Does Cardiac Contractility Modulation Therapy Reduce Atrial Fibrillation Burden?

Cardiac contractility modulation (CCM) is an implantable technology approved by the U.S. Food and Drug Administration and intended for heart failure patients without a cardiac resynchronization therapy indication. CCM leads to reduced heart failure hospitalizations and improvements in exercise tolerance and quality of life. There are a lack of data examining the impact of CCM therapy on atrial fibrillation (AF) burden. We report the case of a 65-year-old man with a history of paroxysmal AF, hypertension, hyperlipidemia, and carotid artery stenosis who presented with newly diagnosed ischemic cardiomyopathy with a left ventricular ejection fraction (LVEF) of 20%-25%. He underwent coronary artery bypass graft surgery for triple vessel disease with an improvement in LVEF to 40% after 4 months of guideline-directed medical therapy. Due to clinical heart failure and paroxysms of AF, he underwent CCM device and implantable loop recorder (ILR) implantation. His LVEF improved to 60%, and the ILR showed no AF. We postulate multiple mechanisms to explain the negligible burden of AF.

Dietary exposure assessment of synthetic food colours using analytical concentrations in Korea.

The safety of nine synthetic colour additives approved in Korea were assessed through hazard identification, hazard characterisation, exposure assessment, and risk characterisation. Hazard identification and characterisation were conducted using new risk information based on toxicology data. Exposure assessment calculated the estimated daily intake (EDI) of the nine colours. Finally, the risk was evaluated by comparing the EDIs of the colours with the acceptable daily intake (ADI). 1,114 samples (24 food categories) among a total of 1,454 samples contained colour additives either at a level that was not detectable or up to a quantified maximum of 288 mg kg-1. The likelihood of risk of exposure to all food colours, evaluated by comparing the EDI with the ADI, was less than 0.52% of the ADI for the general population. These results indicate that use of synthetic food colour in Korea is safe and does not result in excessive exposure to any population group.

Safety assessment of antioxidants and color fixatives for the Korean population using dietary intake monitoring.

Food additives such as antioxidants and color fixatives are substances used in food intentionally for technical effect, such as decolorizing or intensifying the color of food. Based on the necessity of re-evaluating food additives for safety and to improve consumer perception, we conducted safety assessments for food additives according to the Risk Assessment Guidelines of the Korean Ministry of Food and Drug Safety. These safety assessments evaluated new risk information based on toxicology data and estimates of dietary intake exposures to food additives in comparison with the acceptable daily intake (ADI). Estimated daily intakes (EDI) of food additives were calculated using food consumption data for the Korean population derived from the Korea National Health and Nutrition Examination Survey and monitoring data based on the analysis of food additives in food products. Unlike contaminants, antioxidants and color fixatives are purposely added as food additives, and they are largely consumed in processed foods. Therefore, EDI was compared with ADI to investigate the likelihood of potentially hazardous effects in humans. The risk likelihoods of food additives, evaluated by comparing the EDI with the ADI, were less than 2% in the total population. Thus, exposure levels to antioxidants and color fixatives do not exceed the ADI. Based on the safety assessments conducted in this study, we estimate exposure to food additives to be within safe limits for all population groups.

Ingestion of Exopolymers from Aureobasidium pullulans Reduces the Duration of Cold and Flu Symptoms: A Randomized, Placebo-Controlled Intervention Study.

AIM: The objective of the study was to assess the efficacy of exopolymers from Aureobasidium pullulans (EAP) on the incidence of colds and flu in healthy adults. METHODS: We conducted a randomized, double-blind, placebo-controlled study at the onset of the influenza season. A total of 76 subjects (30-70 years of age) were recruited from the general population. The subjects were instructed to take one capsule per day of either EAP or a placebo for a period of 8 weeks. The duration of cold and flu symptoms, a primary variable in assessing effectiveness, and serum cytokine levels as well as WBC counts as secondary variables were also evaluated. RESULTS: EAP was associated with a statistically significant decrease in the duration of cold and flu symptoms, a primary variable in assessing effectiveness. Although cold and flu symptom levels were not significantly different at a significance level of 5%, the cold and flu symptom levels of the EAP group were less severe compared to the placebo group. No statistically significant changes of serum cytokine levels as well as WBC counts were observed. CONCLUSION: The results showed that EAP is a useful pharmaceutical and functional food material for preventing and treating colds and flu.

Silver Nanoparticle Modified Electrode Covered by Graphene Oxide for the Enhanced Electrochemical Detection of Dopamine.

Several neurological disorders such as Alzheimer's disease and Parkinson's disease have become a serious impediment to aging people nowadays. One of the efficient methods used to monitor these neurological disorders is the detection of neurotransmitters such as dopamine. Metal materials, such as gold and platinum, are widely used in this electrochemical detection method; however, low sensitivity and linearity at low dopamine concentrations limit the use of these materials. To overcome these limitations, a silver nanoparticle (SNP) modified electrode covered by graphene oxide for the detection of dopamine was newly developed in this study. For the first time, the surface of an indium tin oxide (ITO) electrode was modified using SNPs and graphene oxide sequentially through the electrochemical deposition method. The developed biosensor provided electrochemical signal enhancement at low dopamine concentrations in comparison with previous biosensors. Therefore, our newly developed SNP modified electrode covered by graphene oxide can be used to monitor neurological diseases through electrochemical signal enhancement at low dopamine concentrations.

Electrochemical nitric oxide biosensor based on amine-modified MoS2/graphene oxide/myoglobin hybrid.

Nitric oxide (NO) is one of the most important molecules in living things due to its role as a signaling molecule in influencing pathological and physiological mechanisms including neurotransmission. In this study, the electrochemical biosensor based on the amine-modified molybdenum disulfide nanoparticles (MoS2), graphene oxide (GO) and myoglobin (Mb) hybrid material (amine-modified MoS2/GO/Mb hybrid) is developed to achieve the accurate detection of NO with electrochemical signal improvement. For the first time, the synthesis of MoS2 accompanying the amine-modification of the surface of MoS2 is done to hybridize with GO efficiently through the short linkage. After the amine-modification of MoS2, it is enclosed with GO directly (amine-modified MoS2/GO). Then, Mb which can induce the reduction of NO is immobilized on the amine-modified MoS2/GO to fabricate the amine-modified MoS2/GO/Mb hybrid for NO detection. The prepared hybrid shows the signal improved redox properties relative to the result of the electrode prepared without hybrid. Furthermore, upon addition of NO, the electrode prepared with hybrid shows the improved amperometric response compared with that of the electrode without hybrid. This amine-modified MoS2/GO/Mb hybrid can be used in the development of the biosensor platform accompanying the electrochemical signal improvement and accurate detection of target materials.

The effect of middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises in upper crossed syndrome.

[Purpose] The purpose of this study was to determine the effectiveness of strength and stretching exercises on upper crossed syndrome. [Subjects and Methods] After measuring cervical alignment using the Global Posture System, 30 students with forward head posture were selected and divided into two groups. The experimental group (n=15) participated in strength and stretching exercises, three times per week for 4 weeks. The control group (n=15) did not participate in the exercises. The exercise program comprised middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises. The temperature of the posterior neck was then measured using digital infrared thermographic imaging. [Results] There was a significant difference between the pretest and posttest results in the experimental group, and a significant difference in posterior neck temperature between the two groups. [Conclusion] This study showed that middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises are more effective for upper crossed syndrome.

In Situ Method for Measuring the Mechanical Properties of Nafion Thin Films during Hydration Cycles.

Perfluorinated ionomers, in particular Nafion, are an essential component in hydrogen fuel cells, as both the proton exchange membrane and the binder within the catalyst layer. During normal operation of a hydrogen fuel cell, the ionomer will progressively swell and deswell in response to the changes in hydration, resulting in mechanical fatigue and ultimately failure over time. In this study, we have developed and implemented a cantilever bending technique in order to investigate the swelling-induced stresses in biaxially constrained Nafion thin films. When the deflection of a cantilever beam coated with a polymer film is monitored as it is exposed to varying humidity environments, the swelling induced stress-thickness product of the polymer film is measured. By combining the stress-thickness results with a measurement of the swelling strain as a function of humidity, as measured by quartz crystal microbalance (QCM) and X-ray reflectivity (XR), the swelling stress can be determined. An estimate of the Young's modulus of thin Nafion films as a function of relative humidity is obtained. The Young's modulus values indicate orientation of the ionic domains within the polymer films, which were confirmed by grazing incidence small-angle X-ray scattering (GISAXS). This study represents a measurement platform that can be expanded to incorporate novel ionomer systems and fuel cell components to mimic the stress state of a working hydrogen fuel cell.

Isolation and identification of phenolic antioxidants in black rice bran.

Black rice bran contains phenolic compounds of a high antioxidant activity. In this study, the 40% acetone extract of black rice bran was sequentially fractionated to obtain 5 fractions. Out of the 5 fractions, ethyl acetate fraction was subfractionated using the Sephadex LH-20 chromatography. The antioxidant activity of phenolic compounds in the extracts was investigated by 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical assay, 2,2-azino-bis-(3-ethylenebenzothiozoline-6-sulfonic acid) (ABTS) radical cation assay, reducing power. The subfraction 2 from ethyl acetate fraction had the highest total phenolic contents (TPC) (816.0 µg/mg) and the lowest EC50 values (47.8 µg/mL for DPPH radical assay, 112.8 µg/mL for ABTS radical cation assay, and 49.2 µg/mL for reducing power). These results were 3.1, 1.3, and 2.6 times lower than those of butylated hydroxytoluene (BHT), respectively. At a concentration of 100 µg/mL, the antioxidant activity and TPC of various extracts was closely correlated, with correlation coefficients (R(2) ) higher than 0.86. The major phenolic acid in subfraction 2 was identified as ferulic acid (178.3 µg/mg) by HPLC and LC-ESI/MS/MS analyses. Our finding identified ferulic acid as a major phenolic compound in black rice bran, and supports the potential use of black rice bran as a natural source of antioxidant.

Determining the effect of transforming growth factor-ß1 on cdk4 and p27 in gastric cancer and cholangiocarcinoma.

Gastric cancer and cholangiocarcinoma are problematic throughout the world due to their destructive malignancy. In attempts to treat cholangiocarcinoma and gastric cancer, researchers often explore the effects of transforming growth factor-ß1 (TGF-ß1). TGF-ß1 plays a crucial role in causing cell cycle arrest and fibrosis in cancer cells. The present study aimed to identify whether TGF-ß1 is capable of functioning as an antitumor agent in two cancer cell lines; cholangiocarcinoma and gastric cancer. The downregulation of cyclin dependent kinase (cdk) 4 and the upregulation of p27 were investigated, in order to identify possible antitumor functions of TGF-ß1. A number of different methods were implemented, including cell proliferation assay, bicinchoninic acid (BCA) assay and western blot analysis with TGF-ß1, AGS (human gastric cancer cell line) and SUN-1196 (human cholangiocarcinoma cell line). In the AGS study, cdk4 values decreased from 1.000 to 0.670 and then to 0.664, with increasing TGF-ß1 concentrations of 0, 0.5 and 5 ng/ml, respectively. By contrast, p27 values increased from 1.000 to 1.391 and then to 1.505, with increasing TGF-ß1 concentrations of 0, 0.5 and 5 ng/ml, respectively. In the SUN-1196 study, p27 values increased from 0.548 to 0.807 and then to 0.844 with increasing TGF-ß1 concentrations of 5, 25 and 50 ng/ml, respectively. Certain concentrations of TGF-ß1 play antitumor roles in gastric cancer through the down-regulation of cdk4 and upregulation of p27. Certain TGF-ß1 concentrations also have antitumor roles in cholangiocarcinoma through the upregulation of p27. With these results, we came a step closer to finding a cure for cholangiocarcinoma and gastric cancer.

Exosomes from ovarian cancer cells induce adipose tissue-derived mesenchymal stem cells to acquire the physical and functional characteristics of tumor-supporting myofibroblasts.

OBJECTIVE: Most tumor tissue is composed of parenchymal tumor cells and tumor stroma. Mesenchymal stem cells (MSCs) can function as precursors for tumor stromal cells, including myofibroblasts, which provide a favorable environment for tumor progression. A close relationship between tumor cells and MSCs in a tumor microenvironment has been described. Exosomes are small membrane vesicles that are enriched with a discrete set of cellular proteins, and are therefore expected to exert diverse biological functions according to cell origin. METHODS: In the current study, we determined the biological effect of exosomes from two ovarian cancer cell lines (SK-OV-3 and OVCAR-3) on adipose tissue-derived MSCs (ADSCs). RESULTS: Exosome treatment induced ADSCs to exhibit the typical characteristics of tumor-associated myofibroblasts, with increased expression of α-SMA, and also increased expression of tumor-promoting factors (SDF-1 and TGF-ß). This phenomenon was correlated with an increased expression of TGF-ß receptors I and II. Analysis of TGF-ß receptor-mediated downstream signaling pathways revealed that each exosome activated different signaling pathways, showing that exosomes from SK-OV-3 cells increased the phosphorylated form of SMAD2, which is essential in the SMAD-dependent pathway, whereas exosomes from OVCAR-3 cells increased the phosphorylated form of AKT, a representative SMAD-independent pathway. Taken together, exosomes from ovarian cancer cells induced the myofibroblastic phenotype and functionality in ADSCs by activating an intracellular signaling pathway, although the activated pathway could differ from exosome-to-exosome. CONCLUSION: The current study suggested that ovarian cancer-derived exosomes contribute to the generation of tumor-associated myofibroblasts from MSCs in tumor stroma.

Diethylnitrosamine (DEN) induces irreversible hepatocellular carcinogenesis through overexpression of G1/S-phase regulatory proteins in rat.

Hepatocellular carcinoma (HCC) is the fifth most frequent cause of cancer deaths in males and was the third most frequent cause of cancer deaths in 2007 throughout the world. The incidence rate is 2-3 times higher in developing countries than in developed countries. Animal models have enabled study of the mechanism of HCC and the development of possible strategies for treatment. Diethylnitrosamine (DEN) is a representative chemical carcinogen with the potential to cause tumors in various organs, including the liver, skin, gastrointestinal tract, and respiratory system. Specifically in HCC, DEN is a complete carcinogen. Many lines of evidence have demonstrated a relationship between carcinogenesis and cell cycle regulation. In this study we found that cell cycle regulatory proteins were critically involved in cancer initiation and promotion by DEN. Cyclin D1, cyclin E, cdk4, and p21(CIP1/WAF1) are factors whose expression levels may be useful as criteria for the classification of hepatic disease. In particular, cdk4 had a pivotal role in the transition to the neoplastic stage. In conclusion, we suggest that changes in the level of cdk4 may be useful as a biomarker for detection of HCC.

Compressive stress generation in sn thin films and the role of grain boundary diffusion.

Stress evolution in high mobility Sn thin films was measured during electrodeposition and electrochemical etching to understand the roles of grain boundary diffusion and surface conditions in controlling stress. During deposition, the stress reaches a steady-state compressive value that depends on the growth rate. When the deposition or etching conditions were changed abruptly, reversible transients were observed that depend on the film thickness. The results are interpreted in terms of a model based on diffusion of atoms into the grain boundary driven by the chemical potential at the surface.

Does the degree of experience for the tension-free vaginal tape procedure influence the results of the suprapubic arc sling procedure during the learning phase?

AIM: The object was to evaluate whether the degree of experience for the tension-free vaginal tape (TVT) procedures influenced the early results of the suprapubic arc (SPARC) sling procedure. MATERIALS AND METHODS: We performed the TVT from March 1999 to May 2003 and SPARC from June to April 2004 by experienced surgeon (A) and inexperienced surgeon (B), respectively. Patients were divided as four subgroups: first 50 patients who underwent the TVT by surgeon A (TVT A); first 15 patients who underwent the TVT by surgeon B (TVT B); first 50 patients who underwent the SPARC by surgeon A (SPARC A); first 15 patients who underwent the SPARC by surgeon B (SPARC B). RESULTS: Bladder perforations were noted in 4 (8.5%) in the TVT A group and 2 (13.3%) in the TVT B group, respectively (P = 0.626). There was no bladder perforation occurred in the SPARC A and B groups. The rates of transient postoperative urinary retention were 6.4% in the TVT A group and 0.0% in the TVT B group, respectively (P = 1.000). No retention occurred in the SPARC A and B groups. Stress urinary incontinence was cured by 89.4% in the TVT A group and 80.0% in the TVT B group, respectively (P = 0.388). Similar success rates were found in the SPARC A (85.4%) and SPARC B (92.3%) group (P = 1.000). CONCLUSION: Our findings suggest that the degree of experience for the TVT procedure does not influence the results of the SPARC procedure during the learning phase.

Significance of tension in tension-free mid-urethral sling procedures: a preliminary study.

We report the results of the release and tape-shortening techniques in polypropylene pubovaginal slings. Of female patients who had undergone mid-urethral sling procedures [tension-free vaginal tape procedure and suburethral polypropylene (SPARC)], in cases in which postoperative retention occurred, the patients were offered release or tape cutting. Women reporting postoperative urinary incontinence underwent a tape-shortening procedure. In these patients, the tape was shortened by the use of clips. Mean follow-up time after the release and/or the shortening operations was 9.9 months (range 6-18). A total of 15 women, ranging from 41 to 75 years old (mean 58.3) were included in this study. Upon the latest follow-up, six women exhibited prolonged urinary retention and subsequently underwent a release procedure (n=5) or a tape-cutting procedure (n=1). After the release procedure, all patients remained continent, but one patient's urinary retention issues were not resolved, and she subsequently underwent a tape-cutting. Both of the patients who underwent the cutting procedure then developed recurrent stress urinary incontinence. The tape-shortening technique was conducted with nine patients. Seven of these patients recovered their continence, and no one patient experienced any urinary retention or other voiding difficulties. Two patients reported only minimal stress leakage and elected to undergo no further interventions. Our findings suggest that tension plays a substantial role in tension-free mid-urethral sling procedures.

Outcome of mid-urethral sling procedures in Korean women with stress urinary incontinence according to body mass index.

BACKGROUND: The objective of this study was to determine whether the outcome of mid-urethral sling procedures is influenced by the body mass index of Korean women suffering from stress urinary incontinence (SUI). METHODS: A total of 285 women, ranging in age from 28 to 80 years (mean 55.4), all of whom were followed up for at least 6 months, were ultimately included in this study. The patients were classified as follows: normal weight, 18.5-23 kg/m2; overweight, 23-27.5 kg/m2; obesity, 27.5 kg/m2 or higher. RESULTS: We noted bladder perforations in 11 cases (4.9%, 3.8% and 2.2% in the normal weight, overweight, and obesity groups, respectively; P = 0.449). We determined there to be no significant differences among the three groups with regard to cure rate (P = 0.173). The rates of postoperative urinary retention were 9.9% in the normal weight group, 10.1% in the overweight group, and 15.6% in the obesity group (P = 0.396). We determined there to be no significant differences among the three groups with regard to the persistence of urgency (P = 0.312). Seventy-nine patients (27.7%) exhibited symptoms indicative of voiding disorder (hesitancy, poor flow, or sensations of incomplete emptying). The postoperative development of these voiding symptoms was not significantly different among the three groups (P = 0.106). CONCLUSION: Our results demonstrate both the feasibility and the safety of mid-urethral sling procedures for obese Korean women who suffer from SUI. Additional studies, including prospective randomized trials with longer follow-up periods, will be required in order to confirm these findings.

Significance of nocturnal hesitancy in treatment of men with lower urinary tract symptoms.

OBJECTIVES: To determine the significance of nocturnal hesitancy in the treatment of men with lower urinary tract symptoms. METHODS: A total of 123 patients with nocturia were prospectively studied. The nocturnal hesitancy scores ranged from 0 to 5 and were scored according to the International Prostate Symptom Score. The patients were stratified on the basis of their nocturnal hesitancy scores as group 1 (0 to 1, n = 57), group 2 (2 to 3, n = 45), and group 3 (4 to 5, n = 21). All patients received treatment with an alpha-blocker once daily for 4 weeks. RESULTS: Group 3 scored significantly higher on the International Prostate Symptom Score at baseline and after treatment than did group 1. The actual number of nightly voids was greatest in group 3 and was lowest in group 1 (P = 0.011 at baseline and P = 0.046 after treatment, respectively). The baseline nocturia indexes were greatest in group 3 and were lowest in group 2 (P = 0.027). A significant but weak correlation was also noted between the nocturia hesitancy score and the differences in scores between the posttreatment and baseline voiding symptoms (r = -0.234, P = 0.021) and total International Prostate Symptom Score (r = -0.270, P = 0.011), respectively. In our multivariate analyses, the straining score was a significant determinant of nocturnal hesitancy. CONCLUSIONS: The results of our study revealed that more emphasis should be placed on nocturnal hesitancy in the terminology of lower urinary tract symptoms. Additional research regarding the pathophysiologic mechanisms underlying nocturnal hesitancy, as well as its effects on those with it, is clearly warranted.

alpha-blocker monotherapy in the treatment of nocturia in men with lower urinary tract symptoms: a prospective study of response prediction.

OBJECTIVE: To determine the efficacy of an alpha-adrenoceptor antagonist, terazosin, in reducing nocturia in men with lower urinary tract symptoms (LUTS), and to identify the factors predicting treatment outcome. PATIENTS AND METHODS: In all, 100 patients were treated with 2 mg of terazosin once daily for the first 7 days, and continued to receive 4 mg of terazosin once daily for the following 3 weeks. The men were assessed at baseline and at the end of treatment using uroflowmetry, the International Prostate Symptom Score (IPSS), and the degree of nocturia estimated from a frequency-volume chart (FVC) and objectively. RESULTS: On the FVC, 27 patients reported that the terazosin treatment reduced their nocturia by more than half, and 14 reported a reduction of 25-49%. On the IPSS, 31 patients reported that the treatment reduced their nocturia by more than half and 27 reported a reduction of 25-49%. On multivariate regression analysis, only the actual number of nightly voids on the FVC was associated with a 2.1-fold chance of an improvement of >25% in objective nocturia (P = 0.016). Using a comparable model, a greater nocturia score on the IPSS was associated with a higher likelihood of improvement in subjective nocturia (odds ratio, 1.653; 95% confidence interval, 1.079-2.533; P = 0.021). CONCLUSION: Treatment with terazosin can reduce patients' episodes of nocturia both subjectively and objectively in some men with LUTS. Our results suggest that both subjective and objective numbers of nocturia episodes are associated with improvements in subjective and objective nocturnal frequencies, respectively.

Clinical and urodynamic features according to subjective symptom severity in female urinary incontinence.

AIMS: The aim of this study was to determine the relationship between subjective symptom severity and clinical or urodynamic parameters and to compare these parameters according to subjective symptom severity. METHODS: A total of 268 female patients with grade II (n = 94) and grade III (n = 174) according to the Ingelman-Sundberg scale were included in the study. Mean patient age was 55.9 years (range 28-80). Of 268 patients, 196 women (73.1%) complained of stress urinary incontinence (SUI) and 72 (26.9%) reported additional symptoms of urge urinary incontinence (UUI). Fifty-four (20.1%) women previously had hysterectomies and 12 (4.5%) underwent surgery for UI. RESULTS: Patients with severe incontinence (grade III) are older, have longer duration of symptoms, concomitant urgency or UUI, and low maximal urethral closure pressure and low Valsalva leak point pressure (VLPP). No difference in other characteristics including pad test loss and urethral mobility was observed in the two groups. In the multivariate logistic regression analysis, a longer duration of symptoms was associated with an increased likelihood of severe symptoms (P = 0.025). Patients with mixed incontinence were at five-fold increased risk of severe symptoms compared with those with SUI only (P = 0.011). In the same model, increasing VLPP was associated with a decreased likelihood of severe symptoms (P = 0.037). CONCLUSIONS: Longer symptom duration, mixed incontinence and low VLPP have independent effects on the severity of incontinence. Our findings suggest that incontinent patients with sphincteric impairment or urge component may have and increased probability of severe symptoms.

Age is not a limiting factor for midurethral sling procedures in the elderly with urinary incontinence.

OBJECTIVE: The object was to evaluate clinical outcome of the midurethral sling procedures in the elderly compared with middle-aged women. METHODS: A total of 266 women who underwent midurethral sling procedures with at least follow-up greater than 6 months were included in the study. Patients were divided as the elderly group (65 years old or older, n = 60) and the middle-aged group (45-64 years old, n = 206). RESULTS: Although postoperative urge symptoms were more prevalent in the elderly group (25.0%) than in the middle-aged group (6.3%), there were no significant differences between the two groups for the rates of postoperative urge incontinence (p = 0.159). Stress incontinence was cured by 91.3% in the middle-aged group and 85.0% in the elderly group, respectively (p = 0.158). CONCLUSIONS: Age does not seem to be a significant risk factor for failure of midurethral sling procedures.