Sung Hak Kang

Synergistic effect between catechin and ciprofloxacin on chronic bacterial prostatitis rat model

Abstract  Background:  Chronic bacterial prostatitis (CBP) is the most common urological disease in adult men. Antibiotic therapy is the gold standard of treatment. However, long‐term therapy resulted in many side‐effects and bacterial resistance. Because of these reasons, we need new treatment modality that could replace traditional antibiotic therapy. Catechin, an extract of green tea, has antimicrobial effect against various bacteria and synergy effect to antibiotics. We evaluate the synergistic effects of catechin on the treatment of CBP in an animal model.

Diagnosing Acute Pyelonephritis with CT, 99mTc-DMSA SPECT, and Doppler Ultrasound: A Comparative Study

Purpose With growing interest in early imaging, the aim of our study was to define the most practical modality for routine clinical use for the diagnosis of acute pyelonephritis (APN). We compared the sensitivity of enhanced computerized tomography (CT), dimercaptosuccinic acid (DMSA) scintigraphy, and Doppler ultrasonography (DUS) by using clinical findings as the standard of reference. Materials and Methods A total of 207 APN patients (191 women, 16 men; mean age, 49.4 years; range, 17-88 years) were enrolled in this study. All the patients underwent imaging modalities during hospitalization. SPECT images were obtained 4 hours after injection of 99mTc-DMSA. Transverse and coronary CT images were obtained before and after injection of the contrast agent. DUS was performed in the longitudinal, transverse, and coronal planes. All the images were read independently by a single radiologist and a nuclear medicine specialist. The sensitivity of each modality for detecting APN was compared. Results CT showed significantly superior sensitivity compared with that of DUS (81.0% vs. 33.3%, respectively, n=147). DMSA scintigraphy also showed significantly superior sensitivity compared with that of DUS (74.7% vs. 33.3%, respectively, n=150). Compared with DMSA scintigraphy, CT showed superior sensitivity, but the difference was not statistically significant (81.0% vs. 74.8%, respectively, n=147, p=0.163). Conclusions For cases of clinically suspected APN, CT and DMSA scintigraphy appear to be equally sensitive and reliable for detecting APN, although CT is more practical in various fields. DUS was significantly less sensitive.

Protective effects of cranberries on infection-induced oxidative renal damage in a rabbit model of vesico-ureteric reflux

To evaluate the protective effects of cranberry fruit, which have known antioxidant effects, on infection‐induced oxidative renal damage in a rabbit model of vesico‐ureteric reflux (VUR).

Arterial Injury Associated with Tension-Free Vaginal Tapes-SECUR Procedure Successfully Treated by Radiological Embolization

Various postoperative complications have been reported after the use of tension-free vaginal tapes (TVT). The transobturator approach was introduced to minimize the potential complications. The next generation of recently introduced TVT-SECUR is intended to minimize the incidence of complications. Herein we report a case of internal pudendal artery injury sustained during this procedure that was successfully treated by radiological embolization. Angiography with vessel embolization, when available, should be considered when the arterial injury is suspected.

Efficacy and Safety of On-Demand Clomipramine for the Treatment of Premature Ejaculation: A Multicenter, Randomized, Double-Blind, Phase III Clinical Trial.

Purpose: The aim of the current trial was to assess the efficacy of on demand clomipramine 15 mg administered before sexual intercourse for the treatment of premature ejaculation. Materials and Methods: A total of 159 patients at 5 centers in Korea were randomly assigned to 2 groups. The first group of 53 men received placebo and the second group of 106 received clomipramine 15 mg for 12 weeks. All patients were evaluated at the beginning of the study and every 4 weeks thereafter. Patients were instructed to ingest a tablet approximately 2 to 6 hours before sexual intercourse. Efficacy was assessed by scores on the IELT (Intravaginal Ejaculation Latency Time) and the PEDT (Premature Ejaculation Diagnostic Tool). Results: Analyses of the IELT fold change in each group in the intent to treat population revealed that the IELT of the clomipramine 15 mg group was significantly increased 12 weeks after administration compared with the placebo group (mean ± SD 4.40 ± 5.29 vs 2.68 ± 2.03, p <0.05). The IELT fold change in the per protocol population also significantly differed between the clomipramine 15 mg group and the placebo group (mean 4.66 ± 5.64 vs 2.80 ± 2.19, p <0.05). There was a significant difference in the PEDT scores between the 2 groups (p <0.001). The most commonly reported adverse events were nausea in 15.7% of men and dizziness in 4.9%. Adverse events were mild to moderate in severity. Conclusions: The results of this multicenter, randomized, double-blind, placebo controlled, fixed dose clinical phase III study suggest that administering clomipramine 15 mg on demand to treat premature ejaculation is effective and safe.

MP59-13 A USEFUL METHOD FOR ASSESSING DIFFERENCES OF COMPENSATORY HYPERTROPHY IN THE CONTRALATERAL KIDNEY BEFORE AND AFTER RADICAL NEPHRECTOMY IN PATIENTS WITH RENAL CELL CARCINOMA: ELLIPSOID FORMULA ON COMPUTED TOMOGRAPHY

before and after partial nephrectomy, and compare the findings with 99mTc-DMSA renal scan. METHODS: The data of 51 patients with a unilateral renal tumor managed by partial nephrectomy were retrospectively analyzed. The RCV of tumor-bearing and contralateral kidneys was measured using ImageJ software. Split estimated glomerular filtration rate (eGFR) and SRV calculated using this RCV were compared with the split renal function (SRF) measured with 99mTc-DMSA renal scan. RESULTS: A strong correlation between SRF and SRV of the tumor-bearing kidney was observed before and after surgery (r 1⁄4 0.89, p < 0.001 and r 1⁄4 0.94, p < 0.001). The preoperative and postoperative split eGRF of the operated kidney showed moderate correlation with SRF (r 1⁄4 0.39, p 1⁄4 0.004 and r 1⁄4 0.49, p < 0.001). Correlation between reductions in SRF and SRV of the operated kidney (r 1⁄4 0.87, p < 0.001) was stronger than that between SRF and percent reduction in split eGFR (r 1⁄4 0.64, p < 0.001). CONCLUSIONS: Compared with split eGFR, the SRV calculated using CT-based renal volumetry has a strong correlation with the SRF measured using 99mTc-DMSA renal scan. CT-based SRV measurement before and after partial nephrectomy can be used as a single modality for anatomical and functional assessment of the tumor-bearing kidney.

MP77-10 THE EFFECT OF ULTRASOUND-GUIDED COMPRESSION PERFORMED IMMEDIATELY AFTER TRANSRECTAL ULTRASOUND-GUIDED PROSTATE BIOPSY ON POSTBIOPSY BLEEDING

INTRODUCTION AND OBJECTIVES: The diagnostic work-up of prostate cancer has experienced a rapid shift worldwide in recent years. This study aims to provide a current appraisal of the practice of prostate biopsy in Australia and New Zealand in the emerging era of transperineal template biopsy (TPB) and multiparametric MRI (mpMRI). METHODS: A 36-question online survey was distributed to 545 members of the Urological Society of Australia & New Zealand (USANZ), including consultant urologists and trainees. This was an updated survey, based on a similar questionnaire distributed to USANZ members in 2012, addressing patterns of prostate biopsy practice in 4 domains: transrectal ultrasound-guided (TRUS) biopsy; TPB; mpMRI and peri-operative antibiotic and analgesia use. Survey results were collated and statistical analysis was performed using descriptive statistics and chi-squared test. RESULTS: 155 participants completed the survey, with a response rate of 21.1%. 81.9% of respondents were consultant urologists and 66.5% worked in a metropolitan setting. 92.3% perform TRUS biopsy and 91.3% sample between 10-16 cores. 66.9% of respondents perform TPB, increased from 38.4% in 2012 (p<0.001). 59.4% perform mpMRI prior to initial biopsy, increased from 19.6% (p<0.001). 90.1% perform MRI prior to repeat biopsy after an initial negative biopsy. 97.2% use prophylactic oral antibiotics prior to TRUS biopsy, most commonly quinolones. 55.7% use parenteral antibiotics, compared to 69.4% previously (p1⁄40.013). 27.7% routinely use carbapenem prophylaxis in settings of recent overseas travel or quinolone exposure, compared to 27.9% in 2012 (p1⁄40.965). General anaesthetic/IV sedation is used for 60.6% of TRUS biopsies and 97.9% of TPB. CONCLUSIONS: Our survey demonstrates a shift in practice of biopsy for the diagnosis of prostate cancer among urologists in Australia & New Zealand, when compared with results of our initial study in 2012. More urologists are performing TPB now, and there has been a corresponding increase in the use of pre-initial biopsy mpMRI despite no current guidelines recommending this practice yet. There has been a reduction in the use of parenteral antibiotics overall, prior to TRUS biopsy, however, rates of carbapenem use have remained stable, suggesting ongoing concerns regarding the risk of sepsis due to antibiotic resistance.

Laparoscopic Hand-Assisted Adrenal-Sparing Surgery for a Giant Adrenal Myelolipoma: A Case Report

INTRODUCTION Adrenal myelolipoma is a rare, benign tumor. Surgical resection is advocated in case of symptomatic, large size (> 4cm), increase of size on follow-up and atypical appearance on imaging. Laparoscopic adrenalectomy is currently the gold standard operation for managing benign adrenal mass. However, to date, laparoscopic entire resection of ipsilateral adrenal gland with the tumor have been mainly reported in the literature. Under clinical circumstances, adrenal sparing surgery underused as first-line therapy for adrenal tumors. CASE PRESENTATION We present a case of adrenal myelolipoma involving the right adrenal gland of a 45-year-old woman who presented with right-sided flank pain. On radiologic and endocrine evaluation, she was diagnosed with a giant adrenal myelolipoma (> 8cm). Right hand-assisted laparoscopic partial adrenalectomy was performed, and postoperative recovery was uneventful. Finally, histological examination confirmed adrenal myelolipoma. On follow-up computed tomography, there was no residual tumor and the remaining right adrenal gland. CONCLUSION Our report suggests that hand-assisted laparoscopic partial adrenalectomy could be considered for appropriate removal of adrenal myelolipoma, even in giant adrenal myelolipoma.