Jae Duck Choi

A comparison of surgical and functional outcomes of robot-assisted versus pure laparoscopic partial nephrectomy.

Robotic-assisted partial nephrectomy is comparable with laparoscopic partial nephrectomy, offering equivalent oncological and functional outcomes.

Transitional Zone Index as a Predictor of the Efficacy of α-Blocker and 5α-Reductase Inhibitor Combination Therapy in Korean Patients with Benign Prostatic Hyperplasia.

Introduction: We investigated the value of the transitional zone index (TZI) for predicting treatment response to combination therapy involving α-blockers and 5α-reductase inhibitors for benign prostatic hyperplasia (BPH). Materials and Methods: Symptomatic BPH patients (n = 118) were randomized to receive 0.2 mg tamsulosin alone or with 0.5 mg dutasteride daily for 12 months. The TZI, International Prostate Symptom Scores, maximum urinary flow rates (Qmax), postvoid residual urine volumes, and prostate-specific antigen (PSA) were evaluated at baseline and after 12 months. The groups were subdivided according to a cut-off TZI value of 0.5 to compare treatment-related changes. Results: After 12 months, the combination therapy group had significantly greater decreases in prostate volume (p < 0.001), TZ volume (p < 0.001) and PSA (p < 0.001) than the monotherapy group, regardless of TZI. However, combination therapy resulted in significantly greater Qmax increases (p < 0.001) only in patients with a TZI ≥0.5. Multivariate analysis determined that TZI was the strongest independent predictor of the Qmax increase at 12 months in the combination therapy group (β = 13.7, p < 0.001). Conclusions: Greater Qmax improvement is expected with combination therapy comprising α-blockers and 5α-reductase inhibitors for patients with a TZI ≥0.5. The TZI may be useful for predicting the Qmax response to combination treatment for BPH.

Detection rates of nonpalpable prostate cancer in Korean men with prostate-specific antigen levels between 2.5 and 4.0 ng/mL.

OBJECTIVE To evaluate the detection rate and pathology of cancer in Korean men with low levels of prostate-specific antigen (PSA), 2.5-4.0 ng/mL. METHODS We examined 1097 patients with PSA level of 2.5-10.0 ng/mL, who underwent transrectal ultrasonography-guided prostate needle biopsies between January 2008 and March 2009. Of the 1097 biopsy patients, 815 met our criteria of benign findings by digital rectal examination and the absence of cancerous lesions by TRUS. Clinical characteristics and detection rates of prostate cancer, as well as the pathology of specimens obtained by needle biopsies and prostatectomies, were evaluated in these patients. RESULTS Of the 815 patients, 349 had group 1 (PSA level, 2.5-4.0 ng/mL) and 466 had group 2 (PSA level, 4.0-10.0 ng/mL). The percentage of patients diagnosed with prostate cancer was not statistically different between the 2 groups (21.8% in group 1, and 20.2% in group 2). In group 1, 70.7% of patients had a pathologic Gleason score of 7 or higher and 91.4% had organ-confined tumors (pT2). The pathologic characteristics, including Gleason score, pathologic stage, and percentage of insignificant cancer were similar in prostatectomy specimens between group 1 and group 2. CONCLUSIONS Detection rates of nonpalpable prostate cancer in Korean men were 21.8% in group 1 and 20.2% in group 2 without statistically significant difference. Pathologic characteristics of prostatectomy specimens also were similar between group 1 and group 2. These results suggest that a lower PSA level might be considered as an indication for prostate biopsy.

MP44-15 ANXA10 AND ATP7A ARE THE MTOR PATHWAY DOWNSTREAM TO PREDICT THE RECURRENCE AND PROGRESSION IN NON-MUSCLE INVASIVE HIGH GRADE UROTHELIAL CARCINOMA OF THE BLADDER

Methylation of a CpG island of the miR200b gene was assessed by bisulfite-pyrosequencing. BCa cells were treated with the DNA demethylating agent 5-aza-20-deoxycytidine (5-aza-dC) to restore the expression of miR-200b. RESULTS: Of the 754 miRNAs analyzed, miR-200b was downregulated in CDDP-resistant BCa cells (Figure 1). Induction of miR-200b in T24RC cells restored the CDDP sensitivity (Figure 2a). In contrast, inhibition of miR-200b increased CDDP resistance in T24 and EJ138 cells (Figure 2b and 2c). The levels of methylation in the CpG islands of miR-200b were significantly increased in T24RC and EJ138RC as compared to their parental cells (T24RC, 83.3%; T24, 53.3%; EJ138RC, 77.0%; EJ138, 62.6%; P < 0.01, Student t test), and treatment with 5-aza-dC restored the miR-200b expression in resistant cells (Figure 3a and 3b). Moreover, treatment with CDDP and 5-aza-dC synergistically inhibited the growth of T24RC cells (Figure 3c). CONCLUSIONS: Our results suggest that epigenetic downregulation of miR-200b may be causally related to the CDDP-resistance in BCa, and that it could be a potential therapeutic target.

Incidence of Nitrituria and Its Association With Metabolic Syndrome: Results From the Korean National Health and Nutrition Examination Survey V (2010-2012)

Purpose: To investigate the incidence of nitrituria and the relationship between nitrituria and metabolic syndrome (MetS). Methods: Data from the Korean National Health and Nutrition Examination Survey V were used. A total of 19,083 participants were included. The chi-square test, the Mantel-Haenszel extension, logistic regression analysis, and multiple linear regression were used to analyze the data. Results: A total of 2.0% of the participants had nitrituria. The incidence of nitrituria significantly increased with age (P trend<0.001). In addition, nitrituria in women began to significantly increase in the fifth decade, more than in men, and this difference was maintained in the 60s, 70s, and greater than 70s age groups (P<0.001). After adjusting for confounders, the odds ratio (OR) for nitrituria in the MetS group was significantly increased, as compared to the OR for nitrituria in the group without MetS (MetS: OR, 1.577; 95% confidence interval [CI], 1.134–2.192; P=0.007). The glycosylated hemoglobin of the nitrite positive group was significantly higher than the negative group (adjusted mean ±standard error: 6.108 ±0.081 vs. 5.883±0.065, P<0.001). Conclusions: An effective health policy for urinary tract infection (UTI) is needed for older age groups and women. Screening or management guidelines for UTI are needed in MetS patients.