June Hyun Han

The clinical significance in healthy men of the association between obesity related plasma hemodilution and tumor marker concentration.

PURPOSE We investigated the association between body mass index and the concentration of tumor markers including carcinoembryonic antigen, alpha-fetoprotein, the carbohydrate antigen 19-9 and prostate specific antigen, as well as the association between body mass index changes and tumor marker concentration changes in a population of healthy men. MATERIALS AND METHODS We evaluated data on 8,776 men screened for tumor markers (carcinoembryonic antigen, alpha-fetoprotein, carbohydrate antigen 19-9 and prostate specific antigen) at least 3 times annually during an annual examination from 2001 to 2007. We assessed the tumor marker test findings for a trend in the age, alanine aminotransferase and creatinine adjusted tumor marker concentration by body mass index. We used multivariate regression analysis to determine whether a change in body mass index was associated with a tumor marker concentration change over time using calculated tumor markers, body mass index, creatinine and alanine aminotransferase concentration change per year. RESULTS After adjusting for age, creatinine and alanine aminotransferase a higher body mass index was associated with lower prostate specific antigen (p for trend <0.001), carcinoembryonic antigen (p for trend <0.001) and carbohydrate antigen 19-9 (p for trend <0.001). On multivariate regression analysis each 1 kg/m(2) of body mass index gain per year was associated with a -0.011 ng/ml change in prostate specific antigen concentration, a -0.030 ng/ml change in carcinoembryonic antigen concentration and a -0.192 IU/ml change in carbohydrate antigen 19-9 concentration per year. CONCLUSIONS In this cohort of healthy men hemodilution from increased plasma volume may be responsible for the observed decreased tumor marker concentration in men with a higher body mass index. In addition, an increase in body mass index may predict a lower tumor marker concentration in an individual.

Relationship Between Serum Prostate-Specific Antigen Levels and Components of Metabolic Syndrome in Healthy Men

OBJECTIVES To assess the correlation between age, body mass index, systolic and diastolic blood pressure (BP), triglycerides, high-density lipoprotein (HDL), and fasting blood glucose (FBG) and the serum prostate-specific antigen (PSA) level and to determine the significant factors for predicting the serum PSA level in men with a low risk of prostate cancer. METHODS A total of 38 356 healthy male employees of the Korea Electric Power Corporation who were <60 years old and had a serum PSA level of <4 ng/mL were enrolled in this study from January 2002 to December 2006. Their BP, body weight, and body height were measured, and biochemical analyses of FBG, triglycerides, HDL, and serum PSA were performed. RESULTS The mean age +/- standard deviation was 44.38 +/- 7.90 years; the mean serum PSA level was 0.89 +/- 0.51 ng/mL; and the incidence of metabolic syndrome was 25.8%. On univariate analysis, significant correlations were noted between the serum PSA level and body mass index, diastolic BP, HDL, and FBG (P < .05). Multiple logistic regression analyses using 4 percentiles (10th, 25th, 75th, and 90th percentile) of the serum PSA level revealed trends for a positive association between older age and diastolic BP and the serum PSA level. The body mass index, HDL, and FBG correlated negatively with the serum PSA level. CONCLUSIONS These results suggest that the serum PSA level is significantly influenced by age and some components of the metabolic syndrome (obesity, diastolic BP, HDL, and FBG).

Modulation of human β-defensin-2 expression by 17β-estradiol and progesterone in vaginal epithelial cells

We investigated the expression of HBD-1 and -2 in vaginal epithelial cells treated with lipopolysaccharide (LPS) and the effects on HBD-2 expressions by 17beta-estradiol and progesterone. Primary vaginal epithelial cells were isolated from a segment of normal anterior vaginal wall obtained during vaginoplasty and were cultured in keratinocyte growth medium and were allowed to undergo their 3rd passage. Expression of HBD-1 and -2 by different stimuli using LPS 0.5 microg/ml, 17beta-estradiol 2 nM and progesterone 1 microM was measured by RT-PCR, ELISA and real-time RT-PCR, respectively. HBD-1 was produced constitutively in vaginal epithelial cells and the production of HBD-1 was not influenced by LPS, 17beta-estradiol and progesterone, but the production of HBD-2 was increased inducibly by LPS. 17beta-Estradiol and progesterone did not change the production of HBD-2 in normal state, but 17beta-estradiol increased the production of HBD-2 and progesterone suppressed the production of HBD-2 under the circumstances with infection. The HBD-2 plays an important role at innate host defense on genitourinary tract. The lacks of estrogen during menopause or uses of a progesterone-based oral contraceptive in sexually active women may influence production of HBD-2 in vaginal epithelium and may increase susceptibility to bacterial vaginitis or recurrent UTI.

Prognostic significance of common preoperative laboratory variables in clear cell renal cell carcinoma

To investigate the prognostic significance of common preoperative laboratory variables evaluated before surgery for clear cell renal cell carcinoma (RCC).

Association between serum prostate-specific antigen level, liver function tests and lipid profile in healthy men

To assess the association between serum prostate‐specific antigen (PSA) level and age, liver function tests (LFTs) including alkaline phosphatase (ALP), total bilirubin (TB), lipid profile (total cholesterol, TC, triglycerides, TG, high‐density lipoprotein, HDL) and fasting blood sugar (FBS), and to determine the significant factors for predicting the serum PSA level in men with a low risk of having prostate cancer.

Association between metabolic syndrome and chronic kidney disease in the Korean population.

Aim:  We performed a retrospective study to examine the association between the metabolic syndrome (MS) and risk for the development of chronic kidney disease (CKD).

Laparoendoscopic Single-Site Ureterolithotomy for Upper Ureteral Stone Disease: The First 30 Cases in a Multicenter Study

PURPOSE We evaluated the usefulness of laparoendoscopic single-site (LESS) ureterolithotomy with a homemade single port device for upper ureteral stones in patients in whom previous shockwave lithotripsy or ureteroscopic stone surgery had failed or the stone was suspected to be impacted. PATIENTS AND METHODS LESS ureterolithotomy was performed on 30 patients by using a homemade single port device composed of an Alexis wound retractor and surgical glove. The mean age of the patients was 42.47±11.15 years (range 24-65 y), and the male-to-female ratio was 13:17. The mean stone diameter was 1.77±0.47 cm. One patient underwent a bilateral operation for bilateral ureteral stones. RESULTS The LESS surgery was converted to conventional laparoscopic surgery in one case. The mean operative time was 110.43±43.75 minutes. The mean length of hospital stay was 3.40±1.54 days. None of the patients used patient-controlled anesthesia, and none presented with major complications. The visual analog pain scale score improved significantly by postoperative day 7 (from 6.87±1.61 preoperatively to 1.67±1.16; P<0.001), and 28 (93.3%) patients said they were satisfied with the postoperative outcome. Postoperative radiologic evaluation revealed that the stones had been removed completely in 28 cases. There were no cases of urinary leakage. CONCLUSION LESS ureterolithotomy using a homemade single port device can be considered to be a feasible and safe alternative to conventional laparoscopic ureterolithotomy.

Variants in the HEPSIN gene are associated with susceptibility to prostate cancer

Background:HEPSIN (HPN) gene is one of the most consistently overexpressed genes in patients with prostate cancer; furthermore, there is some evidence supporting an association between HPN gene variants and the risk of developing prostate cancer. In this study, sequence variants in the HPN gene were investigated to determine whether they were associated with prostate cancer risk in a Korean study cohort.Methods:We evaluated the association of 17 single-nucleotide polymorphisms (SNPs) in the HPN gene with prostate cancer risk and clinical characteristics (Gleason score and tumor stage) in Korean men (240 case subjects and 223 control subjects) using unconditional logistic regression.Results:The statistical analysis suggested that three SNPs (rs45512696, rs2305745, rs2305747) were significantly associated with the risk of prostate cancer (odds ratio (OR)=2.22, P=0.04; OR=0.73, P=0.03; OR=0.76, P=0.05, respectively).Conclusions:The results of this study suggest that, in Korean men, some polymorphisms in the HPN gene might be associated with the risk of developing prostate cancer.

The effects of interleukin-6 on the contraction and relaxation responses of the cavernous smooth muscle from rats

The purpose of this study is to elucidate the effect of IL-6 on the vasomotor reactivity of the corpus cavernosum of the rats. The strips were either left untreated or treated with 1 ng/ml of IL-6 for 60 min. By increasing concentrations of phenylephrine, acetylcholine, or sodium nitroprusside, we assessed concentration-contraction or relaxation responses. The IL-6-treated strips were incubated for 30 min with or without L-NAME (N(W)-nitro-L-arginine methyl ester), L-arginine, indomethacin, BQ-123 (an endothelin receptor A inhibitor), or SQ 29,548 (a thromboxane A(2) [TXA(2)] receptor blocker), and the effects on phenylephrine-induced contraction or acetylcholine-induced relaxation of phenylephrine-induced contraction were measured. The contractile responses to phenylephrine were significantly enhanced in the IL-6-treated strips, compared with the IL-6-nontreated strips, and the relaxation responses to acetylcholine were significantly inhibited in the IL-6-treated group compared with the IL-6-nontreated group. But after endothelial denudation, there was no difference between the IL-6-treated strips and the IL-6-nontreated strips on the contraction-relaxation responses to phenylephrine or acetylcholine. The relaxation responses to sodium nitroprusside were not inhibited in both groups. L-NAME completely inhibited the relaxation response to acetylcholine in the IL-6-treated strips, as well as the IL-6-nontreated strips. Indomethacin and SQ 29,548 significantly inhibited the increased contractile responses to phenylephrine in the IL-6-treated strips. But BQ 123 rarely affected the same responses. L-arginine reversed the inhibited relaxation responses to acetylcholine in the IL-6-treated strips. Therefore, IL-6 inhibits endothelium-dependent, NO-mediated relaxation and also enhances alpha(1)-adrenergic receptor-mediated contraction via an endothelium-dependent TXA(2)-mediated mechanism in the corpus cavernosum of the rat.

Efficacy of Epididymectomy in Treatment of Chronic Epididymal Pain: A Comparison of Patients With and Without a History of Vasectomy

OBJECTIVES To evaluate the surgical outcome in, and satisfaction with treatment of, patients undergoing epididymectomy for postvasectomy pain syndrome. METHODS A total of 49 patients were included. All participants had undergone epididymectomy for chronic epididymal pain from January 2000 to June 2009. Of the 49 patients, 4 had undergone bilateral epididymectomy, and the total number of procedures was 53: 18 in patients with postvasectomy pain syndrome (group 1, n = 16), 21 in patients with chronic epididymitis and no history of vasectomy (group 2, n = 19), and 14 in patients with an epididymal cyst and no history of vasectomy (group 3, n = 14). The preoperative and postoperative pain scale scores and surgical outcome were analyzed. RESULTS For the total patient sample, the mean age was 52.91 ± 13.51 years, and the mean body mass index was 24.10 ± 3.22 kg/m(2). The mean duration of pain was 1.3 years (range 0.25-20), and the mean duration of postoperative follow-up was 4.2 years (range 0.05-10.25). The mean preoperative pain score was 6.91 ± 0.97. The mean postoperative pain scale score was 1.92 ± 1.54 (P < .01). Statistically significant differences in the preoperative and postoperative pain scores were found for each group: group 1, 5.38 ± 1.47 (range 3-8); group 2, 4.10 ± 1.41 (range 2-6), and group 3, 5.21 ± 1.88 (range 2-8; P = .004). In group 1, excellent surgical outcomes and high patient satisfaction were reported for 94.5% (17 of 18) of the procedures performed. CONCLUSIONS The results of our study have shown that epididymectomy is more effective in patients with a history of vasectomy than in those without.