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Objective To investigate whether prostate-specific antigen (PSA) fluctuation correlates with a prostate cancer and to assess whether PSA fluctuation could be used for diagnosis of prostate cancer. Materials and Methods Our study included 229 patients who were performed a prostate biopsy (non-cancer group, 177; prostate cancer group, 52). Enrolled patients were provided twice PSA tests within 6 months. PSA fluctuation (%/month) was defined as a change rate of PSA per a month. Independent t test was used to compare between two groups. Receiver operator characteristic curve was used to assess the availability as a differential diagnostic tool and the correlation. Simple linear regression was performed to analyze a correlation between PSA fluctuation and other factors such as age, PSA, PSA density, and prostate volume. Results There were significant differences in PSA, PSA density, percentage of free PSA, and PSA fluctuation between two groups. PSA fluctuation was significantly greater in non-cancer group than prostate cancer group (19.95±23.34%/month vs 9.63±8.57%/month, P=0.004). The most optimal cut-off value of PSA fluctuation was defined as 8.48%/month (sensitivity, 61.6%; specificity, 59.6%; AUC, 0.633; P=0.004). In a simple linear regression model, only PSA level was significantly correlated with PSA fluctuation. Conclusion Patients with wide PSA fluctuations, although baseline PSA levels are high, might have a low risk of diagnosis with prostate cancer. Thus, serial PSA measurements could be an option in patients with an elevated PSA 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 AND OBJECTIVES: The appearance of extended-spectrum beta-lactamase (ESBL)-producing gram negative bacteria in urinary tract infections (UTIs) constitutes an important therapeutic challenge. The aim of this study was to describe drug susceptibility profiles of (ESBL)-producing gram-negative isolates recovered from urine samples. We also determined the antimicrobial coresistance to several agents, including fosfomycin METHODS: Retrospective analysis of 29,584 urine culture results obtained during January 2008 to December 2013 at Chonnam National Hwasun Hospital in Korea was done. The computerized database was used to identify ESBL-positive urine samples. A total of 869 ESBL positive strains were identified during the study period. We analyzed E. coli and Klebsiella isolates obtained from urine cultures and duplicate isolates; and no fosfomycin tests were excluded. The cases were further categorized according to UTI definition [community acquired (CA) UTI, health care-associated (HCA) UTI and hospital acquired (HA) UTI] and urology sample. ESBLisolates were stratified according their origin into two groups: Urology and non-Urology isolates RESULTS: Antimicrobial susceptibilities of the strains for fosfomycin were tested in 277 ESBL-positive strains: 217 ESBL-EC and 60 ESBL-KP. The most effective agents were carbapenem, such as imipenem and meropenem. The least active substances were ciprofloxacin (20.7%), Levofloxacin (22.7%), Trimethoprim-sulfamethoxazole (34.3%), and ampicillin-clavulanate (42.9 %). Overall, 243/277 (87.7%) of the isolates tested were susceptible to fosfomycin tromethamine. Higher fosfomycin sensitivity in E. coli (94.9%) were observed compared to Klebsiella (61.7%) (p1⁄40.001). ESBL-positive isolates from urological (68 isolates) and nonurological patients (209 isolates) showed similar susceptibility profiles. Except for carbapenem, CA-UTI showed higher sensitivity to fosfomycin (100%) and nitrofurantoin (93.1%), HCA-UTI showed higher sensitivity to amikacin (94.1%) and HA-UTI showed an overall poor sensitivity to antibiotics. CONCLUSIONS: Fosfomycin could be an alternative treatment option for UTIs related to ESBL-producing E. coli spp. and CA-UTI, but not for ESBL-producing Klebsiella spp. Antimicrobial susceptibilities in ESBL producing UTI was different to UTI classification. Fosfomycin showed decreased sensitivity in HCA-UTI and HA-UTI.

Purpose: We investigated whether the Valsalva leak point pressure (VLPP) is valuable for predicting postoperative outcome measurement after transobturator suburethral tape (TVT-O) implantation for treating stress urinary incontinence (SUI) in women. Materials and Methods: A total of 204 female patients who underwent TVT-O placement for treatment of SUI from March 2008 to February 2012 were enrolled in this retrospective study. All patients completed the incontinence quality of Life questionnaire (I-QoL), a self-reported quality of life measure specific to urinary incontinence, and the cure rate of incontinence was measured before and 6 months after surgery. Cure was defined as no leakage of urine postoperatively both subjectively and objectively. We compared pre- and postoperative I-QoL scores according to preoperative VLPP and Stamey grade. Results: The numbers of patients with Stamey grades I, II, and III were 99 (48.5%), 84 (41.2%), and 21 (10.3%), respectively. A total of 30 (14.7%), 87 (42.6%), and 87 patients (42.6%) showed VLPP≤60, 60＜VLPP≤90, and VLPP＞90 cm H2O, respectively. Preoperative VLPP was not significantly different according to preoperative I-QoL or change in I-QoL after surgery. However, I-QoL after surgery improved in patients with a high preoperative Stamey grade (p=0.001). Conclusions: VLPP was not a factor related to surgical outcome from the midurethral sling procedure. Stamey grade rather than VLPP was important for predicting subjective quality of life and improved incontinence-related quality of life after surgery.

Purpose To determine predictive factors for stent failure-free survival in patients treated with a retrograde ureteral stent for a malignant ureteral obstruction. Materials and Methods We retrospectively reviewed 71 patients who underwent insertion of a cystoscopic ureteral stent due to a malignant ureteral obstruction between May 2004 and June 2011. Performance status, type of cancer, hydronephrosis grade, location of the obstruction, presence of bladder invasion, C-reactive protein (CRP), serum albumin, and inflammation-based prognostic score (Glasgow prognostic score, GPS) were assessed using a Cox proportional regression hazard model as predicting factors for stent failure. Results A univariate analysis indicted that hypoalbuminemia (1.2 mg/dL; HR, 2.16; 95% CI, 1.02 to 4.57; p=0.044) were associated with stent failure-free survival. Conclusions A mid or lower ureteral obstruction, GPS ≥1, and serum creatinine before ureteral stent insertion >1.2 mg/dL were unfavorable predictors of stent failure-free survival. These factors may help urologists predict survival time.