Search

BACKGROUND/AIM The purpose of this study was to examine the expression of estrogen receptor α (ERα) and β (ERβ), androgen receptor (AR), SIRT1, SIRT2 and SIRT3 in prostate cancer (PCa). MATERIALS AND METHODS From October 2010 to January 2015, 70 patients who had undergone radical prostatectomy following a PCa diagnosis were enrolled in our study. Normal prostate tissue (NPT) and prostate cancer tissues (PCAT) were separated, and the expression of each receptor in each tissue was analyzed with immunochemical staining. Univariate and multivariate analyses were performed to identify factors affecting the development of PCa. RESULTS ERβ and AR were highly expressed in PCAT compared with NPT (p

The aim of this study was to build an in silico computer-aided design and computer-aided manufacturing (CAD/CAM) resin-composite-block (RCB) model with different silane coupling ratios and to evaluate the physical and mechanical properties of the models, including the elastic modulus, Poisson's ratio, compressive strength, and maximum principal strain. Nanoscale CAD/CAM RCB models were designed by using CAD software that consisted of twelve spherical silica nanofiller particles and a resin matrix. Seven nanoscale models with different silane coupling ratios were prepared with the same filler volume contents. Homogenization analysis was conducted by using voxel-base finite-element analysis software to predict the elastic moduli and Poisson's ratio of the macro CAD/CAM RCB. Localization analysis was used to analyze the maximum principal strain distribution in the hydrolysis layer. In silico multi-scale analysis demonstrated that the compressive strength of the CAD/CAM RCB was reduced with a decrease in the silane coupling ratios of the fillers.

Degradation of silane coupling layers by water ingress in computer-aided design/computer-aided manufacturing (CAD/CAM) of resin composites has been reported qualitatively. In this study, we quantitatively evaluated how water absorption of CAD/CAM resin composites affects the silane coupling layer by in vitro and in silico methods.A Katana Avencia block (KAB) and an experimental matrix block composed of only a matrix resin were used to evaluate the effect of water immersion for seven days on the elastic modulus. X-ray photoelectron spectroscopy (XPS) with fluorine-labeling of the KAB was performed to evaluate the atomic percentage of F1s, which represents the hydrolysis amount by water immersion. In silico analysis of the three-dimensional model of the KAB was performed to determine the coupling ratios before and after water immersion.The elastic modulus of the KAB was 8.2 GPa before and 6.9 GPa after immersion in water. The atomic percentages of F1s in the after- and before-immersion groups were 14.31% and 11.52%, respectively, suggesting that hydrolysis of the silane coupling layer occurred during water immersion. From in silico analysis of the three-dimensional model of the KAB, the coupling ratio was predicted to be 78.2% before water immersion. After water immersion, the coupling ratio was predicted to be 68.4%.The in vitro and in silico approaches established in this study were able to predict the silane coupling ratios of CAD/CAM resin composites, and they showed that the silane coupling ratio decreased by water absorption.

This study aimed to develop an artificial intelligence (AI) model to support the determination of an appropriate implant drilling protocol using cone-beam computed tomography (CBCT) images.Anonymized CBCT images were obtained from 60 patients. For each case, after implant placement, images of the bone regions at the implant site were extracted from 20 slices of CBCT images. Based on the actual drilling protocol, the images were classified into three categories: protocols A, B, and C. A total of 1,200 images were divided into training and validation datasets (n = 960, 80%) and a test dataset (n = 240, 20%). Another 240 images (80 images for each type) were extracted from the 60 cases as test data. An AI model based on LeNet-5 was developed using these data sets. The accuracy, sensitivity, precision, F-value, area under the curve (AUC) value, and receiver operating curve were calculated.The accuracy of the trained model is 93.8%. The sensitivity results for drilling protocols A, B, and C were 97.5%, 95.0%, and 85.0%, respectively, while those for protocols A, B, and C were 86.7%, 92.7%, and 100%, respectively, and the F values for protocols A, B, and C were 91.8%, 93.8%, and 91.9%, respectively. The AUC values for protocols A, B, and C are 98.6%, 98.6%, and 99.4%, respectively.The AI model established in this study was effective in predicting drilling protocols from CBCT images before surgery, suggesting the possibility of developing a decision-making support system to promote primary stability.

A novel trawl door with a trailing edge flap and a trawl door with a hydrophobic surface are proposed to improve the hydrodynamic characteristics of trawl doors. In the former, the flap angle was designed to accommodate rapid changes in water flow velocity, increase the lift force under low-speed conditions, and decrease drag force under high-speed conditions. An evaluation of the hydrodynamic characteristics at different flap angles was conducted through numerical analyses and experimentation. The design of the trawl door with coated hydrophobic surface aims to reduce flow resistance. Both trawl door designs were validated in a circulating water channel ex-periment. At these angles of the trailing edge flap, a 31 % decrement in drag force was observed in the circulating water channel experi-ment, and a 21.3 % decrement in flow resistance was observed when the surface of the trawl door was coated with hydrophobic surface materials.

A preventive measure for debonding has not been established and is highly desirable to improve the survival rate of computer-aided design/computer-aided manufacturing (CAD/CAM) composite resin (CR) crowns. The aim of this study was to assess the usefulness of deep learning with a convolution neural network (CNN) method to predict the debonding probability of CAD/CAM CR crowns from 2-dimensional images captured from 3-dimensional (3D) stereolithography models of a die scanned by a 3D oral scanner. All cases of CAD/CAM CR crowns were manufactured from April 2014 to November 2015 at the Division of Prosthodontics, Osaka University Dental Hospital (Ethical Review Board at Osaka University, approval H27-E11). The data set consisted of a total of 24 cases: 12 trouble-free and 12 debonding as known labels. A total of 8,640 images were randomly divided into 6,480 training and validation images and 2,160 test images. Deep learning with a CNN method was conducted to develop a learning model to predict the debonding probability. The prediction accuracy, precision, recall, F-measure, receiver operating characteristic, and area under the curve of the learning model were assessed for the test images. Also, the mean calculation time was measured during the prediction for the test images. The prediction accuracy, precision, recall, and F-measure values of deep learning with a CNN method for the prediction of the debonding probability were 98.5%, 97.0%, 100%, and 0.985, respectively. The mean calculation time was 2 ms/step for 2,160 test images. The area under the curve was 0.998. Artificial intelligence (AI) technology—that is, the deep learning with a CNN method established in this study—demonstrated considerably good performance in terms of predicting the debonding probability of a CAD/CAM CR crown with 3D stereolithography models of a die scanned from patients.

Purpose The aim of this study was to determine the mechanical properties of computer-aided design/computer-aided manufacturing (CAD/CAM) resin composites for dental restoration assuming perfect silane coupling by in silico homogenization analysis using a three-dimensional model constructed from cryo-electron microscopy (cryo-EM) images. Methods Three-dimensional dataset of a commercial CAD/CAM resin composite block (RCB) was obtained using EM with cryo-stage and focused ion beam at −130 °C. The region of inspection was 1.8 μm × 1.4 μm × 1.2 μm, and 213 slices were obtained from this region. Each slice was processed (noise reduction, threshold setting, and segmentation) using image processing software to design an in silico model. From the processed image slices, a bulk three-dimensional object and stereolithography model were reconstructed using voxel modeling software. To evaluate the elastic modulus and Poisson’s ratio of the CAD/CAM RCB, homogenization analysis was performed. Results The generated voxel model included 37,276,216 voxels, 42,472,040 patches of the surface, 2,123,672 nodes, a volume of 165,748,899, and a surface area of 175,206,723. The mean of the elastic moduli along each axis was 10.71 ± 1.79 GPa. The mean of the Poisson’s ratios of each plane was 0.23 ± 0.02. Conclusions A CAD/CAM resin composite model was successfully reconstructed from cryo-EM images, suggesting that the established image processing method is useful for producing dental restorative materials containing nano-fillers and for predicting homogenized mechanical properties. The homogenized mechanical properties indicated that the mechanical properties of the CAD/CAM RCB assumed perfect silane coupling between the fillers and resin matrix.

Introduction and objective: The purpose of this study was to compare the severity of lower urinary tract symptoms (LUTS) between patients with and without premature ejaculation (PE). Materials and method: The relationship between the severity of LUTS and PE was investigated among 825 male subjects, who underwent medical check-up between July 2013 and July 2018 in our hospital. PE was defined by self-reported intravaginal ejaculation latency time (IELT). The severity of LUTS was determined by international prostate symptom score (IPSS), overactive bladder symptom score (OABSS), transrectal ultrasonography (TRUS), and uroflow rate. A total of 825 subjects were classified into three groups: PE-group (N = 60), Self-reported PE-group (N = 353), and Non-PE group (N = 412). Results: In comparison analysis involving the two groups, the PE-group and the Self-reported PE-group were analyzed to be statistically significantly higher in IPSS items and OABSS items, compared to the Non-PE group (P < 0.05). This showed the same results in the univariate analysis (P < 0.05). Multivariate analysis conducted with the PE-group versus the Non-PE group, and the Self-reported PE-group versus the Non-PE group, revealed significant differences in the values of total IPSS (P < 0.05). Conclusion: Comparison between the PE-group, which included the Self-reported PE-group, and the Non-PE group suggest that the severity of LUTS was comparatively higher in the PE-group. Thus, it is thought that being associated with or without PE may be a significant factor to consider, which affects LUTS severity.

Objective The aim of this study was to evaluate the optical properties of supra-nano spherical fillers with different diameters and the color matching ability of resin composites (RC) incorporating these fillers. Methods Two types of SiO2–ZrO2 nano fillers with different diameters (150 nm and 260 nm) were used. The size distribution of each filler was measured and filler morphology was observed. The colors and spectral reflection spectra were measured by a spectral reflectometer. Experimental RCs incorporating ϕ150-nm/ϕ260-nm filler (D150RC/D260RC) were prepared. For the base dentin part, disc specimens (Estelite Astelia: A1B, A2B, A3B, A3.5B, or A4B) were prepared with a cylindrical cavity. Estelite Astelia with NE shade was layered on top as the enamel layer. Disk specimens with different cavity depths were prepared using A3B shade. Experimental RC was used to fill the cavity, and spectral reflection spectrums were obtained and analyzed. Filtek Supreme Ultra (FSU) with A3B shade was used (n = 10) as a control. Results Both ϕ150-nm and ϕ260-nm nano fillers showed uniform spherical shape and exhibited no aggregation. The maximum peaks of the spectral reflection spectra of the ϕ150-nm and ϕ260-nm nano fillers were 380 nm and 580 nm, producing structural colors close to blue and yellow, respectively. The spectral reflection spectrum of FSU had a broad peak at 540 nm, and D150RC had a significant peak at 420 nm. The D260RC specimen had a broad peak at 680 nm. The peaks of D150RC and D260RC significantly decreased in accordance with the shift in base RC shade from A1B to A4B. There was no significant difference in the peak of the reflection spectral spectra among different cavity depths of D260RC. These results suggest that the experimental RC could reflect base RC colors via the matrix resin, and the amount of transmitted light from the base RC was not much different with cavity depth. Significance D260RC producing structural color demonstrated a broad spectrum and reduction in brightness and chromatic value by adapting to surrounding restorative materials, suggesting its ability to enhance the chameleon (blending) effects to improve color matching. D260RC showed better color matching ability than resin composite containing uniformly sized ϕ150-nm SiO2–ZrO2 supra-nano spherical filler.

Purpose Fractographic analysis has been used to investigate the fracture behavior of Computer-aided design/computer-aided manufacturing (CAD/CAM) composite crowns by subjecting them to compression tests. However, it is difficult to investigate details of the fracture, including its initiation and propagation, using in vitro tests. The aim of this study was to determine the fracture origins and the order of crack initiation of CAD/CAM composite crowns using in silico nonlinear dynamic finite element analysis (FEA). Material and methods The following materials were used: Cerasmart (CS), Katana Avencia Block (KA), and Shofu Block HC (HC) as CAD/CAM crowns, Panavia SA Cement Plus (SA) as a luting material, and Clearfil DC Core Plus (DC) as an abutment. The elastic moduli and fracture strain of each material were obtained from the stress–strain curve of in vitro three-point bending tests. The fracture origins and order of crack initiation of the materials were determined by in silico nonlinear dynamic compression analysis. Load-displacement curves were statistically compared with the results of the in vitro compression tests (Pearson's correlation test, α = 0.05). Results The nonlinear dynamic FEA demonstrated that crack initiation was primarily observed near the lingual side of the CAD/CAM crowns and immediately propagated to the central fossa. The models were fractured following the in vitro fracture strains, showing the same order for the products tested (CS/KA/HC, SA, and DC). Load-displacement curves with the use of CS, KA, and HC were significantly correlated to the corresponding in vitro compression tests results (CS: r = 0.985, p Conclusions The in silico model established in this study clarified the crack initiation of the CAD/CAM composite crowns and the order of crack initiation among the investigated products, suggesting that the present approach is useful for analyzing the fracture behavior of CAD/CAM composite crowns in detail.

To evaluate the fatigue survival, failure mode, and maximum principal stress (MP Stress) and strain (MP Strain) of resin-matrix ceramic systems used for implant-supported crowns.Identical molar crowns were milled using four resin-matrix ceramics (n = 21/material): (i) Shofu Hard, (ii) Cerasmart (iii) Enamic, and (iv) Shofu HC. Crowns were cemented on the abutments, and the assembly underwent step-stress accelerated-life testing. Use level probability Weibull curves at 300 N were plotted and the reliability at 300, 500 and 800 N was calculated for a mission of 50,000 cycles. Fractographic analysis was performed using stereomicroscope and scanning electron microscope. MP Stress and MP Strain were determined by finite element analysis.While fatigue dictated failures for Cerasmart (β1), material strength controlled Shofu Hard, Enamic, and Shofu HC failures (β1). Shofu HC presented lower reliability at 300 N (79%) and 500 N (59%) than other systems (90%), statistically different at 500 N. Enamic (57%) exhibited a significant reduction in the probability of survival at 800 N, significantly lower than Shofu Hard and Cerasmart; however, higher than Shofu HC (12%). Shofu Hard and Cerasmart (93%) demonstrated no significant difference for any calculated mission (300-800 N). Failure mode predominantly involved resin-matrix ceramic fracture originated from occlusal cracks, corroborating with the MP Stress and Strain location, propagating through the proximal and cervical margins.All resin-matrix ceramics crowns demonstrated high probability of survival in a physiological molar load, whereas Shofu Hard and Cerasmart outperformed Enamic and Shofu HC at higher loads. Material fracture comprised the main failure mode.

We investigated the correlation between the presence of leucocytes in expressed prostatic secretion and the lower urinary tract symptom severity by retrospectively reviewing 699 men with lower urinary tract symptoms. The patients were evaluated by the International Prostate Symptoms Score and the Overactive Bladder Symptoms Score and underwent expressed prostatic secretion testing. Patients were classified into groups 1 and 2 based on the expressed prostatic secretion leucocyte count. The mean total and storage score of the International Prostate Symptoms Score, and mean total Overactive Bladder Symptoms Score were higher in group 1. Urine flow metrics showed that voided volume and maximum flow rate were lower in group 1. The scores for International Prostate Symptoms Score questions 4, 6 and 7 and Overactive Bladder Symptoms Score question 2 were higher in group 1 and showed a weak positive correlation with expressed prostatic secretion. Voided volume and maximum flow rate showed the strongest correlation, although International Prostate Symptoms Score question 7 and Overactive Bladder Symptoms Score question 2 were the only independent predictors of expressed prostatic secretion. Therefore, leucocytes in expressed prostatic secretion are associated with the lower urinary tract symptom severity, particularly nocturnal urination symptoms.

Background and objective Although several studies have reported that sexual dysfunction is associated with chronic prostatitis (CP), specific differences in self-reported questionnaires and correlation with CP are not well-known. This study aimed to evaluate the prevalence and correlation of sexual dysfunction in men with CP. Material and methods This cross-sectional study included 892 men who visited our health care center, who were then divided into two groups. In Group 1, subjects are characterized with National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) pain score ≥4, and Group 2 subjects are characterized with NIH-CPSI

Although previous and ongoing clinical studies have used stromal cells during renal ischemia-reperfusion injury (IRI), there is little consensus regarding the optimal protocol. We aimed to optimize the protocol for hypoxic preconditioned human bone marrow-derived mesenchymal stromal cell (HP-hBMSC) therapy in a rat model of renal IRI. We determined the optimal injection route (renal arterial, renal parenchymal, and tail venous injection), dose (low-dose: 1×106, moderate-dose: 2×106, and high-dose: 4×106), and injection period (pre-, concurrent-, and post-IRI). During optimal injection route study, renal arterial injections significantly reduced the decreasing glomerular filtration rate (GFR), as compared to GFRs for the IRI control group, 2 and 4 days after IRI. Therapeutic effects and histological recoveries were the greatest in the group receiving renal arterial injections. During the dose finding study, high-dose injections significantly reduced the decreasing GFR, as compared to GFRs for the IRI control group, 3 days after IRI. Therapeutic effects and histological recoveries were the greatest in the high-dose injection group. While determining the optimal injection timing study, concurrent-IRI injection reduced elevated serum creatinine levels, as compared to those of the IRI control group, 1 day after IRI. Pre-IRI injection significantly reduced the decreasing GFR, as compared with GFRs for the IRI control group, 1 day after IRI. Therapeutic effects and histological recoveries were the greatest in the concurrent-IRI group. In conclusion, the concurrent-IRI administration of a high dose of HP-hBMSC via the renal artery leads to an optimal recovery of renal function after renal IRI.

We investigated the influence of obesity on unfavorable disease in men with low risk prostate cancer eligible for active surveillance and verified the underlying relationship with tumor location.We analyzed the records of 890 patients with biopsy Gleason score 6 who underwent radical prostatectomy for prostate cancer via multicore (12 or more) biopsy at our institution. Unfavorable disease was defined as primary Gleason pattern 4 or greater, or pathological stage T3 or greater. Multivariate logistic regression analysis was performed to identify factors associated with unfavorable disease. The association of unfavorable disease with anatomical location of the index tumor was assessed.Overall 216 (24.3%), 544 (61.1%) and 130 men (14.6%) had a body mass index of less than 23 (normal), 23 to 27.5 (overweight) and 27.5 kg/mObese men with low risk prostate cancer who are eligible for active surveillance are at higher risk for unfavorable pathological features. Obese men more frequently had transition zone cancer, which was associated with unfavorable pathology findings in those with very low risk prostate cancer.

Acute kidney injury (AKI) induced by ischemia/reperfusion (I/R) injury is a major challenge in critical care medicine. The purpose of this study is to determine the therapeutic effects of the adipose-tissue-derived stromal vascular fraction (SVF) and the optimal route for SVF delivery in a rat model of AKI induced by I/R injury. Fifty male Sprague–Dawley rats were randomly divided into five groups (10 animals per group): sham, nephrectomy control, I/R injury control, renal arterial SVF infusion and subcapsular SVF injection. To induce AKI by I/R injury, the left renal artery was clamped with a nontraumatic vascular clamp for 40 min, and the right kidney was removed. Rats receiving renal arterial infusion of SVF had a significantly reduced increase in serum creatinine compared with the I/R injury control group at 4 days after I/R injury. The glomerular filtration rate of the renal arterial SVF infusion group was maintained at a level similar to that of the sham and nephrectomy control groups at 14 days after I/R injury. Masson’s trichrome staining showed significantly less fibrosis in the renal arterial SVF infusion group compared with that in the I/R injury control group in the outer stripe (P

Purpose: To investigate the association of erectile dysfunction (ED), premature ejaculation (PE), and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in men with late-onset hypogonadism (LOH). Materials and Methods: We reviewed the data of 408 enrolled men between January 2014 and January 2019. All participants completed the Androgen Deficiency in the Aging Male (ADAM), international index of erectile function-5 (IIEF-5), National Institutes of Health chronic prostatitis symptom index (NIH-CPSI), and premature ejaculation diagnostic tool (PEDT) questionnaires. Participants were divided by ADAM positive (ADAM+: Group 1) and ADAM negative (ADAM–: Group 2). Results: Total of 289 subjects were in Group 1 and 119 were in Group 2. The mean age was 53.8±7.8 years. The mean total testosterone was 4.8±1.2 ng/dL and showed no differences between the groups (p=0.839). In Groups 1 and 2, ED (IIEF≤21) was identified in 233 (80.6%) versus 37 (31.1%), respectively (p

Purpose The aim of this multi-scale in silico study was to evaluate the influence of resorption cavities on the mechanical properties and load distribution in cortical bone after implant placement with two different drilling protocols. Material and methods Two different micro-scale bone structures were assessed: cortical bone models with cavities (test) and without cavities (control) were designed from μCT data. In a macro-scale model, representing a mandibular ridge, oblique load of 150 N was applied on the implant-abutment. Maximum principal stress/strain, and shear stress/strain were calculated in the macro- and micro-scale models. Results Test presented anisotropic material properties. In tests, significantly greater maximum values of Maximum principal stress/strain were calculated in micro-scale model. These values were located at the implant neck area in the macro-scale model and in the proximity of cavities in the micro-scale model respectively. Greater values of shear stress/strain were found in the test along the mandibular horizontal plane. Conclusions Cortical bone with resorption cavities following undersized drilling showed an impaired load distribution compared with bone without cavities. Subsequently, stress/strain distribution suggests that this bone model is more prone to microdamage, thus delaying the healing process.

Background aims Although clinical studies using stem cells to treat erectile dysfunction have been performed or are ongoing, there is little consensus on the optimal protocol. We aimed to develop a protocol optimizing human bone marrow–derived mesenchymal stromal cell (hBMSC) therapy in a rat model of cavernous nerve injury. Methods We performed, in order, a dose-finding study, a toxicokinetic study of hBMSCs, and a study to determine the timing and number of cell injections. Results From the dose-finding study, 1 × 10 6 cells were selected as the dose per hBMSC injection. From the toxicokinetic study, 14 days was selected as the interval between repeat treatments. In the final study, the ratio of maximal intracavernous pressure to mean arterial pressure was significantly lower in the control group than in the sham group (23.4% vs. 55.1%, P 0.001). An immediate single injection of hBMSCs significantly improved erectile function compared with the control group (39.8%, P = 0.035), whereas a delayed single injection showed improvement with a marginal trend (38.1%, P = 0.079). All histomorphometric changes were significantly more improved in the immediate or delayed single injection groups than in the control group. Repeat treatments did not provide any benefit for the recovery of erectile function and histomorphometric changes. Conclusions Intracavernous injection of 1 × 10 6 hBMSCs results in a recovery of penile erection and histomorphometric changes in a rat model of cavernous nerve injury, even when treatment was delayed until 4 weeks after cavernous nerve injury.

This study was designed to evaluate and compare the oncological outcomes of patients with pathological T1a (pT1a) small renal cell carcinomas (RCCs) with those with incidental pathological T3a (pT3a) RCCs who have been treated using partial nephrectomy (PN). We retrospectively evaluated the records of 1367 consecutive patients who underwent PN for small RCCs (≤4 cm) between 1997 and 2014. The curves for recurrence-free, cancer-specific, and overall survival were estimated using the Kaplan–Meier method. Cox regression analysis was used to estimate the prognostic significance of each variable. Of the 1367 small RCC patients identified, 1324 (96.8 %) had pT1a lesions and 43 (3.2 %) had pT3a lesions. The median ages of the pT1a and pT3a patients were 53.9 and 58.1 years, respectively. Patients received follow-up for a median of 54 months. The 5- and 10-year RFS rates in patients with pT1a and pT3a RCCs were 98.0 and 95.2 %, and 94.4 and 95.2 %, respectively (P = 0.521). None of the patients with recurrent tumors in the pT3a group have died by the time of the writing of this report. A multivariate Cox proportional hazards model showed that tumor size was a significant predictor of RFS and CSS (P

To compare renal functional outcomes in patients with a small renal mass undergoing robot-assisted partial nephrectomy using warm ischemia (wRAPN) or open partial nephrectomy using cold ischemia (cOPN). This study included 185 patients who underwent partial nephrectomy and were assessed by preoperative and postoperative diethylene triamine penta-acetic acid renal scintigraphy. Variables associated with postoperative operated-side glomerular filtration rate decrement (ΔGFR) were assessed using multivariate analysis. Exact 1:1 propensity score matching was performed using variables related to ΔGFR. Furthermore, 30 patients who underwent wRAPN were matched with 30 patients who underwent cOPN, and their differences in ΔGFR were calculated. Patients who underwent cOPN were older (p = 0.025) and had shorter ischemia time (p

Rationale The preoperative diagnosis of massive pulmonary tumor embolism associated with renal neoplasms is relatively rare. In most cases, pulmonary tumor embolism is detected intraoperatively during renal tumor resection. Moreover, primary renal sarcoma is rare, and primary renal sarcoma complicated by pulmonary tumor embolism is extremely rare; accordingly, there is no optimal treatment for such cases. Herein, we report a case of renal sarcoma associated with pulmonary tumor embolism. Patient concerns A 39-year-old man was admitted to the emergency room owing to the sudden onset of dyspnea and palpitation. Diagnosis Contrast-enhanced computed tomography (CT) revealed a large mass in the right kidney involving the infrahepatic inferior vena cava, with massive pulmonary emboli in both the pulmonary arteries. Interventions Emergency pulmonary embolectomy with radical nephrectomy was performed. Outcomes The patient experienced apparent remission of dyspnea, and resolution of right ventricle dysfunction. However, although remnant emboli were detected in the segmental arteries on postoperative CT, complete resolution of pulmonary embolism was observed after adjuvant chemotherapy. Lessons Thus, concomitant cytoreductive nephrectomy with pulmonary embolectomy along with chemotherapy may be effective for patients with renal sarcoma with pulmonary tumor embolism.

The aim of this study was to assess the validity of in silico models of three-point bending tests to reflect in vitro physical properties obtained from three commercially available computer-aided design/computer-aided manufacturing (CAD/CAM) resin composite blocks and demonstrate notchless triangular prism analysis with those properties.Three types of commercially available CAD/CAM resin composite blocks were used: Cerasmart 300 (CS300; GC, Tokyo, Japan), Katana Avencia P Block (AP; Kuraray Noritake Dental, Tokyo, Japan), and KZR CAD HR3 Gamma Theta (GT; Yamakin, Osaka, Japan). In vitro/in silico three-point bending tests were conducted to obtain elastic modulus and fracture strain for non-linear dynamic finite element analysis (n = 10/each). Fractured surfaces of specimens after in vitro NTP tests were observed, and the fracture toughness of each CAD/CAM resin composite was obtained by in silico NTP analysis.Both in vitro and in silico load-displacement curves obtained from three-point bending tests were significantly correlated (p 0.05). The elastic moduli of CS300, AP, and GT were 8.0 GPa, 10.0 GPa, and 9.0 GPa, respectively. The fracture toughness values obtained from in silico NTP analysis of CS300, AP, and GT were 5.057 MPa mThe in silico approach established in this study showed acceptable reflection of in vitro physical properties and will be useful for assessing fracture toughness related to the longevity of CAD/CAM resin composites without wastage of materials.

Background and objectiveTo evaluate the relationship between erectile dysfunction (ED) and premature ejaculation (PE) among men aged 40–79 years and to compare age-related differences between men aged 40–59 years and 60–79 years.Materials and methodsFrom January 2014 to January 2019, records of 892 men aged 40–79 years were analyzed. We performed correlation analysis using the self-reported intravaginal ejaculation latency time (IELT), premature ejaculatory diagnostic tool (PEDT), Male Sexual Health Questionnaire-ejaculation (MSHQ-EjD), and International Index of Erectile Function5 (IIEF5) questionnaires.ResultsThe mean age of the 892 males was 52.8 ± 7.3 years (40–76). All subjects were divided into group 1 (40–59 years old) and group 2 (60–79 years old). The IIEF5 score of group 1 was significantly higher than that of group 2 (18.7 ± 5.5 vs. 17.7 ± 5.7, p = 0.049). Of the total subjects, 71 (8%) had IELT value of less than 1 min. A total of 51 (6.9%) and 20 (13.5%) were in groups 1 and 2, respectively (p = 0.02). The PEDT total score was higher and more subjects were identified as suffering from PE (PEDT ≥ 9) from amongst the ED subjects (IIEF-5 ≤ 21). In both groups 1 and 2, more PE subjects were identified in ED subjects (IIEF-5 ≤ 21) than normal subjects (IIEF-5 > 21) (all p < 0.01). In the total subjects, group 1 and 2, the IIEF-5 and PEDT score showed a weak negative correlation (r = −0.302, r = −0.361, r = −0.248, all p < 0.01). In group 2,the IELT and MSHQ-EjD score also showed a weak positive correlation between the IIEF-5 score (r = 0.166, p = 0.044 and r = 0.164, p = 0.047, respectively).ConclusionMore subjects defined PE value as less than 1 min on the self-reported IELT in the elderly group ≥60 years than those among the 40–59 years age group; moreover, the lower the IIEF5 total score among subjects ≥ 60 years, the higher the PEDT score and the lower the IELT and MSHQ-EjD scores.

Purpose: To determine the role of metabolic syndrome (MetS) as a risk factor for acquired premature ejaculation (PE) after considering the various risk factors, such as lower urinary tract symptoms, erectile dysfunction, hypogonadism, and prostatitis. Materials and Methods: From January 2012 to January 2017, records of 1,029 men were analyzed. We performed multivari-ate analysis to identify risk factors for PE, including the covariate of age, marital status, International Prostate Symptom Score, International Index of Erectile Function (IIEF) score, National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) score, serum testosterone levels, and all components of MetS. Acquired PE was defined as self-reported intravaginal ejacula-tion latency time ≤3 minutes, and MetS was diagnosed using the modified National Cholesterol Education Program Adult Treatment Panel III criteria. Results: Of 1,029 men, 74 subjects (7.2%) had acquired PE and 111 (10.8%) had MetS. Multivariate analysis showed that the IIEF overall satisfaction score (odds ratio [OR]=0.67, p

The aim of this study was to evaluate long-term fatigue behavior using an in vitro step-stress accelerated life test (SSALT), and to determine the crack initiation point using in silico finite element analysis for computer-aided designed and manufactured (CAD/CAM) molar crowns fabricated from three commercial CAD/CAM resin composite blocks: Cerasmart (CS; GC, Tokyo, Japan), Katana Avencia Block (KA; Kuraray Noritake Dental, Niigata, Japan), and Shofu Block HC (HC; Shofu, Kyoto, Japan).Fifty-one mandibular first molar crowns luted on a resin core die were embedded in acrylic resin and covered with a polyvinyl chloride tube. Single compressive tests were performed for five crowns. SSALT was conducted for 36 crowns using three profiles and reliabilities at 120,000 cycles, and a Weibull analysis was conducted. The maximum principal strain of each CAD/CAM resin composite crown model was analyzed by three-dimensional finite element analysis.Fracture loads of CS and KA (3784±144N and 3915±313N) were significantly greater than that of HC (2767±227N) (p0.05). Fracture probabilities at 120,000 cycles were 24.6% (CS), 13.7% (KA), and 14.0% (HC). Maximum principal strain was observed around the mesiolingual cusps of CS and KA and the distobuccal cusp of HC.CAD/CAM resin composite molar crowns containing nano-fillers with a higher fraction of resin matrix exhibited higher fracture loads and greater longevity, suggesting that these crowns could be used as an alternative to ceramic crowns in terms of fatigue behavior.

Pelvic lymphadenectomy is considered the most reliable method of diagnosing lymph node metastases and significant adverse prognostic factor in patients with prostate cancer. In the treatment of prostate cancer, however, the clinical benefit of pelvic lymphadenectomy is debatable. In the past, it was common practice not to conduct radical prostatectomy when the lymph node positive results were seen in the frozen section during surgery [1]. Despite the recent efforts to improve clinical outcomes in patients with prostate cancer, pelvic lymphadenectomy remains controversial. Abdollah et al. recently identified that removing more lymph nodes during radical prostatectomy can significantly improve cancer-specific survival in pN1 patients [2]. Therefore, more comprehensive and accurate nodal staging through extended pelvic lymphadenectomy may indirectly [3].

The aim of this study was to investigate the prevalence of acute kidney injury (AKI) after radical cystectomy, and evaluate its impact on chronic kidney disease (CKD) and mortality. The medical records of 866 patients who underwent radical cystectomy for bladder cancer were reviewed. AKI was assessed within 7 days after surgery according to the Acute Kidney Injury Network criteria. The prevalence of AKI after surgery was examined, and the significance of AKI for CKD and mortality was analyzed. Of 866 patients, 269 (31.1 %) developed AKI in the first week after surgery. Of these, 231 (85.9 %) were at stage 1, 32 (11.9 %) at stage 2, and 6 (2.2 %) at stage 3. Of 722 patients with a preoperative Modification of Diet in Renal Disease estimated glomerular filtration rate (eGFR) of >60 ml/min/1.73 m2, CKD developed in 23.0 % (118/513) of patients in the non-AKI group and 32.5 % (68/209) of patients in the AKI group. Independent factors predicting new-onset CKD were a preoperative eGFR (p

The abilities of intracavernous injection of autologous stromal vascular fraction (SVF) and adipose-derived stem cells (ADSCs) to facilitate recovery of erectile function in a rat model of cavernous nerve (CN) injury were compared. Forty male Sprague-Dawley rats were randomly divided into four groups: sham and control groups (intracavernous injection of phosphate-buffered saline), SVF group (intracavernous injection of SVF), and ADSC group (intracavernous injection of ADSCs). Rats in the latter three groups underwent bilateral CN injury prior to injection. The evaluation of erectile function and histomorphometric studies were performed 4 weeks after injection. The ratio of maximal intracavernous pressure to mean arterial pressure was significantly lower in the control group than in the sham group (0.18 vs. 0.56, p < .001). Intracavernous injection of SVF (0.36, p = .035) significantly improved erectile function compared with that in the control group, whereas the ADSC group (0.35, p = .052) showed marginally significant improvement. The smooth muscle/collagen ratio, smooth muscle content, number of neuronal nitric-oxide synthase-positive nerve fibers, and expression of von Willebrand factor were significantly higher in the SVF and ADSC groups than in the control group. Expression of endothelial nitric-oxide synthase was significantly increased in the SVF group. The increases in the smooth muscle/collagen ratio and von Willebrand factor expression were larger in the SVF group than in the ADSC group. Intracavernous injection of SVF or ADSCs was equally effective in recovering penile erection in a rat model of CN injury.

To evaluate the association between ABO blood group and prognosis in patients with renal cell carcinoma (RCC) undergoing surgery.A review of the nephrectomy database of the Asan Medical Center identified 3,172 consecutive patients who underwent nephrectomy for RCC between 1997 and 2012. Patients were followed up for a median 60.2 months (interquartile range 33-102 months). Recurrence-free (RFS), cancer-specific (CSS), and overall survival (OS) were calculated by the Kaplan-Meier method and compared using the log-rank test. A Cox proportional hazards regression model was used to estimate the prognostic significance of each variable.Of these 3,172 patients, 915 (28.8 %), 1,057 (33.7 %), 860 (26.7 %) and 340 (10.8 %) were blood types O, A, B, and AB, respectively. ABO blood group was not associated with age, sex, operation method, American Society of Anesthesiologists physical status classification, histologic subtype, or pathological TNM stage. The 5-year OS rates in patients with blood types O, A, B, and AB were 86.0, 86.8, 86.6, and 88.6 %, respectively, and the 10-year OS rates were 78.7, 78.6, 79.1, and 76.9 %, respectively (P = 0.990). ABO blood group was not significantly associated with RFS (P = 0.921) or CSS (P = 0.808). Univariable and multivariable analyses showed that ABO blood group was not a significant prognostic factor of RFS, CSS, or OS.Our study found that ABO blood group is not associated with survival outcomes and is not a prognostic factor in patients who underwent surgery for RCC.