Postoperative changes in the pharyngeal airway space through computed tomography evaluation after mandibular setback surgery in skeletal class III patients: 1-year follow-up.

BACKGROUND: This study evaluated the pharyngeal airway space changes up to 1 year after bilateral sagittal split osteotomy mandibular setback surgery and bimaxillary surgery with maxillary posterior impaction through three-dimensional computed tomography analysis. METHODS: A total of 37 patients diagnosed with skeletal class III malocclusion underwent bilateral sagittal split osteotomy setback surgery only (group 1, n = 23) or bimaxillary surgery with posterior impaction (group 2, n = 14). Cone-beam computed tomography scans were taken before surgery (T0), 2 months after surgery (T1), 6 months after surgery (T2), and 1 year after surgery (T3). The nasopharynx (Nph), oropharynx (Oph), hypopharynx (Hph) volume, and anteroposterior distance were measured through the InVivo Dental Application version 5. RESULTS: In group 1, Oph AP, Oph volume, Hph volume, and whole pharynx volume were significantly decreased after the surgery (T1) and maintained. In group 2, Oph volume and whole pharynx volume were decreased (T2) and relapsed at 1 year postoperatively (T3). CONCLUSION: In class III malocclusion patients, mandibular setback surgery only showed a greater reduction in pharyngeal airway than bimaxillary surgery at 1 year postoperatively, and bimaxillary surgery was more stable in terms of airway. Therefore, it is important to evaluate the airway before surgery and include it in the surgical plan.

Precise and selective sensing of DNA-DNA hybridization by graphene/Si-nanowires diode-type biosensors.

Single-Si-nanowire (NW)-based DNA sensors have been recently developed, but their sensitivity is very limited because of high noise signals, originating from small source-drain current of the single Si NW. Here, we demonstrate that chemical-vapor-deposition-grown large-scale graphene/surface-modified vertical-Si-NW-arrays junctions can be utilized as diode-type biosensors for highly-sensitive and -selective detection of specific oligonucleotides. For this, a twenty-seven-base-long synthetic oligonucleotide, which is a fragment of human DENND2D promoter sequence, is first decorated as a probe on the surface of vertical Si-NW arrays, and then the complementary oligonucleotide is hybridized to the probe. This hybridization gives rise to a doping effect on the surface of Si NWs, resulting in the increase of the current in the biosensor. The current of the biosensor increases from 19 to 120% as the concentration of the target DNA varies from 0.1 to 500 nM. In contrast, such biosensing does not come into play by the use of the oligonucleotide with incompatible or mismatched sequences. Similar results are observed from photoluminescence microscopic images and spectra. The biosensors show very-uniform current changes with standard deviations ranging ~1 to ~10% by ten-times endurance tests. These results are very promising for their applications in accurate, selective, and stable biosensing.

Light-induced negative differential resistance in graphene/Si-quantum-dot tunneling diodes.

One of the interesing tunneling phenomena is negative differential resistance (NDR), the basic principle of resonant-tunneling diodes. NDR has been utilized in various semiconductor devices such as frequency multipliers, oscillators, relfection amplifiers, logic switches, and memories. The NDR in graphene has been also reported theoretically as well as experimentally, but should be further studied to fully understand its mechanism, useful for practical device applications. Especially, there has been no observation about light-induced NDR (LNDR) in graphene-related structures despite very few reports on the LNDR in GaAs-based heterostructures. Here, we report first observation of LNDR in graphene/Si quantum dots-embedded SiO2 (SQDs:SiO2) multilayers (MLs) tunneling diodes. The LNDR strongly depends on temperature (T) as well as on SQD size, and the T dependence is consistent with photocurrent (PC)-decay behaviors. With increasing light power, the PC-voltage curves are more structured with peak-to-valley ratios over 2 at room temperature. The physical mechanism of the LNDR, governed by resonant tunneling of charge carriers through the minibands formed across the graphene/SQDs:SiO2 MLs and by their nonresonant phonon-assisted tunneling, is discussed based on theoretical considerations.

Energy transfer from an individual silica nanoparticle to graphene quantum dots and resulting enhancement of photodetector responsivity.

Förster resonance energy transfer (FRET), referred to as the transfer of the photon energy absorbed in donor to acceptor, has received much attention as an important physical phenomenon for its potential applications in optoelectronic devices as well as for the understanding of some biological systems. If one-atom-thick graphene is used for donor or acceptor, it can minimize the separation between donor and acceptor, thereby maximizing the FRET efficiency (EFRET). Here, we report first fabrication of a FRET system composed of silica nanoparticles (SNPs) and graphene quantum dots (GQDs) as donors and acceptors, respectively. The FRET from SNPs to GQDs with an EFRET of ∼78% is demonstrated from excitation-dependent photoluminescence spectra and decay curves. The photodetector (PD) responsivity (R) of the FRET system at 532 nm is enhanced by 10(0)∼10(1)/10(2)∼10(3) times under forward/reverse biases, respectively, compared to the PD containing solely GQDs. This remarkable enhancement is understood by network-like current paths formed by the GQDs on the SNPs and easy transfer of the carriers generated from the SNPs into the GQDs due to their close attachment. The R is 2∼3 times further enhanced at 325 nm by the FRET effect.

Stone heterogeneity index as the standard deviation of Hounsfield units: A novel predictor for shock-wave lithotripsy outcomes in ureter calculi.

We investigated whether stone heterogeneity index (SHI), which a proxy of such variations, was defined as the standard deviation of a Hounsfield unit (HU) on non-contrast computed tomography (NCCT), can be a novel predictor for shock-wave lithotripsy (SWL) outcomes in patients with ureteral stones. Medical records were obtained from the consecutive database of 1,519 patients who underwent the first session of SWL for urinary stones between 2005 and 2013. Ultimately, 604 patients with radiopaque ureteral stones were eligible for this study. Stone related variables including stone size, mean stone density (MSD), skin-to-stone distance, and SHI were obtained on NCCT. Patients were classified into the low and high SHI groups using mean SHI and compared. One-session success rate in the high SHI group was better than in the low SHI group (74.3% vs. 63.9%, P = 0.008). Multivariate logistic regression analyses revealed that smaller stone size (OR 0.889, 95% CI: 0.841-0.937, P < 0.001), lower MSD (OR 0.995, 95% CI: 0.994-0.996, P < 0.001), and higher SHI (OR 1.011, 95% CI: 1.008-1.014, P < 0.001) were independent predictors of one-session success. The radiologic heterogeneity of urinary stones or SHI was an independent predictor for SWL success in patients with ureteral calculi and a useful clinical parameter for stone fragility.

Graphene-Assisted Chemical Etching of Silicon Using Anodic Aluminum Oxides as Patterning Templates.

We first report graphene-assisted chemical etching (GaCE) of silicon by using patterned graphene as an etching catalyst. Chemical-vapor-deposition-grown graphene transferred on a silicon substrate is patterned to a mesh with nanohole arrays by oxygen plasma etching using an anodic- aluminum-oxide etching mask. The prepared graphene mesh/silicon is immersed in a mixture solution of hydrofluoric acid and hydro peroxide with various molecular fractions at optimized temperatures. The silicon underneath graphene mesh is then selectively etched to form aligned nanopillar arrays. The morphology of the nanostructured silicon can be controlled to be smooth or porous depending on the etching conditions. The experimental results are systematically discussed based on possible mechanisms for GaCE of Si.

Impact of colic pain as a significant factor for predicting the stone free rate of one-session shock wave lithotripsy for treating ureter stones: a Bayesian logistic regression model analysis.

PURPOSE: This study was conducted to evaluate colic pain as a prognostic pretreatment factor that can influence ureter stone clearance and to estimate the probability of stone-free status in shock wave lithotripsy (SWL) patients with a ureter stone. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 1,418 patients who underwent their first SWL between 2005 and 2013. Among these patients, 551 had a ureter stone measuring 4-20 mm and were thus eligible for our analyses. The colic pain as the chief complaint was defined as either subjective flank pain during history taking and physical examination. Propensity-scores for established for colic pain was calculated for each patient using multivariate logistic regression based upon the following covariates: age, maximal stone length (MSL), and mean stone density (MSD). Each factor was evaluated as predictor for stone-free status by Bayesian and non-Bayesian logistic regression model. RESULTS: After propensity-score matching, 217 patients were extracted in each group from the total patient cohort. There were no statistical differences in variables used in propensity- score matching. One-session success and stone-free rate were also higher in the painful group (73.7% and 71.0%, respectively) than in the painless group (63.6% and 60.4%, respectively). In multivariate non-Bayesian and Bayesian logistic regression models, a painful stone, shorter MSL, and lower MSD were significant factors for one-session stone-free status in patients who underwent SWL. CONCLUSIONS: Colic pain in patients with ureter calculi was one of the significant predicting factors including MSL and MSD for one-session stone-free status of SWL.

Graphene/Si-quantum-dot heterojunction diodes showing high photosensitivity compatible with quantum confinement effect.

Graphene/Si quantum dot (QD) heterojunction diodes are reported for the first time. The photoresponse, very sensitive to variations in the size of the QDs as well as in the doping concentration of graphene and consistent with the quantum-confinement effect, is remarkably enhanced in the near-ultraviolet range compared to commercially available bulk-Si photodetectors. The photoresponse proves to be dominated by the carriertunneling mechanism.

Correlation of prostatic urethral angle with the severity of urinary symptom and peak flow rate in men with small prostate volume.

PURPOSE: To evaluate the effects of prostatic anatomical factors on male lower urinary tract symptoms (LUTS) and the peak flow rate (Qmax) in patients with small prostate volume (PV). MATERIALS AND METHODS: Records were obtained from a prospectively maintained database of first-visit men with LUTS. Patients whose total PV (TPV) was greater than 30 mL were excluded; 444 patients were enrolled in the study. The TPV, transitional zone volume (TZV), transitional zone index (TZI), intravesical prostatic protrusion (IPP), and prostatic urethral angle (PUA) were measured by transrectal ultrasonography. LUTS were evaluated using the International Prostate Symptom Score (IPSS) and the Overactive Bladder Symptom Score (OABSS) questionnaires. Uroflowmetric measurements were also made. RESULTS: PUA (r = 0.269, P<0.001), TZV (r = 0.160, P<0.001), and TZI (r = 0.109, P = 0.022) significantly correlated with the IPSS. Qmax (r = -0.334, P<0.001) and OABSS (r = 0.211, P<0.001) correlated only with PUA. In a multivariate regression analysis, PUA and age were independently associated with IPSS, OABSS, and Qmax. For IPSS of 20 or greater, the area under the ROC curve (AUC) of PUA was 0.667 and the cut-off value was 43.7°. When Qmax was 10 mL/s or less, the AUC of PUA was 0.664 and the cut-off value was 43.5°. CONCLUSIONS: PUA has a significant association with symptom severity and Qmax among prostatic anatomical factors analyzed in men with LUTS and small PV. PUA should be considered as an important clinical factor in male LUTS management. Furthermore, the impact of PUA on response to medical treatment and disease progression needs to be investigated.

Is type-2 diabetes mellitus associated with overactive bladder symptoms in men with lower urinary tract symptoms?

OBJECTIVE: To elucidate the relationship between type-2 diabetes mellitus (DM) and overactive bladder symptoms in men with lower urinary tract symptoms (LUTS), after adjusting for the impact of age and prostate volume. MATERIALS AND METHODS: Data were obtained from a prospectively maintained database of 905 first-visit patients with LUTS and benign prostatic hyperplasia. After excluding those with comorbidities that may affect urinary symptom, we selected 139 patients with type-2 DM and 139 nondiabetic controls matched by propensity scoring for age and prostate volume. RESULTS: There were no differences in voided volume and maximal flow rate between the 2 groups, whereas residual urine volume was significantly higher in DM patients than controls (29.34 ± 26.99 mL vs 22.45 ± 23.25 mL; P = .028). The total International Prostatic Symptom Score was significantly higher in DM patients than controls (17.80 ± 7.60 vs 15.88 ± 7.05; P = .031). Storage (7.45 ± 3.21 vs 6.58 ± 3.11; P = .024) and postmicturition (2.57 ± 1.49 vs 2.19 ± 1.59; P = .045) symptom scores were higher in DM patients than controls, whereas the groups had similar voiding symptom scores (P = .104). Among storage symptoms, DM patients had higher frequency (P = .010) and nocturia (P = .003) scores but similar urgency scores. The Overactive Bladder Symptom Score was also significantly higher in DM patients; this difference was due to a higher nocturia (but not urgency) score. CONCLUSION: DM patients with LUTS and benign prostatic hyperplasia had greater storage and postmicturition symptoms than age and prostate volume-matched controls. The disparity in storage symptoms was mainly because of frequency and nocturia rather than urgency.

Charlson comorbidity index is an important prognostic factor for long-term survival outcomes in Korean men with prostate cancer after radical prostatectomy.

PURPOSE: To analyze overall survival (OS), prostate cancer (PCa)-specific survival (PCaSS), and non-PCaSS according to the Charlson Comorbidity Index (CCI) after radical prostatectomy (RP) for PCa. MATERIALS AND METHODS: Data from 336 patients who had RP for PCa between 1992 and 2005 were analyzed. Data included age, preoperative prostate-specific antigen (PSA), prostate volume, clinical stage, and pathologic stage. Pre-existing comorbidities were evaluated by the CCI, and patients were classified into two CCI score categories (0, ≥1). RESULTS: The mean age of patients was 64.31±6.12 years. The median PSA value (interquartile range, IQR) was 11.30 (7.35 and 21.02) ng/mL with a median follow-up period (IQR) of 96.0 (85.0 and 121.0) months. The mean CCI was 0.28 (0-4). Five-year OS, PCaSS, and non-PCaSS were 91.7%, 96.3%, and 95.2%, respectively. Ten-year OS, PCaSS, and non-PCaSS were 81.9%, 92.1%, and 88.9%, respectively. The CCI had a significant influence on OS (p=0.022) and non-PCaSS (p=0.008), but not on PCaSS (p=0.681), by log-rank test. In multivariate Cox regression analysis, OS was independently associated with the CCI [hazard ratio (HR)=1.907, p=0.025] and Gleason score (HR=2.656, p<0.001). PCaSS was independently associated with pathologic N stage (HR=2.857, p=0.031), pathologic T stage (HR=3.775, p=0.041), and Gleason score (HR=4.308, p=0.001). Non-PCaSS had a significant association only with the CCI (HR=2.540, p=0.009). CONCLUSION: The CCI was independently associated with both OS and non-PCaSS after RP, but the CCI had no impact on PCaSS. The comorbidities of a patient should be considered before selecting RP as a curative modality for PCa.

Clinical implications of a feeling of incomplete emptying with little post-void residue in men with lower urinary tract symptoms.

AIM: It remains unclear why patients suffer from a feeling of incomplete emptying despite no or little post-void residual (PVR). Accordingly, we evaluated the clinical implications thereof in men with lower urinary tract symptoms (LUTS). METHODS: Records were obtained from a prospectively maintained database for 905 first-visit men with LUTS. Patients with comorbidities that may affect voiding function and with PVR > 20 ml were excluded. Finally, 421 patients were eligible for the study. RESULTS: By International Prostate Symptom Score (IPSS), a score for evaluating a feeling of incomplete emptying, 106 patients (25.2%) were characterized as experiencing no symptoms (score 0, 1), 201 (47.7%) as mild to moderate symptoms (score 2, 3), and 114 (27.1%) as severe symptoms (score 4, 5). The severity of a feeling of incomplete emptying was significantly associated with total IPSS and with subscores for both voiding and storage symptoms (P < 0.001). Comparing patients with severe symptoms (severe group, N = 114) with a propensity score-matched control group, adjusting for age, PVR, and maximum flow rate, total IPSS was significantly different between the two groups (23.04 ± 5.68 vs. 13.21 ± 5.48, respectively; P < 0.001). The subscores for both voiding and storage symptoms were also significantly worse in the severe group. The quality of life score was 4.51 ± 0.80 in the severe group and 3.53 ± 1.05 in control group (P < 0.001). CONCLUSIONS: A feeling of incomplete emptying despite little PVR was frequently observed and, notably, this was significantly associated with worsening of both voiding and storage symptoms, even after adjusting for relevant variables.

Impact of Charlson comorbidity index varies by age in patients with prostate cancer treated by radical prostatectomy: a competing risk regression analysis.

PURPOSE: To investigate the prognostic impact of the Charlson comorbidity index (CCI) on either cancer-specific mortality (CSM) or other-cause mortality (OCM) according to age in patients with prostate cancer (PC) who underwent radical prostatectomy (RP). METHODS: Data from 336 patients who underwent RP for PC between 1992 and 2005 were analyzed. Variables, including the preoperative prostate-specific antigen (PSA), prostate volume, clinical stage, and pathologic stage, were compared across age groups (<65 or ≥65 years old). Preexisting comorbidities were evaluated by the CCI, and patients were classified into two CCI score categories (0 or ≥1). RESULTS: The median (interquartile range) follow-up period was 96 (85-121) months. Subjects were divided into two subgroups according to age: <65 years (n = 151) or ≥65 years (n = 185). There was no significant difference in PSA, biopsy Gleason sum, body mass index, pathologic stage, or CCI between the two age groups. OCM was significantly associated with the CCI score (P = 0.011). Cumulative incidence estimates obtained from competing risk regression analysis indicated that CCI was not associated with CSM (P = 0.795) or OCM (P = 0.123) in the ≥65-year group. However, in men <65 years, cumulative incidence estimates for OCM were significantly associated with CCI (P = 0.036). CONCLUSIONS: CCI was independently associated with OCM after RP, but only in men <65 years old. CCI was not associated with CSM in either age group. Accordingly, a thorough evaluation of patient's comorbidities is mandatory when considering aggressive surgical treatment, especially in relatively young patients.

Clinical features of supervoiders who suffer from lower urinary tract symptoms: a propensity score-matching study.

PURPOSE: To evaluate the clinical characteristics of patients with maximal urine flow rate (Q max) ≥ 25 ml/s complaining of lower urinary tract symptoms (LUTS), using propensity score-matching analysis to compare with the control group. METHODS: Medical records from a prospectively maintained database for first visit male patients with LUTS/benign prostatic hyperplasia between 2010 and 2012 were used to select 818 patients. Of these patients, 68 men with Q max ≥ 25 ml/s were defined as the supervoider group, and 68 patients were selected for the control group using propensity scores, which were calculated for each patient using multivariable logistic regression model based on the following covariates: age, prostate volume, voided urine volume, and post-voided residual volume. International Prostate Symptom Score (IPSS), quality of life score, and Overactive Bladder Symptom Score (OABSS) were also analyzed. RESULTS: Mean Q max was 30.82 ± 5.13 in supervoiders and 15.95 ± 4.88 ml/s in controls (p < 0.001). There were statistical differences in IPSS between supervoiders and controls (12.63 ± 5.81 vs. 16.13 ± 6.90; p = 0.002). Although the IPSS voiding symptom sub-score in supervoiders was lower than controls (5.09 ± 3.35 vs. 7.40 ± 4.00; p < 0.001), there were no significant differences in storage symptom and post-micturitional symptom sub-scores. In OABSS and subdomain scores for frequency, nocturia, and urgency, there were no significant differences between the groups. However, the urge incontinence subdomain score was significantly higher in supervoiders versus controls (0.69 ± 1.26 vs. 0.18 ± 0.52; p = 0.003). CONCLUSIONS: Supervoiders experience comparable levels of storage and post-micturition symptoms, but display more severe urge incontinence despite milder voiding symptoms and better uroflowmetric measurements than propensity score-matched controls.

Protective role of metabolism by intestinal microflora in butyl paraben-induced toxicity in HepG2 cell cultures.

Parabens are alkyl esters of p-hydroxybenzoic acid (BA), including methyl paraben (MP), ethyl paraben, propyl paraben (PP), and butyl paraben (BP). In the present study, possible role of metabolism by fecalase in BP-induced cytotoxicity was investigated in HepG2 cell cultures. As an intestinal bacterial metabolic system, a human fecalase prepared from human fecal specimen was employed. Among the parabens tested, cytotoxicity of BP was most severe. BA, the de-esterified metabolite, did not induce cytotoxicity when compared to other parabens. When BP was incubated with fecalase, it rapidly disappeared, in association with reduced cytotoxicity in HepG2 cells. In addition, BP incubated with fecalase significantly caused an increase in Bcl-2 expression together with a decrease in Bax expression and cleaved caspase-3. Moreover, anti-apoptotic effect by the incubation of BP with fecalase was also confirmed by the TUNEL assay. Furthermore, BP induced a sustained activation of the phosphorylation of JNK only when it was treated alone. Meanwhile, BP-induced cell death was reversed by the pre-incubation of BP with either fecalase or SP600125. Taken together, the findings suggested that metabolism of BP by human fecalase might have protective effects against BP-induced toxicity in HepG2 cells.

Role of metabolism by human intestinal microflora in geniposide-induced toxicity in HepG2 cells.

Possible role of metabolism by the intestinal bacteria in geniposide-induced cytotoxicity was investigated in human hepatoma HepG2 cells. Initially, toxic effects of geniposide and its metabolite genipin were compared. Genipin, a deglycosylated form of geniposide, was cytotoxic at the concentrations that geniposide was not. As metabolic activation systems for geniposide, human intestinal bacterial cultures, fecal preparation (fecalase) and intestinal microbial enzyme mix were employed in the present study. When geniposide was incubated with human intestinal bacteria, either Bifidobacterium longum HY8001 or Bacteroides fragilis, for 24 h, the cultured media caused cytotoxicity in HepG2 cells. Fecalase and intestinal enzyme mix were also effective to metabolically activate geniposide to its cytotoxic metabolite. The present results indicated that genipin, a metabolite of geniposide, might be more toxic than geniposide, and that intestinal bacteria might have a role in biotransformation of geniposide to its toxic metabolite. In addition, among three activation systems tested, intestinal microbial enzyme mix would be convenient to use in detecting toxicants requiring metabolic activation by intestinal bacteria.

Treatment of prostatic abscess: case collection and comparison of treatment methods.

PURPOSE: Prostatic abscess is an uncommon urologic disease but has a high mortality rate if not treated properly. Furthermore, diagnosis and proper treatment of prostatic abscesses remains a challenge for physicians. Therefore, we compared data on conservative treatments, transurethral resection of prostatic abscess, and transrectal ultrasound (TRUS)-guided needle aspiration in 52 cases over a 10-year period. MATERIALS AND METHODS: The records of 52 patients diagnosed with prostatic abscess by computed tomography at Gangnam Severance Hospital between January 2000 and September 2010 were retrospectively reviewed. All patients were discharged when their leukocytosis had normalized and they had been free of fever for 2 days. Multivariate regression analysis was done to determine independent risk factors for the length of hospitalization. RESULTS: At the time of diagnosis, the average age of the 52 patients was 61.3 years (range, 33 to 81 years), the average volume of the prostate was 56.3 ml (range, 21 to 223 ml), the average prostate-specific antigen was 18.54 ng/ml (range, 2.0 to 57.0 ng/ml), and the average abscess size was 3.8 cm (range, 2.1 to 5.5 cm). All patients were treated with parenteral antibiotics during their hospital stay with intravenous antibiotics (fluoroquinolone monotherapy or 3rd-generation cephalosporin in combination with an aminoglycoside). Of 52 patients, 22 had diabetes mellitus (42.3%), 19 had hypertension (36.5%), and 7 (13.5%) had paraplegia due to spinal cord injury. The most common symptoms were fever (47, 90.4%), perineal discomfort (43, 82.7%), dysuria (40, 76.9%), and urinary retention (29, 55.8%). Prostatic abscesses were treated by conservative treatment (11 cases), transurethral resection of prostatic abscess (23 cases), and TRUS-guided needle aspiration (18 cases). The average hospitalization stay was 17.5 days (range, 6 to 39 days); that of conservative treatment patients was 19.1 days (range, 9 to 39 days). Patients treated by transurethral resection of prostatic abscess and TRUS-guided needle aspiration stayed 10.2 days (range, 6 to 15 days) and 23.25 days (range, 18 to 34 days), respectively. Of the 18 cases who underwent needle aspiration, prostatic abscesses recurred in 4 cases (22.2%) within 1 month after patient discharge. The 2 patients subjected to conservative treatment died due to sepsis. We found no independent factors that affected the average hospitalization period. CONCLUSIONS: Patients with prostatic abscess treated by transurethral resection of the prostate had a significantly shorter hospitalization length compared with needle aspiration.

Retroperitoneoscopic partial nephrectomy in a horseshoe kidney.

A 21-year-old woman with a 4 cm enhancing cystic renal mass in the left moiety of a horseshoe kidney was treated through a retroperitoneal laparoscopic approach. The tumor was excised completely with cold scissors, and renal parenchyma suturing with a surgical bolster was done with Vicryl 2-0 sutures. Choosing the proper approach according to the location of the lesion and the surgeon's experience with both approaches are of importance in laparoscopic surgery in horseshoe kidney cases. A preoperative kidney computed tomography angiography was helpful for understanding the complex renal vasculature.

Role of metabolism by intestinal bacteria in arbutin-induced toxicity in vitro.

A possible role of metabolism by intestinal bacteria in arbutin-induced toxicity was investigated in mammalian cell cultures. Following an incubation of arbutin with intestinal bacteria, either Bifidobacterium longum HY81 or Bifidobacterium adolescentis, for 24 h, its aglycone hydroquinone could be produced and detected in the bacterial culture media. The bacterial growth was not affected up to 10 mM arbutin in the culture medium. When the toxicity of bacteria cultured medium with arbutin was tested in the HepG2 cell lines, the medium with arbutin was more toxic than either parent arbutin only or bacteria cultured medium without arbutin, indicating that metabolic activation might be required in arbutin-induced toxicity. In addition, bacteria cultured medium with arbutin could suppress LPS and ConA mitogenicity in splenocyte cultures prepared from normal mice. The results indicate that the present toxicity testing system might be applied for assessing the possible role of metabolism by intestinal bacteria in certain chemical-induced toxicity in mammalian cell cultures.

Are men who undergo radical prostatectomy with lower urinary tract symptoms at an increased risk for aggressive prostate cancer?

PURPOSE: We aimed to determine whether prediagnostic lower urinary tract symptoms (LUTS) are associated with the aggressiveness of nonmetastatic prostate cancer (PCa) and compared the clinicopathologic features of PCa patients with and without preexisting LUTS. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 295 prostate cancer patients who underwent a radical prostatectomy (RP) by a single surgeon from 2006 to 2010. A total of 205 patients were assigned to two groups according to whether they showed preoperative LUTS (International Prostate Symptom Score [IPSS]≥8). Clinical, operative, pathologic, and postoperative functional data were collected. RESULTS: The mean age at RP was 62.7 years in the no LUTS group (group A, n=108) and 64.7 in the LUTS group (group B, n=97). The baseline mean IPSS score was 6.1 in group A and 14.6 in group B (p=0.029). The incidence of pathologic T3a stage or above was significantly higher in group B than in group A (p=0.036). The mean postoperative follow-up period was 16.8 months (range, 4 to 38 months). The mean time to biochemical recurrence was 16.9 and 18.2 months in groups A and B, respectively (p=0.148). The median time to recovery of urinary incontinence was 3.6 and 3.3 months in groups A and B, respectively. CONCLUSIONS: PCa patients without baseline LUTS had a favorable result of pathologic T stage even though there were no significant differences in biochemical recurrence or recovery of postoperative incontinence compared with patients with baseline LUTS.