Purpose: To investigate the thickness of the nerve fiber layer-ganglion cell inner plexiform layer (NFL-GCIPL) complex and microvascular macular changes in Korean patients with early Parkinson’s disease using optical coherence tomography (OCT) and OCT angiography (OCTA). Methods: Forty-three eyes of 22 patients with early Parkinson’s disease were included. A control group of 20 patients (40 eyes) was also recruited. The thickness of the NFL-GCIPL macular complex was measured using OCT, and the densities of the superficial and deep macular retinal vessels were evaluated via OCTA in all subjects. Results: The NFL-GCIPL thicknesses of the superior, inferior, temporal, and nasal sectors were 94.70 ± 9.35, 93.32 ± 9.16, 90.18 ± 6.32, and 93.11 ± 8.75 μm in the control group and 92.05 ± 4.96, 91.32 ± 7.48, 84.74 ± 6.82, and 91.32 ± 7.47 μm in the Parkinson’s disease group, respectively; all thicknesses were significantly greater in the control group. The superficial and deep retinal vessel densities did not differ between the two groups. Conclusions Neurodegenerative macular changes are more obvious than microvascular changes in patients with early Parkinson’s disease. Such neurodegenerative changes should be further evaluated in future cohort studies.

Purpose: To report a case of endophthalmitis and retinal detachment after injury caused by an animal inoculation needle. Case summary: A 39-year-old man received an injury to his left eye with an animal inoculation needle while vaccinating a pig came to the hospital due to decreased visual acuity. At initial presentation, the best-corrected visual acuity in the left eye was “counting fingers,” and slit lamp examination revealed corneal lacerations, anterior capsule rupture, and traumatic cataract. Ultrasonography showed no specific findings in the vitreous and retina. Primary corneal suture, phacoemulsification, anterior vitrectomy due to rupture of the posterior capsule and vitreous prolapse, intraocular lens implantation, and intravitreal antibiotic injection were performed. On day 1 postoperatively, vitrectomy, anterior chamber irrigation, intravitreal antibiotic injection, and silicone oil injection were performed as signs of endophthalmitis, such as hypopyon and retinal tear, and focal retinal detachment were observed during surgery. Silicone oil removal was performed 7 months after the operation and the best-corrected visual acuity was 0.6. There has been no recurrence during follow-up. Conclusions This is the first report in Korea of ocular injury caused by an animal inoculation needle. If the fundus is not observed in such injuries, there is a possibility of endophthalmitis and retinal detachment and early vitrectomy should be considered.

Purpose: To report a case of endophthalmitis and retinal detachment after injury caused by an animal inoculation needle. Case summary: A 39-year-old man received an injury to his left eye with an animal inoculation needle while vaccinating a pig came to the hospital due to decreased visual acuity. At initial presentation, the best-corrected visual acuity in the left eye was “counting fingers,” and slit lamp examination revealed corneal lacerations, anterior capsule rupture, and traumatic cataract. Ultrasonography showed no specific findings in the vitreous and retina. Primary corneal suture, phacoemulsification, anterior vitrectomy due to rupture of the posterior capsule and vitreous prolapse, intraocular lens implantation, and intravitreal antibiotic injection were performed. On day 1 postoperatively, vitrectomy, anterior chamber irrigation, intravitreal antibiotic injection, and silicone oil injection were performed as signs of endophthalmitis, such as hypopyon and retinal tear, and focal retinal detachment were observed during surgery. Silicone oil removal was performed 7 months after the operation and the best-corrected visual acuity was 0.6. There has been no recurrence during follow-up. Conclusions This is the first report in Korea of ocular injury caused by an animal inoculation needle. If the fundus is not observed in such injuries, there is a possibility of endophthalmitis and retinal detachment and early vitrectomy should be considered.

BACKGROUND: Cell division cycle 6 (CDC6) is an essential regulator of DNA replication and plays important roles in the activation and maintenance of the checkpoint mechanisms in the cell cycle. CDC6 has been associated with oncogenic activities in human cancers; however, the clinical significance of CDC6 in prostate cancer (PCa) remains unclear. Therefore, we investigated whether the CDC6 mRNA expression level is a diagnostic and prognostic marker in PCa. METHODS: The study subjects included 121 PCa patients and 66 age-matched benign prostatic hyperplasia (BPH) patients. CDC6 expression was evaluated using real-time polymerase chain reaction and immunohistochemical (IH) staining, and then compared according to the clinicopathological characteristics of PCa. RESULTS: CDC6 mRNA expression was significantly higher in PCa tissues than in BPH control tissues (P = 0.005). In addition, CDC6 expression was significantly higher in patients with elevated prostate-specific antigen (PSA) levels (> 20 ng/mL), a high Gleason score, and advanced stage than in those with low PSA levels, a low Gleason score, and earlier stage, respectively. Multivariate logistic regression analysis showed that high expression of CDC6 was significantly associated with advanced stage (≥ T3b) (odds ratio [OR], 3.005; confidence interval [CI], 1.212–7.450; P = 0.018) and metastasis (OR, 4.192; CI, 1.079–16.286; P = 0.038). Intense IH staining for CDC6 was significantly associated with a high Gleason score and advanced tumor stage including lymph node metastasis stage (linear-by-linear association, P = 0.044 and P = 0.003, respectively). CONCLUSION: CDC6 expression is associated with aggressive clinicopathological characteristics in PCa. CDC6 may be a potential diagnostic and prognostic marker in PCa patients.
Cell Cycle ; DNA Replication ; Gene Expression ; Humans ; Logistic Models ; Lymph Nodes ; Neoplasm Grading ; Neoplasm Metastasis ; Passive Cutaneous Anaphylaxis ; Prostate* ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms* ; Real-Time Polymerase Chain Reaction ; RNA, Messenger*

The aim of the present multi-institutional study was to assess the influence of the American Society of Anesthesiologists Physical Status (ASA-PS) classification on adjuvant chemotherapy eligibility and survival in a multi-institutional cohort of patients treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). We retrospectively reviewed data from 416 patients who underwent RNU for UTUC at four Korean institutions between 2001 and 2013. The ASA-PS classification was obtained from the anesthesia chart. Locally advanced UTUC was defined as ≥ pT3 and/or pN1 disease. The influence of ASA-PS score on survival was evaluated by Kaplan-Meier analyses and a multivariate Cox regression model. Patients with a higher ASA-PS class were less likely to be eligible for adjuvant chemotherapy in locally advanced UTUC (P = 0.016). Kaplan-Meier estimates showed that the high-risk ASA-PS group has a poorer overallsurvival (OS) and cancer-specific survival (CSS) compared to low risk ASA-PS groups in both the total and locally advanced UTUC cohorts. Based on multivariate Cox regression analysis, the high-risk ASA-PS category was an independent predictor for overall mortality (OM) (hazard ratio [HR], 1.919; 95% confidence interval [CI], 1.017–3.619; P = 0.044) and cancer-specific mortality (CSM) (HR, 2.120; 95% CI, 1.023–4.394; P = 0.043). In conclusion, high-risk ASA-PS score was independently associated with a lower survival rate in patients with UTUC after RNU. However, the influence of ASA-PS classification on survival was limited to locally advanced UTUC. The lower eligibility of patients in the high-risk ASA category for adjuvant chemotherapy may contribute to the lower survival rate in this group.
Anesthesia ; Chemotherapy, Adjuvant* ; Classification ; Cohort Studies ; Humans ; Mortality ; Retrospective Studies ; Survival Rate

This study aimed to evaluate the efficacy, safety, and tolerability of 2-cycled neoadjuvant sunitinib therapy (NST) in patients with inoperable metastatic renal cell carcinoma (mRCC). Between 2009 and 2012, 14 patients with inoperable mRCC from 5 Korean academic centers were prospectively enrolled after collecting their clinicopathological data and completing health-related questionnaires. The best overall response (BOR), safety profile, and changes in quality of life during NST were assessed using the RECIST criteria (version 1.0), CTCAE criteria (version 4.0), and the Cancer Quality of Life Questionnaire (QLQ-C30). Among the 14 patients, 9 patients (64.3%) experienced partial response or stable disease state, and 5 patients (35.7%) did not complete treatment, with 1 case of disease progression (7.1%), 3 grade 3 adverse events (21.4%), and 1 voluntary withdrawal (7.1%). Four patients (28.6%) were successfully converted to an operable state and underwent surgery after NST. The BOR for the primary renal lesions was 22.2%, with a median 1.3-cm diameter reduction (range: 0–2.8 cm) from a baseline diameter of 10.3 cm (range: 6.6–15.8 cm). The other 18 measurable metastatic lesions exhibited a BOR of 55.6%. The QLQ-C30 questionnaire results revealed significant improvements in the quality of life domain, although we observed significant increases in the scores for fatigue, nausea and vomiting, and the financial effects of NST (P < 0.05). Two-cycle NST provided limited efficacy for resectability of inoperable mRCC, despite mild improvements in the BOR of the primary lesion and quality of life (Clinical Trial Registry 1041140-1).
Carcinoma, Renal Cell* ; Disease Progression ; Fatigue ; Humans ; Molecular Targeted Therapy ; Multicenter Studies as Topic* ; Nausea ; Neoadjuvant Therapy ; Neoplasm Metastasis ; Prospective Studies* ; Quality of Life ; Response Evaluation Criteria in Solid Tumors ; Vomiting

The prognostic significance of age in renal cell carcinoma (RCC) is a subject of debate. The aim of the present multi-institutional study was to evaluate the impact of age on clinicopathological features and survival in a large cohort of patients with RCC. A total of 5,178 patients who underwent surgery for RCC at eight institutions in Korea between 1999 and 2011 were categorized into three groups according to age at diagnosis as follows: young age (< 40 years, n = 541), middle-age (≥ 40 and < 60 years, n = 2,551), and old age (≥ 60 years, n = 2,096) groups. Clinicopathological variables and survival rates were compared between the three groups. Young patients had lower stage tumors with a low Fuhrman grade, a lower rate of lymphovascular invasion than patients in the other age groups. Regarding histologic type, the young age group had a lower percentage of clear cell histology and a greater incidence of Xp11.2 translocation RCC. Kaplan-Meier estimates showed that cancer-specific survival was significantly better in the young age group than in the other groups (log rank test, P = 0.008). However, age at diagnosis was not an independent predictor of survival in multivariate analysis. In conclusion, young age at diagnosis was associated with favorable pathologic features, although it was not an independent prognostic factor for survival in patients with surgically-treated RCC. Age itself should not be regarded as a crucial determinant for the treatment of RCC.
Carcinoma, Renal Cell* ; Cohort Studies ; Diagnosis* ; Humans ; Incidence ; Korea ; Multivariate Analysis ; Nephrectomy ; Recurrence ; Survival Rate

Mps one binder (MOB) proteins are integral components of signaling pathways that control important cellular processes, such as mitotic exit, centrosome duplication, apoptosis, and cell proliferation. However, the biochemical and cellular functions of the human MOB (hMOB) protein family remain largely unknown. The present study investigated the association between hMOB3B expression and clinicopathological characteristics of prostate cancer (PCa).Study subjects included 137 PCa patients and 137 age-matched benign prostatic hyperplasia (BPH) patients. hMOB3B expression was estimated using real-time PCR and compared with clinicopathological parameters of PCa. hMOB3B mRNA expression was significantly lower in PCa tissues than in BPH control tissues (P<0.001). According to receiver operating characteristics curve analysis, the sensitivity of hMOB3B expression for PCa diagnosis was 84.7%, with a specificity of 86% (AUC=0.910; 95% CI=0.869-0.941; P<0.001). hMOB3B expression was significantly lower in patients with elevated prostate specific antigen (PSA) levels (> or =10 ng/mL), a Gleason score> or =8, and metastatic disease (any T, N+/M+) than in those with low PSA levels, a low Gleason score, and non-metastatic disease (each P<0.05). In conclusion, low levels of hMOB3B are closely associated with aggressive clinicopathologic features in patients with PCa. Our results suggest that hMOB3B may act as a tumor suppressor in human PCa.
Aged ; Aged, 80 and over ; Biomarkers, Tumor/*metabolism ; Case-Control Studies ; Disease Susceptibility ; Gene Expression ; Humans ; Kallikreins/blood ; Male ; Microtubule-Associated Proteins/*metabolism ; Middle Aged ; Neoplasm Grading ; Polymerase Chain Reaction ; Prostate/*pathology/surgery ; Prostate-Specific Antigen/blood ; Prostatic Hyperplasia/blood/pathology ; Prostatic Neoplasms/blood/*pathology/surgery

PURPOSE: The deleted in bladder cancer 1 (DBC1) gene is located within chromosome 9 (9q32-33), a chromosomal region that frequently shows loss of heterozygosity in bladder cancer (BC). It is suspected that it acts as a tumor suppressor gene, but its prognostic value remains unclear. The aim of the present study was to investigate the value of DBC1 as a prognostic marker in BC. MATERIALS AND METHODS: The expression of DBC1 was determined by real-time polymerase chain reaction analysis in 344 patients with BC (220 non-muscle-invasive BC [NMIBC] and 124 muscle-invasive BC [MIBC]) and in 34 patients with normal bladder mucosa. The results were compared with clinicopathologic parameters, and the prognostic value of DBC1 was evaluated by Kaplan-Meier analysis and a multivariate Cox regression model. RESULTS: DBC1 expression was significantly decreased in patients with MIBC compared with those diagnosed with NMIBC (p=0.010). Patients with aggressive tumor characteristics had lower DBC1 expression levels in NMIBC (each, p<0.05). By multivariate Cox regression analysis, low DBC1 expression was a predictor of progression to MIBC (hazard ratio, 7.104; p=0.013). Kaplan-Meier estimates revealed a significant difference in tumor recurrence, progression to MIBC, and cancer-specific survival depending on the level of DBC1 expression in NMIBC (log-rank test, each, p<0.05). CONCLUSIONS: The expression of DBC1 was associated with tumor aggressiveness, progression to MIBC, and survival in NMIBC. Our results suggest that DBC1 expression can be a useful prognostic marker for patients with NMIBC.
Chromosomes, Human, Pair 9 ; Genes, Tumor Suppressor ; Humans ; Kaplan-Meier Estimate ; Loss of Heterozygosity ; Mucous Membrane ; Prognosis ; Real-Time Polymerase Chain Reaction ; Recurrence ; Urinary Bladder ; Urinary Bladder Neoplasms

The necessity of routine prostate biopsy prior to transurethral resection of the prostate (TURP) in elderly comorbid patients with a high prostate specific antigen (PSA) level remains controversial. We assessed the role of TURP in prostate cancer diagnosis in these individuals. A total of 197 patients underwent TURP in conjunction with prostatic needle biopsy. Pathologic reviews of specimens of TUR chips and biopsy cores were analyzed. Overall, prostate cancer (CaP) was detected in 114 patients (57.6%). Ninety-eight cancers (86%) were detected with TURP and biopsy, and seven cancers (6.1%) with only TURP. The Gleason score of a TUR-specimen was identical to that of the biopsy-core in 43.9% of cases. Variables associated with diagnostic accuracy in the TUR-specimens included the prebiopsy PSA level, prostate specific antigen density (PSAD), and the Gleason score in biopsy cores. In patients with a PSA level and a PSAD that was greater than 15.4 ng/mL and 0.69 ng/mL/g, respectively, 100% of the cancers were detected in the TUR-specimens. Our results suggest that a prostatic biopsy might be omitted prior to TURP in elderly patients with significant co-morbidity and levels for PSA of >15.4 ng/mL.
Aged ; Aged, 80 and over ; Area Under Curve ; Biopsy, Needle ; Comorbidity ; Humans ; Male ; Neoplasm Grading ; Prostate/*surgery ; Prostate-Specific Antigen/*blood ; Prostatic Neoplasms/*diagnosis/epidemiology/*pathology/surgery ; ROC Curve ; Transurethral Resection of Prostate