Seo Yeon Lee

Prostate Cancer in Patients with Metabolic Syndrome Is Associated with Low Grade Gleason Score When Diagnosed on Biopsy

Purpose Studies on the relationship of metabolic syndrome (MS) and prostate cancer are controversial. We evaluated the association between MS and prostate cancer characteristics in patients who underwent transrectal ultrasound-guided prostate biopsy. Materials and Methods From October 2003 to May 2011, patients with a prostate-specific antigen (PSA) value≥4 ng/ml or abnormal digital rectal examination (DRE) result underwent transrectal ultrasound-guided prostate biopsy. MS was diagnosed according to the Adult Treatment Panel III. Clinicopathologic factors including PSA, DRE, prostate volume, age, waist circumference, body mass index (BMI), lipid profiles, fasting blood sugar level, and MS were considered for analysis. Results Three hundred fifty-four patients were enrolled (mean age, 68.86±8.95 years; mean PSA, 13.97±20.42 ng/ml). Seventy-five patients (21.2%) had MS and 90 patients (25.4%) were diagnosed as having prostate cancer, including 27 (30%) with MS and 63 (70%) without MS. Total PSA value and prostate volume were significant predictors for prostate cancer. However, MS and BMI were not significantly related to increased cancer risk. Prostate cancer patients with MS had significantly lower Gleason scores (average, 6.63±1.92) than did prostate cancer patients without MS (average, 7.54±1.71; p=0.029). Conclusions Presence of MS was associated with a significantly decreased risk of high-grade prostate cancer. A larger, prospective, multicenter investigation is mandatory to clarify the relationship between MS and prostate cancer.

A Novel Pathway Underlying the Inhibitory Effects of Melatonin on Isolated Rat Urinary Bladder Contraction

The aim of the present study was to elucidate the direct effects of melatonin on bladder activity and to determine the mechanisms responsible for the detrusor activity of melatonin in the isolated rat bladder. We evaluated the effects of melatonin on the contractions induced by phenylephrine (PE), acetylcholine (ACh), bethanechol (BCh), KCl, and electrical field stimulation (EFS) in 20 detrusor smooth muscle samples from Sprague-Dawley rats. To determine the mechanisms underlying the inhibitory responses to melatonin, melatonin-pretreated muscle strips were exposed to a calcium channel antagonist (verapamil), three potassium channel blockers [tetraethyl ammonium (TEA), 4-aminopyridine (4-AP), and glibenclamide], a direct voltage-dependent calcium channel opener (Bay K 8644), and a specific calcium/calmodulin-dependent kinase II (CaMKII) inhibitor (KN-93). Melatonin pretreatment (10-8~10-6 M) decreased the contractile responses induced by PE (10-9~10-4 M) and Ach (10-9~10-4 M) in a dose-dependent manner. Melatonin (10-7 M) also blocked contraction induced by high KCl ([KCl]ECF; 35 mM, 70 mM, 105 mM, and 140 mM) and EFS. Melatonin (10-7 M) potentiated the relaxation response of the strips by verapamil, but other potassium channel blockers did not change melatonin activity. Melatonin pretreatment significantly decreased contractile responses induced by Bay K 8644 (10-11~10-7 M). KN-93 enhanced melatonin-induced relaxation. The present results suggest that melatonin can inhibit bladder smooth muscle contraction through a voltage-dependent, calcium-antagonistic mechanism and through the inhibition of the calmodulin/CaMKII system.

Laparoendoscopic single-site simple nephrectomy using a magnetic anchoring system in a porcine model.

Purpose Magnetic anchoring devices may reduce the number of port sites needed in laparoscopic surgery. In this study, we prospectively assessed the feasibility of using a magnetic anchoring and guidance system (MAGS) in laparoendoscopic single-site (LESS) surgery performed by novices. Materials and Methods A total of 10 LESS simple nephrectomies were performed with or without MAGS in a nonsurvival porcine model by 6 operators with no previous LESS surgery experience. After installation of the homemade single port, an intra-abdominal magnet was fixed to the renal parenchyma with suturing and stabilized by an external magnet placed on the flank so that the position of the kidney could be easily changed by moving the external handheld magnet. The length of the procedure and any intraoperative complications were evaluated. Results Operative time (mean±standard deviation) was shorter in the group using the magnetic anchoring device (M-LESS-N) than in the group with conventional LESS nephrectomy (C-LESS-N) (63±20.8 minutes vs. 82±40.7 minutes, respectively). Although all nephrectomies were completed uneventfully in the M-LESS-N group, renal vein injury occurred during dissection of the renal hilum in two cases of C-LESS-N and was resolved by simultaneous transection of the renal artery and vein with an Endo-GIA stapler. Conclusions LESS-N using MAGS is a feasible technique for surgeons with no LESS surgery experience. Taking into account the 2 cases of renal vein injury in the C-LESS-N group, the application of MAGS may be beneficial for overcoming the learning curve of LESS surgery.

Efficacy and Safety of Hexaminolevulinate Fluorescence Cystoscopy in the Diagnosis of Bladder Cancer

Purpose The aim of this study was to evaluate the efficacy and safety of hexaminolevulinate fluorescence cystoscopy in the diagnosis of bladder cancer. Materials and Methods In a prospective design, we included patients who had a bladder lesion suggesting bladder cancer. Patients with massive hematuria, urethral Foley catheter insertion, chronic retention state, or urinary tract infection were excluded. After the bladder was emptied, hexaminolevulinate was gently administered into the bladder. One hour later, cystoscopy under white light and blue light was performed. After marking the lesions confirmed with white light or blue light, transurethral resection of the bladder lesion and pathologic confirmation were done. Transurethral resection of the lesions that were negative in both white and blue light was also performed. Results From April 2010 to September 2010, 30 patients were enrolled. From the total of 30 patients (25 men and 5 women; mean age, 60.4±9.22 years), 134 specimens were extracted. Among these, 101 specimens showed positive results by blue light cystoscopy (BLC). The sensitivity of BLC and white light cystoscopy (WLC) was 92.3% and 80.8%, respectively (p=0.021). The specificity of BLC and WLC was 48% and 49.1%, respectively (p>0.05). The positive and negative predictive values of BLC were 71.2% and 81.8%, respectively, whereas those of WLC were 72.0% and 68.6%, respectively. With WLC, 48 specimens showed negative findings, but of that group, 15 specimens (31.2%) were revealed to be malignant with BLC. There were no significant side effects in the 24 hours after the instillation of hexaminolevulinate. Conclusions Photodynamic diagnosis with hexaminolevulinate helps to find tumors that could be missed by use of WLC only. Photodynamic diagnosis might be valuable in complete resection as well as for more accurate diagnosis of bladder tumor.

A Comparative Study of Experimental Rat Models of Renal Calcium Oxalate Stone Formation

PURPOSE The aim of this study was to design a simple and convenient rat model with significant calcium oxalate crystal deposition in the kidney. MATERIALS AND METHODS Sprague-Dawley rats were divided into seven groups of 30 rats each. One group of rats was untreated to serve as controls. Two of the groups of rats were provided with drinking water supplemented with 1% ethylene glycol (EG), and of these two groups, one group was also administered vitamin D. Two groups of rats received intraperitoneal injections of EG, and of these two groups, one group also received vitamin D. Two groups of rats received intraperitoneal injections of glyoxylate, and of these two groups, one group also received vitamin D. We analyzed 24-hour urine samples for urinary constituents for all experimental groups, including calcium, oxalate, citrate, uric acid, pH, and urine volume. The kidneys were examined for crystal deposition using histologic examination and for osteopontin expression using immunohistochemical staining. RESULTS Calcium-oxalate crystals were found in all rats injected with glyoxylate after 1 week. The degree of crystal deposition in rats injected with glyoxylate for 1 week was significantly increased compared with rats fed EG for 4 weeks. CONCLUSIONS Intraperitoneal injection of glyoxylate is a faster, more exact, and more reliable method to produce calcium oxalate crystal deposition in the kidney than previous urolithiasis animal models.

Effects of Doxazosin on Alpha 1‐Adrenergic Receptors in Prostates with Benign Prostatic Hyperplasia

Objectives: The present study aimed to evaluate changes in mRNA and protein expression levels of α1‐AR before and after doxazosin treatment.

Daily Mean Temperature and Urolithiasis Presentation in Six Cities in Korea: Time-Series Analysis

Seasonal variation in urinary stone presentation is well described in the literature. However, previous studies have some limitations. To explore overall cumulative exposure-response and the heterogeneity in the relationships between daily meteorological factors and urolithiasis incidence in 6 major Korean cities, we analyzed data on 687,833 urolithiasis patients from 2009 to 2013 for 6 large cities in Korea: Seoul, Incheon, Daejeon, Gwangju, Daegu, and Busan. Using a time-series design and distributing lag nonlinear methods, we estimated the relative risk (RR) of mean daily urolithiasis incidence (MDUI) associated with mean daily meteorological factors, including the cumulative RR for a 20-day period. The estimated location-specific associations were then pooled using multivariate meta-regression models. A positive association was confirmed between MDUI and mean daily temperature (MDT), and a negative association was shown between MDUI and mean daily relative humidity (MDRH) in all cities. The lag effect was within 5 days. The multivariate Cochran Q test for heterogeneity at MDT was 12.35 (P = 0.136), and the related I2 statistic accounted for 35.2% of the variability. Additionally, the Cochran Q test for heterogeneity and I2 statistic at MDHR were 26.73 (P value = 0.148) and 24.7% of variability in the total group. Association was confirmed between daily temperature, relative humidity and urolithiasis incidence, and the differences in urolithiasis incidence might have been partially attributable to the different frequencies and the ranges in temperature and humidity between cities in Korea.

Tension-Free Vaginal Tape-SECUR Procedure for the Treatment of Female Stress Urinary Incontinence: 3-Year Follow-Up Results.

To assess the efficacy and complications associated with the use of the tension‐free vaginal tape (TVT)‐Secur system device for the treatment of female stress urinary incontinence (SUI) based on a 3‐year follow‐up.

THE EFFECT OF HYDROGEN PEROXIDE ON THE CONTRACTION RESPONSE OF THE SMOOTH MUSCLE IN THE BLADDER OF RATS

Hypothesis / aims of study Ischemia followed by reperfusion may evoke progression of bladder dysfunction associated with bladder outlet obstruction and overactivity of bladder. Cyclic episodes of ischemia-reperfusion can lead to both direct ischemic damage and the generation of free radicals including reactive oxygen species (ROS). Hydrogen peroxide (HP) is the one of most important free radical among ROS, nevertheless, it’s effects on bladder smooth muscle are still unknown. Therefore we examined the direct effects of HP on bladder and pathophysiology.