Tae-Kon Hwang

Nerve Growth Factor and Prostaglandins in the Urine of Female Patients With Overactive Bladder

PURPOSE NGF and PGs in the bladder can be affected by pathological changes in the bladder and these changes can be detected in urine. We investigated changes in urinary NGF and PGs in women with OAB. MATERIALS AND METHODS The study groups included 65 women with OAB and 20 without bladder symptoms who served as controls. Evaluation included patient history, urinalysis, a voiding diary and urodynamic studies. Urine samples were collected. NGF, PGE2, PGF2alpha and PGI2 were measured using enzyme-linked immunosorbent assay and compared between the groups. In addition, correlations between urinary NGF and PG, and urodynamic parameters in patients with OAB were examined. RESULTS Urinary NGF, PGE2 and PGF2alpha were significantly increased in patients with OAB compared with controls (p <0.05). However, urinary PGI2 was not different between controls and patients with OAB. In patients with OAB urinary PGE2 positively correlated with volume at first desire to void and maximum cystometric capacity (p <0.05). Urinary NGF, PGF2alpha and PGI2 did not correlate with urodynamic parameters in patients with OAB. CONCLUSIONS NGF and PGs have important roles in the development of OAB symptoms in female patients. Urinary levels of these factors may be used as markers to evaluate OAB symptoms.

Changes of urinary nerve growth factor and prostaglandins in male patients with overactive bladder symptom

Abstract  Aim:  Nerve growth factor (NGF) and prostaglandins (PG) in the urinary bladder can be affected by pathology of bladder, and this change can be noted in the urine. This study was performed to investigate the changes in urinary NGF and PG in male patient with overactive bladder (OAB) symptoms.

Muscarinic and purinergic receptor expression in the urothelium of rats with detrusor overactivity induced by bladder outlet obstruction.

To investigate the expression of muscarinic and purinergic receptors in rat urothelium, and changes in their distribution and expression following detrusor overactivity induced by bladder outlet obstruction (BOO).

Nerve growth factor and vanilloid receptor expression, and detrusor instability, after relieving bladder outlet obstruction in rats

To investigate mRNA expression for nerve growth factor (NGF) and vanilloid receptor TRPV1 in the bladder after relieving bladder outlet obstruction (BOO), and to correlate changes with functional changes of the bladder.

Complications of Percutaneous Nephrolithotomy Classified by the Modified Clavien Grading System: A Single Center's Experience over 16 Years.

Purpose To stratify complications of percutaneous nephrolithotomy (PCNL) in a single, tertiary hospital by use of the modified Clavien system. Materials and Methods From May 1987 to December 2010, 1,236 cases of PCNL were performed at our institute. Medical records were available for 826 cases of PCNL from 698 patients, from February 1995 to December 2010. Using multiple factors, we retrospectively reviewed and analyzed 698 patients for complication rates classified by the modified Clavien grading system, along with success rates. Results In 698 patients, staghorn stone patients accounted for 33.8% (236 patients). Initial and overall stone-free rates were 69.9% and 88.8%. A total of 297 complications were documented in 282 patients. According to the modified Clavien classification, grade I, II, IIIa, IIIb, IVa, IVb, and V complications were observed in 88 (12.6%), 145 (20.8%), 31 (4.4%), 5 (0.7%), 6 (0.9%), 4 (0.6%), and 3 (0.4%) patients, respectively. Transient peri-nephrostomy catheter urine leakage (15.2%) was the most common complication, followed by transient fever >38° (11%) and transfusion (6.9%). Other individual complications occurred in less than 1.5% of cases. In patients with staghorn stones, grade I, II, IIIb, and IVa complications were significantly more common, and all grade IVb and V complications occurred in patients with staghorn stones. Conclusions The modified Clavien classification provides a standardized grading system for complications of PCNL, although consensus on specific complications would prompt better comparison between centers. A shorter operation time is imperative to achieve less bleeding. Previous stone-related fever and staghorn stones are significant contributing factors for developing postoperative fever.

Therapeutic Effect of Adipose-Derived Stem Cells and BDNF-immobilized PLGA Membrane in a Rat Model of Cavernous Nerve Injury

INTRODUCTION Cavernous nerve injury is the main reason for post-prostatectomy erectile dysfunction (ED). Stem cell and neuroprotection therapy are promising therapeutic strategy for ED. AIM To evaluate the therapeutic efficacy of adipose-derived stem cells (ADSCs) and brain-derived neurotrophic factor (BDNF) immobilized Poly-Lactic-Co-Glycolic (PLGA) membrane on the cavernous nerve in a rat model of post-prostatectomy ED. Methods.  Rats were randomly divided into five groups: normal group, bilateral cavernous nerve crush injury (BCNI) group, ADSC (BCNI group with ADSCs on cavernous nerve) group, BDNF-membrane (BCNI group with BDNF/PLGA membrane on cavernous nerve) group, and ADSC/BDNF-membrane (BCNI group with ADSCs covered with BDNF/PLGA membrane on cavernous nerve) group. BDNF was controlled-released for a period of 4 weeks in a BDNF/PLGA porous membrane system. MAIN OUTCOME MEASURES Four weeks after the operation, erectile function was assessed by detecting the ratio of intra-cavernous pressure (ICP)/mean arterial pressure (MAP). Smooth muscle and collagen content were determined by Massons trichrome staining. Neuronal nitric oxide synthase (nNOS) expression in the dorsal penile nerve was detected by immunostaining. Phospho-endothelial nitric oxide synthase (eNOS) protein expression and cyclic guanosine monophosphate (cGMP) level of the corpus cavernosum were quantified by Western blotting and cGMP assay, respectively. RESULTS In the ADSC/BDNF-membrane group, erectile function was significantly elevated, compared with the BCNI and other treated groups. ADSC/BDNF-membrane treatment significantly increased smooth muscle/collagen ratio, nNOS content, phospho-eNOS protein expression, and cGMP level, compared with the BCNI and other treated groups. CONCLUSIONS ADSCs with BDNF-membrane on the cavernous nerve can improve erectile function in a rat model of post-prostatectomy ED, which may be used as a novel therapy for post-prostatectomy ED.

Prognostic Value of Capsular Invasion for Localized Clear-Cell Renal Cell Carcinoma

BACKGROUND The impact of capsular invasion on the survival of patients undergoing surgery for renal cell carcinoma (RCC) has attracted little attention in the literature and remains controversial. OBJECTIVES To evaluate the value of capsular invasion, without perirenal fat invasion, on the prognosis of patients with localized clear-cell RCC. DESIGN, SETTING, AND PARTICIPANTS Between 1984 and 2007, we retrospectively reviewed the records of 317 consecutive patients with localized clear-cell RCC (pT1-T2N0M0) who underwent radical nephrectomy or nephron-sparing surgery at our institution. Overall, 299 patients were eligible for the study. We analyzed clinical (presentation and body mass index [BMI]) and pathologic (tumor size, Fuhrman nuclear grade, collecting system invasion, microvascular invasion, and capsular involvement) parameters. MEASUREMENTS Recurrence-free survival (RFS) and cancer-specific survival (CSS) were investigated using the Kaplan-Meier method, and the Cox regression model was used to determine the significant prognostic factors based on multivariate analysis. RESULTS AND LIMITATIONS Renal capsular invasion was observed in 106 of 299 patients (35.5%). Capsular invasion had a statistically significant association with age, symptomatic presentation, tumor diameter, pathologic stage, collecting system invasion, and microvascular invasion. The mean follow-up was 60.5 mo (range: 1-249). The 5-yr RFS and CSS rates for tumors with capsular invasion were significantly lower compared with rates for tumors without invasion (77.7% vs 92.3% and 85.5% vs 95.7%, respectively; p=0.0004). Multivariate analysis showed that BMI (hazard ratio [HR]=0.19), stage (HR=2.45), and capsular invasion (HR=3.36) were independent prognostic factors of disease recurrence. With respect to CSS, BMI (HR=0.20), tumor size (HR=1.13), and capsular invasion (HR=4.03) were the factors related to death. Nevertheless, we recognize that these findings may be limited by the studys retrospective, single-institution design. CONCLUSIONS Our findings suggest that capsular invasion is associated with poor survival in patients with localized clear-cell RCC.

Hedgehog signaling protein expression and its association with prognostic parameters in prostate cancer: a retrospective study from the view point of new 2010 anatomic stage/prognostic groups.

The expression of Hedgehog (Hh) signaling pathway in prostate cancer is well‐known but its clinicopathologic role has not been elucidated well.

Laparoscopic versus open radical cystectomy for the management of bladder cancer: mid-term oncological outcome.

Objective:  To compare the mid‐term oncological outcome of laparoscopic radical cystectomy (LRC) with those of open radical cystectomy (ORC).

The merlin tumor suppressor interacts with Ral guanine nucleotide dissociation stimulator and inhibits its activity

Neurofibromatosis type 2 (NF2) is the most commonly mutated gene in benign tumors of the human nervous system such as schwannomas and meningiomas. The NF2 gene encodes a protein called schwannomin or merlin, which is involved in regulating cell growth and proliferation through protein–protein interactions with various cellular proteins. In order to better understand the mechanism by which merlin exerts its function, yeast two-hybrid screening was performed and Ral guanine nucleotide dissociation stimulator (RalGDS), a downstream molecule of Ras, was identified as a merlin-binding protein. The direct interaction between merlin and RalGDS was confirmed both in vitro and in the NIH3T3 cells. The domain analyses revealed that the broad C-terminal region of merlin (aa 141–595) is necessary for the interaction with the C-terminal Ras-binding domain (RBD) of RalGDS. Functional studies showed that merlin inhibits the RalGDS-induced RalA activation, the colony formation and the cell migration in mammalian cells. These results suggest that merlin can function as a tumor suppressor by inhibiting the RalGDS-mediated oncogenic signals.