PURPOSE: Prostate specific antigen (PSA) is a test with relatively low specificity used for determination of risk for prostate cancer. PSA velocity (PSAV) has been used as a complimentary test. We investigated the association of PSAV with age and an initial PSA. MATERIALS AND METHODS: We enrolled 989 healthy men with initial PSA of 4.0ng/ml or lower. The PSA levels were measured at intervals of at least 12 months. We analyzed the influence of age and initial PSA on the PSAV. RESULTS: PSAV was directly correlated with age and the initial PSA. The initial PSA was not correlated with the PSAV when adjusted by age (r=0.009, p=0.773); age was correlated with PSAV when adjusted by initial PSA level (r=0.276, p<0.001). The mean PSAV in cases with initial PSA of 2.1-4.0 ng/ml was significantly greater compared to the cases with an initial PSA of 0-2.0 ng/ml (p<0.01). The ratio of the men with a PSAV greater than 0.75 ng/ml/year was significantly higher in cases with an initial PSA of 2.1-4.0 ng/ml (p<0.05). CONCLUSIONS: PSAV is associated with age and an initial PSA level in healthy Korean men. Men with initial PSA of 2.1-4.0 ng/ml had an abnormal PSAV in high proportion, and therefore annual follow up PSA would be useful for the early detection of prostate cancer in these cases.
Follow-Up Studies ; Humans ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Sensitivity and Specificity

PURPOSE: We investigated the predictive factors in patient with prostate cancer diagnosed by repeat prostate biopsy, where initial prostate biopsy results were negative for malignancy. MATERIALS AND METHODS: Between March 2000 and June 2007, 1280 men with suspected prostatic cancer underwent transrectal ultrasound guided needle biopsy of the prostate, with 148 (11.6%) diagnosed as having prostate cancer. Of 1132 men whose biopsy results were negative for malignancy, 655 whose prostate specific antigen (PSA) was elevated persistently underwent second biopsy, and 462 underwent third biopsy as the same course. Twelve core biopsies were performed in the majority of patients. To determine predictive factors, we evaluated prostate volume, serum PSA, percent free PSA, PSA density (PSAD), transition zone PSAD, PSA velocity (PSAV) and pathological report of previous biopsy between the men with cancer detection and the men with negative biopsy in second and third biopsy. RESULTS: Overall cancer detection rate was 16.3% (208/1280). From the first, second and third biopsies, the cancer detection rate were 11.6, 5.5 and 5.2%, respectively. There were significant differences in percent free PSA, transition zone PSAD, PSAV between cancer and negative biopsy groups after serial repeat biopsies (p<0.05). Multivariate logistic regression analysis revealed that the transition zone PSAD, PSAV, and presence of either atypical small acinar proliferation (ASAP) or high grade prostatic intraepithelial neoplasia (HGPIN) in initial biopsy specimen were significant predictors for prostate cancer diagnosed by repeat biopsy. CONCLUSIONS: Of the men with negative results on the first biopsy, 60 (5.4%) were diagnosed prostate cancer after serial biopsies. The transition zone PSAD, PSAV, and presence of either ASAP or HGPIN in initial biopsy specimen are predictable factors for prostate cancer detection on repeat biopsy.
Biopsy ; Biopsy, Needle ; Humans ; Logistic Models ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Intraepithelial Neoplasia ; Prostatic Neoplasms

PURPOSE: In prostate cancer, the anti-apoptotic mechanism of sulfated glycoprotein-2 (clusterin) against tumor necrosis factor-alpha (TNF-alpha) receptors and the action of type 2 TNF-alpha receptor (TNFR2) were investigated. MATERIALS AND METHODS: TNF-alpha, agonistic-TNF type 1 receptor (TNFR1) antibody, agonistic-TNF-R2 antibody and their combination were treated in PC3 cell line with or without anti-clusterin. Cytotoxicity was assessed by trypan blue dye exclusion assay. By using flowcytometric analysis, the exact amount of apoptosis and their changes were assessed. RESULTS: Apoptosis was significantly increased in both agonistic-TNFR1 antibody and TNF-alpha treated cases after blocking the activity of clusterin. The more the anti-clusterin antibody added, the more the apoptosis occurred. The increase of total apoptosis was greater in TNF-alpha treated cells than in agonistic-TNFR1 antibody treated ones. However, there was no increase of apoptosis in agonistic-TNFR2 antibody and TNF-alpha with agonistic-TNFR2 antibody treated cases, respectively. CONCLUSIONS: Clusterin prevents TNF-alpha induced apoptosis by affecting TNFR1. The difference in degree of apoptosis between agonistic-TNFR1 antibody treated cells and TNF-alpha treated ones suggests the possibility of the action of TNFR2. It may be associated with affinity of TNF-alpha to the tumor cell surface.
Apoptosis ; Cell Line ; Clusterin ; Diminazene ; Prostate ; Prostatic Neoplasms ; Receptors, Tumor Necrosis Factor ; Receptors, Tumor Necrosis Factor, Type I ; Receptors, Tumor Necrosis Factor, Type II ; Trypan Blue ; Tumor Necrosis Factor-alpha

Abdominal ultrasonography was performed in 25,622 adults during the period from July 1992 to June 1995 at the Helth Care Examination Center. The renal masses detected and identified by abdominal sonography were investigated to estimate the incidence of each identification. Renal masses were found in 562 cases(2.19%). Of five hundred and sixty two cases, 555(98.75%) were cystic masses and seven(1.25%) were solid masses. Of five hundred and fifty five cystic masses, 550 were simple cyst(97.86%), four polycystic kindney(0.71%) and one cystic renal cell carcinoma(0.18%). Of seven solid masses, two were angiomyolipoma(0.36%) and another four were renal cell carcinoma(0.71%). The rest one case revealed equivocal finding on an ultrasonography, but the patient refused further study. Although the study population was not a random sampling, the incidence of simple cyst was 2,146 per 100,000 in adult and that of renal cell carcinoma was 19 per 100,000 in adult. Furthermore, ultrasonography is a useful tool for screening the renal carcinoma at the low cost.
Adult ; Carcinoma, Renal Cell ; Humans ; Incidence* ; Mass Screening ; Ultrasonography*

PURPOSE: Bovine colostrum contains three times more immunoglobulin than human colostrums does. We investigated the effectiveness of administering Bovine colostrum combined with antibiotics in an animal model of ascending pyelonephritis. MATERIALS AND METHODS: Thirty female Sprague-Dawley rats were divided into 5 groups: the normal group, the non-treated control group, the Bovine colostrum administered group, the antibiotic treatment group and the combined administration of antibiotics and Bovine colostrums group. After anesthetizing, an inoculum of 1 x 10(8) colony forming units per ml of Escherichia coli (E. coli, ATCC 25922 strain) was instilled into the bladder through the urethra and the urethra was occluded for 4 hours. We began treatment with ciprofloxacin (15mg/kg, for 5 days, intramuscularly) alone or Bovine colostrum (6ml/kg, for 5 days, orally) alone or with combination treatment 72 hours after inoculation. The rats were sacrificed 4 weeks after infection. Both kidneys were examined pathologically. We carried bacterial culture examinations of the urine and the kidney tissue. RESULTS: As the results of examining the cultures of the urine and kidney tissues, no bacteria were cultivated in the antibiotics treatment group and the combined treatment group. 66.7% of the control group and 33.3% of the bovine colostrum treatment group had positive urine cultures and 66.7% of the control group and 41.7% of the bovine colostrum treatment group showed a positive reaction on the kidney tissue culture. The severity of pyelonephritis, as noted on the pathological examination, was highest in the control group. The combined treatment group had the lowest degree of infection among all the groups. CONCLUSIONS: The administration of bovine colostrum in combination with antibiotics can significantly reduce the inflammation associated with ascending pyelonephritis.
Animals ; Anti-Bacterial Agents* ; Bacteria ; Ciprofloxacin ; Colostrum* ; Escherichia coli ; Female ; Humans ; Immunoglobulins ; Inflammation* ; Kidney ; Models, Animal ; Pyelonephritis ; Rats ; Rats, Sprague-Dawley ; Stem Cells ; Urethra ; Urinary Bladder

PURPOSE: In this era of the Internet, many university hospitals are making efforts to maximize the benefits of a good homepage which facilitates the sharing and distributing of medical information. By classifying and analyzing different urology homepage, this paper aims to identify the problems and suggest the direction for improvement. MATERIALS AND METHODS: Using the search sites of Yahoo, Lycos, and Daum, some 111 homepage yielded by the keyword search "urology" were classified along the categories of location, sort (individual vs assembled), and the field of specialty. The one with the best quality was analyzed in depth. RESULTS: According to the location, Seoul (45) and Pusan (8) took up 47.7% of the total. There were more homepage devoted to andrologic field than others, typically offering online counselling service. As for the sort, there were more individual homepage (83) than assembled ones (28). The nearest to perfect homepage, upon close analysis, turned out to be too complex for the general user to gain easy access to the information, although its content, design, management, and links were excellent. CONCLUSIONS: Almost all homepage provide online counselling service, but there was a considerable disparity in the answers to questions. A guideline from the professional body would be necessary. Moreover, to prevent possible violation of the intellectual property laws, it would be best for the homepage of professional bodies to be paid sites or at least membership sites. Those managing these homepage should do their best to catch up and cope with high-tech Internet medical services by being more familiar with Internet-related technology.
Busan ; Hospitals, University ; Intellectual Property ; Internet* ; Jurisprudence ; Seoul ; Urology*

PURPOSE: Several naturally-derived biopolymers have been introduced as implantable biomaterial for tissue reconstruction, and some of them are already being applied in various clinical fields. They serve as backbones for the regeneration of damaged tissue. It is well known that growth factors play an important role in this process and some of the naturally- derived biopolymers were known to contain several kinds of growth factors, but there are few reports about any growth factors in the various biopolymers. We tried to confirm the existence of growth factor receptors and neurogenic factors through the expression of the mRNA from the biopolymers. MATERIALS AND METHODS: Bladders were harvested from adult pigs. Vesical submucosa was obtained with using mechanical decellulization technique. Acellular matrices were made from pig bladder with using a cell lysis technique, and they were examined by performing scanning electron microscopy. Expression of the mRNA of vascular endothelial growth factor (VEGF) receptor, fibroblast growth factor (FGF)-1 receptor, neuregulin and brain-derived neurotrophic factor (BDNF) in the acellular matrix and the submucosa of porcine bladder were examined for via reverse transcription- polymerase chain reaction (RT-PCR). RESULTS: The ultrastructure of the acelluar matrix shows collagen fibers with many pores. The mRNA's of VEGF receptor, FGF-1 receptor and neuregulin were expressed in the porcine vesical acellular matrix, whereas BDNF was not expressed. On the other hand, none of the mRNA's examined was expressed in the porcine vesical submucosa. CONCLUSIONS: This study's results shows that several growth factors are detected in the acellular matrix of the porcine bladder. These growth factors may play an important role for the growth of tissue when it is implanted in vivo. It is also assumed that there are more growth factors in naturally-derived biopolymers, and it would be useful to investigate the undefined components of naturally-derived biopolymers for developing new and advanced polymers.
Adult ; Biopolymers ; Brain-Derived Neurotrophic Factor ; Collagen ; Fibroblast Growth Factor 1 ; Fibroblast Growth Factors ; Hand ; Humans ; Intercellular Signaling Peptides and Proteins ; Microscopy, Electron, Scanning ; Nerve Growth Factors* ; Polymerase Chain Reaction ; Polymers ; Receptors, Growth Factor* ; Receptors, Vascular Endothelial Growth Factor ; Regeneration ; RNA, Messenger* ; Swine ; Urinary Bladder ; Vascular Endothelial Growth Factor A

PURPOSE: We evaluated the rate of prostate cancer detection according to the region and number of biopsies in patients with an elevated level of serum prostate-specific antigen (PSA). MATERIALS AND METHODS: Transrectal ultrasound (TRUS) guided prostate biopsies were performed at 12 regions, using the standard sextant, with an additional 6 cores far lateral peripheral zone, in 178 men with an elevated PSA level, and with no suspicious lesions of prostate cancer on digital rectal examination (DRE) and TRUS. We analyzed the rate prostate cancer detection according to the region, number of biopsies, the PSA level, prostate volume and PSA density (PSAD). RESULTS: The rates of cancer detection were 12.9, 11.8 and 7.4% in the 12 core, lateral 6 core and medial 6 core (standard sextant) biopsies, respectively (p<0.05). There were no differences in overall cancer detection rates between 12 core and lateral 6 core plus apex medial 2 core biopsies (12.9%). In men with a PSA level greater than 20ng/ml, no difference in cancer detection was found with the 12 core or either of the 6 core biopsies (positive rate 33.3%). In men with a PSA level over 10ng/ml, a prostate volume less than 49cc or a PSAD greater than 0.15, a lateral 6 core biopsy made no difference to the diagnosis of prostate cancer compared to a 12 core biopsy. CONCLUSIONS: A lateral 6 core biopsy, combined with an apex medial 2 core biopsy, is a more efficient method for the detection of prostate cancer than the standard sextant biopsy in men with an elevated serum PSA level without a suspicious lesion on DRE and TRUS.
Biopsy* ; Diagnosis ; Digital Rectal Examination ; Humans ; Male ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Ultrasonography

PURPOSE: The present study investigated the effects of the type 5 phosphodiesterase(PDE-5) inhibitor, vardenafil on oxytocin expression in the paraventricular nucleus(PVN) of the hypothalamus were investigated. MATERIALS AND METHODS: Spargue-Dawley rats received a 2-week oral treatment with vardenafil(0.25 mg/kg/day oral adminstration, n=5) or(0.5 mg/kg/day oral adminstration, n=5) or(1 mg/kg/day oral adminstration, n=5) or (2 mg/kg/day oral adminstration, n=5) or control(n=3). Oxytocin expression in the paraventricular nucleus was measured. These experiments were performed in the absence of sexual stimulation for at least 36 hours before the experiments. RESULTS: The number of oxytocin-positive cells in the PVN was 46.88+/-15.46/section in the control group, 61.42+/-26.37/section in the 0.25 mg/kg vardenafil-treated group, 78.00+/-33.44/section in the 0.5 mg/kg vardenafil-treated group, 78.81+/-37.18/section in the 1 mg/kg vardenafil-treated group and 94.61+/-57.38/section in the 2 mg/kg vardenafil-treated group. The number of oxytocin-positive cells in the PVN increased in a concentration-dependent manner. CONCLUSIONS: Daily vardenafil administration increases expression of oxytocin in the PVN in a dose-dependent fashion in the absence of sexual stimulation. Thus, these results imply that the PDE-5 inhibitor vardenafil has a direct effect on the erectile pathway in the central nervous system in the absence of sexual stimulation.
Animals ; Central Nervous System ; Hypothalamus ; Oxytocin* ; Paraventricular Hypothalamic Nucleus* ; Rats* ; Vardenafil Dihydrochloride

PURPOSE: The present study investigated the effects of the type 5 phosphodiesterase(PDE-5) inhibitor, vardenafil on oxytocin expression in the paraventricular nucleus(PVN) of the hypothalamus were investigated. MATERIALS AND METHODS: Spargue-Dawley rats received a 2-week oral treatment with vardenafil(0.25 mg/kg/day oral adminstration, n=5) or(0.5 mg/kg/day oral adminstration, n=5) or(1 mg/kg/day oral adminstration, n=5) or (2 mg/kg/day oral adminstration, n=5) or control(n=3). Oxytocin expression in the paraventricular nucleus was measured. These experiments were performed in the absence of sexual stimulation for at least 36 hours before the experiments. RESULTS: The number of oxytocin-positive cells in the PVN was 46.88+/-15.46/section in the control group, 61.42+/-26.37/section in the 0.25 mg/kg vardenafil-treated group, 78.00+/-33.44/section in the 0.5 mg/kg vardenafil-treated group, 78.81+/-37.18/section in the 1 mg/kg vardenafil-treated group and 94.61+/-57.38/section in the 2 mg/kg vardenafil-treated group. The number of oxytocin-positive cells in the PVN increased in a concentration-dependent manner. CONCLUSIONS: Daily vardenafil administration increases expression of oxytocin in the PVN in a dose-dependent fashion in the absence of sexual stimulation. Thus, these results imply that the PDE-5 inhibitor vardenafil has a direct effect on the erectile pathway in the central nervous system in the absence of sexual stimulation.
Animals ; Central Nervous System ; Hypothalamus ; Oxytocin* ; Paraventricular Hypothalamic Nucleus* ; Rats* ; Vardenafil Dihydrochloride