Kwan ng Joo

Chewing gum has a stimulatory effect on bowel motility in patients after open or robotic radical cystectomy for bladder cancer: a prospective randomized comparative study.

OBJECTIVES To determine whether chewing gum during the postoperative period facilitates the recovery of bowel function and has different efficacy according to operative method used in patients with radical cystectomy. METHODS From July 2007 to September 2009, we randomized open radical cystectomy (ORC) patients into Group AI (ORC without gum chewing) and Group AII (ORC with gum chewing). Robot-assisted radical cystectomy (RARC) patients were randomized into Group BI (RARC without gum chewing) and Group BII (RARC with gum chewing). RESULTS A total of 32 ORC (17 Group AI and 15 Group AII) and 28 RARC (13 Group BI and 15 Group BII) patients were completed. The patients perioperative data between the control (AI + BI) and chewing gum (AII + BII) group showed no differences. The median time to flatus and to bowel movement were significantly reduced in chewing gum group compared with the control patients: 57.1 vs. 69.5 hours 76.7 vs. 93.3 hours. In the ORC patients, decrease in time to flatus and bowel movement were observed in gum chewing (AII) group than control (AI) group: 64.3 vs. 80.3 hours 83.8 vs. 104.2 hours. In RARC patients, decrease in time to flatus and bowel movement were found in gum chewing (BII) group than control (BI) group: 48.8 vs. 60.3 hours 69.1 vs. 84.6 hours. No adverse effects were observed with chewing gum. CONCLUSIONS Chewing gum had stimulatory effects on bowel motility after cystectomy and urinary diversion. Chewing gum was safe and could be used for postoperative ileus regardless of the operative method (ORC or RARC).

The Effects of Smoking and Alcohol Intake on Sperm Quality: Light and Transmission Electron Microscopy Findings

Objective: To evaluate the effects of alcohol consumption and cigarette smoking on sperm quality using transmission electron microscopy and light microscopy. Methods: Semen samples were collected from 62 healthy men. The subjects were classified according to alcohol consumption and smoking status. Semen analysis was performed according to World Health Organization criteria. Transmission electron microscopy was used to examine sperm ultrastructure. Results: Heavy smoking (> 20 cigarettes/day) was associated with a decreased sperm count. Moderate/high alcohol consumption (≥15.4 g/day) was associated with an increase in morphologically abnormal sperm. Transmission electron microscopy revealed no effect of smoking on sperm ultrastructure. Alcohol consumption resulted in significant increases in morphologically abnormal nuclei and plasma membranes. Conclusions: Heavy smoking was associated with decreased sperm counts and alcohol consumption was associated with increased numbers of morphologically abnormal sperm.

Heart Rate Variability in Assessment of Autonomic Dysfunction in Patients With Chronic Prostatitis/Chronic Pelvic Pain Syndrome

OBJECTIVE To determine and compare autonomic dysfunction in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). METHODS The subjects were 30-60 years old and had no known systemic disease. Electrocardiographic signals in the patients in the resting state were obtained from 59 patients with CP/CPPS (age 46.5 ± 7.02 years) and 94 healthy subjects (age 48.4 ± 5.96 years), and heart rate variability parameters were compared. RESULTS The standard deviation of the N-N interval (P < .001), square root of the mean squared differences of the successive N-N intervals (P = .004), total power (P = .004), very low frequency (P = .012), and high frequency (P < .001) were lower in the patients with CP/CPPS. However, no significant differences were found in the low frequency and low frequency/high frequency ratios. CONCLUSION Patients with CP/CPPS exhibited lower heart rate variability parameters compared with normal controls, with the exception of low frequency and low frequency/high frequency ratios. Possible differences in autonomic nervous system between those with CP/CPPS and normal healthy subjects could exist and autonomic dysfunction might be 1 of the causes that aggravates CP/CPPS.

Imaging of renal and prostate carcinoma with refractive index radiology

Aim:  Having better edge enhancement and penetrating power, refractive index radiology is suitable for the imaging of weakly absorbing objects such as tissue specimens. In this study the potential of refractive index radiology was evaluated for the imaging of renal cell carcinoma (RCC) and prostate cancer (PCA).

Effect of laminin 332 on motility and invasion in bladder cancer.

We examined the correlation between laminin 332 and malignancy in bladder cancer patients, and, using a strain of invasive bladder cancer cells, determined whether laminin 332 causes bladder cancer motility and invasion. To investigate the correlation between laminin 332 g2 distribution and patient outcome, we performed a semiquantitative immunohistochemical analysis of 35 paraffin‐embedded samples using the antibody D4B5, which is specific for the laminin 5 γ2 chain. To evaluate the role of laminin 332 in NBT‐II cell motility and invasion, we used a scratch assay and the Boyden chamber chemoinvasion system. Tumor stage and grade were significantly correlated with a loss of laminin 332 γ2 chain from the basement membrane (p = 0.001) and its retention in the cytoplasm (p = 0.001) (Kruskal–Wallis test). Kaplan–Meier survival curves revealed an association between the risk of progression and cytoplasmic retention of the laminin 332 γ2 chain. In addition, an in vitro scratch assay showed an increase in the migration of cells treated with laminin 332 from their cluster. The Boyden chamber assay showed that laminin 332 potentiated NBT‐II cell invasion. Immunohistochemistry results showed that bladder cancer patients with a higher malignancy expressed more laminin 332. The in vitro scratch and invasion assay showed that laminin 332 stimulated the motility and invasion of bladder cancer cells. The invasion assay explains the correlation between laminin 332 expression and bladder cancer malignancy.

BCL6 Gene Mutations in Transitional Cell Carcinomas

The B-cell lymphoma-6 (BCL6) gene was initially identified at a translocation site observed frequently in diffuse large B-cell lymphomas. In the present study, BCL6 mutations at the 5′ non-coding region in 47 cases of transitional call carcinoma (TCC) were analysed using polymerase chain reaction–single-strand conformation polymorphism. The results were compared with data obtained previously by immunohistochemical staining for the BCL6 protein. Overall, BCL6 mutations were observed in 44.7% of cases. Mutation of the 5′ non-coding region was not correlated with histological grade of the tumour; however, the better the histological grade, the greater the mutation rate of the E1.12 fragment. The BCL6 mutation occurred independently of over-expression of the protein. The BCL6 gene mutation and the protein expression were detectable in a large proportion of TCCs. BCL6 protein over-expression as well as BCL6 gene mutation of the E1.12 fragment may play an important role in the morphological differentiation of TCC.

Efficacy of Dose Escalation of Tamsulosin for the Treatment of Lower Urinary Tract Symptoms

Objectives: The aim of this study was to compare the efficacy of low (0.2 mg) and intermediate (0.4 mg) dose tamsulosin in treating lower urinary tract symptoms (LUTS).