Biomedical subjects

Luke S Chang

Publications and source records attributed to Luke S Chang.

At least 19 recordsLinked to original sources

PubMed2006

Multifactorial nature of male nocturia.

OBJECTIVES: To conduct a prospective study to determine the causes of nocturia in men. METHODS: The study included 41 male patients (mean age 72.5 years) bothered by nocturia (two or more micturitions per night). Eleven asymptomatic young men (mean age 28.4 years) were enrolled as a control group. All completed a 3-day voiding diary. Daytime and nighttime urine samples were collected to determine osmolality and sodium and potassium levels. Urodynamic studies were performed for all patients with nocturia to evaluate for bladder outlet obstruction using the International Continence Society definition. Polysomnography was performed on selected patients to detect sleep apnea. RESULTS: The average nighttime voiding frequency was 3.9 in the patients with nocturia. Nocturnal polyuria (NP) was found in 34 (82.9%) of 41 patients. In these patients, the nighttime urinary sodium excretion was significantly greater than the daytime excretion, with lower nighttime urine osmolality. In contrast, nighttime and daytime sodium excretion was not significantly different in patients without NP, and greater nighttime urine osmolality was noted in the patients without NP and the control group. Of the 41 patients, 24 (58.5%) had a small nocturnal bladder capacity, with detrusor overactivity in 14 of 24 patients. Eighteen patients (43.9%) had both NP and a small nocturnal bladder capacity. Another 18 patients had bladder outlet obstruction and NP. Two patients had sleep apnea. CONCLUSIONS: Our observations have shown that a significant contributor to male nocturia is NP, which results from a disordered diurnal rhythm of sodium excretion and other unknown factors causing nocturnal urinary dilution. However, male nocturia can also be secondary to a combination of factors. Detailed workup is necessary to elucidate all causes.

Adult↗

PubMed2006

Transurethral prostatic resection for acute urinary retention in patients with prostate cancer.

BACKGROUND: Few studies have focused on clinical findings in prostate cancer patients receiving transurethral resection of the prostate (TURP) for acute urinary retention (AUR). We compared the clinical findings (preoperative characteristics, operative morbidities, and pathology results) of patients with diagnosed prostate cancer undergoing palliative TURP for AUR with those of patients undergoing TURP for AUR who were diagnosed with prostate cancer postoperatively. METHODS: The charts of 25 patients with prostate cancer undergoing TURP for AUR between 1986 and 2003 were retrospectively reviewed. Fourteen patients underwent palliative TURP (group A) and the other 11 patients with newly diagnosed prostate cancer received TURP (group B). The data, including preoperative characteristics, operative morbidities, and pathology results were analyzed. RESULTS: There were no significant differences between the 2 groups in parameters such as age at diagnosis and operation, operative time, hospitalization, and catheter duration. However, the Gleason score was higher in group A (7.6 +/- 1.7) than in group B (5.4 +/- 1.8) (p < 0.005). The mean resected weight was lower in group A (19.9 g) than in group B (39.5 g). Group A was more likely to receive recatheterization (33.3% vs 0%, p = 0.058) and repeat operation (28.6%), although the difference was not statistically significant. There were no complications such as transurethral resection syndrome or perioperative death in either group. CONCLUSION: TURP can be performed safely for relief of AUR in patients with prostate cancer, no matter if the cancer was diagnosed before or after surgery. The higher Gleason score and more advanced cancer stage, as found in group A, may correlate to high recatheterization and reoperation rates due to preexisting tumor progression.

Aged↗

PubMed2006

Hemolysis in transurethral resection of the prostate using distilled water as the irrigant.

BACKGROUND: To investigate the incidence and time course of hemolysis and its clinical effects following transurethral resection of the prostate (TURP) using distilled water as the irrigant. METHODS: Between March 1996 and April 1997, 39 patients who underwent TURP due to benign prostatic hyperplasia (BPH) were randomly included in this study. The levels of plasma hemoglobin, haptoglobin and serum lactic dehydrogenase (LDH) were checked in all patients before, immediately after, and 24 hours after the operation. Serum creatinine and sodium were also checked in 24 patients starting August 1996. Significant hemolysis was identified as simultaneous elevation of plasma hemoglobin (> 10 g/dL), serum LDH and reduction of plasma haptoglobin after TURP. RESULTS: Among the 39 subjects, hemolysis occurred in 17 (43.6%), whose plasma hemoglobin and serum LDH increased while plasma haptoglobin decreased immediately after operation (p < 0.05), but no significant differences between the data before and 24 hours after the operation were noticed. In the hemolysis group, serum creatinine increased while serum sodium decreased immediately after operation (p < 0.05), but the data before and 24 hours after the operation had no significant differences. There were no changes in serum creatinine and sodium levels after TURP in patients without hemolysis. The weight of the resected prostate was 42.5 +/- 15.5 g in the hemolysis group and 23.3 +/- 8.3 g in the nonhemolysis group, while duration of TURP was 68.9 +/- 19.6 minutes in the hemolysis group and 34.2 +/- 8.4 minutes in the nonhemolysis group. Patients with hemolysis had higher resection weight and longer resection time than those without hemolysis (p < 0.001). CONCLUSION: Using distilled water as an irrigant for TURP might cause hemolysis, especially in patients with larger prostates and longer resection times. It is necessary to carry out every effort to shorten resection time and avoid extravasation during surgery.

Aged↗

PubMed2006

Hardness evaluation of penile prostheses.

AIM: This work investigates the hardness and buckling force of penile prostheses to further understand the rigidity of penile prostheses before and after implantation. METHODS: Evaluated herein are four prosthetic samples (three inflatable, one semi-rigid), five real prostheses (one inflatable, four semi-rigid), and one prosthesis after implantation. The hardness is measured with a Shore Durimeter by pressing the tester's indentor to the surface of the specimen. A volunteer with inflatable prosthesis implantation is evaluated with respect to penile hardness versus various numbers of pumping. The buckling force of the prosthesis is also determined by a push-pull gauge and a specially designed sampling table. RESULTS: Results in this study demonstrate that although the inflatable prosthesis could only be pumped to a certain amount of hardness, hardness and buckling force correlate well with each other. After reaching the hardness limit, prostheses can even be pumped a further few times. However, continuous pumping only puts more tension on the prosthetic material without increasing hardness and could induce mechanical failure of the prosthesis. Results also indicate that the buckling force decreases with increasing length of the semirigid prostheses, and increases when the prosthesis has a larger diameter. CONCLUSION: This mechanical measurement of rigidity in penile prostheses could provide more information to clinicians about the penile prosthesis before surgical implantation, and to patients about prosthesis usage after implantation.

Hardness Tests↗

PubMed2006

Superficial transitional cell carcinoma of the ureteral orifice: higher risk of developing subsequent upper urinary tract tumors.

AIM: Reports specifically addressing transitional cell carcinoma (TCC) of the ureteral orifice are scarce. This paper presents our experiences of such tumors, including the characteristics of the disease and the incidence of subsequent upper urinary tract recurrence. METHODS: This study included 572 new cases of TCC of the urinary bladder diagnosed in our institute during a period of 5 years. Thirty-one (5.4%) patients had superficial tumors involving ureteral orifices. All 31 patients underwent transurethral resection of the bladder tumors, including the involved ureteral orifices. After the surgery, patients received regular follow up with cystourethroscopy, urine cytology and periodic intravenous pyelography (IVP). Ureterorenoscopy was performed in cases of suspicious IVP or urine cytology findings. RESULTS: Thirty-one patients with superficial tumors involving the ureteral orifice were followed up for 5-8 years or until death. The pathological stage was Ta in 16 cases and T1 in 15 cases. Bladder tumor recurrence was noted in three (18.8%) of the pTa patients and in seven (46.7%) of the pT1 patients. Subsequent upper urinary tract tumors developed in four (12.9%) patients between 33 and 67 months (mean: 33.5) after the first transurethral resection. All four cases of upper tract recurrence had pT1 primary bladder tumor, which recurred for 1-3 times (mean 1.8) before upper tract recurrence. None of these patients had ureteral stenting after bladder tumor resection. Three of four patients with upper tract recurrence had single lower ureteral tumor, while the remaining one patient had multiple tumors. Patients with subsequent upper urinary tract tumors underwent nephroureterectomy and bladder cuff excision. One died of the disease; the other three cases were free of the disease after the therapy. CONCLUSIONS: Patients with primary superficial bladder transitional cell carcinoma involving the ureteral orifice have a higher risk of developing subsequent upper urinary tract tumors, particularly for pT1 primary bladder tumors. Frequent and close follow up is recommended.

Aged↗

PubMed2006

Voiding pattern of healthy Taiwanese women.

AIM: Few studies have examined the voiding pattern of healthy females, despite the importance of such research for diagnosing abnormal voiding behavior. This study investigates the voiding behavior of healthy women in Taiwan. METHODS: 68 healthy women, aged 19-66 years and claiming to void normally were enrolled. Twenty-two of the subjects (32.4%) were postmenopausal. Each woman completed a 3-day voiding diary. The diary recorded urine volume, voiding frequency, urine volume per voiding for the whole day (24 h), and urine volume during both daytime and nighttime. Age and various other voiding parameters were correlated, and the voiding patterns were compared between premenopausal and postmenopausal women. RESULTS: All women voided 7.34 +/- 1.63 times daily. Higher age was associated with higher whole day and daytime voiding frequency. Nocturia was not common for the group as a whole, with a mean nocturnal voiding of 0.25 times per night. However, higher age was significantly associated with a higher nighttime voiding frequency. A significantly positive correlation was also observed between age and whole day urine volume. Compared with regularly menstruating women, postmenopausal women had a significantly higher whole day and nighttime voiding frequency. Menopause and age both independently affect voiding parameters after multivariate analysis. CONCLUSIONS: The results of this study provide invaluable baseline data on female voiding behavior. Additionally, this study found that for healthy women, age and menstruation status significantly affect voiding patterns. Analysis of female voiding behavior thus should consider these two factors.

Adolescent↗

PubMed2005

Detrusor mitochondrial lipid peroxidation and superoxide dismutase activity in partial bladder outlet obstruction of rabbits.

OBJECTIVES: Bladder outlet obstruction has shown to damage detrusor mitochondria with impaired detrusor contractility. One likely cause for mitochondrial injury is reactive oxygen species (ROS)-induced damages, including lipid peroxidation injury. We designed this study to examine this hypothesis. MATERIALS AND METHODS: Placing a silicon ring around the bladder neck of male New Zealand rabbits induced bladder outlet obstruction. The bladders were removed 3 (N = 6), 7 (N = 6), and 14 days (N = 8) later. Sham operated animals (N = 6 for each time period) served as the controls. Contractile function of the bladder was assessed by the response of the detrusor strips to bethanechol and field stimulation. Detrusor mitochondrial superoxide dismutase (SOD) activity and mitochondrial content of malondialdehyde (MDA) were determined. Detrusor contents of phosphocreatine and adenine triphosphate (ATP) were assayed. RESULTS: (1) Outlet obstruction induced an increase in the bladder weight and a decrease in the contractile function; (2) mitochondrial SOD activity significantly elevated in every time period of the obstruction, indicating a persistently increased ROS generation; (3) detrusor MDA level increased in 3-day obstruction animals. It returned to the control level in 7- and 14-day groups; (4) phosphocreatine content was significantly reduced in every time period of the obstruction; (5) ATP content was significantly decreased in 3- and 7-day groups; while 14-day obstruction group contained similar level as the sham-operated group. CONCLUSIONS: This study shows that bladder outlet obstruction increases generation of ROS and enhances lipid peroxidation of detrusor mitochondria. The resulted mitochondrial damages might sustain, leading to persistently depressed energy production and impaired detrusor contractility.

Adenosine Triphosphate↗

PubMed2005

Primary urothelial carcinoma of the ureter: 11-year experience in Taipei Veterans General Hospital.

BACKGROUND: Urothelial carcinoma of the upper urinary tract is relatively rare, occurring in 5% of all urothelial tumors. Ureteral urothelial carcinoma is even less common than that of the renal pelvis, accounting for about 25% of all upper urinary tract tumors. The aim of this study was to evaluate the clinical behavior, survival, recurrence and prognostic information of primary ureteral urothelial carcinoma from our 11 years of experience at the Taipei Veterans General Hospital. METHODS: We retrospectively reviewed 111 patients with ureteral urothelial carcinoma who had been treated in our hospital between January 1993 and December 2003. Tumor staging was according to the 2002 AJCC TNM classification and stage groupings. Patients with stage Oa and stage Ois were categorized as stage Oa/is, and patients with pathologic T stage pTa and pTis were categorized as pTa/is for statistical analysis. The Kaplan-Meier method was used for survival analysis. RESULTS: There were 69 males and 42 females, with a mean age of 70.5 +/- 9.4 years at diagnosis. Of the 111 patients, 5 presented with stage Oa/is, 38 with stage I, 23 with stage II, 21 with stage III, and 24 with stage IV. Nephroureterectomy with bladder cuff excision was performed in 78 patients, 12 patients received segmental resection of the ureter, 4 received ureteroscopic laser coagulation, and 17 underwent chemotherapy or radiotherapy or both. Tumors were located on the left side in 53 patients, on the right in 53, and bilaterally in 5. The most frequent initial presenting symptom was gross hematuria (65%). The mean postoperative follow-up period was 49.3 months. Disease recurrence in the nephroureterectomy group occurred in 36 patients (46.2%), with 17 (21.8%) at the urinary bladder, 2 (2.6%) at the retroperitoneum, 1 (1.3%) at the contralateral ureter, 6 (7.7%) with distant metastases to the lung, bone, distant lymph nodes or liver, and 10 (12.8%) at multiple sites. The 5-year cancer-specific survival rate was 100% for pTa/is, 95.2% for pT1, 69.4% for pT2, and 43.8% for pT3. All 3 pT4 cases died of cancer in a median of 12 months. Significant prognostic factors for cancer-specific survival by univariate analysis were pT (p = 0.00001), stage (p = 0.00001), type of treatment (p = 0.00001) and grade (p = 0.0001). On multivariate analysis, only stage (p = 0.0001) and grade (p = 0.014) were significant for cancer-specific and overall survival. Stage (p = 0.0001), pT (p =0.0001) and grade (p = 0.026) were also significant prognostic factors of recurrence in multivariate analysis. CONCLUSION: Our experience showed that patients with pTa/is and pT1 tumors treated with radical surgery have excellent prognoses. Tumor stage and grade are the only significant prognostic factors for both cancer-specific and overall survival.

Adult↗

PubMed2005

Urothelial carcinoma of the urinary bladder in young adults--clinical experience at Taipei Veterans General Hospital.

BACKGROUND: The clinical behavior and prognosis of bladder cancer in young patients is not well defined. The aim of this study was, therefore, to evaluate the clinical behavior, pathologic characteristics and prognosis of urothelial carcinoma of the urinary bladder in young adults. METHODS: We retrospectively reviewed records from 30 young patients (23 males, 7 females; age < or = 40 years) with urothelial carcinoma of the urinary bladder who had been treated in our hospital between May 1990 and October 2003. Data were analyzed by the Kaplan-Meier method to assess disease recurrence and survival. RESULTS: The mean age at diagnosis was 34.3 +/- 5 years (range, 22-40 years). Fifteen patients presented with pTa, 9 with pT1, 4 with pT2, 1 with pT3, and 1 with pT4. Twenty-six patients (87.2%) had low-grade bladder cancer, and the other 4 had high-grade disease. The most frequent initial presenting symptom was gross hematuria. The mean postoperative follow-up period was 72.8 months (range, 4-149 months). Fifty percent of superficial bladder cancers recurred a mean of 10.7 months (range, 3-68 months) after operation. One patient died from invasive bladder cancer after radical cystectomy, and 1 died from superficial bladder cancer due to tumor progression. The 5-year cancer-specific survival rate was 95.2% for superficial cancer and 83.3% for invasive cancer. The overall survival rate was 93.3%. CONCLUSION: Urothelial carcinoma of the urinary bladder in young adults is usually associated with low grade and low stage. Invasive bladder cancer had no worse a survival rate than superficial bladder cancer.

Adult↗

PubMed2005

Correlation between voiding and erectile function in patients with symptomatic benign prostatic hyperplasia.

BACKGROUND: The relationship between lower urinary tract symptoms and male sexual dysfunction remains controversial. In this study, we aimed to evaluate the relationship between voiding and erectile function (EF) using the American Urological Association Symptom Index (AUA-SI) and International Index of EF (IIEF-15) in patients with benign prostatic hyperplasia (BPH). METHODS: From March 2001 to January 2002, 50 men (aged 43-92 years) with symptomatic BPH were enrolled in the study. They completed the AUA-SI and IIEF-15 questionnaires. An additional question about subjective erectile dysfunction (ED) was also evaluated. AUA-SI scores were divided into 3 categories (irritative, obstructive, and total), and IIEF-15 scores were divided into 6 categories (EF, orgasmic function [OF], sexual desire [SD], intercourse satisfaction [IS], overall satisfaction [OS], and total). RESULTS: Irritative, obstructive and total AUA-SI scores were 7.8 +/- 3.7, 8.4 +/- 5.6 and 16.3 +/- 8.2, respectively. Scores in the 6 categories of the IIEF-15 questionnaire were as follows: EF, 12.1 +/- 10.1; OF, 3.7 +/- 3.8; SD, 4.4 +/- 2.0; IS, 4.5 +/- 4.4; OS, 4.4 +/- 2.6; and total, 29.4 +/- 22.2. No obvious correlation was noted between AUA-SI and IIEF-15 scores. Further, no statistical significance was noted, either between AUA-SI and IIEF-15 severity, or between AUA-SI and EF severity. Among 22 patients who self-reported the absence of ED, 17 (77%) had an EF-domain score less than 26. The mean age of patients with, versus those without, ED was significantly greater. CONCLUSION: Voiding and EF, assessed by the AUA-SI and IIEF-15 questionnaires, respectively, are not correlated in patients with BPH.

Adult↗

PubMed2005

Human kallikrein-2 gene polymorphism is associated with the occurrence of prostate cancer.

PURPOSE: Human glandular kallikrein, which is encoded by the human kallikrein-2 (KLK2) gene, is significantly associated with the occurrence of prostate cancer (PCa). We tested the association between a functional C748T polymorphism of the KLK2 gene and the occurrence of PCa. MATERIALS AND METHODS: Peripheral venous blood samples were obtained from 254 patients with PCa and 168 controls with benign prostatic hyperplasia. All control subjects had normal serum prostate specific antigen and proved to be free from malignancy on pathological examination of resected prostatic tissues. Serum prostate specific antigen, testosterone, Gleason score, clinical and pathological stage, tumor and prostate volume of the patients were investigated. The KLK2 gene polymorphism was determined by the polymerase chain reaction based restriction fragment length polymorphism method. RESULTS: The PCa group had a younger mean age +/- SEM (73.0 +/- 0.5 vs 74.7 +/- 0.5 years, p = 0.010) and higher C allele frequency (82.1% vs 74.7%, p = 0.010) than the control group. The frequency of the CC, CT and TT genotypes was 65.7%, 32.7% and 1.6% in patients with PCa, and 56.0%, 37.5% and 6.5%, respectively, in controls (p = 0.010). C allele carriers (CC and CT genotypes) were at significantly higher risk for PCa than TT homozygous subjects (p = 0.002). CC homozygous subjects were at significantly higher risk for PCa than T allele carriers (CT and TT genotypes) (p = 0.043). The PCa subgroup of patients with pathologically proved, localized PCa also had a higher frequency of the C allele (87.5% vs 74.7%, p = 0.026) and CC genotypes (78.7% vs 56.0%, p = 0.019) than controls. CONCLUSIONS: Our results suggest that the C allele of the functional C748T polymorphism of KLK2 may increase the risk of PCa.

Aged↗

PubMed2005

In vivo tension sustained by fascial sling in pubovaginal sling surgery for female stress urinary incontinence.

PURPOSE: In pubovaginal sling surgery arguments have focused on selecting stronger sling materials, better suturing methods and superior fixation techniques. However, the grounding information prerequisite for these arguments is still lacking, ie the in vivo tension sustained by the sling. We designed this study to obtain this information. MATERIALS AND METHODS: A total of 10 female patients (mean age 65.4 years) underwent pubovaginal sling surgery while under epidural anesthesia. A strip of rectus fascia (2 x 6 cm) was isolated. Each end of the fascia was anchored with a 1-zero Prolene suture (Ethicon, Somerville, New Jersey). The fascial sling was placed over the proximal urethra. Both ends of the prolene (polypropylene) sutures were transferred to the lower abdominal incision and tied on each other. The fascial sling was adjusted just to touch the proximal urethra without elevating it. We hooked the tied polypropylene suture on a digital force gauge to measure the tension sustained by the fascial sling. Patients were instructed to cough, and the tension was measured at different bladder volumes (100, 200, 300, 400 ml) and in 2 positions (horizontal and operative table tilted head-up 20 degrees). Intravesical pressure was monitored with a pressure transducer to ensure adequate cough strength. We also investigated the in vitro length-tension relationship and tensile strength of 3 rectus fascia strips (0.5 x 6 cm) obtained from 3 of these patients. RESULTS: Mean tension +/- SEM sustained by the fascial sling during cough in the horizontal position was 0.046 +/- 0.004, 0.043 +/- 0.006, 0.0475 +/- 0.006 and 0.0485 +/- 0.007 kg at 100, 200, 300 and 400 ml bladder volume, respectively. Bladder volume did not statistically affect the sustained tension. The 20-degree head-up position also did not statistically change the tension sustained. In vitro study showed that the fascia strip could be stretched for a mean of 0.4 cm before sling tension began to increase. A mean load of 2.4 kg broke 0.5 x 6 cm strips. CONCLUSIONS: In the horizontal and mild tilting positions during an increase in intra-abdominal pressure, the fascial sling only sustains minor tension, which is far less than the maximal load needed to break fascial strips. The excellent elasticity of the fascia may dissipate the straining force and partly explains the measured small sustained tension.

Aged↗

PubMed2004

The impact of polymorphism on prostate specific antigen gene on the risk, tumor volume and pathological stage of prostate cancer.

PURPOSE: A single nucleotide polymorphism with adenine (A) to guanine (G) substitution is identified at position -158 in the androgen response elements region of the prostate specific antigen (PSA) gene. We evaluated the relationship between the PSA -158A/G polymorphism and the risk, tumor volume and pathological stage of prostate cancer. MATERIALS AND METHODS: Peripheral venous blood samples were obtained from 122 patients with prostate cancer and 84 controls with benign prostatic hyperplasia. The diagnosis, tumor volume and pathological stage of prostate cancer were all determined according to the pathological reports of transrectal ultrasound guided prostate biopsy, transurethral prostate resection and radical prostatectomy. The PSA -158A/G polymorphism was determined by polymerase chain reaction based restriction fragment length polymorphism methods. RESULTS: Patients with prostate cancer had significantly greater frequencies of the G allele (87.3% vs 77.4%) and GG genotype (78.7% vs 61.9%) than the control group (p = 0.008 and 0.028, respectively). The OR of GG to AG and AA was 2.27 (p = 0.008). In the prostate cancer group the GG genotype was also associated with larger tumor volume (2.34 vs 0.82 ml) and higher pathological stage (organ confined cancer 68.2% vs 31.8% and extracapsular extension 100% vs 0%) than the GA and AA genotypes (p = 0.013 and 0.036, respectively). CONCLUSIONS: The PSA -158A/G polymorphism is associated with prostate cancer. The G allele increases the risk of prostate cancer and the GG genotype is associated with larger tumor volume and higher pathological stage.

Aged↗

PubMed2004

8-hydroxy-2'-deoxyguanosine in leukocyte DNA of spermatic vein as a biomarker of oxidative stress in patients with varicocele.

PURPOSE: We examined oxidative damage to leukocyte DNA in the spermatic vein and sperm DNA of patients with varicocele. MATERIALS AND METHODS: A total of 32 young male patients with varicocele (group 1), 20 young male patients with subclinical varicocele (group 2) and 15 normal young males without varicocele (group 3) were recruited in this study. Varicocele and subclinical varicocele were confirmed by physical examination and Doppler ultrasonography. Blood samples were drawn from peripheral and spermatic veins of controls and patients before varicocelectomy. The 8-hydroxy-2'-deoxyguanosine (8-OHdG) in leukocyte DNA and sperm DNA were measured by high performance liquid chromatography. The 4977 bp deletion of mitochondrial DNA (mtDNA) in spermatozoa was detected by polymerase chain reaction. RESULTS: The mean 8-OHdG level +/- SD in leukocyte DNA of spermatic veins was significantly higher than that of corresponding peripheral veins in groups 1 and 2 (12.39 +/- 2.90 vs 7.11 +/- 0.75/10 deoxyguanosine for group 1 and 10.28 +/- 2.43 vs 6.82 +/- 0.62/10 deoxyguanosine for group 2, p <0.001). The 8-OHdG level in leukocyte DNA of the spermatic vein and 8-OHdG in sperm DNA were highest in group 1 followed by those in groups 2 and 3, and correlated inversely with motility, morphology and density of spermatozoa. The incidence of 4977 bp deletion of mtDNA in sperm was 40.6%, 20% and 0% in groups 1, 2 and 3, respectively. These results indicate that oxidative stress in patients with varicocele or subclinical varicocele was greater than in healthy subjects. CONCLUSIONS: 8-OHdG in leukocyte DNA of the spermatic vein and in sperm DNA, and 4977 bp deletion of mtDNA in sperm might be useful markers for the assessment of oxidative stress in patients with varicocele and subclinical varicocele.

8-Hydroxy-2'-Deoxyguanosine↗

PubMed2004

Lymphangioma of male exogenital organs.

Lymphangioma manifesting in the genitourinary tract is an uncommon disease. Cystic lymphangioma is a congenital lymphatic hamartoma known as lymphatic malformation. Herein we report 2 cases of lymphangioma of male exogenital organs. After complete excision of the tumor and subsequent follow-up for 6 months, both of them were free of recurrence. Ultrasonography and computed tomography scans are very useful in the differential diagnosis of this cystic disease.

Adult↗

PubMed2004

Correlation between urinary tract pure stone composition and stone morphology on plain abdominal film.

BACKGROUND: Crystallographic composition of urinary tract stone varies in several chemical groups and determines the degree of fragmentation to extracorporeal shock wave lithotripsy (ESWL) which has been widely used for the treatment of renal and ureteral calculi. Visual prediction of stone composition by its morphology from plain radiograph may provide a simple method and clinical hint to decide therapeutic modalities. A prospective study was designed to determine the correlation of stone composition with its radiographic morphology. METHODS: One hundred patients of urolithiasis with passage of stone fragments (after ESWL, surgical lithotomy or endoscopic lithotripsy) analyzed as pure stone by infrared spectrometry were reviewed by plain abdominal film to classify their morphology, location and size. Five experienced surgeons familiar with the radiographic patterns of different types of pure stones were invited to predict the stone composition on plain abdominal film. RESULTS: Five different patterns of radiographic appearances of the stones were identified. Calcium oxalate monohydrate referred to the smooth-shaped and homogeneous ones with denser opacity. Calcium oxalate dihydrate referred to those smaller ones that had irregular margin with stippled border and were less dense. Calcium phosphate (CaP) had moderate density and size without significant figures. Struvite meant staghorn stone; usually bilateral. Uric acid referred to those being radiolucent, slightly opacified, and in large size. The 5 surgeons achieved an overall accuracy of 27.4%. There was no obvious relations between accuracy and location or size of the stones. CaP stone was the most likely to be misclassified, and achieved only 20% accuracy. CONCLUSIONS: Different stone composition showed grossly specific radiographic appearances, but clinical test revealed poor correct rate in prediction of stone composition from plain abdominal film. The results of our study suggest that prediction of stone component based on stone morphology on plain abdominal film may not be accurate enough. Patient's clinical information and other laboratory data should be considered while interpreting plain abdominal film for better treatment choice of urolithiasis.

Calcium Oxalate↗

PubMed2003

Role of testicular interstitial macrophages in regulating testosterone release in hyperprolactinemia.

Hyperprolactinemia-induced hypogonadism has been linked to a dysfunction of the hypothalamus-pituitary-testis axis. The direct inhibitory effects of prolactin on the testicular release of testosterone have also been demonstrated, though their mechanisms remain unclear. Incubation of rat testicular interstitial cells (TICs) with prolactin stimulated the release of testosterone. TICs from rats with anterior pituitary-grafting-induced hyperprolactinemia release lower amounts of testosterone than controls. However, Leydig cells isolated from anterior pituitary-grafted rats release a greater amount of testosterone. These paradoxical observations have remained unexplained. This study examined the roles of testicular interstitial macrophages and of their product, tumor necrosis factor-alpha (TNF-alpha), in regulating Leydig cells under condition of hyperprolactinemia. Hyperprolactinemia was induced by grafting two anterior pituitary glands of rats under the renal capsule. Control animals were grafted with rat cortex tissue. The rats were sacrificed 6 weeks later. TICs and macrophages, and Leydig cells were isolated for in vitro incubation and drugs challenge. Testosterone released by testicular interstitial or Leydig cells was measured by radioimmunoassay. TNF-alpha concentration in the medium of TICs or macrophages was measured by enzyme-linked immunosorbent assay (ELISA). A dose-dependent stimulation of TNF-alpha secretion in the medium of TICs or macrophages by the prolactin challenge was observed. Higher amounts of TNF-alpha were released by TICs in the anterior pituitary-grafted rats than in the control group. In contrast, the release of TNF-alpha by testicular interstitial macrophages isolated from the anterior pituitary- and cortex-grafted groups was quantitatively similar. Challenge with human chorionic gonadotropin did not modify the TNF-alpha release by testicular interstitial macrophages in either group. Challenge of Leydig cells with TNF-alpha inhibited their release of testosterone stimulated by human chorionic gonadotropin, but not their basal testosterone release. These different patterns of testosterone release in TICs versus Leydig cells cultures in anterior pituitary-grafted rats may be due to the influence of testicular interstitial macrophages. These observations correlate with in vivo conditions, where prolactin increases the release of TNF-alpha by testicular interstitial macrophages, which, in turn, decreases the human chorionic gonadotropin-stimulated release of testosterone by Leydig cells. In summary, hyperprolactinemia-induced hypogonadism involves a mechanism of prolactin-originated, macrophage-mediated inhibitory regulation of testosterone release by Leydig cells. TNF-alpha, one of the cytokines secreted by macrophages, may play a key role in this mechanism.

Animals↗

PubMed2003

Effect of excitatory amino acid receptor agonists on penile erection after administration into paraventricular nucleus of hypothalamus in the rat.

OBJECTIVES: To investigate whether the excitatory amino acid receptor agonists can activate the paraventricular nucleus of the hypothalamus (PVN) and induce penile erections in the rat. METHODS: Male adult Sprague-Dawley rats were used. A 26-gauge needle was inserted into the corpus cavernosum to monitor the intracavernous pressure (ICP) simultaneously with the systemic arterial pressure and heart rate. The study was divided into seven parts: stereotaxic delivery of N-methyl-d-aspartic acid (NMDA) (50 ng/500 nL) into the PVN; administration of the NMDA noncompetitive antagonist MK-801 (100 ng/250 nL) and NMDA (50 ng/250 nL) into the PVN; administration of the NMDA competitive antagonist (+/-)-3-(2-carboxypiperazin-4-yl)-propyl-1-phosphonic acid (CPP; 100 ng/250 nL) and NMDA (50 ng/250 nL) into the PVN; microinjection of (+/-)-alpha-(amino)-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA; 100 ng/500 nL) into the PVN; microinjection of trans-(+/-)-1-amino-1,3-cyclopentanedicarboxylic acid (ACPD; 100 ng/500 nL) into the PVN; saline 500 nL into the PVN; and intracavernous administration of NMDA (50 ng/100 microL). RESULTS: On administration of NMDA into the PVN, a significant increase occurred in the ICP from a resting 8.3 +/- 1.8 mm Hg to a peak at 59.0 +/- 8.4 mm Hg. No change occurred in the resting ICP after administration of either the mixture of MK-801 and NMDA or CPP and NMDA into the PVN. Microinjection of AMPA, ACPD, or saline into the PVN and intracavernous administration of NMDA were all ineffective to induce an increase in ICP. CONCLUSIONS: The results of this study suggest that ionotropic excitatory amino acid (NMDA) may have an effect on inducing penile erection through activation of the PVN in the rat.

Animals↗