PURPOSE: We investigated the impact on prostate-specific antigen (PSA) and prostate volume (PV) of statin medication for 1 year in patients with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: We retrospectively investigated 791 patients in whom BPH was diagnosed. For analysis, the patients were divided into four groups according to their medications: group A, alpha-blocker; group B, alpha-blocker+statin; group C, alpha-blocker+dutasteride; group D, alpha-blockers+statin+dutasteride. To investigate changes in serum PSA, PV, and total cholesterol, we analyzed the data at the time of initial treatment and after 1 year of medication. RESULTS: After 1 year, group A showed a 1.3% increase in PSA and a 1.0% increase in PV. Group B showed a 4.3% decrease in PSA and a 1.8% decrease in PV. The difference in PV reduction between groups A and B was statistically significant (p<0.001). Group C showed a 49.1% reduction in PSA and a 22.9% reduction in PV. Group D showed a 51.6% reduction in PSA and a 24.5% reduction in PV. The difference in PV reduction between groups C and D was not statistically significant (p=0.762). By use of a multivariate logistic regression model, we found that the probability of PV reduction after 1 year was more than 14.8 times in statin users than in statin nonusers (95% confidence interval, 5.8% to 37.6%; p<0.001). CONCLUSIONS: Statin administration reduced PSA and PV in BPH patients. This finding may imply the improvement of lower urinary tract symptoms and prevention of cardiovascular disease and chemoprevention of prostate cancer with statin treatment.
Azasteroids ; Cardiovascular Diseases ; Chemoprevention ; Cholesterol ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors* ; Logistic Models ; Lower Urinary Tract Symptoms ; Morinda ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia* ; Prostatic Neoplasms ; Retrospective Studies ; Dutasteride

PURPOSE: Animal tumor models are important for the evaluation of novel therapeutic modalities. Since the initial report of an orthotopic bladder tumor model, several modifications have been proposed to improve the tumor take rate. Here we compared the HCl-pretreated and electrocauterization-pretreated orthotopic murine bladder tumor models. MATERIALS AND METHODS: MBT-2 murine bladder cancer cells were transurethrally implanted in the bladder of syngeneic C3H/He mice. The mice were divided into three groups according to pretreatment methods (electrocautery, HCl, and control group) and were subjected to pretreatment before instillation of MBT-2 tumor cells into the bladder. Mice were sacrificed on day 21, and bladders were harvested, weighed, and examined histopathologically. RESULTS: The tumor take rate of the control, electrocautery, and HCl groups was 0%, 54%, and 100%, respectively. The tumor take rate of the HCl group was significantly higher than that of the control group (p<0.01) and the electrocautery group (p=0.01). Pathologic reports revealed that all established bladder tumors were high-grade papillary urothelial carcinomas. CONCLUSIONS: The HCl pretreatment model was a preferable murine bladder tumor model for evaluating further therapeutic interventions.
Administration, Intravesical ; Animals ; Electrocoagulation ; Mice ; Models, Animal ; Urinary Bladder ; Urinary Bladder Neoplasms

The incidence of horseshoe kidney is about 1 in 400 cases. The presence of Wilms' tumor with a horseshoe kidney is unusual, and the occurrence of Wilms' tumor in a horseshoe kidney is estimated at 0.4 to 0.9% of all Wilms' tumors. We report the case of a 5-year-old boy who presented with a stage IV Wilms' tumor in a horseshoe kidney. The patient was treated with preoperative chemotherapy followed by surgical resection and adjuvant chemotherapy. This case illustrates the role of preoperative chemotherapy for preserving renal function and aims to highlight the multimodality treatment of Wilms' tumor.
Chemotherapy, Adjuvant ; Humans ; Incidence ; Kidney ; Neoadjuvant Therapy ; Preschool Child ; Wilms Tumor

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

AIMTo characterize the feasibility of the surgical replacement of the penile tunica albuginea (TA) and to evaluate the value of a porcine bladder acellular matrix (BAM) graft.

METHODSAcellular matrices were constructed from pigs' bladders by cell lysis, and then examined by scanning electron microscopy (SEM). Expression levels of the mRNA of the vascular endothelial growth factor (VEGF) receptor, fibroblast growth factor (FGF)-1 receptor, neuregulin, and brain-derived neurotrophic factor (BDNF) in the acellular matrix and submucosa of the pigs'bladders were determined through the reverse transcription-polymerase chain reaction (PCR). A 5 mm X 5 mm square was excised from the penile TA of nine rabbits. The defective TA was then covered in porcine BAM. Equal numbers of animals were sacrificed and histochemically examined at 2, 4 and 6 months after implantation.

RESULTSSEM of the BAM showed collagen fibers with many pores. VEGF receptor, FGF-1 receptor and neuregulin mRNA were expressed in the porcine BAM; BDNF mRNA was not detected. Two months after implantation, the graft sites exhibited excellent healing without contracture, and the fusion between the graft and the neighboring normal TA appeared to be well established. There were no significant histological differences between the implanted tunica and the normal control tunica at 6 months after implantation.

CONCLUSIONThe porcine BAM graft resulted in a structure which was sufficiently like that of the normal TA. This implantation might be considered applicable to the reconstruction of the TA in conditions such as trauma or Peyronie's disease.

Animals ; Brain-Derived Neurotrophic Factor ; genetics ; Cyclophilins ; genetics ; Disease Models, Animal ; Male ; Microscopy, Electron, Scanning ; Neuregulins ; genetics ; Penis ; surgery ; Polymerase Chain Reaction ; Receptors, Fibroblast Growth Factor ; genetics ; Receptors, Vascular Endothelial Growth Factor ; genetics ; Reconstructive Surgical Procedures ; Surgery, Plastic ; Swine ; Urinary Bladder ; physiology ; surgery ; ultrastructure

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

The occurrence of bladder tumors in the first 2 decades of life are rare neoplasias. Transitional cell tumors of the bladder are extremely a rare clinical disease entity. Here, a case of a papillary urothelial tumor in a 5-year-old girl is reported, with a brief review of the literature. Histologically, the tumor was a solitary and papillary urothelial tumor of low malignant potential (by WHO and the ISUP).
Child ; Child, Preschool* ; Female* ; Humans ; Urinary Bladder Neoplasms ; Urinary Bladder*

Endometriosis represents extrauterine nonneoplastic endometrial tissue. It is most commonly diagnosed in women of childbearing age, with a peak age of 40 to 44 years. The incidence of genitourinary involvement ranges from 1% to 2%. Ureteral endometriosis is a rare entity, and its diagnosis requires a high index of suspicion. We report a case of ureteral endometriosis in a 44-year-old multiparous woman with a brief review of literature.
Adult ; Diagnosis ; Endometriosis* ; Female ; Humans ; Hydronephrosis ; Incidence ; Ureter*

PURPOSE: An animal model with experimental uremia is an important research tool for the study of pathophysiological events that take place during chronic renal failure. Among the several techniques of making uremic models, the two-stage 5/6 nephrectomized rat model is the most popular method, but this modality has some disadvantages. The aim of this study was to simplify the complicated method for experimental uremic animal models in the rat. MATERIALS AND METHODS: Forty Sprague-Dawley rats were used for this study. They were divided into three groups: 20 in the experimental group, 10 in the control group, and 10 in the Sham operation group. The ligation of the left renal vessels and 2/3 right renal partial nephrectomy using the 3-0 Silk tie of renal parenchyme were performed simultaneously in the experimental group. The BUN and serum creatinine were measured in all groups in intervals of every two weeks for a total time of nine weeks after nephrectomy. The kidneys of experimental rats were harvested and analyzed histologically. RESULTS: One week after operation, BUN and creatinine of the experimental group were increased compared to the control group and Sham operation group (p<0.001). At 9 weeks, increased levels of BUN and creatinine were maintained in the experimental group (p<0.001). Histologically, fibrotic changes of partially nephrectomized kidneys and decreased numbers of microorgans, such as the glomeruli and tubules, were observed in the experimental group. Four rats (4/20) in the experimental group died during this experiment. CONCLUSIONS: To induce chronic renal failure in rats, the one-stage procedure (2/3 nephrectomy using the suture tie and ligation of contralateral renal vessels) is an acceptable method with a low mortality rate.
Animals ; Creatinine ; Kidney ; Kidney Failure, Chronic* ; Ligation ; Models, Animal ; Models, Theoretical* ; Mortality ; Nephrectomy ; Rats* ; Rats, Sprague-Dawley ; Renal Insufficiency ; Silk ; Sutures ; Uremia

PURPOSE: It is well known that alcoholics with hepatic cirrhosis exhibit alterations in the hypothalamic-pituitary-gonadal axis as well as vitamins and trace element deficiencies leading to an inadequate testicular function, which is related to impotence and infertility. Several studies on chronic alcoholics have revealed that alcohol exerts cytotoxic effect at the testicular level. However, the exact mechanisms of alcohol cytotoxicity on testicular cells have not been clarified. In this study, it was determined whether or not alcohol induces apoptosis in Leydig cells. MATERIALS AND METHODS: The Leydig cells, TM3, were grown in culture. The cells were exposed to various alcohol (Ethanol) concentrations for 3 hours, ranging from 50mM to 500mM. The cells without alcohol treatment served as the controls. The cell viability and proliferative activities were determined using a 3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide (MTT) assay. The apoptotic cellular changes were assessed by 4,6-diamidino-2-phenylindole (DAPI) staining, a terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end-labeling (TUNEL) assay, which were confirmed with a DNA fragmentation assay. A further investigation with reverse transcription-polymerase chain reaction (RT-PCR), caspase-3 enzyme assay, and Western blot analysis was performed. RESULTS: The MTT assay revealed that alcohol induces Leydig cell cytotoxicity in a concentration dependent manner. Alcohol treatment resulted in definitive apoptotic features including DNA fragmentation, increased caspase-3 enzyme activity, mRNA expression, and protein. CONCLUSIONS: In this study, alcohol was shown to induces typical apoptosis on Leydig cells via caspase-3 activation. It is suggested that alcohol-induced apoptosis is one of the important mechanisms in male urogenital disorders including erectile dysfunction and infertility. Further studies to clarify the detailed mechanisms of alcohol-induced apoptosis on Leydig cells are recommended.
Alcoholics ; Apoptosis* ; Axis, Cervical Vertebra ; Blotting, Western ; Caspase 3 ; Cell Line* ; Cell Survival ; DNA Fragmentation ; DNA Nucleotidylexotransferase ; Enzyme Assays ; Erectile Dysfunction ; Humans ; Infertility ; Leydig Cells ; Liver Cirrhosis ; Male ; RNA, Messenger ; Vitamins