Purpose: The aim of this study was to investigate the efficacy of ethanol extracts of Cornus alba (ECA) against benign prostatic hyperplasia (BPH) in vitro and in vivo. Materials and Methods: The prostate stromal cells (WPMY-1) and epithelial cells (RWPE-1) were used to examine the action mechanism of ECA in BPH in vitro. ECA efficacy was evaluated in vivo using a testosterone propionate (TP)-induced BPH rat model. Results: Treatment with ECA inhibited the proliferation of prostate cells by inducing G1-phase cell cycle arrest through the regulation of positive and negative proteins. Treatment of prostate cells with ECA resulted in alterations in the mitogen-activated protein kinases and protein kinase B signaling pathways. The transcriptional binding activity of the NF-κB motif was suppressed in both ECA-treated prostate cells. In addition, treatment with ECA altered the level of BPH-associated axis markers (5α-reductase, fibroblast growth factor-2, androgen receptor, epidermal growth factor, Bcl-2, and Bax) in both cell lines. Finally, the administration of ECA attenuated the enlargement of prostatic tissues in the TP-induced BPH rat model, accompanied by histology, immunoblot, and serum dihydrotestosterone levels. Conclusions These results demonstrated that ECA exerted beneficial effects on BPH both in vitro and in vivo and might provide valuable information in the development of preventive or therapeutic agents for improving BPH.

Purpose: Predicting improvements in voiding symptoms following deobstructive surgery for male lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH) is challenging when detrusor contractility is impaired. This study aimed to develop an artificial intelligence model that predicts symptom improvement after holmium laser enucleation of the prostate (HoLEP), focusing on changes in maximum flow rate (MFR) and voiding efficiency (VE) 1-month postsurgery. Methods: We reviewed 1,933 patients who underwent HoLEP at Samsung Medical Center from July 2008 to January 2024. The study employed a deep neural network (DNN) for multiclass classification to predict changes in MFR and VE, each divided into 3 categories. For comparison, additional machine learning (ML) models such as extreme gradient boosting, random forest classification, and support vector machine were utilized. To address class imbalance, we applied the least squares method and multitask learning. Results: A total of 1,142 patients with complete data were included in the study, with 992 allocated for model training and 150 for external validation. In predicting MFR, the DNN achieved a microaverage area under the receiver operating characteristic curve (AUC) of 0.884±0.006, sensitivity of 0.783±0.020, and specificity of 0.891±0.010. For VE prediction, the microaverage AUC was 0.817±0.007, with sensitivity and specificity values of 0.660±0.014 and 0.830±0.007, respectively. These results indicate that the DNN's predictive performance was superior to that of other ML models. Conclusions The DNN model provides detailed and accurate predictions for recovery after HoLEP, providing valuable insights for clinicians managing patients with LUTS/BPH.

Purpose: The aim of this study was to investigate the efficacy of ethanol extracts of Cornus alba (ECA) against benign prostatic hyperplasia (BPH) in vitro and in vivo. Materials and Methods: The prostate stromal cells (WPMY-1) and epithelial cells (RWPE-1) were used to examine the action mechanism of ECA in BPH in vitro. ECA efficacy was evaluated in vivo using a testosterone propionate (TP)-induced BPH rat model. Results: Treatment with ECA inhibited the proliferation of prostate cells by inducing G1-phase cell cycle arrest through the regulation of positive and negative proteins. Treatment of prostate cells with ECA resulted in alterations in the mitogen-activated protein kinases and protein kinase B signaling pathways. The transcriptional binding activity of the NF-κB motif was suppressed in both ECA-treated prostate cells. In addition, treatment with ECA altered the level of BPH-associated axis markers (5α-reductase, fibroblast growth factor-2, androgen receptor, epidermal growth factor, Bcl-2, and Bax) in both cell lines. Finally, the administration of ECA attenuated the enlargement of prostatic tissues in the TP-induced BPH rat model, accompanied by histology, immunoblot, and serum dihydrotestosterone levels. Conclusions These results demonstrated that ECA exerted beneficial effects on BPH both in vitro and in vivo and might provide valuable information in the development of preventive or therapeutic agents for improving BPH.

Purpose: The aim of this study was to investigate the efficacy of ethanol extracts of Cornus alba (ECA) against benign prostatic hyperplasia (BPH) in vitro and in vivo. Materials and Methods: The prostate stromal cells (WPMY-1) and epithelial cells (RWPE-1) were used to examine the action mechanism of ECA in BPH in vitro. ECA efficacy was evaluated in vivo using a testosterone propionate (TP)-induced BPH rat model. Results: Treatment with ECA inhibited the proliferation of prostate cells by inducing G1-phase cell cycle arrest through the regulation of positive and negative proteins. Treatment of prostate cells with ECA resulted in alterations in the mitogen-activated protein kinases and protein kinase B signaling pathways. The transcriptional binding activity of the NF-κB motif was suppressed in both ECA-treated prostate cells. In addition, treatment with ECA altered the level of BPH-associated axis markers (5α-reductase, fibroblast growth factor-2, androgen receptor, epidermal growth factor, Bcl-2, and Bax) in both cell lines. Finally, the administration of ECA attenuated the enlargement of prostatic tissues in the TP-induced BPH rat model, accompanied by histology, immunoblot, and serum dihydrotestosterone levels. Conclusions These results demonstrated that ECA exerted beneficial effects on BPH both in vitro and in vivo and might provide valuable information in the development of preventive or therapeutic agents for improving BPH.

Purpose: Predicting improvements in voiding symptoms following deobstructive surgery for male lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH) is challenging when detrusor contractility is impaired. This study aimed to develop an artificial intelligence model that predicts symptom improvement after holmium laser enucleation of the prostate (HoLEP), focusing on changes in maximum flow rate (MFR) and voiding efficiency (VE) 1-month postsurgery. Methods: We reviewed 1,933 patients who underwent HoLEP at Samsung Medical Center from July 2008 to January 2024. The study employed a deep neural network (DNN) for multiclass classification to predict changes in MFR and VE, each divided into 3 categories. For comparison, additional machine learning (ML) models such as extreme gradient boosting, random forest classification, and support vector machine were utilized. To address class imbalance, we applied the least squares method and multitask learning. Results: A total of 1,142 patients with complete data were included in the study, with 992 allocated for model training and 150 for external validation. In predicting MFR, the DNN achieved a microaverage area under the receiver operating characteristic curve (AUC) of 0.884±0.006, sensitivity of 0.783±0.020, and specificity of 0.891±0.010. For VE prediction, the microaverage AUC was 0.817±0.007, with sensitivity and specificity values of 0.660±0.014 and 0.830±0.007, respectively. These results indicate that the DNN's predictive performance was superior to that of other ML models. Conclusions The DNN model provides detailed and accurate predictions for recovery after HoLEP, providing valuable insights for clinicians managing patients with LUTS/BPH.

Purpose: The aim of this study was to investigate the efficacy of ethanol extracts of Cornus alba (ECA) against benign prostatic hyperplasia (BPH) in vitro and in vivo. Materials and Methods: The prostate stromal cells (WPMY-1) and epithelial cells (RWPE-1) were used to examine the action mechanism of ECA in BPH in vitro. ECA efficacy was evaluated in vivo using a testosterone propionate (TP)-induced BPH rat model. Results: Treatment with ECA inhibited the proliferation of prostate cells by inducing G1-phase cell cycle arrest through the regulation of positive and negative proteins. Treatment of prostate cells with ECA resulted in alterations in the mitogen-activated protein kinases and protein kinase B signaling pathways. The transcriptional binding activity of the NF-κB motif was suppressed in both ECA-treated prostate cells. In addition, treatment with ECA altered the level of BPH-associated axis markers (5α-reductase, fibroblast growth factor-2, androgen receptor, epidermal growth factor, Bcl-2, and Bax) in both cell lines. Finally, the administration of ECA attenuated the enlargement of prostatic tissues in the TP-induced BPH rat model, accompanied by histology, immunoblot, and serum dihydrotestosterone levels. Conclusions These results demonstrated that ECA exerted beneficial effects on BPH both in vitro and in vivo and might provide valuable information in the development of preventive or therapeutic agents for improving BPH.

Purpose: Predicting improvements in voiding symptoms following deobstructive surgery for male lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH) is challenging when detrusor contractility is impaired. This study aimed to develop an artificial intelligence model that predicts symptom improvement after holmium laser enucleation of the prostate (HoLEP), focusing on changes in maximum flow rate (MFR) and voiding efficiency (VE) 1-month postsurgery. Methods: We reviewed 1,933 patients who underwent HoLEP at Samsung Medical Center from July 2008 to January 2024. The study employed a deep neural network (DNN) for multiclass classification to predict changes in MFR and VE, each divided into 3 categories. For comparison, additional machine learning (ML) models such as extreme gradient boosting, random forest classification, and support vector machine were utilized. To address class imbalance, we applied the least squares method and multitask learning. Results: A total of 1,142 patients with complete data were included in the study, with 992 allocated for model training and 150 for external validation. In predicting MFR, the DNN achieved a microaverage area under the receiver operating characteristic curve (AUC) of 0.884±0.006, sensitivity of 0.783±0.020, and specificity of 0.891±0.010. For VE prediction, the microaverage AUC was 0.817±0.007, with sensitivity and specificity values of 0.660±0.014 and 0.830±0.007, respectively. These results indicate that the DNN's predictive performance was superior to that of other ML models. Conclusions The DNN model provides detailed and accurate predictions for recovery after HoLEP, providing valuable insights for clinicians managing patients with LUTS/BPH.

Purpose: The aim of this study was to investigate the efficacy of ethanol extracts of Cornus alba (ECA) against benign prostatic hyperplasia (BPH) in vitro and in vivo. Materials and Methods: The prostate stromal cells (WPMY-1) and epithelial cells (RWPE-1) were used to examine the action mechanism of ECA in BPH in vitro. ECA efficacy was evaluated in vivo using a testosterone propionate (TP)-induced BPH rat model. Results: Treatment with ECA inhibited the proliferation of prostate cells by inducing G1-phase cell cycle arrest through the regulation of positive and negative proteins. Treatment of prostate cells with ECA resulted in alterations in the mitogen-activated protein kinases and protein kinase B signaling pathways. The transcriptional binding activity of the NF-κB motif was suppressed in both ECA-treated prostate cells. In addition, treatment with ECA altered the level of BPH-associated axis markers (5α-reductase, fibroblast growth factor-2, androgen receptor, epidermal growth factor, Bcl-2, and Bax) in both cell lines. Finally, the administration of ECA attenuated the enlargement of prostatic tissues in the TP-induced BPH rat model, accompanied by histology, immunoblot, and serum dihydrotestosterone levels. Conclusions These results demonstrated that ECA exerted beneficial effects on BPH both in vitro and in vivo and might provide valuable information in the development of preventive or therapeutic agents for improving BPH.

Background: s/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021. Methods: Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop. Results: In November 2021, the finalized draft was presented for public scrutiny during a formal hearing. Conclusions The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.

Purpose: BRAF mutations are detected in 30%-80% of papillary thyroid cancer (PTC) cases. DaBRAFenib and trametinib showed promising antitumor activity in patients with BRAFV600E-mutated metastatic melanoma and non–small cell lung cancer. This study aimed to evaluate the efficacy and safety of daBRAFenib and trametinib in patients with metastatic BRAFV600E-mutated thyroid cancer. Materials and Methods: This was a retrospective study to evaluate the efficacy of daBRAFenib and trametinib in patients with metastatic BRAFV600E-mutated PTC. The patients received daBRAFenib 150 mg twice daily and trametinib 2 mg once daily at the Samsung Medical Center. This study evaluated the progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR) overall survival (OS), and safety of daBRAFenib and trametinib. Results: Between December 2019 and January 2022, 27 PTC patients including eight patients with poorly differentiated or anaplastic transformation, received daBRAFenib and trametinib. The median age was 73.0 years, and the median follow-up period was 19.8 months. The majority (81.5%) had undergone thyroidectomy, while 8 patients had received prior systemic treatments. ORR was 73.1%, with 19 partial responses, and DCR was 92.3%. Median PFS was 21.7 months, and median OS was 21.7 months. Treatment-related adverse events included generalized weakness (29.6%), fever (25.9%), and gastrointestinal problems (22.2%). Dose reduction due to adverse events was required in 81.5% of the patients. Conclusion DaBRAFenib and trametinib demonstrated a high ORR with promising PFS; however, most patients with BRAFV600E-mutated metastatic PTC required a dose reduction.