Semirigid Ureteroscopy Therapy against Childhood Kidney Stones.

Objective: The purpose of the current study was to assess the effectiveness of semirigid ureterorenoscopy (URS) as first-line therapy for early childhood patients with <20 mm stones in the pelvic, middle, or upper calices. Methods: In all, 61 pediatric kidney stone patients who had flexible ureteroscopy (fURS) between January 1, 2010, and December 31, 2019, were included in this study. Before fURS, semirigid URS employed the UreTron or holmium: YAG (Ho : YAG) laser was conducted. When semirigid URS was unsuccessful, fURS was used for retrograde intrarenal surgery (RIRS). All participants were monitored clinically for a minimum of three months after each procedure. Results: The patient's mean age was 4.52 ± 1.53 years, and 52 (83.61%) participants underwent semirigid URS successfully. Mean procedural duration of semirigid URS was 36.49 ± 7.72 min. The stone-free rate after semirigid URS was 92.16% (47/51). During the postprocedural medical observation, there were no serious adverse effects. Conclusions: Based on the present study's findings, semirigid URS is a low-risk, effective therapy for kidney stones in selected pediatric patients.

Co-existence of mucin-producing urothelial-type adenocarcinoma of the prostate and inverted papilloma of the bladder.

Adenocarcinoma of prostate with mucinous differentiation arising in the male urethra is extremely rare, with only 21 cases reported in the previous literature. A diagnosis of mucin-producing urothelial carcinoma of the prostate is based on the pathology, immunohistochemistry, and clinical examination by excluding the secondary adenocarcinoma of the prostate. We present a case of unexpected mucinous urothelial carcinoma of prostate with co-existing inverted papilloma of bladder in a 57-year-old man. The patient underwent transurethral resection of the prostate (TURP) and transurethral resection of a bladder tumour (TUR-Bt), and the pathologic result showed mucinous prostate carcinoma and bladder inverted papilloma. Immunohistological stain was negative for prostate-specific antigen (PSA), prostate-specific acid phosphatase (PSAP), and P63, but positive for cytokeratin 7 (CK 7), CK 20, clone 34ßE12 and P504S. A complete endoscopic examination was performed to exclude the secondary adenocarcinoma of prostate. This case illustrates the clinical and pathological features of a rare and unexpected mucin-producing urothelial carcinoma of prostate in a bladder neoplasm patient.

Plasmakinetic enucleation of prostate versus 160-W laser photoselective vaporization for the treatment of benign prostatic hyperplasia.

To evaluate the safety and efficacy of plasmakinetic enucleation of the prostate (PKEP) for the treatment of symptomatic benign prostatic hyperplasia (BPH) compared with 160-W lithium triboride laser photoselective vaporization of the prostate (PVP). From February 2011 to July 2012, a prospective nonrandomized study was performed. One-hundred one patients underwent PKEP, and 110 underwent PVP. No severe intraoperative complications were recorded, and none of the patients in either group required a blood transfusion. Shorter catheterization time (38.14 ± 23.64 h vs 72.54 ± 28.38 h, P< 0.001) and hospitalization (2.32 ± 1.25 days vs 4.07 ± 1.23 days, P< 0.001) were recorded in the PVP group. At 12-month postoperatively, the PKEP group had a maintained and statistically improvement in International Prostate Symptom Score (IPSS) (4.07 ± 2.07 vs 5.00 ± 2.10; P< 0.001), quality of life (QoL) (1.08 ± 0.72 vs 1.35 ± 0.72; P= 0.007), maximal urinary flow rate (Qmax) (24.75 ± 5.87 ml s-1 vs 22.03 ± 5.04 ml s-1 ; P< 0.001), postvoid residual urine volume (PVR) (14.29 ± 6.97 ml vs 17.00 ± 6.11 ml; P= 0.001), and prostate-specific antigen (PSA) value (0.78 ± 0.57 ng ml-1 vs 1.27 ± 1.07 ng ml-1 ; P< 0.001). Both PKEP and PVP relieve low urinary tract symptoms (LUTS) due to BPH with low complication rates. PKEP can completely remove prostatic adenoma while the total amount of tissue removed by PVP is less than that can be removed by PKEP. Based on our study of the follow-up, PKEP provides better postoperative outcomes than PVP.

AICAR induces AMPK-independent programmed necrosis in prostate cancer cells.

AICAR (5-Aminoimidazole-4-carboxamide riboside or acadesine) is an AMP-activated protein kinase (AMPK) agonist, which induces cytotoxic effect to several cancer cells. Its potential activity in prostate cancer cells and the underlying signaling mechanisms have not been extensively studied. Here, we showed that AICAR primarily induced programmed necrosis, but not apoptosis, in prostate cancer cells (LNCaP, PC-3 and PC-82 lines). AICAR's cytotoxicity to prostate cancer cells was largely attenuated by the necrosis inhibitor necrostatin-1. Mitochondrial protein cyclophilin-D (CYPD) is required for AICAR-induced programmed necrosis. CYPD inhibitors (cyclosporin A and sanglifehrin A) as well as CYPD shRNAs dramatically attenuated AICAR-induced prostate cancer cell necrosis and cytotoxicity. Notably, AICAR-induced cell necrosis appeared independent of AMPK, yet requiring reactive oxygen species (ROS) production. ROS scavengers (N-acetylcysteine and MnTBAP), but not AMPKα shRNAs, largely inhibited prostate cancer cell necrosis and cytotoxicity by AICAR. In summary, the results of the present study demonstrate mechanistic evidences that AMPK-independent programmed necrosis contributes to AICAR's cytotoxicity in prostate cancer cells.

Mitochondrial protein cyclophilin-D-mediated programmed necrosis attributes to berberine-induced cytotoxicity in cultured prostate cancer cells.

The prostate cancer is one of the leading causes of men's cancer mortality. The development of alternative chemotherapeutic strategies is urgent. Berberine has displayed significant anti-prostate cancer activities. The underlying mechanisms are not fully understood. In the current study, we found that berberine induced apoptosis and programmed necrosis in cultured prostate cancer cells (LNCaP and PC-82 lines), and necrosis weighted more than apoptosis in contributing berberine's cytotoxicity. We demonstrated that mitochondrial protein cyclophilin-D (Cyp-D) is required for berberine-induced programmed necrosis. Inhibition of Cyp-D by its inhibitors cyclosporin A (CSA) or sanglifehrin A (SFA), and by Cyp-D shRNA depletion alleviated berberine-induced prostate cancer cell necrosis (but not apoptosis). Our data found that in prostate cancer cells, berberine induced reactive oxygen species (ROS) production, which dictated P53 translocation to mitochondria, where it physically interacted with Cyp-D to open mitochondrial permeability transition pore (mPTP). The anti-oxidant N-acetylcysteine (NAC), the P53 inhibitor pifithrin-α (PFTα) as well as P53 siRNA knockdown suppressed berberine-induced P53 mitochondrial translocation and Cyp-D association, thus inhibiting mitochondrial membrane potential (MMP) decrease and prostate cancer cell necrosis. In summary, the results of the present study provide mechanistic evidence that both apoptosis and programmed necrosis attribute to berberine's cytotoxicity in prostate cancer cells.

The incidence and clinical features of acute kidney injury secondary to ureteral calculi.

The aim of this study is to evaluate the incidence and clinical features of acute kidney injury (AKI) secondary to ureteral calculi. Between February 2002 and December 2009, the prevalence of AKI was 0.72% in our series of 2,073 cases of ureteral stones. The AKI patients received ureteroscopy or percutaneous nephrostomy as the primary treatment. The most popular symptom was significant decrease in urine output (75%, 12/16). Five cases (33.3%) were caused by bilateral ureteral stones, and 76.19% of the stones were located in the upper ureter, the mean size of single stone was 1.35 ± 0.38 cm. The serum creatinine before treatment was 514.34 ± 267.04 µmol/L and the blood urea nitrogen before treatment was 21.31 ± 10.24 mmol/L. 46.67% of the patients had a functional or anatomical solitary kidney unit. Our study suggests that risk factors for developing AKI in ureteral stone patients are bigger sized stones, ureteral stones in patients with only one functioning kidney or pre-existing kidney disease, and bilateral ureteral stones. Early effective drainage in these cases could decrease the risk developing AKI secondary to ureteral calculi.