Biomedical subjects

Seok-Soo Byun

Publications and source records attributed to Seok-Soo Byun.

At least 19 recordsLinked to original sources

PubMed2007

Prognostic significance of tumor necrosis in primary transitional cell carcinoma of upper urinary tract.

OBJECTIVE: We investigated the prognostic significance of tumor necrosis in primary transitional cell carcinoma (TCC) of upper urinary tract. METHODS: We retrospectively analyzed the records of 119 patients who received surgical management for primary TCC of upper urinary tract. The presence or absence of tumor necrosis was evaluated based on the macroscopic description of the tumor. Along with pathologic features of tumor necrosis, we assessed the impacts of various prognostic factors previously reported for TCC of upper urinary tract. RESULTS: Tumor necrosis was identified in 19 (16.0%) patients. Patients with tumor necrosis were more likely to have higher local stage, nodal involvement, higher tumor grade, lymphovascular invasion (LVI), and recurrence of disease. Among all subjects, disease-specific survival rates at 5 years after surgery for patients with and without macroscopic tumor necrosis were 36.7 and 83.2%, respectively (P = 0.0001). In multivariate analysis, only pathologic T stage, LVI and tumor necrosis were shown to be independent predictors for disease-specific survival. For solely the invasive tumors, variables including age, surgical margin and tumor necrosis were observed to be independent prognostic factors for disease-specific survival in multivariate analysis, with tumor necrosis showing the highest rank order of statistical significance. CONCLUSIONS: Our results suggest that macroscopic tumor necrosis may be a useful prognostic indicator for primary TCC of upper urinary, especially for invasive tumors. Further investigation would be warranted for the prognostic implications of tumor necrosis in TCCs of upper urinary tract and on actual pathogenesis of tumor necrosis in upper tract TCC.

Adult↗

PubMed2006

Assessing the body mass index of patients might help to predict blood loss during radical retropubic prostatectomy in Korean men.

OBJECTIVE: To examine the intraoperative blood loss and patient characteristics in patients treated with radical retropubic prostatectomy (RRP), to determine the independent risk factors that predict increased blood loss and transfusion requirements in Korean men. PATIENTS AND METHODS: We retrospectively analysed the records of 264 consecutive patients who had RRP; all medical records were reviewed for various factors before RRP, including prostate volume and body mass index (BMI), and during RRP, e.g. operative duration, estimated blood loss (EBL), calculated blood loss (CBL) and neurovascular bundle preservation. We evaluated differences in clinical characteristics and intraoperative factors in patients categorised by BMI. Multivariate logistic regression analysis was used to establish the relationship between preoperative independent variables and endpoints related to a high CBL. RESULTS: The mean EBL was lower than the CBL (387.3 vs 716.9 mL). When the group of men was stratified by BMI, although the difference in mean EBL (P = 0.160) and transfusion rate (P = 0.511) among normal, overweight and obese categories were not statistically significant, the difference in mean CBL (P = 0.011) and operative duration (P = 0.022) was statistically significantly higher in overweight and obese men. Patients who had their neurovascular bundles preserved had no statistically differences in CBL, EBL and operative duration from those with did not. The multivariate logistic regression analysis showed that BMI was the only preoperative variable that predicted a high CBL. CONCLUSIONS: The EBL was underestimated by the CBL, and the BMI was the only predictor before RRP of blood loss during RRP in these Korean men.

Aged↗

PubMed2006

Prognostic significance of common preoperative laboratory variables in clear cell renal cell carcinoma.

OBJECTIVE: To investigate the prognostic significance of common preoperative laboratory variables evaluated before surgery for clear cell renal cell carcinoma (RCC). PATIENTS AND METHODS: We retrospectively analysed the records of 355 patients who had surgery for clear cell RCC, assessing: clinical factors, including preoperative laboratory measurements, i.e. haemoglobin level, leukocyte count, platelet count, erythrocyte sedimentation rate (ESR), serum calcium, alkaline phosphatase (ALP), albumin, bilirubin, alanine aminotransferase, aspartate aminotransferase, and red blood cells in urine; and pathological factors, with the survival rates after surgery. RESULTS: The presence of metastasis, tumour stage and tumour size, with the ESR and ALP before surgery, were identified as significant prognostic factors for progression-free survival in a multivariate analysis. The same factors were significant independent factors for disease-specific survival, except for ESR and ALP, which were nearly statistically significant. When limited to non-metastatic tumours only, the multivariate analysis showed that ESR and ALP, with tumour stage, grade, size and necrosis, were independent prognostic factors for disease-specific survival. CONCLUSIONS: Along with traditionally accepted prognostic factors, these results suggest that common laboratory variables assessed before surgery, e.g. ESR and ALP, might also be useful in assessing the prognosis for patients with non-metastatic clear cell RCC. Including various laboratory variables in prognostic algorithms for RCC should be considered after further validation in RCCs of various histological subtypes and stages.

Adult↗

PubMed2006

T1c prostate cancer detection rate and pathologic characteristics: comparison between patients with serum prostate-specific antigen range of 3.0 to 4.0 ng/mL and 4.1 to 10.0 ng/mL in Korean population.

OBJECTIVES: To prospectively evaluate the Stage T1c prostate cancer detection rate and pathologic characteristics of patients with a serum prostate-specific antigen (PSA) level of 3.0 to 4.0 ng/mL and compare this with the rate of patients who had a PSA level of 4.1 to 10.0 ng/mL. METHODS: We analyzed the data of patients who had PSA levels of 3.0 to 10.0 ng/mL, benign findings on digital rectal examination, and no specific lesion identified on transrectal ultrasonography. The clinical characteristics, cancer detection rate, and pathologic findings of the biopsy and prostatectomy specimen were compared between the low (3.0 to 4.0 ng/mL) and intermediate (4.1 to 10.0 ng/mL) PSA groups. RESULTS: A total of 450 patients met our criteria. Of these 450 patients, 85 and 365 had a low or an intermediate PSA level, respectively. Prostate cancer was diagnosed in 26% of the low and 19% of the intermediate PSA group. No significant difference was found between the two groups in the pathologic biopsy findings, including the mean Gleason score and percentage of patients with a Gleason score of 7 or more. The pathologic findings of the prostatectomy specimens also showed no significant differences between the two groups, including the mean Gleason score, pathologic stage, and percentage of insignificant prostate cancer. CONCLUSIONS: No statistically significant difference was found in the incidence of Stage T1c prostate cancer or pathologic characteristics in comparison between the low and intermediate PSA groups. These results suggest that a lower PSA cutoff should be considered as an indication for prostate biopsy in the Korean population.

Biopsy, Needle↗

PubMed2006

Impact of variations in prostatic apex shape on early recovery of urinary continence after radical retropubic prostatectomy.

OBJECTIVES: To investigate the impact of the variations in the shape of the prostatic apex observed on preoperative magnetic resonance imaging (MRI) on patients' status regarding urinary continence after undergoing radical retropubic prostatectomy, as well as the prevalence of such variations. METHODS: We performed a retrospective analysis of 156 patients who had undergone preoperative MRI of the prostate and were followed up postoperatively by review of the records. For our analyses, patients were categorized into four different groups according to the shape of the prostatic apex shown on the midsagittal MRI scan. Patient status, including early (within 3 months after surgery) recovery of urinary continence, was also assessed. RESULTS: Group 1 was the largest with 59 patients (37.8%), group 2 had 39 patients (25%), group 3 had 24 (15.3%), and group 4 had 34 patients (21.8%). Group 4 was composed of patients with the prostatic apex not overlapping with membranous urethra either anteriorly or posteriorly on MRI and had a significantly greater percentage (83.3% versus 66.7%) of patients with an early return of urinary continence after radical retropubic prostatectomy compared with the other groups (P = 0.014). On multivariate analysis of the predictive factor for the early return of urinary continence, anterior or posterior overlapping of the membranous urethra with the prostatic apex as shown on preoperative MRI was the only variable significantly associated with an early return of continence. CONCLUSIONS: The results of our study provide objective evidence that variations in the shape of the prostatic apex in relation to the membranous urethra may significantly affect early recovery of urinary continence after radical retropubic prostatectomy.

Aged↗

PubMed2006

Detection of prostate cancer at low and intermediate serum prostate-specific antigen levels in a country with a low incidence of prostate cancer.

BACKGROUND: The objective of this study was to evaluate the cancer detection rate and the pathologic findings of biopsy in men at low and intermediate prostate-specific antigen (PSA) levels in an Asian population. METHODS: Patients between 40 and 79 years were entered into a study and 755 patients with serum PSA level of 2.0-10.0 ng/ml underwent trus-guided systematic biopsy. Patients were divided to low (PSA 2.0-4.0 ng/ml, n = 144) and intermediate (PSA 4.1-10.0 ng/ml, n = 611) PSA groups. RESULTS: Patients in the low PSA group had significantly smaller prostates (P = 0.003) and lower PSA density (P < 0.001). The rate of cancer detection was 16.7% (24 of 144) in the low PSA group and 23.7% (145 of 611) in the intermediate PSA group (P = 0.067). In men with normal digital rectal examination (DRE), prostate cancer was diagnosed in 14 (13.3%) of the 105 men in the low PSA group and 99 (19.5%) of the 508 men in the intermediate PSA group (P = 0.139). In all patients and patients with normal DRE, no statistically significant differences were found in the pathologic findings of biopsy between the two groups. CONCLUSIONS: Our findings provide a rationale to recommend prostate biopsy at lower PSA threshold in this population. At present, however, it is not clear that men who are treated when their cancers are detected at lower PSA levels have better outcomes than those who are treated when the PSA is higher than 4.0 ng/ml.

Adult↗

PubMed2006

Significance of macroscopic tumor necrosis as a prognostic indicator for renal cell carcinoma.

PURPOSE: We investigated the prognostic significance of macroscopic tumor necrosis in renal cell carcinoma. MATERIALS AND METHODS: We retrospectively analyzed the records of 485 patients who underwent surgical treatment for organ confined or metastatic renal cell carcinoma. The presence or absence of tumor necrosis was evaluated based on macroscopic description of the tumor, and tumors were considered necrotic only if they exhibited more than 10% macroscopic necrosis. RESULTS: Macroscopic tumor necrosis was identified in 27% of total patients. Patients with macroscopic necrotic renal cell carcinoma were more likely to have larger tumor, metastatic disease, higher local stage and higher tumor grade (all p < 0.001). Pathological features of microvascular invasion (p = 0.026) and sarcomatoid differentiation (p = 0.002) along with several laboratory findings were also observed to be associated with macroscopic tumor necrosis. Among the total subjects those without macroscopic tumor necrosis had significantly higher progression-free (p < 0.0001) and disease specific survival (p < 0.0001). When survival analysis was limited to nonmetastatic tumors only, the same logic applied, which was not the case for the patients with metastatic disease (p > 0.05). Among the different histological subtypes of renal cell carcinoma, macroscopic tumor necrosis was observed to have a significant impact only for the clear cell subtype. In patients with nonmetastatic RCC multivariate analysis revealed that macroscopic tumor necrosis (p = 0.004) was an independent prognostic predictor of disease specific survival along with pathological T stage, tumor grade and tumor size. CONCLUSIONS: Our results suggest that macroscopic tumor necrosis may be a reliable prognostic indicator for nonmetastatic clear cell renal cell carcinoma which should routinely be examined for during pathological analysis.

Adult↗

PubMed2006

Evaluation of concordance of Gleason score between prostatectomy and biopsies that show more than two different Gleason scores in positive cores.

OBJECTIVES: To evaluate variables that may predict the Gleason score of radical prostatectomy specimens in patients with more than two different Gleason scores in the positive cores of their biopsy specimens. METHODS: We reviewed the pathologic data of 98 patients who had more than two different Gleason scores in 12-site biopsy specimens. We assessed the following biopsy parameters: the greatest Gleason score on the biopsy specimen, the Gleason score of the greatest tumor percentage in the core, the Gleason score of the largest linear cancer length, and the greatest tumor ratio score (Gleason score of the greatest total tumor length of the same Gleason score/total core length of the same Gleason score). We also assessed the concordance in Gleason scores between biopsy specimens and prostatectomy specimens. RESULTS: The greatest tumor ratio score was associated with the greatest (67%) concordance rate. The concordance of the greatest Gleason score on biopsy specimens was only 49%. When stratified into categories of well-differentiated (Gleason score 6 or less), moderate (Gleason score 7), and poorly differentiated (Gleason score 8 or more), the grade concordance rate of the greatest tumor ratio score was 73%. The grade concordance rate of the Gleason scores of the greatest tumor percentage in the core, Gleason score core with maximal tumor length, and the greatest Gleason score was 64%, 62%, and 57%, respectively. CONCLUSIONS: If biopsy specimen results in more than two different Gleason scores in the positive cores, the greatest tumor ratio score may be the most useful variable with regard to the prediction of the final Gleason score in the radical prostatectomy specimen.

Biopsy, Needle↗

PubMed2006

Metastatectomy prior to immunochemotherapy for metastatic renal cell carcinoma.

INTRODUCTION: We reviewed our experiences in performing cytoreductive metastatectomy before initiating systemic immunochemotherapy and tried to investigate potential prognostic factors for such an approach. PATIENTS AND METHODS: A retrospective analysis of 57 patients who received interleukin-2, interferon-alpha, and 5-fluorouracil immunochemotherapy for metastatic renal cell carcinoma was conducted. Before undergoing immunochemotherapy, 20 of the 57 patients had received metastatectomy along with nephrectomy (metastatectomy group) and the other 37 nephrectomy alone (non-metastatectomy group). RESULTS: The metastatectomy group demonstrated median disease-specific and progression-free survival of 23 and 13 months, respectively. The patients in the metastatectomy group were identified as having a better performance status and primarily demonstrating pulmonary metastasis compared with those in the non-metastatectomy group. As assessed in the metastatectomy group, factors such as the number of metastatic lesions, completeness of metastatectomy, and location of metastatic lesions (lung only vs. others) were observed to be significantly associated with overall survivals on univariate analysis. CONCLUSIONS: Metastatectomy may still play a significant therapeutic role for metastatic renal cell carcinoma even in the era of immunochemotherapy as part of a multidisciplinary treatment approach in a selected group of patients in adequate general condition who have pulmonary-limited metastasis that can be completely resected.

Adult↗

PubMed2006

Significance of cancer involvement at the ureteral margin detected on routine frozen section analysis during radical cystectomy.

INTRODUCTION: We investigated the clinical significance of preoperatively-unsuspected ureteral involvement of cancer detected on intraoperative frozen section analysis of ureteral margins during radical cystectomy. PATIENTS AND METHODS: We performed a retrospective study of 115 patients who received radical cystectomy for locally-advanced but node-negative transitional cell carcinoma of the bladder between 1995 and 2002 by reviewing their records. RESULTS: Of 115 total patients, 5 (4.3%) demonstrated carcinoma in situ at the ureteral margin with 2 of 5 having a positive margin on final pathologic analysis. Meanwhile, only 3 of 115 total patients (2.6%) later showed upper urinary tract recurrence at a median interval of 30 months after cystectomy. And all 3 patients had intramural or juxtavesical ureter involvement of disease (p = 0.006), while not demonstrating carcinoma in situ in ureteral margins resected during cystectomy. On multivariate analysis, only the stage and grade of bladder cancer along with pathologic feature of vascular invasion were observed to be independent prognostic predictors of disease-specific survival. CONCLUSIONS: Cancer involvement of the distal ureteral margin detected through intraoperative frozen section analysis may not be a significant factor regarding upper tract recurrence and survival of patients with locally-advanced bladder cancer after radical cystectomy. Upper tract recurrence may be more prone to occur in patients with cancer involvement at the intramural or juxtavesical ureter.

Adult↗

PubMed2006

Adjuvant chemotherapy in the management of pT3N0M0 transitional cell carcinoma of the upper urinary tract.

INTRODUCTION: We investigate the efficacy of postoperative adjuvant chemotherapy for locally advanced, but lymph node negative, pathologic stage T3 transitional cell carcinoma (TCC) of the upper urinary tract. PATIENTS AND METHODS: A retrospective study on 27 patients who had undergone radical nephroureterectomy with regional lymphadenectomy for pT3N0M0 primary upper urinary tract TCC at our institution from 1996 to 2001 was performed. Among the 27 patients, 16 also received adjuvant chemotherapy following surgery (adjuvant group), whereas the other 11 patients did not (nonadjuvant group). RESULTS: Adjuvant and nonadjuvant therapy groups were not significantly different with respect to age, sex, performance status, tumor grade, and tumor location. Overall, 5 of the 16 patients (31%) in the adjuvant group and 4 of the 11 patients (36%) in the nonadjuvant group had recurrence of cancer at 40 months of follow-up. The two groups demonstrated no significant differences in recurrence-free survival (p = 0.794) and disease-specific survival (p = 0.783). CONCLUSIONS: Although it would be difficult to draw any definite conclusions from the results of our investigations, our data suggest that adjuvant therapy with traditional conventional chemotherapeutic regimens alone may not be effective as previously anticipated in significantly improving survival rates for locally advanced, but lymph node negative, TCC of the upper urinary tract.

Aged↗

PubMed2006

Role of transrectal ultrasonography in the prediction of prostate cancer: artificial neural network analysis.

OBJECTIVE: The purpose of this study was to evaluate the diagnostic performance of an artificial neural network (ANN) model with and without transrectal ultrasonographic (TRUS) data. METHODS: Six hundred eighty-four consecutive patients who had undergone TRUS-guided prostate biopsy from May 2003 to January 2005 were enrolled. We constructed 2 ANN models. One (ANN_1) incorporated patient age, digital rectal examination findings, prostate-specific antigen (PSA) level, PSA density, transitional zone volume, and PSA density in the transitional zone as input data, whereas the other (ANN_2) was constructed with the above and TRUS findings as input data. The performances of these 2 ANN models according to PSA levels (group A, 0-4 ng/mL; group B, 4-10 ng/mL; and group C, >10 ng/mL) were evaluated using receiver operating characteristic analysis. RESULTS: Of the 684 patients who underwent prostate biopsy, 214 (31.3%) were confirmed to have prostate cancer; of 137 patients with positive digital rectal examination results, 60 (43.8%) were confirmed to have prostate cancer; and of 131 patients with positive TRUS findings, 93 (71%) were confirmed to have prostate cancer. In groups A, B, and C, the AUCs for ANN_1 were 0.738, 0.753, and 0.774, respectively; the AUCs for ANN_2 were 0.859, 0.797, and 0.894. In all groups, ANN_2 showed better accuracy than ANN_1 (P < .05). CONCLUSIONS: According to receiver operating characteristic analysis, ANN with TRUS findings was found to be more accurate than ANN without. We conclude that TRUS findings should be included as an input data component in ANN models used to diagnose prostate cancer.

Adult↗

PubMed2005

Upregulation of Bcl-2 is associated with cisplatin-resistance via inhibition of Bax translocation in human bladder cancer cells.

The efficacy of cisplatin in cancer chemotherapy is limited by the development of resistance. To elucidate the molecular basis of resistance to cisplatin, we compared cisplatin-induced apoptotic responses of the parental human bladder cancer cell line, T24 and its resistant subclone, T24R2. In T24 cells, cisplatin induce apoptosis and the activation of caspase-8, -9 and -3 and poly(ADP-ribose) polymerase cleavage. The expression levels of Fas, FasL, and FADD were not changed by the treatment with cisplatin. Furthermore, neither Fas-neutralizing antibody nor dominant negative mutant of FADD affected cisplatin-induced apoptosis. Western blot analysis of subcellular fractions showed that cisplatin induced redistribution of Bax and cytochrome c. Thus, cisplatin causes apoptosis in a death receptor-independent and mitochondria-dependent fashion in T24 cells. In contrast, overexpressed Bcl-2 protein inhibited cisplatin-induced Bax translocation and its downstream events in T24R2. Downregulation of Bcl-2 by RNAi potentiated the redistribution of Bax and cytochrome c and reversed cisplatin-resistance. Our results indicate that upregulation of Bcl-2 contributes to the development of cisplatin-resistance and usage of siRNA which targets the Bcl-2 gene may offer a potential tool to reverse the resistance to cisplatin in bladder cancer.

Antineoplastic Agents↗

PubMed2005

Direct ureteric length measurement from intravenous pyelography: does height represent ureteric length?

Ureteric length is the most important factor for determining the ideal length of a ureteric stent. In most of the literature, ureteric length is estimated according to a patient's height. We investigated the reliability of a patient's height as a measure of ureteric length. We measured the actual length of the ureteric trace (ALUT) and the linear distance (LD) from the ureterorenal junction to the ureterovesical junction by intravenous pyelography (IVP), using a 15 min view. A total of 203 patients (100 men, 103 women, 406 ureters) with normal findings were studied, and ALUT, LD and height were measured. The mean patient height was 164.3 +/- 8.3(SD) cm. Mean ALUTs of the right and left ureters were 23.4 +/- 1.9 cm and 24.4 +/- 2.0 cm, respectively, and the mean LDs of the right and left ureters were 22.1 +/- 1.9 cm and 22.9 +/- 2.0 cm, respectively. Height was significantly correlated with the ALUTs of both sides, but these were not linear (r2 = 0.024 right, 0.059 left). However, LD showed significant linear correlations with the ALUTs of both sides (r2 = 0.879 right, 0.884 left). Two formulas to estimate the ALUT from LD were suggested: right ALUT = 0.94 x right LD + 2.6, left ALUT = 0.96 x left LD + 2.4. Our results demonstrated that patient height does not provide a reliable estimate of ureteric length. LD by IVP is preferable to patient height when estimating the ureteric length.

Adolescent↗

PubMed2005

Early removal of nasogastric tube after cystectomy with urinary diversion: does postoperative ileus risk increase?

OBJECTIVES: To examine the risk factors of postoperative ileus and investigate whether the duration of postoperative nasogastric tube (NGT) use affects the rate of postoperative ileus in patients undergoing radical cystectomy with urinary diversion. METHODS: A total of 101 patients underwent radical cystectomy with urinary diversion from 1999 to 2003. We examined the demographic and perioperative variables of the patients who did and did not develop postoperative ileus. We divided the patients into two groups--those who had the NGT removed within 24 hours and those who had the NGT removed at first flatus. We compared the two groups for the incidence of ileus and clinical variables. RESULTS: Postoperative ileus was observed in 23 patients (23%). The demographic data of both groups were not different in terms of age or American Society of Anesthesiologists score. Also, the operative time, estimated blood loss, type of diversion, and postoperative complication rate were not significantly different between the two groups (P >0.05). However, the risk of postoperative ileus was significantly greater in those who took polyethylene glycol for bowel preparation than in those who took sodium phosphate (40% versus 18%, respectively, P = 0.02). No significant difference in the prevalence of ileus was found between the patients whose NGT was removed within 1 day and those in whom it was removed after 2 days (25% versus 22%, respectively, P >0.05). CONCLUSIONS: The results of our study suggest that the use of sodium phosphate for bowel preparation may reduce the incidence of postoperative ileus and that early NGT removal after cystectomy is not correlated with ileus.

Aged↗

PubMed2005

Relative proportions of tissue components in the prostate: are they related to the development of symptomatic BPH in Korean men?

OBJECTIVES: To investigate the high prevalence of lower urinary tract symptoms in Korean men with a small prostate, we studied the proportions of histologic components of prostatic adenoma in patients with symptomatic benign prostatic hyperplasia. METHODS: Prostatic adenoma specimens were obtained from men with symptomatic benign prostatic hyperplasia who underwent open prostatectomy or transurethral resection of the prostate. Patients were divided into three groups according to the prostate volume as measured by preoperative transrectal ultrasonography (group 1, 20 to 40 cm3, 21 men; group 2, 41 to 80 cm3, 22 men; and group 3, greater than 80 cm3, 23 men). The age distribution and the severity of symptoms were comparable in these three groups (P > 0.05). The proportion of the stroma in the prostatic adenoma and the proportions of smooth muscle, collagen types I, II, III, and V, fibronectin, and laminin in stromal tissue were determined using automatic image analyzer quantitatively. RESULTS: The proportions of the stroma in the prostatic adenoma specimens of groups 1 and 2 were significantly greater than in group 3 (P < 0.05). The proportions of smooth muscle, collagen types I, III, and V, fibronectin, and laminin were not significantly different in the three groups (P > 0.05). The relative smooth muscle proportion in the prostatic adenoma (proportion of stroma x proportion of smooth muscle in stromal tissue) in groups 1 and 2 was significantly greater than in group 3 (P < 0.05). CONCLUSIONS: These results suggest that the dynamic component of bladder outlet obstruction, which is mediated by smooth muscle tone, may play a more important role in the development of symptomatic benign prostatic hyperplasia in Korean men.

Aged↗

PubMed2005

Systemic chemotherapy in patients with indwelling ureteral stenting.

BACKGROUND: We investigated whether systemic chemotherapy increased episodes of acute pyelonephritis (APN) in patients with an indwelling double-J stent due to non-urological malignant ureteral obstruction. METHODS: A retrospective study was performed on a total of 74 patients (16 men and 58 women; median age, 53.0; range, 34-84 years) with non-urological malignant ureteral obstruction, who were managed by double-J stenting between October 1997 and December 2001. The patients were divided into those who received (33 patients, group I) and those who did not receive systemic chemotherapy (41 patients, group II) during the stent indwelling period (median, 7.0; range, 1-44 month). Routine antibiotic prophylaxis was not administered to any patient. Median follow-up was 10.5 (range, 1-45) months. Clinical features, including the incidence of febrility and APN, were compared between the two groups. RESULTS: Of the 74 patients, 18 patients (24.3%) experienced acute febrile episodes during ureteral stenting, but only five (6.8%) patients were diagnosed as having APN. No significant difference in the incidence of fever or APN was found between the two groups (P = 1.000 and P = 0.651, respectively). Univariate logistic analysis indicated that only the duration of follow-up was a risk factor for an episode of fever. Other parameters had no clinical significance. CONCLUSION: Our findings suggest that systemic chemotherapy may not predispose the risk of acute pyelonephritis in patients with an indwelling ureteral stent due to non-urological malignant ureteral obstruction.

Acute Disease↗

PubMed2005

Augmentation of cisplatin sensitivity in cisplatin-resistant human bladder cancer cells by modulating glutathione concentrations and glutathione-related enzyme activities.

OBJECTIVES: To investigate the roles of glutathione and glutathione-S-transferase (GST) in cisplatin-resistance mechanisms in human bladder cancer, by using glutathione-depleting or GST-blocking agents. MATERIALS AND METHODS: Cisplatin-resistant human bladder cancer cell lines were established by continuous exposure of T24 cells to increasing concentrations of cisplatin. Buthionine sulphoximine (BSO), ethacrynic acid and indomethacin were used to deplete glutathione or block GST. Intracellular glutathione content, GST activity and cisplatin cytotoxicity were determined after exposing parental and drug-resistant cell lines to these agents. RESULTS: Intracellular glutathione content and GST activity were significantly decreased, and cisplatin cytotoxicity significantly enhanced, in both parental and resistant cell lines by glutathione-depleting or GST-blocking agents. However, the resistance of cisplatin-resistant cell lines did not fully recover to that of the parental cells with combined BSO and indomethacin. CONCLUSIONS: Both increased glutathione content and GST activity are significant in the cisplatin resistance of human bladder tumour cells. Because BSO, ethacrynic acid and indomethacin caused a partial recovery of resistance in the cisplatin-resistant cell line, further studies are needed to investigate their efficacy for treating patients with metastatic bladder carcinoma resistant to cisplatin.

Antineoplastic Agents↗