Chongwook Lee

The impact of lower urinary tract symptoms and comorbidities on quality of life: the BACH and UREPIK studies.

In a large epidemiological study, authors investigated the effect of LUTS on quality of life among various cultures. They showed a close association between the two, and that the effect of having moderate symptoms has a similar effect on quality of life as diabetes, hypertension or cancer, and that having severe symptoms had a similar effect as a heart attack or stroke.

Epidemiologic Survey of Lower Urinary Tract Symptoms in Asia and Australia Using the International Prostate Symptom Score

Background The prevalence of lower urinary tract symptoms was determined by survey as an initial step in estimating the significance of benign prostatic hyperplasia (BPH) in Asia and Australia.

Prevalence of lower urinary tract symptoms in Korean men in a community-based study

Objective: The prevalence of lower urinary tract symptoms was determined in Korean men aged 50 and over. Methods: A community-based, epidemiologic study was performed in Yonchon County, Korea. The Korean version of the International Prostate Symptom Score (I-PSS) was used to assess the severity of urinary symptoms in a representative sample of 514 men. Results: Nocturia and weak stream were the most prevalent symptoms and urgency was the least. Overall, 23.2% of the men were moderately to severely symptomatic: 17.7% in the age group of 50–59 years, 23.3% in that of 60–69 years and 35.3% in that of 70 years and over. The proportion of severely symptomatic men approximately doubled with each decade of age. The ‘quality of life’ score showed a high correlation with the I-PSS. Our estimation indicated that in 1995 approximately 800,000 Korean men had moderate to severe lower urinary tract symptoms that were likely to be associated with benign prostatic hyperplasia. Conclusions: The prevalence of moderate to severe lower urinary tract symptoms in Korean men is substantially similar to that in Caucasians.

Augmentation of cisplatin sensitivity in cisplatin-resistant human bladder cancer cells by modulating glutathione concentrations and glutathione-related enzyme activities

To investigate the roles of glutathione and glutathione‐S‐transferase (GST) in cisplatin‐resistance mechanisms in human bladder cancer, by using glutathione‐depleting or GST‐blocking agents.

Effect of subclinical prostatic inflammation on serum psa levels in men with clinically undetectable prostate cancer

OBJECTIVESnTo examine whether subclinical prostatic inflammation might influence serum prostate-specific antigen (PSA) levels in men with clinically undetectable prostate cancer.nnnMETHODSnA total of 461 patients who underwent prostate biopsy at our hospital were studied between January 1996 and December 1999. Of these patients, a total of 125 patients without detectable prostate cancer or a history or symptoms of prostatitis, with serum PSA levels of less than 20.0 ng/mL and other specified exclusion criteria, were included in the study. Inflammation observed at biopsy was scored for inflammation extent and inflammatory aggressiveness, and the effects of these morphologic aspects of inflammation on serum PSA levels were examined.nnnRESULTSnThe extent of inflammation tended to increase as the prostate volume increased (P = 0.006). Patients with a PSA greater than 2.5 ng/mL had a greater extent and aggressiveness of inflammation than those with PSA levels of 2.5 ng/mL or less (P = 0.004 and P = 0.050, respectively). However, no statistically significant differences were found in terms of the extent of inflammation or inflammatory aggressiveness between patients with PSA levels greater than 4.0 ng/mL and those with PSA levels of 4.0 ng/mL or less. Furthermore, the extent of inflammation did not account for PSA levels greater than 2.5 or 4.0 ng/mL by multivariate analysis.nnnCONCLUSIONSnOur results indicate that subclinical prostatic inflammation is not the etiology of a serum PSA greater than 4.0 ng/mL in men without clinically detectable prostate cancer.

Prevalence and epidemiologic characteristics of urolithiasis in Seoul, Korea

OBJECTIVESnTo study the epidemiologic details of urolithiasis in Seoul, Korea. The prevalence of urolithiasis varies by different regions in the world and has been reported to be 4% to 15%.nnnMETHODSnA total of 2643 persons 40 to 79 years old living in Seoul were selected by stepwise random sampling. Questionnaires were used and completed by trained interviewers concerning whether the subjects had experienced urinary stone disease at any time in their life.nnnRESULTSnOf 2643 persons interviewed, 65 experienced 78 episodes of urinary stone formation in their lifetime. Calibrated after the Seoul population census, the overall standardized lifetime prevalence rate was estimated to be 3.5%, 6.0% in men and 1.8% in women. The point prevalence rate was estimated to be 0.9%, 1.9% in men and 0.3% in women. Most of the urinary stone diseases were diagnosed at the fifth decade. Kidney stones in family members were present in 8.1% of patients with stones and 4.1% of stone-free control individuals. Twenty percent of the patients with stones experienced recurrences.nnnCONCLUSIONSnIn this first systematically assessed epidemiologic survey about the rate of urolithiasis in Korea, 6.0% of Korean men and 1.8% of women are expected to experience urinary stone disease during their lifetime.

Prognostic Markers of Intravesical Bacillus Calmette‐Guérin Therapy for Multiple, High‐Grade, Stage T1 Bladder Cancers

Background:

Intravesical Mitomycin C Instillation as a Prophylactic Treatment of Superficial Bladder Tumor

A study was performed to determine the prophylactic efficacy of intravesical mitomycin C instillation in 43 patients with recurrent (more than 3), multiple (more than 3) or large (more than 3 cm.) superficial bladder tumors (stage Ta or T1). Of the patients 21 were treated with 8 weekly intravesical instillations of 40 mg. mitomycin C after transurethral resection and 22 were followed conventionally. The recurrence rate was 42.9 per cent in the mitomycin C group and 40.9 per cent in the controls during the first 3 months, and it was 81.0 and 77.3 per cent, respectively during 24 months. Recurrences per 100 patient-months were 8.7 and 8.9, respectively. Two patients in the mitomycin C group and 4 controls had recurrent tumors with progression in stage. We conclude tentatively from these observations that intravesical mitomycin C instillation is not effective in the prophylaxis of tumor recurrence in patients at high risk. This finding is contrary to other reports indicating a marked decrease in recurrence with mitomycin C.

Apoptosis induced by oxalate in human renal tubular epithelial HK-2 cells

AbstractsOxalate is not only considered to be one of the main constituents of urinary stones, but it also has toxic effects on renal tubular epithelial cells, affecting the pathogenesis of nephrolithiasis. We tried to elucidate the effects of oxalate on human renal tubular epithelial cells (HK-2 cells). In addition, we investigated whether the toxic effect of oxalate occurs by apoptosis, and determined the expression of Bcl-2 family and caspase 9 proteins known as apoptosis-related protein. HK-2 cells were incubated with different concentrations of oxalate, and the effect of oxalate on the growth of the cells was assessed by MTT assay. A caspase-3 activity assay and TUNEL assay were performed on HK-2 cells after oxalate exposure in order to evaluate apoptosis. Immunoblot analysis of Bax, Bcl-2, Bcl-xL, and caspase-9 were performed. Oxalate exposure resulted in significant growth inhibition of HK-2 cells as oxalate concentrations increased. The toxic effect of oxalate on HK-2 cells was considered to occur through apoptosis, as suggested by the increase of caspase-3 activity. The percentage of positive nuclei stained using the TUNEL method was 18±2.3 in oxalate-treated cells and 2.5±0.9 in untreated cells (P<0.05). Bax and caspase-9 protein expression increased significantly as oxalate concentrations increased, but Bcl-2 protein expression decreased. There was no difference in Bcl-xL protein expression among the various concentrations of oxalate. Our results show that oxalate has a toxic effect on HK-2 cells and that this effect is induced by apoptosis, which may be mediated by an intrinsic pathway.

Multicentric papillary adenocarcinoma of the renal pelvis and ureter report of a case with ultrastructural study

A case of multicentric papillary adenocarcinoma arising in the renal pelvis and proximal ureteral mucosa of a 35‐year‐old man is presented. The left nephrectomy specimen demonstrated multiple, fungating, papillary tumors. The largest tumor measured 10 × 9 × 6 cm and invaded the renal parenchyma. Smaller tumors with long stalks were found. Microscopically, the papillary fronds of each neoplasm were lined by a single layer of cuboidal to low columnar epithelium admixed with a few areas of invasive tubular adenocarcinoma. The adjacent pelvic mucosa was the site of cuboidal epithelial metaplasia. The ultrastructure of both the papillary tumor and the pelvic mucosa suggested that they originated from the nonmucigenic metaplastic epithelium with a partial similarity to the lining of the proximal convoluted tubule. The growth pattern and the multicentric development of this unusual neoplasm suggest that this is a case of the malignant counterpart of the nephrogenic adenoma in the kidney and ureter, and reflect a biologic behavior corresponding to ordinary urothelial papillary tumors.