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Objectives: This study aims to evaluate the impact of anterior fibromuscular stroma preserved enucleation (AFSPE) of the prostate on serum testosterone levels in patients with benign prostatic obstruction (BPO) and to explore age‐related differences in postoperative testosterone elevation. Methods: In a retrospective analysis, 304 patients from a pool of 560 who underwent AFSPE at Linkou Chang Gung Memorial Hospital between January 2018 and December 2021 were evaluated. Patients were stratified based on preoperative testosterone levels into low (<3.5 ng/mL) and normal (≥3.5 ng/mL) groups. Serum testosterone levels were measured preoperatively, at 1.5 and 3–6 months postoperatively. Age and other demographic data were analyzed as potential factors influencing testosterone changes. Results: The low‐testosterone group (n = 90) showed significant testosterone increases, from an average of 2.61 ng/mL preoperatively to 3.3 ng/mL at 1.5 months and 3.59 ng/mL at 3–6 months postoperatively (p < 0.0001). The normal‐testosterone group (n = 214) maintained stable testosterone levels at 1.5 months but exhibited a significant rise to 6.06 ng/mL by 3–6 months (p = 0.0079). Older age was inversely associated with postoperative testosterone elevation in both groups. Improvements in nocturia were notable in both groups. Conclusions: AFSPE of the prostate significantly elevates serum testosterone levels in men with BPO, particularly benefiting those initially with low levels. Age is a crucial factor influencing postoperative testosterone changes, indicating that younger patients may benefit more from this intervention. AFSPE offers a promising approach for improving hormonal health in BPO patients, alongside alleviating urinary symptoms. [ABSTRACT FROM AUTHOR]

Microfluidics has enabled the miniaturization of fluidic systems for various biomedical and industrial applications, including small-scale robotic propulsion. One mechanism for generating propulsive force through microfluidics is by exploiting the solutal Marangoni effect via releasing surfactant on the air-water interface. Surfactants locally reduce the surface tension, which leads to a surface stress that can propel the floating robot, called Marangoni surfer. However, so far the release of the surfactant is not controllable. In this study, we combine microfluidics-based Marangoni propulsion with a novel untethered magnetic pumping mechanism to enhance its controllability. The proposed magnetic micropump capitalizes on the interaction force between two soft magnets, which can generate a pumping force of 4.64 mN to actuate a membrane, and achieve a deformation of 450 μm. Net flow is achieved using a nozzle/diffuser flow rectifier whose efficacy as a function of the channel geometry is numerically studied. We investigate the flow rate of the pump with regard to the actuation frequency. Finally, we demonstrate its ability to control the motion of the Marangoni surfer. [ABSTRACT FROM AUTHOR]

Aims: Evidence showed that SGLT2 inhibitors have greater protective effects against retinal diseases compared to other hypoglycemic agents. Thus, we explore the association between SGLT2 inhibitor usage and macular degeneration (MD) in Taiwanese patients with diabetes. Methods: The National Health Insurance (NHI) program's claim data are released as the National Health Insurance Research Database (NHIRD). This database covers more than 99% of the residents in Taiwan. We included data on patients who were newly diagnosed with type 2 diabetes mellitus (ICD-9-CM: 250, exclude 250.1x; ICD-10-CM: E11), with an age at diagnosis of over 20 years as our study population. Patients who received (sodium-glucose cotransporter 2 inhibitor) SGLT2i (ATC code: A10BK) over 90 days in 2016–2019 were defined as the SGLT2i cohort. Conversely, patients who did never received SGLT2i were defined as the non-SGLT2i cohort. The exclusion criteria were having MD before the index date, receiving SGLT2i within 1–89 days, and missing data on sex, age, or days of SGLT2i usage. Two cohorts were matched by 1:1 propensity score matching, which was based on age, sex, payroll bracket grade, urbanization, comorbidities, and medications. Results: Compared to non-SGLT2i cohort, patients who received SGLT2i had a significantly lower risk of MD (adjusted hazard ratio = 0.70, 95%CI = 0.66–0.75). Conclusions: We found that SGLT2is has a strong protective effect against MD in patients with diabetes. SGLT2is may have benefits beyond glycemic control in patients with DR. However, additional clinical and experimental studies are required. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to investigate the surgical outcomes of endoscopic enucleation of the prostate in older males with or without preoperative urinary retention (UR). Material and methods: We conducted a study on selected patients with symptomatic benign prostatic hyperplasia (BPH) who underwent either thulium:YAG laser (vela XL) prostate enucleation (ThuLEP) or bipolar plasma enucleation of the prostate (B-TUEP) at the geriatric urology department of our institution. The studied patients were categorized into two groups, namely the UR group and the non-UR group, on the basis of whether they experienced UR in the 1 month preceding their surgery. Their clinical outcomes following prostate endoscopic surgery were evaluated and analyzed. Results: Our results revealed comparable outcomes for operation time, length of hospital stay, percentage of tissue removed, re-catheterization rate, and urinary tract infection rate within the 1 month between the B-TUEP and ThuLEP surgery groups, regardless of UR history. However, the non-UR B-TUEP group experienced more blood loss relative to the non-UR ThuLEP group (P =.004). Notably, patients with UR exhibited significantly greater changes in IPSS total, IPSS voiding, and prostate-specific antigen values relative to those without UR. Conclusions: Both ThuLEP and B-TUEP were effective in treating BPH-related bladder outlet obstruction. Our study identified more pronounced changes in IPSS total, IPSS voiding, and prostate-specific antigens within the UR group. Moreover, the rate of postoperative UR in this group was not higher than that observed in the non-UR group. Our study also revealed that the presumed benefits of laser surgery in reducing blood loss were less pronounced for patients with UR. [ABSTRACT FROM AUTHOR]

Natural products have attracted great interest in the development of tissue engineering. Recent studies have demonstrated that unsaturated fatty acids found in natural plant seed oil may exhibit positive osteogenic effects; however, few in vivo studies have focused on the use of plant seed oil for bone regeneration. The aim of this study is to investigate the effects of seed oil found in Sapindus mukorossi (S. mukorossi) on the osteogenic differentiation of mesenchymal stem cells and bone growth in artificial bone defects in vivo. In this study, Wharton-jelly-derived mesenchymal stem cells (WJMSCs) were co-cultured with S. mukorossi seed oil. Cellular osteogenic capacity was assessed using Alizarin Red S staining. Real-time PCR was carried out to evaluate ALP and OCN gene expression. The potential of S. mukorossi seed oil to enhance bone growth was assessed using an animal model. Four 6 mm circular defects were prepared at the parietal bone of New Zealand white rabbits. The defects were filled with hydrogel and hydrogel-S. mukorossi seed oil, respectively. Quantitative analysis of micro-computed tomography (Micro-CT) and histological images was conducted to compare differences in osteogenesis between oil-treated and untreated samples. Although our results showed no significant differences in viability between WJMSCs treated with and without S. mukorossi seed oil, under osteogenic conditions, S. mukorossi seed oil facilitated an increase in mineralized nodule secretion and upregulated the expression of ALP and OCN genes in the cells (p < 0.05). In the animal study, both micro-CT and histological evaluations revealed that new bone formation in artificial bone defects treated with S. mukorossi seed oil were nearly doubled compared to control defects (p < 0.05) after 4 weeks of healing. Based on these findings, it is reasonable to suggest that S. mukorossi seed oil holds promise as a potential candidate for enhancing bone healing efficiency in bone tissue engineering. [ABSTRACT FROM AUTHOR]

Purpose: Postoperative urinary retention (PUR) is a common complication after prostate enucleation, which leads to an increased length of hospital stay and decreased postoperative satisfaction. This study determined the predictive factors of postoperative urine retention within 1 month after prostate enucleation and investigated whether PUR influences surgical outcomes at the 2-week, 3-month, and 6-month follow-up time points. Methods: Data were collected from the electronic medical records of 191 patients with benign prostatic obstruction (BPO) during October 2018 to September 2021. Of them, 180 patients who underwent thulium laser or plasma kinetic enucleation of the prostate (ThuLEP, PKEP) were separated into the PUR group (n = 24) and the non-PUR (NPUR) group (n = 156). Uroflowmetry and the International Prostate Symptom Score (IPSS) questionnaire were followed up at 2 weeks, 3 months, and 6 months postoperatively. Results: The PUR group had a significantly higher percentage of patients with type 2 diabetes mellitus (DM) than the NPUR group. Postoperatively, compared with the NPUR group, the PUR group had significantly less improvement in changes in the IPSS Quality of Life scores at 2 weeks, the total IPSS(International Prostate Symptom Score) at all follow-up times, the IPSS-S(IPSS storage subscores) at 2 weeks and 3 months, and the IPSS-V(IPSS voiding subscores) at all follow-up times. Predictive factors for PUR include lower preoperative maximum urinary flow (Qmax), lower preoperative total IPSS, and higher operation time. Conclusion: Lower preoperative Qmax, lower IPSS scores, and longer operation time were risk factors for PUR. Furthermore, PUR could be a prognostic factor for prostatic enucleation surgical outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This study is centered on the critical role of anterior fibromuscular stroma (AFS) preservation in prostate enucleation, an emerging strategy aimed at minimizing postoperative urinary incontinence—a common concern in benign prostatic hyperplasia (BPH) surgeries. By focusing on postoperative voiding volumes (VV), our research investigates the efficacy of AFS preservation. This approach, distinct in its methodology, is hypothesized to improve urinary function post-surgery, thereby offering a potentially significant advancement in BPH surgical treatments. Materials and Methods: A retrospective analysis was conducted, comparing patients who underwent prostate enucleation in 2017 without intentional AFS preservation to those in 2019 with this technique. We examined variables including age, BMI, diabetes, hypertension, and preoperative VV to assess their effect on post-catheter removal VV. The study's methodology includes a thorough review of the primary statistical analysis methods employed. Results: Our analysis indicates that while the 2017 and 2019 cohorts were similar in most preoperative parameters, the 2019 group that underwent AFS-preserved surgery showed a significant improvement in postoperative VVs. This was less pronounced in the patient group aged over 70, underscoring the importance of this demographic in our study. Conclusions: The study concludes that intentional preservation of AFS during prostate enucleation positively impacts early postoperative VVs, with limited improvement in older patients. These findings highlight the potential of AFS preservation not only in enhancing urinary outcomes post-surgery but also in shaping future BPH surgical procedures and research directions. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify the characteristics associated with the need for urinary intervention for a blunt renal injury with collection system involvement using a computed tomography (CT) protocol for trauma. Materials and Methods: Abdominal CT images of patients with blunt renal injuries from 2016 to 2020 were reviewed. Patients with low-grade renal trauma, non-collecting system involvement, American Association for the Surgery of Trauma grade V shattered kidney, and emergent nephrectomy were excluded. The largest perinephric mass thickness was measured in the axial view using CT, and a cutoff value was obtained using a receiver-operating characteristic curve analysis. Risk factors for further urinary intervention were analyzed. Results: Among the 70 patients included in this study, those with perinephric mass thicknesses < 25 mm (n = 36) had a significantly lower rate of urinary intervention than those with perinephric mass thicknesses ≥ 25 mm (0 vs. 5; p = 0.023). There was no significant difference in the follow-up durations of the groups (19 days vs. 38 days; p = 0.198). More than 90% of the perinephric mass in the < 25 mm group resolved within a median follow-up duration of 38 days, whereas nearly half of the ≥ 25 mm group had a residual perinephric mass during a median follow-up duration of 19 days. Conclusion: The initial CT protocol for trauma was useful for predicting the need for further urinary interventions for collecting system injuries. A perinephric mass thickness < 25 mm is predictive of a low likelihood of requiring urinary intervention. [ABSTRACT FROM AUTHOR]

Bubble‐driven microsystems inspired by the therapeutic use of microbubbles under clinical ultrasound actuation offer innovative remote manipulation in biological settings. Ultrasound‐powered microrobots, benefiting from a distribution of vibrating microbubbles (1–100 μm in diameters), exhibit localized fluid flow for self‐propulsion. Microbubbles also contribute to the design of acoustic metamaterials, where distributed actuation of bubbles enables exotic material properties (e.g., negative refractive index). Herein, a metamaterial‐inspired microrobot design, which exploits the streaming induced by the collective oscillation of microbubble arrays (> 10), is reported. Such a large distribution of bubbles offers twofold advantages: a mesoscale microrobot allowing ease of handling and motion at a considerably low acoustic driving pressure of 50 kPa. In this work, the oscillatory amplitude of a single bubble that acts as a unit cell of the metamaterial‐based microrobot is first characterized. Thereon, this amplitude is related to the flow generated by the collective vibration of all the bubbles close to the theoretically predicted resonant frequency of the bubbles. Finally, the hovering motion of the microrobot induced by the streaming and flow‐assisted debris clearance is demonstrated. Such auxiliary functionalities of the microrobot can be useful for applications like contactless sample extraction in inaccessible biological environments. [ABSTRACT FROM AUTHOR]

Double-side-emission (DSE) CdSe@CdZnSeS/ZnS quantum dot (QD) light-emitting diodes (DSE-QLEDs) with transparent nanometer-thick metal electrodes were achieved by monolayer (ML) MoS2-mediated van der Waals (vdW) epitaxy. Via the transfer of a wafer-area MoS2 film from sapphire to polyethylene terephthalate (PET) substrates and ZnO nanoparticle (NP) layer surfaces, flexible red DSE-QLEDs with the structure of MoS2/Au/M-PEDOT:PSS/poly-TPD/QD/ZnO NP/MoS2/Al can be readily obtained by spin-coating and thermal evaporation. The unique van der Waals epitaxy on MoS2 surfaces greatly helps the lateral film formation for both nanometer-thick Au films on flat PET substrates and Al films on the rough ZnO layer surface. The conductive Au and Al films grown on MoS2 surfaces act as effective anode and cathode electrodes for current injections of the QLEDs, respectively, while the ML MoS2 contributes to the balance of injected charges by suppressing the electron injection rate. Finally, with the 10 nm-thick Au anode and 15 nm-thick Al cathode, our flexible DSE-QLEDs exhibit a subthreshold turn-on voltage of 1.8 V, a maximum luminance of ∼83000 cd/m2, and a current efficiency of 31.9 cd/A, in which approximately 36% of total luminance is contributed from the Al cathode side emission. [ABSTRACT FROM AUTHOR]

Simple Summary: Liver cancer is a significant health challenge worldwide, often developing in individuals with pre-existing conditions like chronic hepatitis and fatty liver. This study delves into the possible benefits of colchicine, a medication traditionally used to treat gout, in reducing the risk of developing liver cancer. By examining extensive health data from the China Medical University Hospital in Taiwan, we compared liver cancer development in two groups: one that used colchicine and another that did not. Our findings reveal that colchicine users had a 19% reduced risk of developing liver cancer, a promising indication that requires further investigation. If these findings are substantiated via further research, colchicine could become a valuable tool in preventing liver cancer, especially for those with liver conditions, potentially saving numerous lives and reducing the burden on healthcare systems. This study underlines the importance of exploring new uses for existing medications and highlights the potential impact of colchicine on liver cancer prevention. This could lead to newer, cost-effective strategies to mitigate the risks and impacts of liver cancer, bringing hope to millions worldwide. Background: Liver cancer and notably hepatocellular carcinoma (HCC), results in significantly high mortality rates worldwide. Chronic hepatitis and fatty liver, recognized precursors, underscore the imperative need for effective preventive strategies. This study explores colchicine, traditionally acknowledged for its anti-inflammatory properties and investigates its potential in liver cancer prevention. Methods: Utilizing the iHi Data Platform of China Medical University Hospital, Taiwan, this study analyzed two decades of medical data, incorporating 10,353 patients each in the Colchicine and Non-Colchicine cohorts, to investigate the association between colchicine use and liver cancer risk. Results: The study identified that colchicine users exhibited a 19% reduction in liver cancer risk, with a multivariable-adjusted odds ratio of 0.81 after accounting for confounding variables. Additionally, the influence of gender and comorbidities like diabetes mellitus on liver cancer risk was identified, corroborating the existing literature. A notable finding was that the prolonged use of colchicine was associated with improved outcomes, indicating a potential dose–response relationship. Conclusions: This study proposes a potential new role for colchicine in liver cancer prevention, extending beyond its established anti-inflammatory applications. While the findings are promising, further research is essential to validate these results. This research may serve as a foundation for future studies, aiming to further explore colchicine's role via clinical trials and in-depth investigations, potentially impacting preventive strategies for liver cancer. [ABSTRACT FROM AUTHOR]

This Viewpoint discusses the challenges to implementing artificial intelligence–based translation in clinical settings and what health care organizations can do to mitigate these challenges. [ABSTRACT FROM AUTHOR]

Background: Benign prostate obstruction (BOO) is becoming increasingly important in this aging society. Some urge/stress urinary incontinence (UUI/SUI) still occurs after endoscopic enucleation of the prostate (EEP). It remains unclear how post-EEP incontinence can be avoided. Currently, early apical release to ameliorate the traction of the external sphincter is the best technique for incontinence prevention. Objective: To describe our surgical technique of anterior fibromuscular stroma (AFS)-preserved EEP for BOO. Design, setting, and participants: The medical records of 60 consecutive patients who underwent AFS-preserved EEP for BOO in our center from September 2019 to December 2019 were retrospectively reviewed. Surgical procedure: AFS-preserved EEP starts at the 12 o'clock position of the urethra, and the junction between the AFS and transitional zone (T-zone) was identified. The AFS and T-zone were separated first to protect the AFS in the initial operative procedure. Then, following the usual enucleation procedure, AFS-preserved EEP could be achieved. Measurements: Postoperative prostate-specific antigen (PSA), testosterone, urethral stricture, and voiding status, such as incontinence, uroflow, and postvoiding residual urine were assessed. Results and limitations: The data show that AFS-preserved EEP could achieve similar surgical outcomes as other early apical release approaches. Conclusions: The preserved AFS provides a nice landmark at the 12 o'clock position during EEP. [ABSTRACT FROM AUTHOR]

Background and Objectives: This study evaluated and compared the surgical outcomes of retrograde intrarenal surgery (RIRS) lithotripsy versus robot-assisted laparoscopic pyelolithotomy (RAPL) in community patients with renal pelvic stones larger than 2 cm. Materials and Methods: A total of 77 patients who underwent RIRS (RIRS group, n = 50) or RAPL (RAPL group, n = 27) at our institution between December 2016 and July 2022 were recruited. A single surgeon performed all surgical operations. Preoperative, operative, and postoperative data were recorded. The study evaluated various clinical outcomes, namely, urinary tract infections, analgesic use, emergency room readmissions, stone clearance rates, surgical complications, and medical expenditures associated with the treatment courses, and compared them between the groups. Results: The RAPL group had a larger mean stone diameter and higher degree of hydronephrosis than the RIRS group did. The RIRS group had superior outcomes regarding operative time, length of postoperative hospital stay, surgical wound pain, and medical expenditures. Regarding postoperative outcomes, comparable rates of postoperative urinary tract infection, prolonged analgesic use, and emergency room readmissions were observed between the groups. However, the RAPL group had a higher stone clearance rate than the RIRS group did (81.5% vs. 52.0%, p = 0.014). Conclusions: For the surgical treatment of renal pelvis stones larger than 2 cm, RAPL has a superior stone clearance rate than RIRS; however, RIRS achieves superior outcomes in terms of medical expenditures, length of hospital stay, and surgical wound pain. Both procedures were equally safe. [ABSTRACT FROM AUTHOR]

The androgen-dependent or -independent pathways are regarded as primary therapeutic targets for the neoplasm of the prostate. Mucosa-associated lymphoid tissue 1 (MALT1) acting as a paracaspase in the regulation of nuclear factor κB (NF-κB) signal transduction plays a central role in inflammation and oncogenesis in cancers. This study confirmed the potential linkages between androgen and NF-κB activation by inducing MALT1 in the androgen receptor-full length (ARFL)-positive LNCaP and 22Rv1 prostate cancer cells. Although androgen did not stimulate MALT1 expression in AR-null or ectopic ARFL-overexpressed PC-3 cells, the ectopic overexpression of the AR splicing variant 7 (ARv7) upregulated MALT1 to activate NF-κB activities in 22Rv1 and PC-3 cells. Since the nuclear translocation of p50 and p65 was facilitated by ARv7 to motivate NF-κB activity, the expressions of MALT1, prostate-specific antigen (PSA), and N-myc downstream regulated 1 (NDRG1) were therefore induced in ectopic ARv7-overexpressed prostate cancer cells. Ectopic ARv7 overexpression not only enhanced 22Rv1 or PC-3 cell growth and invasion in vitro but also the tumor growth of PC-3 cells in vivo. These results indicate that an androgen receptor induces MALT1 expression androgen-dependently and -independently in ARFL- or ARv7-overexpressed prostate cancer cells, suggesting a novel ARv7/MALT1/NF-κB-signaling pathway may exist in the cells of prostate cancer. [ABSTRACT FROM AUTHOR]

Soft robotics can be used not only as a means of achieving novel, more lifelike forms of locomotion, but also as a tool to understand complex biomechanics through the use of robotic model animals. Herein, the control of the undulation mechanics of an entirely soft robotic subcarangiform fish is presented, using antagonistic fast‐PneuNet actuators and hyperelastic eutectic gallium–indium (eGaIn) embedded in silicone channels for strain sensing. To design a controller, a simple, data‐driven lumped parameter approach is developed, which allows accurate but lightweight simulation, tuned using experimental data and a genetic algorithm. The model accurately predicts the robot's behavior over a range of driving frequencies and a range of pressure amplitudes, including the effect of antagonistic co‐contraction of the soft actuators. An amplitude controller is prototyped using the model and deployed to the robot to reach the setpoint of a tail‐beat amplitude using fully soft and real‐time strain sensing. [ABSTRACT FROM AUTHOR]

This document is a letter to the editor discussing the use of pigtail suture stents (PSS) versus Double J stents in ureterorenoscopy (URS) procedures. The letter highlights studies that show PSS may result in fewer post-operative bladder irritative symptoms compared to Double J stents. However, the letter also raises concerns about the efficacy of PSS in managing conditions such as ureteral edema, trauma, or residual stone formations. It also discusses the potential benefits of PSS in preserving the competency of the ureterovesical junction (UVJ) and reducing upper tract damage. The letter emphasizes the need to find a balance between stent placement duration, managing obstruction and vesicoureteral reflux (VUR), and considering the role of ureteral external compression by tumors. The authors also mention the potential complications associated with indwelling ureteric stents. The letter concludes by stating that the insights from previous studies should be considered when inserting Double J stents. [Extracted from the article]

The study by Kato et al. explores the relationship between nocturnal polyuria (NP) and inadequate nighttime blood pressure reduction in men with lower urinary tract symptoms (LUTS). The findings suggest that men with NP have less reduction in systolic blood pressure during sleep compared to those without NP, indicating a potential therapeutic avenue of enhancing nocturnal blood pressure reduction to mitigate NP. The authors also propose a mechanism that explains the interconnection between disturbances in urine production at night, circadian rhythm disruptions, and hormonal regulation. They emphasize the importance of considering factors such as nocturia, NP, and testosterone levels in the management of LUTS. [Extracted from the article]

The article discusses the anterior prostatic urethral mucosa preservation (APUMP) technique and its effectiveness in reducing postoperative stress urinary incontinence during holmium laser enucleation of the prostate (HoLEP). The APUMP technique, similar to the AFS-preserved method, focuses on preserving critical anatomical structures to mitigate complications. The preservation of the anterior prostatic urethral mucosa is a consequential result of preserving the anterior fibromuscular stroma (AFS), which significantly reduces urinary incontinence rates. The article also highlights the importance of preserving the AFS in maintaining structural integrity and enhancing functional outcomes. Both the APUMP technique and the AFS-preserved technique contribute to improving patient outcomes in prostate surgeries. [Extracted from the article]

This article discusses the relationship between lower extremity muscle strength, area, specific force, and lower urinary tract symptoms (LUTS) in older men. The study, which analyzed data from the Baltimore Longitudinal Study of Aging, found a correlation between higher thigh muscle strength and specific force with milder LUTS in cross-sectional models. However, longitudinal analyses did not reveal a significant connection between baseline muscle measurements and changes in urinary symptoms over time. The article suggests that nocturia and testosterone levels may play a role in the relationship between muscle function and LUTS. It emphasizes the importance of managing nocturia to prevent the decline of testosterone and maintain muscle mass and strength. [Extracted from the article]

Bleeding during endoscopic prostate surgery is often overlooked, and appropriate measurement techniques are rarely applied. We proposed a simple and convenient method for assessing the severity of bleeding during endoscopic prostate surgery. We determined the factors affecting bleeding severity and whether they affected the surgical results and functional outcomes. Records from March 2019 to April 2022 were obtained for selected patients who underwent endoscopic prostate enucleation through either 120-W Vela XL Thulium:YAG laser or bipolar plasma enucleation of the prostate. The bleeding index was measured using the following equation: irrigant hemoglobin (Hb) concentration (g/dL) × irrigation fluid volume (mL)/preoperative blood Hb concentration (g/dL) × enucleated tissue (g). Our research revealed that patients who underwent surgery employing the thulium laser, those aged over 80 years, and those with a preoperative maximal flow rate (Qmax) of more than 10 cc/s experienced less surgical bleeding. The patients' treatment outcomes differed depending on the severity of the bleeding. Enucleating prostate tissue was easier in the patients with less severe bleeding, who also had a lower risk of developing urinary tract infections and an improved Qmax. [ABSTRACT FROM AUTHOR]

Background: Given that highly migrated cervical disk herniation (CDH) is a rare condition, its treatment remains controversial as reported by Srinivasan (2011). When the primary pathology is located posterior or lateral to the lateral edge of the spinal cord that causes a foraminal or far lateral disk herniation, a posterior full-endoscopic cervical discectomy (pFECD) may be appropriate as reported by Ahn (2020). Methods: We introduced the pFECD with retrocorporeal technique and hemilaminectomy performed on a case of C4/C5 highly downward migrated CDH with left C5/C6 cervical neural foraminal stenosis (Fig. 1). Conclusions: pFECD with retrocorporeal technique and hemilaminectomy could be an effective and minimally invasive option for highly migrated CDH. [ABSTRACT FROM AUTHOR]

Background: We evaluated the impact of endoscopic enucleation of the prostate on testosterone levels in hypotestosteronemic patients with bladder outlet obstruction. Methods: We enrolled 294 men with lower urinary tract symptoms (LUTS) who received surgery between January 2019 and December 2020 in simple tertiary centre. The inclusion criteria were as follows: being a male patient aged 45–95 years and having recurrent urinary tract infection, having previously failed medical treatment for LUTS or urine retention, and undergoing bipolar or thulium laser enucleation of the prostate. The preoperative and postoperative data were retrospectively reviewed. Results: This study included 112 men with a mean age of 69.4 years. The mean preoperative and postoperative testosterone levels were 4.8 and 4.98, respectively. Of the patients, 88 (78.6%) received ThuLEP and 24 received BipolEP. We divided the patients into two groups according to preoperative serum testosterone levels: normal-testosterone (≥3 ng/mL) and low-testosterone (<3 ng/mL) groups. A significant change in testosterone levels (p = 0.025) was observed in the low-testosterone group. In contrast, no significant difference in testosterone levels was noted in the normal-testosterone group (p = 0.698). Conclusions: Endoscopic enucleation surgery of the prostate could improve postoperative testosterone levels in hypotestosteronemic patients with bladder outlet obstruction. [ABSTRACT FROM AUTHOR]

The WNT1 inducible signaling pathway protein 1 (WISP1), a member of the connective tissue growth factor family, plays a crucial role in several important cellular functions in a highly tissue-specific manner. Results of a RT-qPCR indicated that WISP1 expressed only in cells of the human prostate fibroblasts, HPrF and WPMY-1, but not the prostate carcinoma cells in vitro. Two major isoforms (WISP1v1 and WISP1v2) were identified in the HPrF cells determined by RT-PCR and immunoblot assays. The knock-down of a WISP1 blocked cell proliferation and contraction, while treating respectively with the conditioned medium from the ectopic WISP1v1- and WISPv2-overexpressed 293T cells enhanced the migration of HPrF cells. The TNFα induced WISP1 secretion and cell contraction while the knock-down of WISP1 attenuated these effects, although TNFα did not affect the proliferation of the HPrF cells. The ectopic overexpression of WISP1v1 but not WISP1v2 downregulated the N-myc downstream regulated 1 (NDRG1) while upregulating N-cadherin, slug, snail, and vimentin gene expressions which induced not only the cell proliferation and invasion in vitro but also tumor growth of prostate carcinoma cells in vivo. The results confirmed that WISP1 is a stroma-specific secreting protein, enhancing the cell migration and contraction of prostate fibroblasts, as well as the proliferation, invasion, and tumor growth of prostate carcinoma cells. [ABSTRACT FROM AUTHOR]

This document is a letter to the editor discussing the use of pigtail suture stents (PSS) versus Double J stents in ureterorenoscopy (URS) procedures. The letter highlights studies that show PSS may result in fewer post-operative bladder irritative symptoms compared to Double J stents. However, the letter also raises concerns about the efficacy of PSS in managing conditions such as ureteral edema, trauma, or residual stone formations. It also discusses the potential benefits of PSS in preserving the competency of the ureterovesical junction (UVJ) and reducing upper tract damage. The letter emphasizes the need to find a balance between stent placement duration, managing obstruction and vesicoureteral reflux (VUR), and considers the role of ureteral external compression by tumors. The authors conclude by suggesting that insights from previous studies should be considered when inserting Double J stents due to the associated high morbidity. [Extracted from the article]

This letter to the editor responds to a study on renal function after bilateral flexible ureteroscopy (fURS) for kidney stones. The authors of the letter agree with the study's conclusion that patient selection and shorter surgery times are important in preventing acute renal function decline. However, they also suggest that the placement of bilateral double-J stents and the alteration of the ureterovesical junction (UPJ) integrity may contribute to postoperative renal function decline. They cite other studies that demonstrate the mechanical impact of stenting on renal function and suggest that the effects of bilateral stenting may extend beyond mechanical drainage. The authors advocate for a comprehensive consideration of the mechanical and physiological impacts of bilateral double-J stenting on renal function post-fURS. [Extracted from the article]

A recent study examined the use of melatonin in managing nocturia in Parkinson's disease patients. The study found that a 2-mg dose of melatonin significantly reduced nighttime urine volume and the number of voiding episodes during the night. This finding is particularly relevant to men with prostate enlargement who experience nocturia. Melatonin supplementation may be a safer and more effective alternative to other treatments for nocturia, such as desmopressin. However, there are discrepancies in the effectiveness of melatonin dosage, highlighting the challenges in standardizing treatment. An upstream approach that considers hormonal regulation may be more effective in formulating treatment guidelines for nocturnal polyuria. [Extracted from the article]

This article discusses the relationship between testosterone deficiency (TD) and nocturia, a condition characterized by frequent urination at night. While previous studies have focused on TD as a contributing factor to nocturia, this article proposes that nocturia may actually lead to TD by disrupting sleep and the circadian rhythm centered in the hypothalamus. The disruption of sleep patterns may also exacerbate metabolic syndromes and conditions like benign prostatic hyperplasia (BPH), intensifying nocturia symptoms. The article suggests that a holistic approach, addressing metabolic syndrome and its components, could potentially mitigate BPH progression and improve patient outcomes. Further research is needed to understand the bidirectional nature of TD and nocturia and develop therapeutic interventions. [Extracted from the article]

Xanthogranulomatous pyelonephritis (XGP) is a rare inflammatory disease often associated with high morbidity and mortality. Whether the midline transperitoneal or the flank retroperitoneal approach is superior remains unknown. We searched through pathology databases and reviewed 86 patients with an XGP diagnosis from 2000 to 2021 at our institution. After the patients who did not meet the inclusion criteria were excluded, 35 patients who had undergone nephrectomy through the midline transperitoneal or the flank retroperitoneal laparotomy approach were recruited. Nine (25.71%) of the thirty-five patients underwent nephrectomy through a midline approach, whereas twenty-six (74.29%) received a flank approach. Patients in the midline approach group had a longer surgical time (p = 0.03) than those in the flank approach group. In addition, patients in the flank approach group took less time after surgery to resume oral intake than those in the midline approach group (p = 0.01). No significant differences in the rates of intraoperative and postoperative complications such as peritonitis or intraabdominal infection were observed between the groups. For the patients with XGP who are good candidates for surgery, nephrectomy is a relatively safe surgical treatment method. Both surgical methods produced favorable surgical outcomes, and the patients who received these methods had similar complication rates. [ABSTRACT FROM AUTHOR]

RT4 cells are bladder papillary tumor cells, and HT1376, TSGH-8301, and T24 cells are urothelial carcinoma cells. Results of in vitro Ki67 proliferation and Matrigel invasion assays showed that MT2A knockdown bladder carcinoma cells grew faster and increased cell invasion more than the mock-knockdown bladder carcinoma cells, while MT2A-overexpressed bladder carcinoma cells grew slower than the mock-transfected bladder carcinoma cells (Figure 6). The results of the present study indicated that knockdown of MT2A significantly resisted H SB 2 sb O SB 2 sb treatment-induced cell apoptosis, while ectopic overexpression of MT2A significantly enhanced cell apoptosis induced by H SB 2 sb O SB 2 sb in bladder carcinoma cells (Figure 3). [Extracted from the article]

Growth differentiation factor 15 (GDF15) is known as a TGFβ-like cytokine acting on the TGFβ receptor to modulate target genes. GDF15 is regarded as a tumor suppressor gene in the human bladder and the caffeic acid phenethyl ester (CAPE) induces GDF15 expression to inhibit the tumor growth in vitro and in vivo. However, the interactions among GDF15, CAPE, and TGFβ/Smads signaling in the human bladder carcinoma cells remain unexplored. Results revealed that TGFβ downregulated the expression of GDF15 via the activation of Smad 2/3 and Smad 1/5. Induction of GDF15 on its downstream genes, NDRG1 and maspin, is dependent on the TGFβ/Smad pathways. Moreover, TGFβ blocked the CAPE-inducing expressions of GDF15, maspin, and NDRG1. Pretreatment of TGF receptor kinase inhibitor not only blocked the activation of TGFβ but also attenuated the activation of GDF15 on the expressions of maspin and NDRG1. The CAPE treatment attenuated the activation of TGFβ on cell proliferation and invasion. Our findings indicate that TGFβ downregulated the expressions of GDF15, maspin, and NDRG1 via TGFβ/Smad signaling. Whereas, CAPE acts as an antagonist on TGFβ/Smad signaling to block the effect of TGFβ on the GDF15 expression and cell proliferation and invasion in bladder carcinoma cells. [ABSTRACT FROM AUTHOR]

Optical phase shifts generated by the spatial variation of refractive index and thickness inside the transparent samples can be determined by intensity measurements through quantitative phase contrast imaging. In this review, we focus on isotropic quantitative differential phase contrast microscopy (qDPC), which is a non-interferometric quantitative phase imaging technique that belongs to the class of deterministic phase retrieval from intensity. The qDPC is based on the principle of the weak object transfer function together with the first-order Born approximation in a partially coherent illumination system and wide-field detection, which offers multiple advantages. We review basic principles, imaging systems, and demonstrate examples of DPC imaging for biomedical applications. In addition to the previous work, we present the latest results for isotropic phase contrast enhancements using a deep learning model. We implemented a supervised learning approach with the U-net model to reduce the number of measurements required for multi-axis measurements associated with the isotropic phase transfer function. We show that a well-designed and trained neural network provides a fast and efficient way to predict quantitative phase maps for live cells, which can help in determining morphological parameters of cells for detailed study. The prospects of deep learning in quantitative phase microscopy, particularly for isotropic quantitative phase estimation, are discussed. [ABSTRACT FROM AUTHOR]

Background and Purpose: In this study, we compared patient outcomes between the 120-W thulium laser (Vela™XL) prostate enucleation (ThuLEP) and bipolar transurethral enucleation of the prostate (B-TUEP) techniques.Methods: We excluded patients with concomitant prostate cancer and bladder cancer and prospectively analyzed patients with benign prostatic obstruction (BPO) who underwent ThuLEP and B-TUEP from October 2018 to January 2021 in our institution. Patients' demographics, comorbidities, prostate volumes, prostate-specific antigen (PSA) levels, and International Prostate Symptoms Score (IPSS) were recorded. Perioperative outcomes including intraoperative blood loss, prostate resection percentage of the transition zone, postoperative pain score (numeric rating scale, NRS), complications, changes in postoperative uroflowmetry parameters, IPSS, and the rate of reuse of BPH medications were also evaluated.Results: The data of a total of 111 patients (ThuLEP: 49, B-TUEP: 62) met the inclusion criteria were collected and analyzed prospectively. Our results revealed no significant differences between ThuLEP and B-TUEP in terms of operation time, prostate tissue enucleated, and days of hospitalization. However, patients in the ThuLEP group reported less pain after surgery than those in the B-TUEP group, and a higher proportion of patients in the B-TUEP group returned to the emergency department due to complications within one month postoperatively, with hematuria being the main cause. No significant differences were observed between the groups in changes in uroflowmetry parameters and IPSS at 2 weeks, 3 months, and 6 months postoperatively.Conclusion: The efficacy of ThuLEP was comparable to that of B-TUEP in terms of maximal flow rate, voiding volume, IPSS, and quality of life. ThuLEP also had several advantages over B-TUEP, including less blood loss and less postoperative pain. Therefore, ThuLEP can be considered a treatment of choice for BPH/bladder outlet obstruction, specifically for patients with a bleeding tendency and fear of pain. [ABSTRACT FROM AUTHOR]

Quantitative differential phase-contrast (qDPC) imaging is a label-free phase retrieval method for weak phase objects using asymmetric illumination. However, qDPC imaging with fewer intensity measurements leads to anisotropic phase distribution in reconstructed images. In order to obtain isotropic phase transfer function, multiple measurements are required; thus, it is a time-consuming process. Here, we propose the feasibility of using deep learning (DL) method for isotropic qDPC microscopy from the least number of measurements. We utilize a commonly used convolutional neural network namely U-net architecture, trained to generate 12-axis isotropic reconstructed cell images (i.e. output) from 1-axis anisotropic cell images (i.e. input). To further extend the number of images for training, the U-net model is trained with a patch-wise approach. In this work, seven different types of living cell images were used for training, validation, and testing datasets. The results obtained from testing datasets show that our proposed DL-based method generates 1-axis qDPC images of similar accuracy to 12-axis measurements. The quantitative phase value in the region of interest is recovered from 66% up to 97%, compared to ground-truth values, providing solid evidence for improved phase uniformity, as well as retrieved missing spatial frequencies in 1-axis reconstructed images. In addition, results from our model are compared with paired and unpaired CycleGANs. Higher PSNR and SSIM values show the advantage of using the U-net model for isotropic qDPC microscopy. The proposed DL-based method may help in performing high-resolution quantitative studies for cell biology. [ABSTRACT FROM AUTHOR]

This study investigated and compared the surgical outcomes of using endoscopic enucleation (thulium: YAG laser and bipolar plasma; ThuLEP) with robotic-assisted simple prostatectomy (RASP) in the treatment of prostates larger than 80 cm3. Records were obtained for the period from January 2014 to December 2020 for selected patients with BPO who underwent RASP, ThuLEP, or bipolar transurethral enucleation of the prostate (B-TUEP). Patients were excluded if they had active malignant disease, neurogenic bladder, lower urinary tract syndrome for reasons other than BPO, and a history of prostate surgery. Data of 396 patients who underwent B-TUEP, ThuLEP, and RASP were examined. A total of 112 patients met the including criteria, 85 of whom (B-TUEP: 29; ThuLEP: 41; RASP: 15) completed the final visit. The mean operation time and duration of postoperative hospital stays in the RASP group were significantly longer than those of the B-TUEP and ThuLEP groups. Only 1 patient in the RASP group required blood transfusion. The RASP group was superior to the other groups in voiding improvement including Qmax and IPSS voiding score. The pain score of the ThuLEP group after surgery was significantly lower than that of the other two groups during hospitalization, whereas the QoL scores were identical between the three groups at 2 weeks, 3 months, and 6 months post operation. The rates of returning to ER within the first postoperative month did not differ significantly between the three groups, and all the reasons for return involved minor complications that required no additional invasive treatment. These three surgical methods (B-TUEP, ThuLEP, and RASP) are all effective and safe for treating prostates larger than 80 cm3, with each having its particular advantages. B-TUEP requires the shortest operation time, ThuLEP causes the lowest postoperative pain, and RASP results in superior voiding function improvement. [ABSTRACT FROM AUTHOR]

Few studies have addressed the impact of diagnostic urine metabolites and the clinical outcomes associated with genitourinary urothelial (GU) cancer to date. Furthermore, longitudinal analysis of the dynamics of urine metabolites contributing to the detection of GU cancer has not yet been fully investigated; therefore, the discovery of novel diagnostic urine biomarkers is of enormous interest. We explored the correlation of the urine metabolomic profiles to GU cancers. The aqueous metabolites of the GU cancer and the control were also identified and analyzed through high-resolution1H nuclear magnetic resonance (NMR) spectroscopy. Compared with the control, the urine metabolites of the tumor were studied in relation to changes over time in a linear mixed model for repeated measures. The urine metabolites of sixty-three (44 male and 19 female) patients with GU cancers were systemically analyzed. The urine metabolite profile in GU cancer was significantly higher than those in the control group (p<0.05). Sevenurine metabolites including histidine, propylene glycol, valine, leucine, acetylsalicylate, glycine, and isoleucine as well as other pathways were identified statistically and were significantly associated with GU cancer detection with longitudinal analysis. We discovered that histidine, propylene glycol, valine, leucine, acetylsalicylate, glycine, isoleucine, succinic acid, lysine2-aminobutyric acid, and acetic acid are involved significantly in all types of male patients in whom the type (upper tract) of urine metabolites were found to be statistically significant compared with the control. We did not find any statistical significance in urine biomarkers between female and male patients. However, a statistically insignificant correlation was found among the grade and stage with the metabolites. [ABSTRACT FROM AUTHOR]

The biocompatible hydrogel materials are used for the fabrication of artificial cornea. The refractive index of the hydrogel material can affect the optical quality of the artificial cornea. It is challenging to measure the refractive index of the hydrogel material because it is between solid and liquid status during the fabrication processes. In this work, we propose using the Shack–Hartmann wavefront sensor system to measure the wavefront images and to calculate the corresponding aberrations of optical material. The wavefront aberrations can be used to estimate the refractive index of the optical material. To prove the concept, the standard N-BK7 bi-convex lenses with focal lengths of 100 and 150 mm at wavelengths 780, 532, and 450 nm have been measured, and the results show that the relative errors of the average measured refractive indices are about 0.1%–0.17%. We used this proposed method to measure the refractive index of the P407-DA hydrogel material. We found that the average measured refractive indices of the P407-DA hydrogel material are 1.3175, 1.3516, and 1.3645 at wavelengths 780, 532, and 450 nm, respectively. Compared with the refractive index of human cornea, the P407-DA hydrogel can be used as the artificial cornea material. The Cauchy dispersion formula can be used to calculate the Abbe number of the P407-DA hydrogel material, which is about 11, lower than the human cornea’s Abbe number. It means that the P407-DA hydrogel material has higher chromatic dispersion than the human cornea material. Moreover, the elasmobranch (shark) corneas, which are known as the suitable material for xenotransplantation, are measured by the Shack–Hartmann wavefront sensor system. The ABBE refractometer (ATAGO DR-M4) is used to measure the flat P407-DA hydrogel sample and it is found that the refractive index is slightly different when compared with the measured results by the Shack–Hartmann wavefront sensor system. The refractive indices of other biocompatible hydrogels poly(acrylic acid) (PAA) and poly(2-hydroxyethyl methacrylate) (PHEMA) are also measured by our proposed method, and it is found that the refractive index of P407-DA is more suitable for designing corneal samples than other hydrogels. It is found that the refractive indices of the elasmobranch corneas are similar to the P407-DA material. Our proposed method to measure the refractive index of hydrogel material using the Shack–Hartmann wavefront sensor system is useful. It is a non-contact, minimally invasive, and time-efficient method for shaped structures. The results can be used as a guide for developing better biocompatible material for artificial cornea. [ABSTRACT FROM AUTHOR]

A study conducted in South Korea suggests that prolonged antibiotic usage, particularly exceeding 180 days or using four or more antibiotic types, may be associated with a heightened risk of prostate cancer. Antibiotics are commonly prescribed for upper respiratory tract infections (URIs) and urinary tract infections (UTIs), which are prevalent in older males with comorbidities such as prostate cancer and benign prostatic hyperplasia (BPH). The study also highlights the possibility of incidental prostate cancer detection during routine tests for URIs. However, an alternative perspective proposes that chronic nocturia, a common issue in BPH patients, could lead to disruptions in circadian rhythm, alterations in gut microbiota, and exacerbation of metabolic syndrome, all of which are linked to cancer development. The findings emphasize the importance of judicious antibiotic prescription, particularly in patients with BPH. [Extracted from the article]

The bactericidal effects of fluorescent metal nanoclusters have impeded their bacterial bioimaging applications due to the reactive oxygen species (ROS) generation that is induced by the nanoclusters in bacteria to cause bacterial death. Herein, an ROS scavenger of cysteine was exploited as a surface ligand to prepare cysteine-conjugated gold nanoclusters (Cys–AuNCs) and cysteine-conjugated silver nanoclusters (Cys–AgNCs) using a facile hydrothermal approach. The structural and optical characterizations demonstrated successful syntheses of Cys–AuNCs and Cys–AgNCs. With the same weight concentration, the bactericidal effect increased in the order of Cys–AuNCs, Cys–AgNCs, and silver nanoparticles (AgNPs), according to the results of the bacterial growth curves. Furthermore, based on the results of the standard colony-counting method, the Cys–AuNCs revealed the best biocompatibility compared to those of the Cys–AgNCs and AgNPs in Escherichia coli (E. coli). The superior biocompatibility of the Cys–AuNCs can be attributed to the use of the ligand of cysteine as an ROS scavenger to reduce ROS in E. coli. Electron paramagnetic resonance (EPR) analyses indicated that the use of the ROS scavenger cysteine as the surface ligand of the Cys–AuNCs eliminated the ROS production induced by the Cys–AuNCs in E. coli. The biocompatible Cys–AuNCs were also confirmed as a fluorescent probe using confocal microscopy. Highly biocompatible Cys–AuNCs could be a potential fluorescent probe in the application of bacterial bioimaging. [ABSTRACT FROM AUTHOR]

Background: Psychiatric disorders and ocular neurovascular diseases may share a similar pathophysiological route of vascular structures or neurological changes. The aim of this study is to investigate the association between ocular neurovascular diseases and the risk of major psychiatric disorders. Methods: This was a retrospective case–control, population-based study including patients aged ≥20 and were diagnosed between 1997 and 2013. Ocular neurovascular diseases diagnosed between 1997 and 2006 and newly diagnosed psychiatric disorders including bipolar disorder (BD), major depressive disorder (MDD), and schizophrenia between 2007 and 2013 were registered. Patients were propensity-score matched with control groups without psychiatric disorders in each cohort based on selected covariates. Results: A total of one million sampled patients in the database were categorized based on their diagnoses; 2243 (37.4% men) were categorized into the BD group, 10,110 (35.2% men) into the MDD group, and 1623 (43.1% men) into the schizophrenia group. In the BD group, all glaucoma (OR 1.49, [1.18–1.89]), open-angle glaucoma (OR 2.08, [1.34–3.24]), and closed-angle glaucoma (OR 2.12, [1.36–3.33]) showed statistical significance of risk. In the MDD group, age-related macular degeneration (OR 1.33, [1.13–1.57]), all glaucoma (OR 1.24, [1.11–1.37]), open-angle glaucoma (OR 1.47, [1.21–1.80]), and dry eye syndrome (OR 1.22, [1.13–1.31]) were associated with a significantly higher risk. In the schizophrenia group, only all glaucoma (OR 1.47, [1.02–2.11]), glaucoma suspect (OR 1.88, [1.01–3.49]), and open-angle glaucoma (OR 2.19, [1.13–4.26]) showed statistical significance. Conclusions: In this population-based study, ocular neurovascular diseases, especially glaucoma, were associated with increased risks of BD, MDD, and schizophrenia. [ABSTRACT FROM AUTHOR]