T.H. Kim

916 PSA velocity per prostate volume: A novel tool for prostate biopsy prediction

age at diagnosis and dichotomously-coded PSA density ( 0.15 ng/ ml/cm3 vs. 0.15 ng/ml/cm3; all p 0.04). However, neither PSA density nor age maintained their independent predictor status when the analyses were restricted only to patients with 18 cores (p 0.2). At cubic spline analyses, we observed a no-plateau-linear association between the number of cores taken and the probability of finding a pIPCa at final pathology. CONCLUSIONS: The rate of pIPCa in patients diagnosed with a single MiFC of PCa is up to 27.9%. The rate of pIPCa is null in patients with 12 biopsy cores taken, while it is roughly 40% in patients with 18 cores at biopsy. When patients were diagnosed with extended biopsy sampling no other predictors of pIPCa were found. Therefore, when conservative treatments are considered, adequate prostate sampling is mandatory.

981 RELATIONSHIP BETWEEN INSULIN RESISTANCE, OBESITY AND SERUM PROSTATE-SPECIFIC ANTIGEN LEVELS IN HEALTHY MEN

The purpose of this study was to determine the relationship between insulin resistance, obesity and serum prostate-specific antigen (PSA) levels in healthy men with serum PSA level below 4 ng mL -1 . The men included in the study cohort were 11 827 healthy male employees of the Korea Hydro and Nuclear Power Co., LTD who had undergone medical checkups including fasting glucose, fasting insulin and serum PSA between January 2003 and December 2008. Insulin resistance was calculated by homeostasis model assessment (HOMA (fasting glucose × fasting insulin)/22.5) and quantitative insulin sensitivity check index (QUICKI; 1/(log (fasting insulin) + log (fasting glucose))). Age-adjusted body mass index (BMI) was significantly increased according to increasing quartile of insulin resistance as determined by HOMA and QUICKI, respectively, in analysis of variance (ANOVA) test and Duncans multiple comparison test (P < 0.001), but age-adjusted serum PSA concentration was significantly decreased according to increasing quartile of insulin resistance as determined by HOMA and QUICKI (P < 0.001). Age, BMI, insulin resistance by HOMA or QUICKI were significantly independent variables to serum PSA level in a multivariate linear regression analysis (P < 0.001). Insulin resistance was a significant independent variable to serum PSA level along with BMI. Insulin resistance and BMI were negatively correlated with serum PSA level in healthy men. Insulin resistance was positively correlated with BMI.

438 THE CLINICAL SIGNIFICANCE OF SERUM AND URINE CYTOKINE IN PATIENTS WITH ACUTE UNCOMPLICATED PYELONEPHRITIS

Purpose: In this prospective study, we evaluated the clinical significance of inflammatory cytokines in women with acute uncomplicated pyelonephritis undergoing antimicrobial therapy. Materials and Methods: We analyzed 26 female patients diagnosed with acute uncomplicated pyelonephritis between September 2007 and March 2008. Body temperature, white blood cell (WBC) counts, serum C-reactive protein (CRP), and serum and urine interleukin (IL)-6 and IL-8 were measured before and 12 hours, 24 hours, and 4 days after the intravenous administration of empirical ciprofloxacin. Results: Initial serum CRP levels were correlated with initial serum IL-6 and initial urine IL-8 levels. Twenty-four hours after the start of antibiotic treatment, the CRP level and urine IL-8 level continued to be high, whereas serum IL-6 levels decreased significantly (26.1±32.4 vs 9.9±23.5pg/dl, p<0.01). When we divided the patients into mild (CRP<15mg/dl, n=14) and severe (CRP≥15mg/dl, n=12) groups according to initial CRP levels, the serum IL-6 level decreased significantly in both the mild (14.2±4.0 vs 4.0±1.7pg/dl, p<0.01) and the severe (41.1±12.7 vs. 22.7±16.4pg/dl, p<0.01) groups within 24 hours, whereas CRP and urine IL-8 levels did not change significantly in either group. Conclusions: Clinically, initial serum IL-6 and urine IL-8 levels were increased according to disease severity. Moreover, the serum IL-6 level decreased rapidly after antibiotic treatment within 24 hours. Serum IL-6 levels are a better indicator of the severity of disease and the therapeutic effect of empirical parenteral antibiotic use in patients with acute uncomplicated pyelonephritis than were either CRP or WBC counts. (Korean J Urol 2009;50:33-38)