Yong Hyun Park

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

PURPOSEnNGF 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.nnnMATERIALS AND METHODSnThe 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.nnnRESULTSnUrinary 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.nnnCONCLUSIONSnNGF 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

Abstractu2003 Aim:u2002 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.

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.

Psychological Problems in Young Men with Chronic Prostatitis-like Symptoms

Objective: To take a different perspective in assessing young men with chronic prostatitis-like symptoms, this study was designed since few prospective studies are available to survey a population of young men. Material and Methods: One hundred and fifty men aged 20 years dwelling in the community were randomly selected. Chronic prostatitis-like symptoms were measured by the National Institutes of Health-Chronic Prostatitis Symptom Index and the selfreported scores for pain and urinary symptoms were used to identify chronic prostatitis-like symptoms. The psychological methods used were the Beck Depression Inventory, the State-Trait Anxiety Inventory, and the Bem Sex Role Inventory. A total of 87 men (a response rate 58%) completed self-administered questionnaires. Results: As the scores for pain and urinary symptoms increased, those for depression increased ( p < 0.001 and p = 0.01, respectively). However, the mean scores for state and trait anxiety were not different according to the scores for pain and urinary symptoms. The mean masculinity scores were not different according to the scores for pain but those were significantly different according to the scores of urinary symptoms ( p = 0.042). The mean femininity scores were not different according to the scores of pain and urinary symptoms. Conclusions: Our findings suggest that psychological factors, especially depression and weak masculine identity may be associated with an early stage of chronic prostatitis-like symptoms. Young men with chronic prostatitis-like symptoms also have psychological problems.

Changes in detrusor and urinary growth factors according to detrusor function after partial bladder outlet obstruction in the rat

Objectives. To investigate the changes in detrusor and urinary growth factors according to detrusor function after partial bladder outlet obstruction in the rat. Growth factors have been reported to play a role in the remodeling of the bladder after obstruction. n nMethods. Female rats (n = 40) were used and divided into three groups: sham-operated control, 2-week mild obstruction, and 2-week severe obstruction. The voided urine was collected and the detrusor contractility to electrical stimulation recorded. mRNA expression and the urinary concentration of transforming growth factor beta-1 (TGF-β1) and basic fibroblast growth factor (bFGF) were analyzed. n nResults. The contractile response to electrical stimulation was increased in the mild obstruction group (P <0.05) but decreased in the severe obstruction group (P <0.05). The detrusor mRNA expression of TGF-β1 in the mild obstruction group was not different from that in the control group. However, in the severe obstruction group, the mRNA expression of TGF-β1 increased. The detrusor mRNA expression of bFGF was gradually increased in the mild and severe obstruction groups. The urinary concentration of TGF-β1 in the mild obstruction group was not significantly different from that in the control group. However, in the severe obstruction group, the concentration of TGF-β1 was significantly increased (P <0.05). The concentration of urinary bFGF was too small to compare the results in each group. n nConclusions. Growth factors such as TGF-β1 and bFGF change in mRNA expression according to bladder function, and urinary TGF-β1 reflects the change of detrusor mRNA. Thus, changes in TGF-β1 may be a marker to evaluate detrusor function.

Collagen studies for pediatric ureteropelvic junction obstruction

OBJECTIVESnUreteropelvic junction (UPJ) obstruction is the most common form of urinary tract obstruction in pediatrics. There is controversy regarding the need for early surgical intervention in many patients with apparent neonatal UPJ obstruction. To demonstrate the differences in type and amount of collagen in adult and pediatric UPJ obstruction, collagen studies were performed.nnnMETHODSnThe experimental groups are 9 pediatric patients with UPJ obstruction and 13 adult patients with UPJ obstruction. Six patients with normal UPJ were assigned as controls for each experimental group. The collagen content of UPJ was quantitated by hydroxyproline analysis. Immunohistochemical staining and Western blotting for collagen types I and III were performed.nnnRESULTSnThe collagen content of pediatric UPJ was significantly lower in value than that of adult UPJ (P < 0.05). Immunohistochemical staining revealed that collagen type I was located in interfascicular space and collagen type III was located in intrafascicular space in both age groups. In Western blotting the relative intensity of collagen type III for pediatric UPJ was weaker than that of adult groups.nnnCONCLUSIONSnThese results suggest that a larger series of patients should be examined to determine whether quantitative analysis for collagen types I and III would provide some kind of prognostic test for UPJ outcome in pediatric patients.

Perioperative and long-term renal functional outcomes of robotic versus laparoscopic partial nephrectomy: a multicenter matched-pair comparison.

PurposeWe compared perioperative and long-term renal functional outcomes of robot-assisted partial nephrectomy (RAPN) with laparoscopic partial nephrectomy (LPN) for small renal masses.Materials and methodsA total of 1,032 patients were included for evaluation; propensity score matching was performed to adjust for potential baseline confounders, which resulted in 195 LPNs matched to 195 RAPNs. Patient characteristics including preoperative estimated glomerular filtration rate (eGFR) were investigated, and postoperative results were evaluated.ResultsNo significant differences were found between the groups with regard to age, body mass index, sex distribution, preoperative eGFR, or tumor size. The mean follow-up period was 32.4xa0±xa021.1xa0months for LPN patients versus 31.1xa0±xa024.5xa0months for RAPN patients (pxa0=xa00.589). Operative time (pxa0<xa00.001) and warm ischemic time (pxa0<xa00.001) were significantly shorter in the RAPN group. No significant differences were observed in the overall change in eGFR (pxa0=xa00.768) or positive surgical margin rate (pxa0=xa00.653). A multivariate analysis showed that preoperative eGFR and hypertension significantly influenced the risk of stage 3 and 4 chronic kidney disease. A significant deterioration in renal function occurred 3xa0months after surgery. However, renal function increased gradually after the nadir eGFR was reached. The amount of renal functional recovery was higher in the RAPN group.ConclusionsOperative parameters for RAPN appear to be less affected by tumor complexity. Functional outcomes of RAPN were superior to those of LPN. Renal function recovered continuously during the 60-month follow-up period after partial nephrectomy.

Combination Therapy Using Human Adipose-derived Stem Cells on the Cavernous Nerve and Low-energy Shockwaves on the Corpus Cavernosum in a Rat Model of Post-prostatectomy Erectile Dysfunction.

OBJECTIVEnTo investigate combined therapeutic efficacy of human adipose-derived stem cells (h-ADSCs) application on injured cavernous nerve and low-energy shockwave therapy (SWT) on the corpus cavernosum in a rat model of post-prostatectomy erectile dysfunction.nnnMATERIALS AND METHODSnRats were randomly divided into 5 groups: control, bilateral cavernous nerve injury (BCNI), adipose-derived stem cell (ADSC) (BCNI group with h-ADSCs on the cavernous nerve), SWT (BCNI group with low-energy SWT on the corpus cavernosum), and ADSC/SWT (BCNI group with a combination of h-ADSCs and low-energy SWT). After 4 weeks, erectile function was assessed using intracavernosal pressure. The cavernous nerves and penile tissue were evaluated through immunostaining, Western blotting, and a cyclic guanosine monophosphate assay.nnnRESULTSnADSC/SWT significantly improved intracavernosal pressure compared to the other experimental group. ADSC had significantly increased β-III tubulin expression of the cavernous nerve, and SWT had a markedly enhanced vascular endothelial growth factor expression in corpus cavernosum. The ADSC/SWT group had a significantly increased in alpha smooth muscle actin content (P < .05), neural nitric oxide synthase (nNOS) of the dorsal penile nerve (P < .05), endothelial nitric oxide synthase (eNOS) protein expression (P < .05), and cyclic guanosine monophosphate level (P < .05) compared to the ADSC or SWT alone group. In addition, ADSC/SWT reduces the apoptotic index in the corpus cavernosum.nnnCONCLUSIONnIn this study, h-ADSCs showed an effect on the recovery of injured cavernous nerve and low-energy SWT improved angiogenesis in the corpus cavernosum. The h-ADSCs combined with low-energy SWT showed beneficial effect on the recovery of erectile function in a rat model of postprostatectomy erectile dysfunction.

Prostate-specific extracellular vesicles as a novel biomarker in human prostate cancer.

Extracellular vesicles (EVs) may play an important role in cancer development and progression. We aimed to investigate the prognostic potential of prostate-specific EVs in prostate cancer (PCa) patients. Plasma and prostate tissue were collected from patients who underwent surgery for PCa (nu2009=u200982) or benign prostatic hyperplasia (BPH, nu2009=u200928). To analyze the quantity of EVs in prostate, we performed transmission electron microscopy (TEM), immuno-TEM with CD63 and prostate-specific membrane antigen (PSMA), and immunofluorescence staining. After EV isolation from plasma, CD63 and PSMA concentration was measured using ELISA kits. PSMA-positive areas in prostate differed in patients with BPH, and low-, intermediate-, and high-risk PCa (2.4, 8.2, 17.5, 26.5%, pu2009<u20090.001). Plasma PSMA-positive EV concentration differed in patients with BPH, and low-, intermediate-, and high-risk PCa (21.9, 43.4, 49.2, 59.9u2009ng/mL, pu2009<u20090.001), and ROC curve analysis indicated that plasma PSMA-positive EV concentration differentiated PCa from BPH (AUC 0.943). Patients with lower plasma PSMA-positive EV concentration had greater prostate volume (50.2 vs. 33.4 cc, pu2009<u20090.001) and lower pathologic Gleason score (pu2009=u20090.025). During the median follow-up of 18 months, patients with lower plasma PSMA-positive EV concentration tended to have a lower risk of biochemical failure than those with higher levels of prostate-specific EVs (pu2009=u20090.085).

Association between Perioperative Blood Transfusion and Oncologic Outcomes after Curative Surgery for Renal Cell Carcinoma.

Purpose: We aimed to elucidate the association between perioperative blood transfusion (PBT) and the prognosis of patients undergoing curative surgery for renal cell carcinoma (RCC). Methods: In all, 3,832 patients with RCC who had undergone curative surgery were included in this study from a multicenter database. PBT was defined as the transfusion of packed red blood cells within seven days before surgery, during surgery, or within the postoperative hospitalization period. The association of PBT with oncologic outcomes was evaluated using univariate and multivariate Cox regression analyses, and regression adjustment with propensity score matching. Results: Overall, 11.7% (447/3,832) of patients received PBT. Patients receiving PBT were significantly older at diagnosis, and had lower BMI, higher comorbidities, worse ECOG performance status, and more initial symptoms. Moreover, higher pathologic TNM stage, larger mass size, higher nuclear grade, more sarcomatoid differentiation, and more tumor necrosis were all observed more frequently in patients who received PBT. In univariate analysis, relapse-free survival, cancer-specific survival, and overall survival rates were worse in patients who received PBT; however, these factors became insignificant in the matched pairs after propensity score matching. On multivariate Cox regression analysis and regression adjustment with propensity score matching, significant prognostic effects of PBT on disease relapse, cancer-specific mortality, and all-cause mortality were not observed. Conclusions: This multicenter database analysis demonstrates no significant prognostic association between PBT and oncologic outcomes in patients with RCC.