serum PSA to 0.70+/-0.52, 0.64+/-0.35, and 0.59+/-0.49 from baseline level at 2, 6, and 12 months after the medication, respectively. However, there was no statistical significance among the three groups in serum PSA changes after dutasteride. There were statistically significant correlations between a high pre-treatment serum PSA level and a large reduction of follow-up PSA levels at 2, 6, and 12 months after dutasteride treatment. CONCLUSIONS: The reduction of serum PSA is variable in patients to patients at 2, 6, and 12 months after dutasteride treatment. The patient with high initial serum PSA revealed a large reduction of serum PSA level after treatment. The traditional concept that follow-up serum PSA level should be doubled for prostate cancer screening may overestimate real serum PSA level within 12 months in Korean men receiving 5alpha reductase inhibitors.

Proteomic Analysis of Proteins changed by Bilateral Orchiectomy in the Male Rabbit Bladder

PURPOSE: The aim of this study was to investigate the effects of testosterone deprivation on urinary bladder in male rabbits by proteomic analysis. MATERIALS AND METHODS: New Zealand white male rabbits (2.5-3 kg) were divided into 2 group; control group with 5 rabbits and bilateral orchiectomized group, bilateral orchiectomized group was divided into post-operative 4 weeks group (group 1), and 8 weeks group (group 2) with 5 rabbits respectively. Bladder wall was excised partly at 4 or 8 weeks from the beginning of the experiment. Conventional proteomics was performed with high resolution 2-D gel electrophoresis followed by computational image analysis and protein identification using mass spectrometry. We decided to consider 'significant' if protein had 50% decreasing or 200% increasing expression rate. RESULTS: Six proteins were significantly changed in orchiectomy group, compared to control group; serum albumin precursor, GABA transaminase, dimethylarginine dimethylaminohydrolase 2, serum/glucocorticoid regulated kinase and LOC304923 protein were over-expressed in both group 1 and group 2. Annexin A1 was significantly over-expressed in the group 2 only. CONCLUSION: An overexpression of Annexin A1 and GABA transaminase mean a processing of neuronal reactions to injury in orchiectomized rabbit bladder. Also an overexpression of dimethylarginine dimethylaminohydrolase 2 would increase NO synthesis and thereby promote re-endothelialization in the rabbit bladder after orchiectomy. Serum/glucocorticoid regulated kinase would relate to Na+ transport. Albumin precursor and LOC304923 protein are remained to further research. These data suggested that bilateral orchiectomy would make the urinary bladder unstable. However more information is needed in human bladder tissue.

Efficacy of Propiverine for Chronic Prostatitis / Chronic Pelvic Pain Syndrome

PUROPOSE: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common disorder to men and the syndrome is diagnosed only on the basis of symptoms, principally pain or discomfort in the pelvic region. However many patients have a urinary symptoms, especially storage symptoms such as frequency and urgency. The aim of this study was to evaluate the efficacy of anticholinergics in a prospective randomized, single-blind trial to young and middle aged patients to exclude the effect of benign prostatic hyperplasia as possible. MATERIAL AND METHODS: Forty six men with CP/CPPS (age of third to fifth decades) were randomized in a single-blind fashion to receive either group 1; gatifloxacin (200mg, bid) of 15 patients, or group 2; gatifloxacin (200mg, bid) and propiverine (20mg, once daily) of 31 patients for 2 months. The NIH chronic prostatitis symptom index (NIH-CPSI) and International Prostate Symptom Score (IPSS) were used to grade symptoms and the quality of life (QoL) impact at the start, 1 month and 2 months of the study. RESULTS: There was no significant difference between group 1 and group 2 in about age and duration of the disease. In addition, no significant difference was found between group 1 and 2 in the scores of sub-factors of IPSS and NIH-CPSI at the time of baseline. No statistically significant difference in the NIH-CPSI total score and each domain was seen after treatment. Statistically significant difference in the storage symptom of IPSS was seen after treatment. CONCLUSIONS: The efficacy of propiverine (combined to antibiotics) for CP/CPPS were improvements of the storage symptom of IPSS significantly.

Proteomic Analysis of the Proteins That were Changed by Bilateral Orchiectomy in the Rabbit Corpus Cavernosum / 대한비뇨기과학회지

PURPOSE: The pathophysiological role of androgen deprivation in male sexual dysfunction remains controversial, and this is especially true at the molecular level. We investigated the effect of androgen deprivation on the changes of proteins in the penile corpus cavernosum of castrated rabbits by the proteomic approach. MATERIALS AND METHODS: New Zealand white male rabbits(2.5-3kg) were divided into 2 groups: the control group with 5 rabbits and the bilateral orchiectomized group. The bilateral orchiectomized group was divided into the post-operative 4 weeks group(group 1), and the 8 weeks group (group 2) with 5 rabbits in groups 1 and 2, respectively. The penile corpus cavernosum was partly excised at 4 or 8 weeks from the beginning of the experiment. Conventional proteomics was performed with high resolution 2-D gel electrophoresis; this was followed by computational image analysis and protein identification with using mass spectrometry. RESULTS: A comparison of the corpus cavernosum of the orchiectomized group with the control group showed that nine proteins had a changed expression. Glycerol-3-phosphate dehydrogenase and F-actin binding protein were under-expressed in groups 1 and 2, and myosin regulatory light chain 2, tropomyosin beta chain and tropomyosin 1 were significantly under- expressed in group 1 and they were insignificantly over-expressed in group 2. In addition there were 4 proteins that were insignificantly under- expressed; skeletal muscle myosin heavy chain MyHC-EO/III, a protein that was similar to suppressor of cytokine signaling 6 isoform, myosin light chain 1 and heat shock 27kDa protein 1. CONCLUSIONS: This data suggests that changes of proteins, and especially tropomyosin 1, mean there is processing of the cellular apoptosis pathway in the orchiectomized rabbits' corpus cavernosum. However more information is needed about human corpus cavernosal tissue.

Proteomic Analysis of the Proteins That were Changed by Bilateral Orchiectomy in the Rabbit Corpus Cavernosum / 대한비뇨기과학회지

PURPOSE: The pathophysiological role of androgen deprivation in male sexual dysfunction remains controversial, and this is especially true at the molecular level. We investigated the effect of androgen deprivation on the changes of proteins in the penile corpus cavernosum of castrated rabbits by the proteomic approach. MATERIALS AND METHODS: New Zealand white male rabbits(2.5-3kg) were divided into 2 groups: the control group with 5 rabbits and the bilateral orchiectomized group. The bilateral orchiectomized group was divided into the post-operative 4 weeks group(group 1), and the 8 weeks group (group 2) with 5 rabbits in groups 1 and 2, respectively. The penile corpus cavernosum was partly excised at 4 or 8 weeks from the beginning of the experiment. Conventional proteomics was performed with high resolution 2-D gel electrophoresis; this was followed by computational image analysis and protein identification with using mass spectrometry. RESULTS: A comparison of the corpus cavernosum of the orchiectomized group with the control group showed that nine proteins had a changed expression. Glycerol-3-phosphate dehydrogenase and F-actin binding protein were under-expressed in groups 1 and 2, and myosin regulatory light chain 2, tropomyosin beta chain and tropomyosin 1 were significantly under- expressed in group 1 and they were insignificantly over-expressed in group 2. In addition there were 4 proteins that were insignificantly under- expressed; skeletal muscle myosin heavy chain MyHC-EO/III, a protein that was similar to suppressor of cytokine signaling 6 isoform, myosin light chain 1 and heat shock 27kDa protein 1. CONCLUSIONS: This data suggests that changes of proteins, and especially tropomyosin 1, mean there is processing of the cellular apoptosis pathway in the orchiectomized rabbits' corpus cavernosum. However more information is needed about human corpus cavernosal tissue.