Purpose: To evaluate patient‐reported experiences of 3 primary treatments for localized or locally advanced prostate cancer—radical prostatectomy (RP), radiation therapy (RT), and active surveillance (AS)—based on cross‐sectional data from a prospective registry, and to explore how these findings can inform a structured shared decision making (SDM) framework. Materials and Methods: Men with clinical stage cT3aN0M0 or lower were enrolled. Those who underwent RP or RT were surveyed 6–24 months posttreatment; men on AS had 6–60 months of follow‐up. All participants completed the EORTC QLQ‐PR25 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Prostate Cancer Module), capturing urinary, bowel, hormonal, and sexual function. The Kruskal‐Wallis test evaluated group differences, with significance set at p<0.05. Results: Among 542 patients, 435 underwent RP, 73 received RT (43% with androgen deprivation therapy), and 34 were on AS. RP patients reported higher rates of urinary incontinence and sexual dysfunction, whereas RT patients had more severe urinary irritative and bowel symptoms. AS generally preserved baseline sexual function but still involved some urinary complaints and anxiety regarding disease progression. These findings underscore the distinct trade‐offs among the 3 management strategies, emphasizing the importance of individualized SDM that accounts for functional priorities and patient values. Conclusion Each treatment modality poses unique impacts on quality of life. Incorporating these patient‐reported data into SDM discussions can improve alignment between clinical recommendations and patient preferences, potentially reducing decisional regret and enhancing long‐term outcomes.

Objectives: Epidemiological studies have shown an inverse association between Helicobacter pylori infection and ulcerative colitis (UC). In this study, we investigated the protective effects of H. pylori infection on the severity of UC. Methods: This single-center study included 316 patients with newly diagnosed UC based on findings of colonoscopy and upper endoscopy for H. pylori evaluation between January 1994 and December 2015. Patients’ medical records were retrospectively reviewed, and severity of UC was assessed based on endoscopic findings, clinical symptoms, treatment regimens, and Mayo scores. Results: The prevalence of H. pylori infection in patients with UC was 74/316 (23.4%). Based on upper endoscopic findings, the percentage of patients with duodenal ulcers was significantly higher in the H. pylori positive group than that in the H. pylori negative group (27.0% vs. 11.6%, p=0.022). Disease extent and endoscopic severity showed no significant intergroup difference (p=0.765 and p=0.803, respectively). Endoscopic severity was unaffected by the H. pylori infection status, based on the extent of endoscopically documented disease and endoscopic findings. Furthermore, UC-related symptom severity assessed on the basis of stool frequency, rectal bleeding severity, and rate of admission necessitated by UC aggravation was not associated with H. pylori infection (p=0.185, 0.144, and 0.182, respectively). Use of steroids as induction therapy for severe UC did not differ with regard to H. pylori infection (p=0.327). No intergroup difference was observed in disease severity of UC classified using the Mayo score (p=0.323). Conclusions H. pylori infection was detected in approximately 25.0% of patients with UC. However, the H. pylori infection status was not associated with the severity of UC based on endoscopic disease activity, patients’ symptoms, steroid use, or the Mayo clinic score.

Background/Aims: Transcatheter arterial embolization (TAE) is useful for management of uncontrolled upper gastrointestinal (UGI) bleeding. We investigated clinical outcomes of TAE for non-variceal bleeding from benign UGI diseases uncontrolled with endoscopic intervention. Methods: This retrospective study performed between 2017 and 2021 across four South Korean hospitals. Ninety-two patients (72 men, 20 women) who underwent angiography were included after the failure of endoscopic intervention for benign UGI disease- induced acute non-variceal bleeding. We investigated the factors associated with endoscopic hemostasis failure, the technical success rate of TAE, and post-TAE 30-day rebleeding and mortality rates. Results: The stomach (52/92, 56.5%) and duodenum (40/92, 43.5%) were the most common sites of bleeding. Failure of endoscopic procedures was attributable to peptic ulcer disease (81/92, 88.0%), followed by pseudo-aneurysm (5/92, 5.4%), and angiodysplasia (2/92, 2.2%). Massive bleeding that interfered with optimal visualization of the endoscopic field was the most common indication for TAE both in the stomach (22/52, 42.3%) and duodenum (14/40, 35.0%). Targeted TAE, empirical TAE, and exclusive arteriography were performed in 77 (83.7%), nine (9.8%), and six patients (6.5%), respectively. The technical success rate, the post-TAE 30-day rebleeding rate, and the overall mortality rate were 100%, 22.1%, and 5.8%, respectively. On multivariate analysis, coagulopathy (OR, 5.66; 95% CI, 1.71~18.74; P=0.005) and empirical embolization (OR, 5.71; 95% CI, 1.14~28.65; P=0.034) were independent risk factors for post-TAE 30-day rebleeding episodes. Conclusions TAE may be useful for acute non-variceal UGI bleeding. Targeted embolization and correction of coagulopathy can improve clinical outcomes.

OBJECTIVE: Tributyltin (TBT), an endocrine disrupting chemical, has been reported to decrease ovarian function by causing apoptosis in the ovary, but the mechanism is not fully understood. Therefore, we examined whether TBT increases the expression of adipogenesis-related genes in the ovary and the increased expression of these genes is associated with apoptosis induction. METHODS: Three-week-old Sprague-Dawley rats were orally administered TBT (1 or 10 mg/kg body weight) or sesame oil as a control for 7 days. The ovaries were obtained and weighed on day 8, and then they were fixed for terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) or frozen for RNA extraction. Using the total RNA of the ovaries, adipogenesis- and apoptosis-related genes were analyzed by real-time polymerase chain reaction (PCR). RESULTS: The ovarian weight was significantly decreased in rats administered 10 mg/kg TBT compared to that in control rats. As determined by the TUNEL assay, the number of apoptotic follicles in ovary was significantly increased in rats administered 10 mg/kg TBT. The real-time PCR results showed that the expression of adipogenesis-related genes such as PPARgamma, aP2, CD36, and PEPCK was increased after TBT administration. In addition, apoptosis-related genes such as TNFalpha and TNFR1 were expressed more in the TBT-administered rats compared with the control rats. CONCLUSION: The present study demonstrates that TBT induces the expression of adipogenesis- and apoptosis-related genes in the ovary leading to apoptosis in the ovarian follicles. These results suggest that the increased expression of adipogenesis-related genes in the ovary by TBT exposure might induce apoptosis resulting in a loss of ovarian function.
Adipogenesis ; Animals ; Apoptosis ; DNA Nucleotidylexotransferase ; Female ; In Situ Nick-End Labeling ; Ovarian Follicle ; Ovary ; PPAR gamma ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Receptors, Tumor Necrosis Factor, Type I ; RNA ; Sesame Oil ; Trialkyltin Compounds ; Tumor Necrosis Factor-alpha

OBJECTIVE: Tributyltin (TBT), an endocrine disrupting chemical, has been reported to decrease ovarian function by causing apoptosis in the ovary, but the mechanism is not fully understood. Therefore, we examined whether TBT increases the expression of adipogenesis-related genes in the ovary and the increased expression of these genes is associated with apoptosis induction. METHODS: Three-week-old Sprague-Dawley rats were orally administered TBT (1 or 10 mg/kg body weight) or sesame oil as a control for 7 days. The ovaries were obtained and weighed on day 8, and then they were fixed for terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) or frozen for RNA extraction. Using the total RNA of the ovaries, adipogenesis- and apoptosis-related genes were analyzed by real-time polymerase chain reaction (PCR). RESULTS: The ovarian weight was significantly decreased in rats administered 10 mg/kg TBT compared to that in control rats. As determined by the TUNEL assay, the number of apoptotic follicles in ovary was significantly increased in rats administered 10 mg/kg TBT. The real-time PCR results showed that the expression of adipogenesis-related genes such as PPARgamma, aP2, CD36, and PEPCK was increased after TBT administration. In addition, apoptosis-related genes such as TNFalpha and TNFR1 were expressed more in the TBT-administered rats compared with the control rats. CONCLUSION: The present study demonstrates that TBT induces the expression of adipogenesis- and apoptosis-related genes in the ovary leading to apoptosis in the ovarian follicles. These results suggest that the increased expression of adipogenesis-related genes in the ovary by TBT exposure might induce apoptosis resulting in a loss of ovarian function.
Adipogenesis ; Animals ; Apoptosis ; DNA Nucleotidylexotransferase ; Female ; In Situ Nick-End Labeling ; Ovarian Follicle ; Ovary ; PPAR gamma ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Receptors, Tumor Necrosis Factor, Type I ; RNA ; Sesame Oil ; Trialkyltin Compounds ; Tumor Necrosis Factor-alpha

BACKGROUND/AIMS: Along with the expansion of the field of laparoscopic surgery, many laparoscopic instruments have been developed and these all together made laparoscopic surgery possible in many operative procedures which used to be considered impossible to be done using a laparoscope. Suturing is a technique quite often required during laparoscopic surgery and so far we have used imported suture material. In this article, we have compared the safety and harmfulness of suture material developed domestically in Korea with those imported using house rabbits. METHODS: A total of 40 white house rabbits from New Zealand weighing 3.0-3.4 Kg were used from July 1, 2000 until April 30, 2001. Under general anesthesia, we created a pneumoperitoneum using a veress needle with a pressure of 10 mmHg followed by insertion of a 5mm laparoscope right above the umbilicus and two 5mm trocars were inserted in the right and left midclavicular lines 5cm below the costal margin. After perforating the pylorus of the stomach using laparoscopic scissors, we sutured two sites using Laploop and then perforated the body of the stomach and again sutured two sites but this time using Vicryl #3-0 for comparison with Laploop. 10 house rabbits were sacrificed each on post operation days 10, 20, 30 and 40 and tissues obtained from those house rabbits were compared using the Sewell method. RESULTS: Suturing and ties were done without any problems and there were no postoperative complications or deaths. On postoperation days 10 and 20, Laploop showed a moderate degree of tissue reaction proved by a Sewell score of 57 and 48 respectively and on postoperation days 30 and 40, a mild to moderate degree of tissue reaction occurred with a S score of 36 and 33 respectively. In models using Vicryl, the S scores were 67 an 62 on postoperation days 10 and 20 respectively showing a moderate degree of tissue reaction and on postoperation days 30 and 40, it showed a mild to moderate degree of tissue reaction with a S score of 52 and 44 respectively which is similar to the results obtained by Laploop. CONCLUSION: Imported Vicryl and Laploop were both applicable in terms of biologic compatibility but Laploop was easier to apply, more cost effective compared to Vicryl but most of all, there were no complications such as a loosening of a knot or a knot being undone. Therefore it could be concluded that Laploop shows a promising future as a suture material in laparoscopic surgery.
Anesthesia, General ; Korea ; Laparoscopes ; Laparoscopy ; Needles ; New Zealand ; Pneumoperitoneum ; Polyglactin 910 ; Postoperative Complications ; Pylorus ; Rabbits* ; Stomach ; Surgical Instruments ; Surgical Procedures, Operative ; Sutures ; Umbilicus