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Objectives To analyze the urothelial responses to mitomycin C treatment after urethral injury in rats, as the urothelium might play a role in the pathogenesis of urethral stricture. Methods Male Sprague–Dawley rats were divided into four groups (n = 5/group): negative control, positive control without further treatment, experimental control treated with sodium hyaluronate and sodium carboxymethylcellulose, and experimental treated with mitomycin C after internal urethrotomy. Results Compared with negative controls, positive controls showed a significant increase in cell proliferation and DNA damage accompanied by a considerable decrease in DNA repair in the urothelium, which resulted in urethral stricture. Experimental controls showed a significant increase in cell proliferation, DNA damage and DNA repair compared with negative controls. The mitomycin C-treated group showed a significant decrease in cell proliferation and DNA damage, but a considerable increase in DNA repair compared with the positive and experimental control groups. DNA damage was immediately increased after urethral injury, but DNA repair and cell proliferation showed belated and upregulated expression after mitomycin C treatment. Conclusions Mitomycin C could induce healthy re-epithelialization without severe damage in the urothelium. This finding might support the possibility of using mitomycin C as an adjuvant therapy for urethral strictures, and it might also suggest a urothelial role in the process of urethral stricture after urethral injury.

Purpose: It is suggested that caveolin and aquaporin might be closely associated with bladder signal activity. We investigated the effect of the deletion of caveolin 1, using caveolin 1 knockout mice, on the expression of aquaporin 1 in order to identify their relation in the urothelium of the urinary bladder. Methods: The cellular localization and expressions of aquaporin 1 and caveolin 1, in the wild type and caveolin 1 knockout mice urinary bladder, were examined by Western blot and immunofluorescence techniques. Results: Aquaporin 1 and caveolin 1 were coexpressed in the arterioles, venules, and capillaries of the suburothelial layer in the wild type controls. Aquaporin 1 protein expression was significantly higher in the caveolin 1 knockout mice than in the wild type controls (P

The aim of the present study was to verify the usefulness of Point Aa as a substitute marker of the Q-tip angle and urethral mobility before and after midurethral sling operation for the treatment of stress urinary incontinence (SUI) in women. In this study, 118 women presenting with SUI who underwent the tension-free vaginal tape obturator (TVTO) procedure were prospectively examined and followed-up for ≥6 months after operation. Spearman's correlation coefficient was used to assess the degree of correlation between Point Aa of the Pelvic Organ Prolapse Quantification system and Q-tip angles before and after midurethral sling surgery. There were significant postoperative changes in Point Aa (from -0.4 ± 1.9 to -2.7 ± 0.6; P = .001) and Q-tip angle (from 58.7 ± 19.4 to 15.4 ± 17.5 degrees; P =.001) compared with preoperative values. A fair correlation between Point Aa position and straining Q-tip angle was found before (r = 0.45, P = .05) and after (r = 0.49, P = .04) the procedure, with no significant difference in values before and after the procedure (P = .62). The results of the present study show fair correlation between the Point Aa position and straining Q-tip angle before and after midurethral sling surgery. Point Aa could be used as an indicator of urethral mobility after the TVTO procedure in women with SUI.

Objectives To evaluate the surgical feasibility of laparoscopic adrenalectomy using the lateral retroperitoneal approach for the treatment of large pheochromocytomas, and to identify the preoperative risk factors for intraoperative hypertension. Methods We retrospectively reviewed 51 patients who underwent laparoscopic adrenalectomy using the lateral retroperitoneal approach for the treatment of pheochromocytomas. Patient characteristics and perioperative outcomes were analyzed and compared between the two study groups based on tumor size: group A (n = 27, ≤6 cm) and group B (n = 24, ˃6 cm). Results There was no significant difference in preoperative characteristics between the two groups except for tumor size (P = 0.001) and urinary metanephrine (P = 0.011). Group B patients required longer operating time (P = 0.008), had a greater estimated blood loss (P = 0.001) and hemoglobin change (P = 0.002). However, no significant differences were observed in perioperative complications and mortality. Multivariate analysis showed that symptomatic pheochromocytomas (P = 0.004) and tumor size (P = 0.007) were significant risk factors for intraoperative hypertension. Conclusions Laparoscopic adrenalectomy using the lateral retroperitoneal approach for pheochromocytomas can be regarded as a treatment option, even for tumors measuring >6 cm. Symptomatic pheochromocytomas and large tumor size seem to represent risk factors for intraoperative hypertension.

// Ho Song Yu 1,* , Jun Eul Hwang 3,* , Ho Seok Chung 1 , Yang Hyun Cho 1 , Myung Soo Kim 1 , Eu Chang Hwang 1 , Kyung Jin Oh 1 , Sun-Ouck Kim 1 , Seung Il Jung 1 , Taek Won Kang 1 , Dong Deuk Kwon 1 , Kwangsung Park 1 , Soo Bang Ryu 1,2 , Sung-Hoon Jung 3 , Young Hoe Hur 4 , Joon Hwa Noh 5 , Myung Ki Kim 6 , Ill Young Seo 7 , Chul-Sung Kim 8 , Sung Gu Kang 9 , Seok Ho Kang 9 and Jun Cheon 9 1 Department of Urology, Chonnam National University Medical School, Gwangju, Korea 2 Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea 3 Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Korea 4 Department of General Surgery, Chonnam National University Medical School, Gwangju, Korea 5 Department of Urology, Kwangju Christian Hospital, Gwangju, Korea 6 Department of Urology, Chonbuk National University Medical School, Jeonju, Korea 7 Department of Urology, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea 8 Department of Urology, Chosun University School of Medicine, Gwangju, Korea 9 Department of Urology, Korea University College of Medicine, Seoul, Korea * These authors have contributed equally to this work as first co-authors Correspondence to: Eu Chang Hwang, email: // Keywords : renal insufficiency, chronic, carcinoma, transitional cell, prognosis Received : January 02, 2017 Accepted : March 06, 2017 Published : March 15, 2017 Abstract Purpose: The aim of this study was to determine the effect of preoperative chronic kidney disease (CKD) on the prognosis of patients with upper urinary tract urothelial carcinoma (UTUC) who had undergone radical nephroureterectomy (RNU). Results: The median follow-up period was 31.1 months (interquartile range: 16.2-55.7 months). Among the study patients, 224 patients in the non-CKD group were selected via propensity score matching. The median recurrence-free, cancer-specific, and overall survival were significantly shorter for patients with preoperative CKD than for non-CKD patients ( p = 0.001, p = 0.001, and p = 0.001, respectively). According to multivariable Cox regression analysis, preoperative CKD was related to worse recurrence-free (hazard ratio [HR]: 1.81, 95% confidence interval [CI]: 1.15-2.86, p = 0.011), cancer-specific (HR: 2.44, 95% CI: 1.44-4.14, p = 0.001), and overall survival (HR: 1.66, 95% CI: 1.15-2.40, p = 0.007). Methods: A total of 566 patients who underwent RNU at 6 institutions from 2004 to 2014 were retrospectively reviewed. Of these patients, 342 had an estimated glomerular filtration rate (eGFR) ≥ 60 ml/min/1.73 m 2 (non-CKD group) and 224 patients had an eGFR

Osteoprotegerin (OPG) is secreted by stromal and osteoblastic lineage cells and inhibits osteoclastogenesis by preventing the interaction of receptor activator of nuclear factor-κB ligand (RANKL) with receptor activator of nuclear factor-κB (RANK). In this study, the expression of OPG in osteoclasts themselves and its biological functions during osteoclastogenesis were investigated for the first time. OPG expression in vivo in the developing rat maxilla was examined by immunofluorescence analysis. OPG expression in osteoclasts during in vitro osteoclastogenesis was determined by reverse-transcription polymerase chain-reaction (RT-PCR), Western blot, and immunofluorescence staining. We determined the function of OPG produced by osteoclasts during osteoclastogenesis by silencing the OPG gene. The effects of OPG on bone-resorbing activity and apoptosis of mature osteoclasts were examined by the assay of resorptive pit formation on calcium-phosphate-coated plate and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) staining, respectively. In the immunofluorescence findings, strong immunoreactivities were unexpectedly seen in multinucleated tartrate-resistant acid phosphatase (TRAP)-positive osteoclasts around the growing and erupting tooth germs in the rat alveolar bone. In vitro, OPG expression was significantly increased during the differentiation of osteoclasts from mouse bone-marrow-derived cells treated with a combination of macrophage colony-stimulating factor (M-CSF) and RANKL. Interestingly, it was found that OPG small interfering (si)RNA treatment during osteoclastogenesis enhanced the sizes of osteoclasts, but attenuated their bone-resorbing activity. Also, the increased chromosomal DNA fragmentation and caspase-3 activity in the late phase of osteoclastogenesis were found to be decreased by treatment with OPG siRNA. Furthermore, effects of OPG siRNA treatment on osteoclastogenesis and bone-resorbing activity were recovered by the treatment of exogenous OPG. These results suggest that OPG, expressed by the osteoclasts themselves, may play an auto-regulatory role in the late phase of osteoclastogenesis through the induction of apoptosis.

Aim To investigate the molecular mechanisms of nitric oxide (NO)-induced cytotoxic effect in human gingival fibroblast (HGF) cells. Methodology After sodium nitroprusside (SNP), as NO donor, was treated to HGF, viability was measured by MTT assay and apoptosis was determined by TUNEL and DNA fragmentation assay. Mitochondrial membrane potential was detected using confocal microscopy, and caspase activity assay was measured by spectrophotometer. Mitogen-activated protein kinases (MAPK) activation, Bax/Bcl-2 ratio and cytochrome c release were analysed by Western blot analyses. Cells were exposed to MAPK inhibitors (U0126, SB203580 and SP600125) before SNP treatment to investigate the effects of MAPK kinases on the NO-induced apoptosis in HGF. Statistical analysis was performed using one-way analysis of variance with the Student–Newman–Keuls post hoc test for multiple group comparison. Results Apoptosis was significantly increased (P = 0.011 and 0.0004, respectively) in the presence of SNP (1 and 3 mmol L−1) after 12 h in HGF. However, 1H-[1,2,4] oxadiatolo [4, 3-a] cluinoxaline-1-one (ODQ), a soluble guanylate cyclase inhibitor, did not block the decrement of cell viability by NO. SNP treatment induced the loss of mitochondrial membrane potential, release of cytochrome c, increased Bax/Bcl-2 ratio and activation of caspases in HGF. Also, SNP treatment increased phosphorylation of MAPKinases and c-Jun N-terminal kinase (JNK) inhibitor (5 and 10 μmol L−1) rescued cell viability decreased by SNP in HGF (P = 0.024 and 0.0149, respectively). Conclusion Nitric oxide induced apoptosis in human gingival fibroblast through the mitochondria-mediated pathway by regulation of Bcl-2 family and JNK activation.

Purpose: Systemic inflammatory responses, which are defined in terms of the Glasgow prognostic score (GPS), have been reported to be independent predictors of unfavorable outcomes in various human cancers. We assessed the utility of the GPS as a predictor of intravesical recurrence after radical nephroureterectomy (RNU) in upper urinary tract carcinoma (UTUC). Materials and Methods: We collected data for 147 UTUC patients with no previous history of bladder cancer who underwent RNU from 2004 to 2012. Associations between perioperative clinicopathological variables and intravesical recurrence were analyzed by using univariate and multivariate Cox regression models. Results: Overall, 71 of 147 patients (48%) developed intravesical recurrence, including 21 patients (30%) diagnosed with synchronous bladder tumor. In the univariate analysis, performance status, diabetes mellitus (DM), serum albumin, C-reactive protein, GPS, and synchronous bladder tumor were associated with intravesical recurrence. In the multivariate analysis, performance status (hazard ratio [HR], 2.33; 95% confidence interval [CI], 1.41–3.85; p=0.001), DM (HR, 2.04; 95% CI, 1.21–3.41; p=0.007), cortical thinning (HR, 2.01; 95% CI, 1.08–3.71; p=0.026), and GPS (score of 1: HR, 6.86; 95% CI, 3.69–12.7; p=0.001; score of 2: HR, 5.96; 95% CI, 3.10–11.4; p=0.001) were independent predictors of intravesical recurrence. Conclusions: Our results suggest that the GPS as well as performance status, DM, and cortical thinning are associated with intravesical recurrence after RNU. Thus, more careful follow-up, coupled with postoperative intravesical therapy to avoid bladder recurrence, should be considered in these patients.

Dear Editor,Monochorionic (MC) dizygotic twins (DZT) are rarely conceived naturally [1]. However, the number of pregnancies conceived by assisted reproductive technology (ART) has increased from 9,864 in 1994 to 29,733 in 2006, thus multiple birth rate in-creased from 10/1,000 live births in 1980’s to 27.5/1,000 live births in 2008 in Korea [2]. All MC DZT are theoretically chime-ric for blood cells because blood stem cells might be exchanged through the common (MC) placenta [1, 3]. To date, there is no report on MC DZT exhibiting blood group chimerism in Korea. There has been only one reported instance of blood group chi-merism in a dizygotic dichorionic pregnancy, even though IVF-ET is widely used in Korea [2, 4]. We report blood group chime-rism in sex-discordant MC DZT conceived via IVF-ET, initially misdiagnosed at birth as having blood subgroup B3. The sex-discordant MC DZT conceived via IVF-ET were born at a tertiary university hospital and assigned the blood subgroup B3. Twenty-three months later, the male twin (propositus) vis-ited the same hospital for a preoperative workup prior to hydro-cele surgery. Approximately a half of his red blood cells (RBCs) agglutinated strongly (4+) with anti-B reagents on forward typ-ing, whereas the remaining RBCs did not (mixed field agglutina-tion). His serum reacted with A

Objective Patients with lower urinary tract symptoms (LUTS) have a higher prevalence of cardiovascular disease. We evaluated the correlation between LUTS and cardiovascular risk factors in men presenting with benign prostatic hyperplasia (BPH). Methods We retrospectively reviewed the medical records of 295 men with transurethral resection of the prostate for the treatment of BPH and LUTS. Risk factors for cardiovascular disease included: hypertension, diabetes mellitus (DM), smoking, and dyslipidemia. The severity of LUTS measured by the International Prostatic Symptom Score (IPSS), prostate volume, prostate specific antigen (PSA), maximal urinary flow rate (Qmax), and postvoid residual urine (PVR) in subjects with or without cardiovascular risk factors were compared. Results IPSS-total (22.9 ± 7.8 vs. 21.2 ± 7.3, P = 0.01) and obstructive symptom score (13.3 ± 5.2 vs. 11.9 ± 4.7, P = 0.01) was significantly different between men with hypertension and without cardiovascular risk factors. There was no significant difference of variables between subjects with DM, smoking or dyslipidemia and without cardiovascular risk factors. In the Pearson correlation, the systolic and diastolic blood pressure (BP) were related with prostate volume (r = 0.138, P = 0.040; r = 0.163, P = 0.020), IPSS-total (r = 0.139, P = 0.043; r = 0.138, P = 0.043), and an obstructive symptom score (r = 0.168, P = 0.014; r = 0.143, P = 0.037), respectively. Conclusions Men with hypertension are more likely to have a higher IPSS and large prostate volume than men without hypertension. This finding implicates a pathophysiological association between hypertension and LUTS, and the need to manage comorbid symptoms simultaneously.

Interstitial cells of Cajal (ICCs) from the urinary bladder regulate detrusor smooth muscle activities. We cultured ICCs from the urinary bladder of mice and performed patch clamp and intracellular Ca(2+) ([Ca(2+)]i) imaging to investigate whether cultured ICCs can be a valuable tool for cellular functional studies. The cultured ICCs displayed two types of spontaneous electrical activities which are similar to those recorded in intact bladder tissues. Spontaneous electrical activities of cultured ICCs were nifedipine-sensitive. Carbachol and ATP, both excitatory neurotransmitters in the urinary bladder, depolarized the membrane and increased the frequency of spike potentials. Carbachol increased [Ca(2+)]i oscillations and basal Ca(2+) levels, which were blocked by atropine. These results suggest that cultured ICCs from the urinary bladder retain rhythmic phenotypes similar to the spontaneous electrical activities recorded from the intact urinary bladder. Therefore, we suggest that cultured ICCs from the urinary bladder may be useful for cellular and molecular studies of ICCs.

Odontogenesis, tooth development, is derived from two tissue components: ectoderm and neural crest-derived mesenchyme. Cyto-differentiation of odontogenic cells during development involves time-dependent and sequential regulation of genetic programs. This study was conducted to detect molecules implicated in cyto-differentiation of developing molar germs of rats. Differential display-PCR revealed that PrPc was differentially expressed between cap/early bell-staged germs (maxillary 3rd molar germs) and root formation-staged germs (maxillary 2nd molar germs) at postnatal day 9. Both levels of PrPc mRNA and protein expression were higher in the root formation stage than the cap/early bell stage and increased in a time-dependent manner. Immunofluorescence revealed for the first time that PrPc was not localized in the enamel organ, but localized in dental follicular cells for the development of the periodontal ligament and cementum as well as odontoblasts, both of which are of neural crest origin. These results suggest that the physiological functions of the PrPc in tooth development may be implicated in the differentiation of neural crest-derived mesenchyme including the periodontal tissues for root formation rather than epithelial tissue. Anat Rec, 296:1929–1935, 2013. © 2013 Wiley Periodicals, Inc.

Cartilage oligomeric matrix protein-angiopoietin-1 (COMP-Ang1) is an angiogenic factor for vascular angiogenesis. The aim was to investigate the effect of an intracavernosal injection of COMP-Ang1 on cavernosal angiogenesis in a diabetic rat model. Male Otsuka Long-Evans Tokushima Fatty (OLETF) rats made up the experimental group (1 yr old) and Long-Evans Tokushima Otsuka (LETO) rats made up the control group. The experimental group was divided into vehicle only, 10 µg COMP-Ang1, and 20 µg COMP-Ang1. COMP-Ang1 was injected into the corpus cavernosum of the penis. After 4 weeks, the penile tissues of the rats were obtained for immunohistochemistry and Western blot analysis. The immunoreactivity of PECAM-1 and VEGF was increased in the COMP-Ang1 group compared with the vehicle only group. Moreover, the expression of PECAM-1 and VEGF was notably augmented in the 20 µg Comp Ang-1 group. In the immunoblotting study, the expression of PECAM-1 and VEGF protein was significantly less in the OLEFT rats than in the control LETO rats. However, this expression was restored to control level after intracavernosal injection of COMP-Ang1. These results show that an intracavernosal injection of COMP-Ang1 enhances cavernous angiogenesis by structurally reinforcing the cavernosal endothelium.

To investigate patients' preferences for the gender of their urologist.Patients who visited a urologic center were asked to complete a self-administered questionnaire on the preferences for the gender of their urologist as well as on their age, education level and employment status.Of 270 respondents, 144 subjects (53%) had a preference for the gender of their urologist, whereas 126 subjects (47%) had no preference. Among 154 female respondents, 56 (36.4%) patients had no preference;96 (62.3%) patients had preferences for female urologists; and only 2 (1.3%) patient preferred male urologists. Among 116 male respondents, 70 (60.3%) patients had no preference; 30 (25.9%) patients had preferences for male urologists; and 16 (13.8%) preferred female urologists. Of patients that did express a preference, 87.5% (126/144) preferred the same gender urologist, with 65.2% (30/46) of male patients preferring male urologists and 97.9% (96/98) of female patients preferring female urologists (plt; .001). However, age and education level werenot correlated with gender preference.More than half the female participants had a preference for the same gender of urologist, whereas the majority of male participants expressed no preference for the gender of their urologist. Furthermore, gender preference was not correlated with age and education level.

inoculation of uropathogenic E. coli strain UTI89. The extent of neutrophil infiltration in the urothelium was assessed using confocal immunofluorescence microscopy (CIM) and urine neutrophil elastase activity assay. The presence of intracellular bacterial community (IBC) formed by UTI89 was assessed at 12 hours, 24 hours, 3 days and 7 days post-UTI89 inoculation with CIM using an anti-E. coli antibody and bacterial culture. Functional defects in neutrophil migration were verified using in vitro migration assays of peripheral blood neutrophils. RESULTS: Hyperglycemia (440-470 mg/dl) was induced reproducibly and permanently in all the mice administered with STZ with little inter-animal variation. Normal controls and STZ-induced DM mice transurethrally inoculated with UTI89 showed marked differences in neutrophil infiltration at all time points examined. While in normal mice neutrophils that infiltrated into the urothelium were most frequently seen surrounding IBCs, in STZ mice the neutrophils were very sparse and scattered. There was a 2-fold reduction of neutrophil elastase at 12 hours post-inoculation in STZ mice than in the normal controls. In contrast, IBCs were considerably more prevalent in STZ mice at 12 and 24 hours post-inoculation. On day 3 and 7 when few IBCs remained in normal mouse urothelium, numerous IBCs were seen in the STZ mice, often lining the entire segment of superficial urothelium. Bacterial culture confirmed the IBC staining data. Finally, in vitro assay showed that neutrophils from the STZ mice were three-fold less migratory than those from the normal mice. CONCLUSIONS: Our data provide the first experimental evidence indicating that diabetic conditions impair neutrophil migration and infiltration into the urothelium, resulting in markedly delayed host responses in IBC clearance and consequently prolonged bladder infection.

RESULTS: 126 patients were enrolled from March 2014 to July 2015. Logistic regression models to predict recovery within 14 days was dependent upon age (below 70, OR 4.11?2.18, p1⁄40.008), retention volume (over 450, OR 0.22?0.14, p1⁄40.017; over 600, OR 0.26?0.15, p1⁄40.024), recent operation (vs. spontaneous, OR 4.38?2.26, p1⁄40.004), and sex (females were less likely with OR 0.11?0.06, p

Introduction: We compared Valsalva leak point pressure (VLPP) in urodynamically proven stress urinary incontinence (SUI) in women at different bladder volumes; examined the relationship between VLPP and cough-induced leak point pressure (CLPP) compared by incontinence severity; and evaluated the influence of bladder volume on each leak point pressure (LPP).Methods: Women with urodynamically proven SUI who underwent serial VLPP and CLPP measurement at bladder volumes of 150, 200, 250, and 300 mL were included in this study (n=228). LPP determination was repeated two times in each subject after finishing one series of LPP measurement. LPP at different bladder volumes was compared by subjective symptom severity of Stamey grade.Results: Patients mean age was 51.3±7.6 years (range: 40‒65 years). Stamey grade I, II, and III was assigned to 68 (29.8%), 102 (44.7%), and 58 (25.4%) patients, respectively. Mean CLPP was higher than VLPP (p=0.002) at every bladder volume. VLPP and CLPP were significantly decreased by the increase of bladder volume (p=0.001). The mean first positive LPPs were significantly lower at higher Stamey grade (p=0.004).Conclusions: LPP is more frequently induced by cough than by the Valsalva maneuver. VLPP and CLPP decreased significantly with bladder filling and those with severe symptoms of SUI are more likely to have low LPP.

We investigated the value of the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) as markers of mortality in patients with Fournier's gangrene.Records from 62 patients treated for Fournier's gangrene between 2003 and 2014 were reviewed retrospectively. Data were collected regarding medical history, symptoms, physical examination findings, admission laboratory tests, and the extent of body surface area involved (%). Fournier's Gangrene Severity Index score, NLR, and PLR were calculated. The data were assessed separately for surviving and deceased patients.Of the 62 patients, 36 survived (58%, group 1) and 26 died (42%, group 2). Parameters that were statistically different between the two groups (p 0.05) were the NLR, PLR, Fournier's Gangrene Severity Index score, and admission laboratory parameters, including body temperature, heart rate, bicarbonate, albumin, and serum calcium. The average body surface area affected in group 2 was statistically different from that of group 1 (6.0% versus 2.3%, p = 0.001). A high Fournier's Gangrene Severity Index score (9), high NLR (8), and high PLR (140) were associated more frequently with group 2 patients. Multivariable regression analysis showed that high NLR (adjusted odds ratio [OR], 4.66; 95% confidence interval [CI], 1.25-17.3; p = 0.022) and high PLR (adjusted OR, 11.6; 95% CI, 2.7-49.5; p = 0.001) were independent prognostic factors for poor prognosis from Fournier's gangrene. However, the Fournier's Gangrene Severity Index score did not shown any statistically significant effect on mortality (p = 0.086).The Fournier's Gangrene Severity Index scoring system was not associated with determining poor prognosis, however, high NLR and high PLR were associated with predictors of mortality in patients with Fournier's gangrene.

The purpose of this study was to compare the results of the Q-tip test before and after the tension-free vaginal tape-obturator (TVT-O) in women with stress urinary incontinence (SUI) to determine the value of the Q-tip test in predicting the outcome of transobturator tape (TOT).Between June 2008 and June 2009, 59 women with SUI who underwent the TVT-O procedure and were followed up for at least 6 months were analyzed. Urethral hypermobility was defined as a maximal straining angle greater than 30° as measured by the Q-tip test. Parameters of evaluation included a comprehensive medical history, physical examination, Q-tip test, stress test, and urodynamic study, which included determination of the Valsalva leak point pressure. Cure was defined as no leakage of urine postoperatively either subjectively or objectively, whereas failure was defined as the objective loss of urine during the stress test.The patients were divided into two groups according to their preoperative Q-tip angle:30° (group 1, n=21) and ≥30° (group 2, n=38). The Q-tip angle decreased significantly in both groups: from 25.9 ± 5.98° preoperatively to 18.4 ± 7.23° postoperatively in group 1 (p=0.04) and from 36.6 ± 6.75° preoperatively to 24.1 ± 5.48° postoperatively in group 2 (p=0.03). The difference was obviously pronounced in group 2. The incontinence cure rate was significantly higher in group 2 (97.4 %) than in group 1 (85.7 %; p=0.04).Our results suggest that mobility of the proximal urethra is associated with a high rate of success of the TVT-O procedure.

The aim of this study was to investigate the frequency of secondary evaluation to detect prostate cancer that was primarily manifested as abnormal hypermetabolism detected by 18-fluoro-2-deoxyglucose (FDG) positron emission tomography–computed tomography (PET/CT). We also evaluated the association of maximum standardized uptake values (SUVmax) on PET/CT with clinicopathologic results. We evaluated PET/CT reports from a total of 12,037 patients to find cases with abnormal prostate hypermetabolism. Patients with known prostate cancer or a recent prostate procedure were excluded. We analyzed the frequency of secondary evaluations such as digital rectal exams (DRE), levels of serum prostate-specific antigen (PSA), and/or biopsy to confirm prostate cancer. Biopsied patients were categorized into benign and cancer groups. Clinicopathologic characteristics were compared between the groups. Among 12,037 PET/CT images, 184 (1.5 %) showed abnormal hypermetabolism in the prostate. Secondary evaluation was carried out in 120 patients. Biopsy was performed in 38 patients and prostate cancer was confirmed in 23 patients. The median serum PSA level was 3.2 and 49.7 ng/mL in the benign group and cancer group, respectively. The SUVmax was higher in the cancer group (5.7 ± 5.1) than in the benign group (4.8 ± 2.7), but the difference was not statistically significant (p = 0.37). In the cancer group, a high serum PSA level (≥20 ng/mL) was detected in 78.3 % of the patients. The Gleason score was 7 in 34.7 % and 8–10 in 56.5 % of prostate cancer patients. Hypermetabolism in the prostate was incidentally detected in 1.5 % of patients, and only 65.2 % of these patients underwent further evaluation (DRE and/or serum PSA levels). Among cases of incidentally detected hypermetabolism in the prostate, patients with abnormal findings (DRE and/or PSA levels) showed high positivity by biopsy, and more than two-thirds of the positive biopsies showed significant prostate cancer. Therefore, patients with hypermetabolism in the prostate should not be ignored and should be secondarily evaluated by DRE and PSA level.

Small Heterodimer Partner (SHP) interacts with diverse transcription factors such as Runx2 and regulates many cellular events including differentiation, proliferation, and energy metabolism. SHP is reported to be a positive regulator of BMP2-induced bone formation. This study aimed to clarify the role of SHP in odontoblast differentiation and matrix mineralization. Rat tooth germs were isolated, and gene expression was determined by RT-PCR and real-time PCR. Localization of SHP protein expression was identified by immunofluorescent analysis. Primary human dental pulp cells (HDPCs) were cultured with BMP2 and/or Ad-siSHP. Matrix mineralization was evaluated by Alizarin red staining. Transient transfection experiment was performed with the SHP or Dlx5 expressional plasmids and the DSPP gene. In tooth germs from post-natal days 3 to 9, BMP-2 and SHP expression increased with DSPP and DMP1 mRNA expression. In an immunostaining study, SHP was expressed in odontoblasts and surrounding osteoblasts. When HDPCs were cultured with BMP2 in mineralization-inducing medium, SHP expression also increased with an increase in DSPP expression. Down-regulation of SHP by Ad-siSHP inhibited matrix mineralization. In transient transfection experiments, overexpression of SHP was shown to enhance DSPP promoter activity through interactions between SHP and Dlx5. These results suggest that SHP may mediate BMP2 signaling to promote mineralization of the dentin matrix.

Objective: Our intent was to investigate the impact of specific parameters—clinical status, performance status (Eastern Cooperative Oncology Group (ECOG)), C-reactive protein, serum albumin, and inflammation (Glasgow Prognostic Score)—on progression-free survival and overall survival in patients given systemic chemotherapy as the first-line treatment of advanced bladder cancer. Methods: A total of 67 patients treated for advanced bladder cancer in a 7-year period (2004‐ 10) were reviewed. Prior to administration of first-line chemotherapy (gemcitabine plus cisplatin), baseline ECOG performance status, C-reactive protein, albumin, Glasgow Prognostic Score and clinical status were assessed. Patients with both elevated C-reactive protein (.1.0 mg/dl) and low albumin (,3.5 mg/dl) were assigned a Glasgow Prognostic Score of 2, while lesser scores were set when one (Glasgow Prognostic Score 1) or both levels (Glasgow Prognostic Score 0) were within the normal range. To evaluate relationships to progressionfree survival and overall survival, univariate and multivariate analyses were conducted. Results: By multivariate analysis, ECOG performance status (hazard ratio ¼ 3.48, 95% confidence interval 1.87‐6.45, P ¼ 0.001) and hypoalbuminemia (hazard ratio ¼ 2.04, 95% confidence interval 1.10‐3.78, P ¼ 0.023) were found to be factors independently associated with reduced progression-free survival. Factors independently associated with shortened overall survival were ECOG performance status (hazard ratio ¼ 5.32, 95% confidence interval 2.22‐ 12.71, P ¼ 0.001) and Glasgow Prognostic Score 2 (hazard ratio ¼ 7.00, 95% confidence interval 2.53‐19.36, P ¼ 0.001). Conclusions: These outcomes indicate that a systemic inflammatory response coupled with hypoalbuminemia (Glasgow Prognostic Score 2) correlates significantly with shortened overall survival and may thus be useful as a prognostic index in this setting.

Bladder capacity is an important factor in the diagnosis and treatment of children with voiding dysfunction. The purpose of this study was to define the normal maximal voided volume formula in Korean children younger than 2 years.We measured the bladder capacities of 151 Korean children between 0 and 24 months of age (83 boys and 68 girls) who did not have clinical voiding dysfunction. The maximal voided volume was determined in all subjects using a 2-day frequency volume chart with a four-hour voiding observation. The largest voided volume for each patient was considered to be the maximal voided volume. Statistical analyses were carried out using linear regression analysis.The maximal voided volume increased with age and weight (P = 0.0001). There was no significant difference between males and females (P = 0.771). A formula that approximates bladder capacity with respect to age is the following: bladder capacity (ml) = [1.6 × age (months)] + 45 (t = 8.757, P = 0.0001). A formula that approximates bladder capacity with respect to weight is the following: bladder capacity (ml) = [4.1 × weight (kg)] + 28 (t = 10.152, P = 0.0001).These formulas may be useful for the diagnosis of abnormal bladder capacity and the evaluation of voiding dysfunction in Korean children younger than 24 months.

Study Type – Diagnostic (validating cohort) Level of Evidence 2a What's known on the subject? and What does the study add? The relationship between the maximum voided volume followed a linear curve. The formula presented, bladder capacity (mL) = 12 ×[age (years) + 11], is thought to be a reasonable one for Korean children. Korean children have a smaller bladder capacity than that reported in previous Western studies. OBJECTIVE • To develop practical guidelines for the prediction of normal bladder capacity in Korean children measured by a frequency volume chart (FVC), maximum voided volume (MVV) is an important factor in the diagnosis of children with abnormal voiding function. SUBJECTS AND METHODS • In all, 298 children, aged 3–13 years, with no history of voiding disorders volunteered for the study. The MVV was determined in 219 subjects by use of a completely recorded FVC. RESULTS • Linear regression analysis was used to define the exact relationship between age and bladder capacity. An approximate formula related age to bladder capacity as follows: bladder capacity (mL) = 12 ×[age (years) + 11]. CONCLUSIONS • The relationship between the MVV measured by a FVC by age (3–13 years) of Korean children followed a linear curve. • When applied to normal voiding patterns, the formula presented appears to be a reasonable one for Korean children.

Purpose: We investigated the efficacy of ketoconazole and estramustine before chemotherapy for treating patients with progressive castration-resistant prostate cancer (CRPC) after anti-androgen withdrawal syndrome. Materials and Methods: Eighty-four patients who were diagnosed with CRPC and were treated between 2005 and 2009 were included. Thirty-nine patients were treated with 600 mg of ketoconazole and 10 mg of prednisolone per day (group I), and 45 patients were treated with 560 mg of estramustine per day (group II). The prostate-specific antigen (PSA) response, progression-free survival, and side effects were compared. Results: The median age of the patients, PSA level, and follow-up period were 72 years, 48.5 ng/ml, and 4 months (range, 1 to 29 months), respectively. The overall PSA response rate was 35.7%, and the PSA response rates were 33.3% for group I and 37.8% for group II (p=0.672). The median progression-free survival times were 8 months (95% confidence interval [CI] 5.9-10.1) overall, 5 months (95% CI 1.6-8.3) in group I, and 8 months (95% CI 5.9-10.0) in group II (p=0.282). The most common complications in groups I and II were nausea and vomiting (51.3%) and anemia (77.8%), respectively. Nausea and vomiting and hepatotoxicity were observed more often in group I, and gynecomastia, neutropenia, and anemia were observed more often in group II. The toxicities of each adverse effect were ≤grade 2. Conclusions: With a resultant PSA decline and mild adverse effects, both ketoconazole and estramustine are worth consideration as treatment options for progressive CRPC patients after primary hormonal therapy.

Aims Recent studies have showed that interstitial cells (ICs) are widely distributed in the genitourinary tract and have suggested their involvement in spontaneous electrical activity and muscle contraction. Nitric oxide (NO) is thought to play a role in bladder overactivity related with bladder outlet obstruction (BOO). The purposes of this study were to investigate the effect of bladder overactivity induced by BOO on ICs and nitric oxide synthase (NOS) isoforms in rat urinary bladder. Methods Female Sprague-Dawley rats (230–240 g, n = 40) were divided into two groups: control (group Con, n = 20) and partial BOO (group BOO, n = 20). After 4 weeks, urodynamic studies measuring contraction interval and contraction pressure were done. The cellular localization of cKit immunoreactive ICs and the expression of endothelial NOS (eNOS) and neuronal NOS (nNOS) were determined by Western blot and immunohistochemistry in the rat urinary bladder. Results Filling cystometry studies demonstrated a reduced interval between voiding contractions and an increased voiding pressure in BOO bladders. The contraction interval time (2.9 ± 0.35 min) was significantly decreased in the BOO group compared to the control (6.1 ± 0.05; P

Summary The aim of this study is to report our experience of modified microsurgical subinguinal varicocelectomy without delivery of the testes. We retrospectively evaluated 138 men treated with microsurgical varicocelectomy who took part in 1-year follow-up between 1997 and 2007. The varicoceles were grade III in 115 (81.6%), grade II in 23 (16.3%), and grade I in 3 (2.1%) men. We used a technical modification of the standard microsurgical subinguinal technique: division of the spermatic cord before microsurgical dissection, and the testes were not delivered. Patient age, varicocele grade, operation time, 1-year follow-up results, including complications, symptom relief, and recurrence, were recorded. We performed 141 varicocelectomies (Left: n = 135; bilateral: n = 3) in 138 men. The patients’ mean age was 23.5 ± 2.7 (range: 11–45) years. The mean operation time was 69.6 ± 15.6 (range: 35–140) min. There were three complications (2.2%; post-operative haematomas: n = 2; wound infection: n = 1) and 6 recurrences (4.3%; grade II: n = 1; grade III: n = 5). Among the 86 patients with scrotal pain, 74 (77.9%) reported complete resolution of pain and 13 (12.9%) reported partial resolution. Modified microsurgical subinguinal varicocelectomy without testis delivery is safe and effective.

PURPOSE To evaluate the impact of nocturia on health-related quality of life and sleep in men. METHODS From January 2008 to December 2008, 284 patients with lower urinary tract symptoms were selected for this study. The participants completed a series of questionnaires on health-related quality of life (the overactive bladder questionnaire, or OAB-q), the Medical Outcomes Study (MOS) sleep scale, and the frequency volume chart. RESULTS The patient population had a mean age of 60.0±13.4 years (range, 40 to 79 years). The mean duration of symptoms was 28.8±34.6 months. The mean number of voiding episodes per night was measured as follows: 88 patients (31.0%) reported no nocturia, 60 patients (21.1%) reported 2>voids/night ≥1, 56 patients (19.7%) reported 3>voids/night ≥2, and 80 patients (28.2%) reported ≥3 voids/night. The mean number of nocturia episodes increased with age (P=0.001), and the number of nocturia episodes was significantly associated with the OAB-q symptom score (P=0.001) and symptom bother (P=0.001). Among the categories of the MOS sleep scale, sleep index I (P=0.020), sleep disturbance (P=0.010), adequacy of sleep (P=0.005), and somnolence (P=0.041) were significantly associated with an increased number of nocturia episodes. CONCLUSIONS The number of nocturia episodes increased with age in men. Nocturia appeared to be associated with further negative effects on sleep quality, health-related quality of life, and symptom bother.

Purpose: The aim of this study was to evaluate whether low-dose anticholinergics combined with an α1-receptor antagonist would continue the effect of an alpha-blocker, decrease the side effects of anticholinergics, and improve the symptoms of lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). Materials and Methods: Two hundred nine men with LUTS/BPH with storage symptoms (International Prostate Symptom Score [IPSS] ≥12; storage symptoms ≥4) were randomly assigned in a prospective, multicentered, and single-blind fashion to either the control group (alfuzosin 10 mg, once daily) or the combined group (alfuzosin 10 mg, once daily, and propiverine 10 mg, once daily) for 2 months. IPSS, maximal urinary flow rate (Qmax), and postvoid residual volume (PVR) were used to grade symptoms, side effects, and the impact on quality of life (QoL) at the start of the study and after 1 and 2 months. Results: There were no significant differences in patient background, including age, prostate size, Qmax, and PVR, between the control group and the combined group. In the combined group, the IPSS total score and the IPSS storage symptom score were significantly improved compared with the control group. The IPSS voiding symptom score, QoL, Qmax, and PVR did not differ significantly. There were no serious side effects in either group. Conclusions: Management with an α1-receptor antagonist combined with a low-dose anticholinergic improved the total score and storage symptom score of the IPSS compared with α1-receptor antagonist only group without causing serious side effects. This initial combination medication can be considered an effective and safe treatment modality for LUTS/BPH patients with storage symptoms.

Penile growth is under androgenic control. Human chorionic gonadotropin (hCG) has a stimulatory effect on testicular steroidogenesis and penile growth. The purpose of this study was to evaluate the effect of hCG treatment on the gonadal response and penile growth in male idiopathic hypogonadotrophic hypogonadism (IHH) presenting with micropenis. A total of 20 IHH patients who met the criteria for micropenis were included in this study. hCG (1,500-2,000 IU) was administrated intramuscularly, 3 times per week, for 8 weeks. Basic laboratory and hormonal indexes (including serum testosterone and LH levels), penis length (flaccid and stretched), and testicular volume were measured before and 24 weeks after hCG treatment. The patients' mean age was 18.9 years (range, 12 to 24 years). The mean serum testosterone level was significantly increased after hCG treatment (baseline, 2, 4, 12, and 24 weeks: 0.90±1.35 ng/ml, 1.77±1.31 ng/ml, 3.74±2.24 ng/ml, 5.49±1.70 ng/ml, and 5.58±1.75 ng/ml, respectively; p

Purpose The purposes of this study were to investigate the effect of hormonal alterations on the expression of caveolin-1 in the urinary bladders of ovariectomized rats and to determine the role of caveolin-1 in the overactivity of the detrusor muscle that occurs with hormonal alterations in rats. Methods Female Sprague-Dawley rats were divided into three groups: a control group, a group that underwent bilateral ovariectomy (Ovx), and a group that underwent bilateral ovariectomy followed by subcutaneous injections of 17β-estradiol (Ovx+Est). After 4 weeks, urodynamic studies were done to measure the contraction interval and contraction pressure. The expression and cellular localization of caveolin-1 were determined by Western blot and immunofluorescence in the urinary bladders of rats. Results On cystometrograms, the contraction interval was significantly shorter in the Ovx group (3.0±0.3 minute) than in the control group (5.6±0.5 minute) but was longer in the Ovx+Est group (9.2±0.4 minute) (P

Purpose: To compare the clinical efficacy and safety in children with vesicoureteral reflux (VUR) of a single injection of two different bulking agents: polydimethylsiloxane (Macroplastique) or dextranomer/hyaluronic acid copolymer (Deflux). Methods: A total of 73 patients (106 renal units, 41 boys and 32 girls) aged 2–15 years (mean age, 34.5 months) were included. A single subureteral injection of either Macroplastique or Deflux was performed in 37 children (55 ureters) and 36 children (51 ureters), respectively. VUR was grade II in 34 ureterorenal units, grade III in 23, grade IV in 31, and grade V in 18 ureterorenal units. Results: Overall, the reflux was corrected in 84 of the renal units (86%) with one injection. The correction rates, according to the reflux grade, were 91, 91, 83, and 72% for grades II–V, respectively. At the 3-month follow-up visit, reflux was corrected in 48 (87%) of 55 refluxing ureters in the Macroplastique group and in 43 (84%) of 51 refluxing ureters in the Deflux group. Conclusions: A single subureteral injection of either Macroplastique or Deflux is an effective treatment modality for children with VUR. The procedure was well tolerated, safe, and associated with low morbidity.

Purpose: The precise etiology and classification of nocturia in women is not enough. We evaluated age related changes and clas sified the type of nocturia by age in women. Methods: We included 118 women 20 years or older with nocturia at least one time during night time. Subjects were divided into three groups by the age: group 1, under 40 years; group 2, 40 through 59 years; group 3, 60 years and above. The causes of nocturia and its pattern changed by age in women were evaluated using 3 days frequency volume chart. Nocturia was devided into three types: nocturnal polyuria, decreased nocturnal bladder capacity and mixed type. Results: The mean age was 57.2 ± 11.8 and the mean nocturnal frequency was 2.7 ± 1.8. In all age group, noctural polyuria was the major cause for noturia (40.8%), followed by low nocturnal bladder capacity (23.7%). As a major cause of nocturia, there was a significant increase of the incidence of nocturnal polyuria in aged people: group 1, 32.4%; group 2, 41.0%; group 3: 47.6% (P < 0.04). Conclusions: Nocturnal polyuria and decreased nocturnal bladder capacity are the major causes of nocturia in women. Nocturnal polyuria was the major cause of nocturia with age over 60 years old. In aged women, nocturnal polyuria should be considered as a main cuase of nocturia and treated based on these result.

Summary The radioprotective effects of granulocyte colony-stimulating factor (GCSF) were further investigated with respect to the testicular system. Recombinant human GCSF (100 μg kg−1 body weight/day) was administrated to male C3H/HeN mice by subcutaneous injection for three consecutive days before pelvic irradiation (5 Gy) and histopathological parameters were assessed at 12 h and 21 days post-irradiation (pi). The GCSF protected the germ cells from radiation induced- apoptosis (P

Rationale Persistent Mullerian duct syndrome (PMDS) is rare form of male pseudohermaphroditism characterized by the presence of uterus and fallopian tubes with normal external genitalia and secondary sexual characteristics. Transverse testicular ectopia (TTE) is also a rare form of testicular ectopia that may be associated with PMDS. Patient concerns We present a 2-year-old boy who presented with bilateral non-palpable testes with left inguinal mass. Diagnosis TTE with PMDS. Interventions On exploration, both testes were present in the left inguinal region. Uterus and fallopian tubes were located between the testes. A hysterectomy was perfomed with resection of the underdeveloped fallopian tubes. Bilateral orchiopexy was performed by placing both gonads into subdartos pouches in each scrotum with transseptal approach. Outcomes Both testes were palpable in both the scrotum at 1-year postoperative follow-up and we are planning a regular follow-up. Lessons In case of TTE with PMDS, optimal surgical approach with orchiopexy and excision of Mullerian duct should be needed. A long-term postoperative follow-up is necessary for assessment of malignant transformation and infertility.

Purpose: The purpose of this study was to determine whether periurethral injection of allogenic mesenchymal stem cells (MSCs) could increase the leak point pressure (LPP) in a rat model of stress urinary incontinence. Materials and Methods: Female Sprague-Dawley rats (230–240 g, n = 30) were divided into 3 groups: sham operation (group C), saline-treated (group S) and MSC-treated (group M). Bilateral pudendal nerve dissection followed by normal saline or MSC injection on both sides of the urethra was done. LPP and closing pressure (CP) testing was performed after the treatment. The specific markers for smooth muscle cells in the transplantation sites of the urethra were determined. Results: Both the LPP and CP were significantly lower in group S than controls. However, these were restored to the control values in group M (p < 0.05). The LPPs of groups C, S and M were 29.1 ± 2.1, 22.0 ± 2.2 and 43.1 ± 3.2 cm H2O, respectively. The CPs of groups C, S and M were 27.1 ± 3.1, 21.1 ± 3.2, and 32.1 ± 2.1 cm H2O, respectively. The injected MSCs stained positive for muscle-specific markers. Conclusion: This study suggests that MSCs might differentiate into muscle lineage cells and may contribute to the repair of damaged muscle tissue.

This study was performed to determine effects of alendronate on the tibial proximal epiphyseal cartilage undergoing endochondral ossification and the expression of vascular endothelial growth factor (VEGF) from the cartilage. Alendronate was injected subcutaneously every other day in postnatal Day 1 Sprague Dawley rats. The rats were sacrificed 3, 5, 7, and 10 days after the first injection. The effect of alendronate treatment for 10 days was demonstrated from the morphological change that the area of the secondary ossification center in the epiphysis was significantly smaller in the alendronate group than that in the control group (P < 0.05). Strong immunoreactivity to VEGF was observed in the hypertrophied chondrocytes and some proliferating chondrocytes in the epiphyseal cartilage at postnatal Day 5 and was decreased after the alendronate treatment for 5 days. Immunoreactivity was observed in not only hypertrophied cells but also the peripheral cartilaginous matrix adjacent to the vascular canals invading into the central portion of the cartilage at postnatal Day 7. This reactivity was also reduced considerably by the alendronate treatment for 7 days. The level of VEGF expression was reduced by the alendronate treatment at both the transcription and translation levels. However, the transcriptional level of the flt-1 and flk-1 receptors was relatively unaltered by the treatment. These results suggest that VEGF expression is required for vascular invasion into the developing cartilage and alendronate can affect its resorption by downregulating VEGF expression.

Purpose: Few studies have explored the treatment of isolated communicating hydroceles via scrotal incision. We prospectively evaluated the surgical outcomes of such treatment in boys with hydroceles compared with that using traditional, inguinal incision hydrocelectomy. Materials and Methods: Of 347 boys aged 0–12 years who were diagnosed as hydrocele on ultrasonography, 173 boys were assigned to the scrotal incision hydrocelectomy group (group I, n=173) and 172 boys were assigned to the traditional inguinal incision hydrocelectomy group (group II, n=172), and finally 156 boys in group I and 156 boys in group II were included in this study. Surgical outcomes, including postoperative complications and hydrocele relapse rates, were compared between groups. Results: The overall success rates were similar in both groups (group I, 96.8%; group II, 89.1%; p=0.740). The operation time and hospital stay were significantly shorter in group I (30.94±3.95 minutes and 3.94±0.30 days) than in group II (38.02±7.12 minutes and 4.24±0.99 days; p

Objective The chorda-lingual (CL) nerve carries parasympathetic fibers to the hilum of the sublingual and submandibular glands (SMGs) and evokes the secretion of saliva. The effect of cutting the CL nerve on the biological processes in SMGs was investigated by examining the gene-expression profiles in the SMGs after a surgical parasympathectomy. Methods At day 3 after the CL nerve cut, the changes in the SMGs at both the experimental cut and contralateral control sides were analysed by microarray and light microscopy. The expression levels of 6 selected genes were confirmed by real-time PCR, Western blot and immunofluorescence staining. Results The wet weight of the parasympathectomised SMGs decreased significantly compared to that of the contralateral side (p

The expression of aquaporin (AQP) water channels in rat vagina was recently reported.The purposes of this study were to investigate the effect of 17beta-estradiol on the expression of the AQP-1 and AQP-2 water channels and nitric oxide synthase (NOS) isoforms in rat vagina.Female Sprague-Dawley rats (230-240 g, N = 90) were divided into three groups: control (N = 30), bilateral ovariectomy (N = 30), and bilateral ovariectomy, followed by subcutaneous injections of 17beta-estradiol (50 microg/kg/day, N = 30). After 4 weeks, genital hemodynamics and vaginal secretions were measured after pelvic nerve stimulation, and the animals were then killed. The expression and cellular localization of AQP-1, AQP-2, endothelial NOS (e-NOS), and neuronal NOS (n-NOS) were determined in each group by immunohistochemistry and Western blot.The expression and cellular localization of AQPs and NOS isoforms after estrogen deprivation.Estimated vaginal secretions (mg, mean +/- standard error) were significantly lower in the ovariectomized group (2.9 +/- 0.62) than in the control group (5.7 +/- 1.25) and returned to the control value in the group after treatment with 17beta-estradiol (6.5 +/- 1.22) (P0.05). Both AQP-1 and e-NOS immunoreactivities were localized in the capillaries and venules of the lamina propria of the vagina, and n-NOS was expressed in the nerve fibers of the subepithelial lamina propria. The expression of AQP-2 was localized solely in the superficial layer of the vaginal epithelium. The protein expressions of AQP-2, e-NOS, and n-NOS were significantly lower after ovariectomy and were restored to the control level after 17beta-estradiol treatment. However, there was no significant change in AQP-1 expression.Decreased vaginal secretion after estrogen deprivation may be partly due to functional changes in both AQPs and NOS isoforms in the vagina. The potential role of AQPs in water transport in the vagina might differ according to the type of AQP.

Objective This study examined the expression pattern of the Deleted-in-colorectal-carcinoma (DCC) gene in developing rat tooth germs. Methods Rat pups at 4, 7 and 10 d postpartum were used in this study. Reverse transcription-polymerase chain reaction (RT-PCR) and immunofluorescent localization were used to determine the level of DCC expression during tooth development. Results There was more than 2-fold higher level of DCC mRNA in the rat 2nd maxillary molar tooth germs on 10 d postpartum, which was the root stage, than in the rat 3rd maxillary molar tooth germ, which was at the cap/early bell development stage. In addition, the levels of DCC mRNA in the 2nd maxillary molar germs at 4, 7 and 10 d postpartum increased gradually according to tooth development. Interestingly, immunoreactivity against DCC was specifically detected in the differentiating ameloblasts. DCC was observed in the lateral and apical sides of the newly differentiating and secretory stage ameloblasts. Afterwards, DCC was localized only in the apical side of the maturation stage ameloblasts, not in the lateral side. Conclusion DCC is expressed in the differentiating ameloblasts, which suggests that this molecule plays a crucial role in amelogenesis.

PURPOSE: Preexisting bone loss in men with prostate cancer is an important issue due to the accelerated bone loss during androgen deprivation therapy (ADT). In addition, a high prostate-specific antigen (PSA) level has been reported to be related to bone metabolism. This study assessed the factors associated with osteoporosis in Korean men with non-metastatic prostate cancer before undergoing ADT. MATERIAL AND METHODS: The study enrolled patients admitted for a prostate biopsy because of a high PSA or palpable nodule on a digital rectal examination. We divided the patients (n = 172) according to the results of the biopsy: group I, non-metastatic prostate cancer (n = 42) and group II, benign prostatic hypertrophy (BPH; n = 130). The lumbar bone mineral density (BMD) was evaluated using quantitative computed tomography. The demographic, health status, lifestyle, body mass index (BMI), serum testosterone concentration, and disease variables in prostate cancer (Gleason score, clinical stage, and PSA) were analyzed prospectively to determine their effect on the BMD. RESULTS: The estimated mean T-score was higher in group I than in group II (-1.96 ± 3.35 vs. -2.66 ± 3.20), but without statistic significance (p = 0.235). The significant factors correlated with BMD in group I were a high serum PSA (ß = -0.346, p = 0.010) and low BMI (ß = 0.345, p = 0.014) in the multiple linear regression model. Also old age (r = -0.481, p = 0.001), a high serum PSA (r = -0.571, p < 0.001), low BMI (r = 0.598, p < 0.001), and a high Gleason’s score (r = -0.319, p = 0.040) were the factors related to BMD in the correlation. The significant factors correlated with BMD in group II were old age (ß = -0.324, p = 0.001) and BMI (ß = 0.143, p = 0.014) in the multiple linear regression model. CONCLUSIONS: The risk factors for osteoporosis in men with prostate cancer include a low BMI, and elevated serum PSA. Monitoring BMD from the outset of ADT is a logical first step in the clinical strategy to avoid or minimize potential bone-related complications in these patients.

This study investigated the potential adverse effects of 1,3-dichloro-2-propanol (1,3-DCP) on pregnant dams and the embryo-fetal development after maternal exposure on gestational days (GD) 6 through 19 in Sprague-Dawley rats. The test chemical was administered to pregnant rats by gavage at dose levels of 0, 10, 30, and 90mg/kg per day (n=10 for each group). All dams underwent Caesarean sections on GD 20, and their fetuses were examined for morphological abnormalities. Maternal toxicity was noted at 90mg/kg/day. Manifestations of toxicity included clinical signs of illness, lower body weight gain, decreased food intake, and increases in the weight of the adrenal glands and the liver. Developmental toxic effects including decreases in fetal body weight and increases in visceral and skeletal variations also occurred at the highest dose. At 30mg/kg, only a minimal maternal toxicity, including a decrease in maternal food intake and an increase in the liver weight, was observed. No adverse maternal or developmental effects were observed at 10mg/kg/day. These results revealed that a 14-day repeated oral dose of 1,3-DCP was minimally embryotoxic but not teratogenic at a maternal toxic dose (90mg/kg/day), and was not embryotoxic at a minimally maternal toxic dose (30mg/kg/day) in rats. Because the developmental toxicity of 1,3-DCP was observed only in the presence of maternal toxicity, it is concluded that the developmental findings observed in the present study are secondary effects to maternal toxicity. Under these experimental conditions, the no-observed-adverse-effect level of 1,3-DCP is considered to be 10mg/kg/day for dams and 30mg/kg/day for embryo-fetal development.

Introduction Ginseng is an herbal medicine with a variety of biological activities. Aim The purpose of this study was to investigate the effect of Korean red ginseng (KRG) extract on the relaxation response in isolated rabbit vaginal tissue and its mechanism as a potential therapeutic agent for female sexual dysfunction. Method Strips of rabbit vagina were mounted in organ chambers to measure isometric tension. After the strips were precontracted with phenylephrine, the contractile responses to KRG extract (1–20 mg/mL), nitric oxide inhibitor (N[omega]‐nitro‐L‐arginine methyl ester [L‐NAME]), an inhibitor of soluble guanylate cyclase (methylene blue), an inhibitor of Ca 2+ ‐activated K + channels (tetraethylammonium [TEA]), and an adenosine triphosphate (ATP)‐sensitive K + channel blocker (glybenclamide) were examined. Main Outcome Measures The relaxation of the vaginal tissue strip was assessed after treating KRG extract or other chemicals. Results KRG (1–20 mg/mL) extract relaxed the vaginal tissue strip in a dose‐dependent manner up to 85%. The relaxation effect was significantly inhibited by L‐NAME (30 µM) and methylene blue (30 µM) ( P P Conclusions These data show that KRG extract has a relaxing effect on rabbit vaginal smooth muscle tissue. These effects might be mediated partly through the NO pathway and hyperpolarization via Ca 2+ ‐activated K + channels. Kim S‐O, Kim MK, Lee H‐S, Park JK, and Park K. The effect of Korean red ginseng extract on the relaxation response in isolated rabbit vaginal tissue and its mechanism. J Sex Med 2008;5:2079–2084.

Introduction Aquaporins (AQPs) are membrane proteins that facilitate water movement across biological membranes. There has been little research on the role of AQPs in the female sexual arousal response. Aim The purposes of this study were to investigate the localization and functional roles of AQP1, AQP2, and AQP3 in rat vagina. Methods Female Sprague-Dawley rats (230–240 g, N = 20) were anesthetized. The vaginal branch of the pelvic nerve was stimulated for 60 seconds (10 V, 16 Hz, 0.8 ms), and the animals were sacrificed either immediately or 5 minutes later. The expression and cellular localization of AQP1, 2, and 3 were determined by Western blot and immunohistochemistry of the vagina. The intracellular membrane and plasma membrane fractions of the proteins in vaginal tissue were studied by immunoblot analysis with the differential centrifugation. Main Outcome Measures The expression and cellular localization of AQPs, and pelvic nerve stimulation induced translocation of AQPs in rat vaginal tissue. Results Immunolabeling showed that AQP1 was mainly expressed in the capillaries and venules of the vagina. AQP2 was expressed in the cytoplasm of the epithelium, and AQP3 was mainly associated with the plasma membrane of the vaginal epithelium. AQPs were found to be present primarily in the cytosolic fraction of untreated tissues. The translocation of AQP1 and 2 isoforms from the cytosolic compartment to the membrane compartment was observed immediately after nerve stimulation and had declined at 5 minutes after nerve stimulation, while the subcellular localization of AQP3 was not changed by nerve stimulation. Conclusions These results showed a distinct localization of AQPs in the rat vagina. Pelvic nerve stimulation modulated short-term translocation of AQP1 and 2. These results imply that AQPs may play an important role in vaginal lubrication. Park K, Han HJ, Kim SW, Jung SI, Kim S-O, Lee H-S, Lee MN, and Ahn K. Expression of aquaporin water channels in rat vagina: Potential role in vaginal lubrication.

To assess the reproducibility of the Valsalva leak point pressure (VLPP) based on urodynamics in females with stress urinary incontinence (SUI).From October 2008 to December 2009, 65 consecutive women with urodynamically confirmed SUI underwent duplicate VLPP measurements. The intra-individual reproducibility of the VLPP recording obtained by one urologist was determined. The two observations were separated by a 10-min interval.The differences between the repeated measurements were not significant (initial vs. repeat VLPP, 84.8plusmn; 19.9 vs. 86.7plusmn; 20.3 cmH2O; P = .094). Repeated VLPP measurements were reproducible. Defining intrinsic sphincter deficiency (ISD) as VLPPlt; 60 cmH2O, the diagnosis of ISD changed between successive tests in three cases (from 55 to 89, 58 to 64, and 61 to 55 cmH2O).In female SUI, the VLPP is a reproducible method for evaluating urethral resistance. For VLPPlt; 90 cmH2O, the diagnosis of ISD changed in repeated measurements in some patients; therefore, other clinical findings must be considered when deciding on a treatment method.

Tooth movement by application of orthodontic biophysical force primarily reflects the role of soluble molecules released from the periodontal ligament (PDL). Thus far, many factors have been reported to be involved in orthodontic tooth movement (OTM), but key molecules that orchestrate responses of periodontal tissues to biophysical force are still enigmatic. In this in vivo study, in which the upper first molars in rats were moved, differential display–polymerase chain reaction revealed that CC chemokine receptor 5 (CCR5) level was differentially increased during OTM. Strong immunoreactivity for CCR5 was found in the PDL undergoing force application. Moreover, the in vitro compression or tension force application to primary cultured human PDL cells increased the expression of CCR5 and CCR5 ligands. In vitro tension force on human PDL cells did not induce RANKL, an osteoclastogenesis-inducing factor, but did induce the upregulation of IL12, an osteoclast inhibitory factor, and osteoblast differentiation factors, including Runx2, which was attenuated under tension by CCR5 gene silencing whereas augmented with CCR5 ligands. In contrast, in vitro compression force did not induce the expression of osteoprotegerin, a decoy receptor for RANKL and Runx2, but did induce the upregulation of RANKL, which was attenuated under compression by CCR5 gene silencing. These results suggest that the CCR5–CCR5 ligands axis in PDL cells may play a crucial role in the remodeling of periodontal tissues and can be a therapeutic target for achieving efficient OTM.