Ki Hak Song

Expression of Nitric Oxide Synthase and Aquaporin-3 in Cyclophosphamide Treated Rat Bladder

PURPOSE The expression of Nitric oxide Synthase (NOS) and aquaporin (AQP) water channels in rat bladder is recently reported. The aim of this study is to evaluate the expression of inducible NOS (iNOS), aquaporin-3 (AQP-3) in cyclophosphamide (CYP) induced rat bladder. MATERIALS AND METHODS The 32 Sprague-Dawley rats were divided into cystitis group (n=20) and control group (n=12). In cystitis group, 100mg/kg CYP was injected every second day for 1 week whereas in control group, normal saline was injected. After extracting of the bladder and dividing dome, body and trigone of the bladder, independently H&E staining and immunohistochemical staining for iNOS and AQP-3 were performed. Expressions of iNOS and AQP-3 were analyzed with a confocal laser scanning microscope and an image analyzer. RESULTS The expression of iNOS significantly increased in the mucosa, submucosa layer of dome in cystitis group (p<0.05). The expression of AQP-3 significantly increased in the mucosa, submucosa, vessel layer of dome in cystitis group (p<0.05). CONCLUSIONS These results suggest that inflammatory change activates NOS and AQP-3 expression in the bladder tissue of rats. These may imply that NOS and AQP-3 have a pathophyiological role in the cyclophophamide induced interstitial cystitis. Further study on the NOS and AQP-3 in bladder is needed for clinical application.

Clinical implication of serum C-reactive protein in patients with uncomplicated acute pyelonephritis as marker of prolonged hospitalization and recurrence.

OBJECTIVES To analyze the clinical value of C-reactive protein (CRP) as a marker of prolonged hospitalization and a predictor of recurrence in patients after uncomplicated acute pyelonephritis (APN). METHODS A total of 202 consecutive adult patients with APN were prospectively enrolled from September 2005 to June 2007. APN was defined as the concomitant presence of 4 major and >/=2 minor clinical or laboratory signs or symptoms suggestive of APN. All patients were treated with parenteral antibiotics. The patients were discharged after normalization of body temperature, serum white blood cell counts, and urinalysis. Correlations among the recurrence of APN and various factors, including CRP, were investigated. RESULTS Of the 202 patients, 13 were excluded because of the presence of complicating factors or insufficient data. APN recurrence developed in 4 patients (2.1%). The CRP level at discharge correlated significantly with the recurrence of APN on univariate and multivariate analysis. Irrespective of the normalization of body temperature, serum white blood cell counts, and urinalysis, the recurrence of APN was significantly greater in the patients with CRP >4 mg/dL than in those with <4 mg/dL at discharge. Patients with a maximal CRP of >15 mg/dL during admission had a longer hospitalization and required more intravenous antibiotic therapy than did the patients with a maximal CRP of <15 mg/dL. CONCLUSIONS As a marker of prolonged hospitalization and recurrence, CRP can complement the present clinical and laboratory parameters used as guides in the proper treatment of patients with uncomplicated APN.

Efficacy of Adjuvant Gemcitabine-Cisplatin Chemotherapy: A Comparative Study between Locally Advanced Transitional Cell Carcinoma of the Bladder and Upper Urinary Tract

Objective: To evaluate the comparative efficacy of adjuvant gemcitabine and cisplatin (GC) chemotherapy between patients with locally advanced transitional cell carcinoma (TCC) of the bladder and upper urinary tract. Patients and Methods: From 2001 to 2005, we retrospectively selected a total of 64 patients with locally advanced TCC of the bladder and upper urinary tract who received at least 3 cycles of adjuvant GC chemotherapy. We compared disease-free and overall survival between the 2 groups. Results: The recurrence rate was 30.3% in TCC of the bladder and 25.8% of the upper urinary tract (p = 0.633). Statistical analysis revealed that there was no significant difference in the disease-free or overall survival rate between TCC of the bladder and upper urinary tract treated with adjuvant GC chemotherapy. Conclusion: Under the circumstances of limited data about TCC of the upper urinary tract, this study may suggest that adjuvant GC chemotherapy in locally advanced TCC of the upper urinary tract is as effective as those of bladder.

A multi-institutional study on histopathological characteristics of surgically treated renal tumors: The importance of tumor size

Purpose The incidence of accidentally detected small renal tumors is increasing throughout the world. In this multi-institutional study performed in Korea, histopathological characteristics of contemporarily surgically removed renal tumors were reviewed with emphasis on tumor size. Materials and Methods Between January 1995 and May 2005, 1,702 patients with a mean age of 55 years underwent surgical treatment at 14 training hospitals in Korea for radiologically suspected malignant renal tumors. Clinicopathological factors and patient survival were analyzed. Results Of the 1,702 tumors, 91.7% were malignant and 8.3% were benign. The percentage of benign tumors was significantly greater among those ≤ 4 cm (13.2%) than those > 4 cm (4.5%) (p < 0.001). Among renal cell carcinoma patients, the percentage of tumors ≤ classed as stage ≥ T3 was significantly less among tumors 4 cm (5.2%) than those > 4 cm (26.8%) (p < 0.001). The percentage of tumors classed as Fuhrmans nuclear grades ≥ 3 was also significantly less among tumors ≤ 4 cm (27.3%) than tumors > 4 cm (50.9%) (p < 0.001). The 5-year cancer-specific survival rate was 82.7%, and T stage (p < 0.001), N stage (p < 0.001), M stage (p = 0.025), and Fuhrmans nuclear (p < 0.001) grade were the only independent predictors of cancer-specific survival. Conclusion In renal tumors, small tumor size is prognostic for favorable postsurgical histopathologies such as benign tumors, low T stages, and low Fuhrmans nuclear grades. Our observations are expected to facilitate urologists to adopt function-preserving approach in the planning of surgery for small renal tumors with favorable predicted outcomes.

DO ANDROGEN RECEPTOR POLYMORPHISMS CONTRIBUTE TO AN INCREASED RISK FOR CHRONIC PROSTATITIS/CHRONIC PELVIC PAIN SYNDROME (CP/CPPS) AND PROSTATE CANCER (CaP)?

86 DO ANDROGEN RECEPTOR POLYMORPHISMS CONTRIBUTE TO AN INCREASED RISK FOR CHRONIC PROSTATITIS/CHRONIC PELVIC PAIN SYNDROME (CP/CPPS) AND PROSTATE CANCER (CaP)? Ki Hak Song*, Donald E Riley, Teresa L Gilbert, In Rae Cho, Young Seop Chang, John N Krieger. Seattle, WA, Ilsan, Republic of Korea, and Daejeon, Republic of Korea. INTRODUCTION AND OBJECTIVE: Prostate development requires the presence of testicular androgens. Some recent studies