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Liao CH, Chiang HS, Yu HJ. Serum testosterone levels significantly correlate with nocturia in men aged 40-79 years. Urology 2011; 78:631-5. [PMID: 21782223 DOI: 10.1016/j.urology.2011.05.033] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Revised: 05/22/2011] [Accepted: 05/24/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To investigate the association between serum sex hormone levels and lower urinary tract symptoms in men aged 40-79 years. METHODS A cross-sectional study was conducted in 509 men (mean age 58 years). The serum total testosterone (TT), dihydrotestosterone, and estradiol levels were measured. The total prostate volume measured by transrectal ultrasonography and International Prostate Symptom Score (IPSS) questionnaire were obtained. Correlations were determined using univariate and multivariate regression analysis. RESULTS The subjects with moderate to severe lower urinary tract symptoms (total IPSS≥8) were older, with a greater incidence of hypertension and diabetes, a larger prostate, and had lower serum TT levels. On the univariate analysis, the serum TT levels were negatively associated with the total IPSS, IPSS storage subscore, weak stream, and nocturia. After adjusting for age, hypertension, diabetes, and total prostate volume, only the serum TT level was significantly associated with nocturia (>2 times/night; P=.042), and men with serum TT levels in the greatest quartile had a 44% reduced risk of nocturia than in the lowest quartile (P=.037). CONCLUSION In our relative healthy male cohort, most IPSS items showed no significant association with serum sex hormone levels, except for nocturia, which showed a negative correlation with the serum testosterone level.
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Lee WC, Chuang YC, Chiang PH, Chien CT, Yu HJ, Wu CC. Pathophysiological Studies of Overactive Bladder and Bladder Motor Dysfunction in a Rat Model of Metabolic Syndrome. J Urol 2011; 186:318-25. [PMID: 21600594 DOI: 10.1016/j.juro.2011.03.037] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Indexed: 01/09/2023]
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Hsieh JT, Chen SC, Yu HJ, Chang HC. Finasteride upregulates expression of androgen receptor in hyperplastic prostate and LNCaP cells: implications for chemoprevention of prostate cancer. Prostate 2011; 71:1115-21. [PMID: 21557276 DOI: 10.1002/pros.21325] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 11/23/2010] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although finasteride is recognized for its role as a chemopreventive agent for prostate cancer, higher grades of malignancy have been reported. It is questioned whether blocking of testosterone conversion to dihydrotestosterone (DHT) by finasteride in prostate tissue will change expression of androgen receptor (AR). Therefore, this study evaluated the effects of finasteride on AR expression in prostate tissue and in the LNCaP cell line. METHODS Between January and December 2006, we retrospectively selected and evaluated 47 cases of benign prostatic hyperplasia treated with variable duration of finasteride (5 mg QD) before transurethral resection of the prostate. AR expression in prostate tissue was semiquantified by immunostaining and compared with duration of finasteride treatment. An androgen-dependent prostate cancer cell line (LNCaP) was cultured in charcoal/dextran-treated FBS with DHT or testosterone, and treated with finasteride for 1-3 weeks. Samples of total RNA were collected to analyze expression of AR by real-time quantitative reverse transcription polymerase chain reaction. RESULTS Immunohistochemical study revealed significant upregulation of ARs by finasteride treatment for 30-180 days. In cell line study, quantitative real-time reverse transcription polymerase chain reaction revealed significant upregulation of ARs treated by finasteride. CONCLUSIONS In our study, finasteride influenced AR expression in benign prostate tissue and prostate cancer cell. Before we can use finasteride in chemoprevention with confidence, we still need to clarify the influence of finasteride in ARs and its regulation pathway.
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Liao CH, Guh JH, Chueh SC, Yu HJ. Anti-angiogenic effects and mechanism of prazosin. Prostate 2011; 71:976-84. [PMID: 21541974 DOI: 10.1002/pros.21313] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2010] [Accepted: 10/26/2010] [Indexed: 12/20/2022]
Abstract
BACKGROUND Alpha1-adrenoceptors antagonists (doxazosin, terazosin, prazosin) are commonly prescribed for benign prostate hyperplasia and hypertension. Doxazosin and terazosin exhibit anti-angiogenic effects and apoptotic activities against multiple cell types and are potential preventive agents for prostate cancer. Prazosin induces apoptosis in three prostate cancer cell lines. We hypothesized that prazosin, a more potent alpha1-adrenoceptor antagonist with a distinct mechanism, exhibits anti-angiogenic activity. METHODS We examined the effect of prazosin on growth and tube formation of human umbilical vascular endothelial cells (HUVECs). We used flow cytometry to assess the effect of prazosin on cell cycle progression and Western blotting to assess its effect on the expression of various apoptotic proteins. RESULTS Prazosin inhibited the growth of HUVEC with an IC(50) of 6.53 µM and suppressed tube formation in a dose-dependent manner. Unlike prostate cancer cells, prazosin did not arrest cell cycle progression at the G2/M checkpoint. We used rhodamine 123 staining to show that prazosin (20 µM) treatment induced a loss of mitochondrial membrane potential by 12 hr. Prazosin treatment of HUVECs resulted in reduced MCL-1 expression, increased Bad, and Bcl-xL expression, cytochrome c release, and induction of apoptosis via the intrinsic apoptosis pathway. Prazosin induced apoptosis in prostate cancer cells and normal HUVEC cells via different mechanisms. CONCLUSIONS These data suggest that prazosin exhibits anti-angiogenic activity and differentially modulates apoptotic pathways depending on the cell type.
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Weng WC, Lin WC, Pu YS, Yu HJ, Huang CY. An Unusual Presentation of Prostate Adenocarcinoma Metastatic to the Oral Cavity. UROLOGICAL SCIENCE 2011. [DOI: 10.1016/s1879-5226(11)60019-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Yu HJ, Lin ATL, Yang SSD, Tsui KH, Wu HC, Cheng CL, Cheng HL, Wu TT, Chiang PH. Non-inferiority of silodosin to tamsulosin in treating patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). BJU Int 2011; 108:1843-8. [PMID: 21592295 DOI: 10.1111/j.1464-410x.2011.10233.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
UNLABELLED What's known on the subject? and What does the study add? Silodosin administered by 4 mg twice daily is as effective as tamsulosin 0.2 mg daily in treating patients with LUTS associated with BPH. Relative to tamsulosin, silodosin has less cardiovascular side effects as judged by the minimal changes of blood pressure and pulse rats after treatment. OBJECTIVE • To test the hypothesis that the efficacy of silodosin would not be inferior to tamsulosin in treating patients with lower urinary tract symptoms associated with benign prostate hyperplasia (BPH). PATIENTS AND METHODS • At nine medical centres, 209 patients with an International Prostate Symptom Score (IPSS) of ≥13 were randomized to silodosin (4 mg twice daily) or tamsulosin (0.2 mg once daily) for 12 weeks. • The primary efficacy measure was the mean change from baseline to endpoint in IPSS. • The non-inferiority margin of the IPSS change was set at 1.0. • Secondary efficacy measures included change in maximal urinary flow rate (Q(max)) and health-related quality of life (HRQL) score. RESULTS • Of the 170 (81.3%) patients who completed the study, 86.2% in the silodosin group vs 81.9% in the tamsulosin group achieved a ≥25% decrease in IPSS (P= 0.53). • The mean difference (silodosin minus tamsulosin) in IPSS change from baseline was -0.60 (95% confidence interval -2.15, 0.95), inferring the non-inferiority of silodosin to tamsulosin. • The mean changes in the Q(max) and HRQL score from baseline were comparable between the groups (both, P > 0.05). Although patients receiving silodosin had a significantly higher incidence of abnormal ejaculation (9.7% vs tamsulosin 1.0%, P= 0.009), only 1.9% discontinued treatment. • Tamsulosin treatment resulted in a significant reduction in mean systolic blood pressure (-4.2 mmHg, within-group P= 0.004) relative to the negligible change of silodosin (-0.1 mmHg, within-group P= 0.96) CONCLUSION • The trial shows the non-inferiority of silodosin 4 mg twice daily to tamsulosin 0.2 mg once daily in patients with symptoms of BPH.
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Chen JH, Mehta RS, Baek HM, Nie K, Liu H, Lin MQ, Yu HJ, Nalcioglu O, Su MY. Clinical characteristics and biomarkers of breast cancer associated with choline concentration measured by 1H MRS. NMR IN BIOMEDICINE 2011; 24:316-24. [PMID: 20862660 PMCID: PMC3075960 DOI: 10.1002/nbm.1595] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Revised: 06/30/2010] [Accepted: 07/02/2010] [Indexed: 05/21/2023]
Abstract
This study investigated the association between the total choline (tCho) concentration and the clinical characteristics and biomarker status of breast cancer. Sixty-two patients with breast cancer, 1.5 cm or larger in size on MR images, were studied. The tCho concentration was correlated with the MRI features, contrast enhancement kinetics, clinical variables and biomarkers. Pairwise two-tailed Spearman's nonparametric test was used for statistical analysis. The tCho concentration was higher in high-grade than moderate-/low-grade tumors (p = 0.04) and in tumors with higher K(trans) and k(ep) (p < 0.001 for both). The association of tCho concentration with age (p = 0.05) and triple negative biomarker (p = 0.09) approached significance. tCho was not detected in 17 patients, including 15 with invasive ductal cancer and two with infiltrating lobular cancer. Fifteen of the 17 patients had moderate- to low-grade cancers, and 11 had human epidermal growth factor-2-negative cancer, suggesting that these two factors might lead to false-negative choline. Higher tCho concentration in high-grade tumors and tumors with higher K(trans) and k(ep) indicates that choline is associated with cell proliferation and tumor angiogenesis. The higher choline level in younger women may be caused by their more aggressive tumor type. The results presented here may aid in the better interpretation of (1)H MRS for the diagnosis of breast lesions.
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Ho CH, Chang TC, Guo YJ, Chen SC, Yu HJ, Huang KH. Lower urinary tract symptoms and urinary flow rates in female patients with hyperthyroidism. Urology 2011; 77:50-4. [PMID: 21195824 DOI: 10.1016/j.urology.2010.07.479] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2010] [Revised: 07/14/2010] [Accepted: 07/19/2010] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To investigate lower urinary tract symptoms (LUTS) and voiding function in a cohort of hyperthyroid women. The autonomic nervous system (ANS) imbalance has been thought to cause LUTS in hyperthyroidism. METHODS Between January 2008 and December 2008, 65 newly diagnosed, untreated female hyperthyroid patients were enrolled in this study. Another 62 age-matched healthy women were enrolled as a control group. Demographics, LUTS, urinary flow rates, hyperthyroid symptoms, and serum levels of thyroid hormones were recorded before and after the medical treatment for hyperthyroidism. RESULTS Compared with the control group, the hyperthyroid patients had a higher mean symptom score of frequency (1.15 ± 1.75 vs 0.31 ± 1.05, P = .01), incomplete emptying (0.91 ± 1.47 vs 0.29 ± 1.12, P = .02), straining (1.05 ± 0.85 vs 0.27 ± 0.51, P <.01), voiding symptoms (3.05 ± 3.28 vs 1.06 ± 2.63, P <.01), and total symptoms (5.88 ± 6.17 vs 2.76 ± 4.65, P <.01). Fifty-three (81.5%) of them had an IPSS of <8, while only 12 (18.5%) had an International Prostate Symptom Score (IPSS) of ≥8. Hyperthyroid women demonstrated a lower mean peak flow rate (25.0 ± 5.3 vs 28.6 ± 6.1 mL/s, P = .02). After treatment, both LUTS and flow rates improved significantly. The severity of LUTS was associated with neither serum levels of thyroid hormone nor other hyperthyroid symptoms. CONCLUSIONS Hyperthyroid women have worse LUTS and lower peak flow rates than healthy controls. However, the severity of LUTS is only mild (IPSS <8) in the majority, and only 18.5% have moderate-to-severe LUTS. Both LUTS and flow rates improve after the treatment for hyperthyroidism. The exact mechanisms of LUTS and/or lower urinary tract dysfunction in hyperthyroidism require further investigation.
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Li J, Cun Y, Tang WR, Wang Y, Li SN, Ouyang HR, Wu YR, Yu HJ, Xiao CJ. Association of eNOS gene polymorphisms with essential hypertension in the Han population in southwestern China. GENETICS AND MOLECULAR RESEARCH 2011; 10:2202-12. [PMID: 21968727 DOI: 10.4238/vol10-3gmr1160] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Mehta RS, Chen JH, Bahri S, Carpenter P, Kuzucan A, Yu HJ, Nalcioglu O, Su MY. Abstract P2-02-11: Evaluation of Tumor Response Using 3T Breast MRI Following Neoadjuvant Albumin-Bound Paclitaxel and Carboplatin with Bevacizumab or Trastuzumab. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p2-02-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
PURPOSE: MRI is known as the most accurate imaging modality for evaluating the extent of residual disease following neoadjuvant chemotherapy (NAC). Although in general breast MRI is done at 1.5T, 3T can provide a better signal-to-noise ratio and may be more sensitive to detect residual disease. In this study the diagnostic performance of 3T MRI for NAC response was investigated.
METHODS AND MATERIALS: In a period of 30 months, 42 NAC patients (29-83 y/o, mean 50 y/o) who received at least three MRI scans before, during and after therapy, and had surgery after completing NAC were analyzed in this study. The NAC protocol included albumin-bound paclitaxel, carboplatin and trastuzumab for HER-2 positive patients (N= 15), or bevacizumab for HER-2 negative patients (N=27). Some patients received doxorubicin and cyclophosphamide, bi-weekly for 4 cycles, as clinically indicated. Twenty-eight lesions were mass types and 14 showed non-mass-like enhancements. The residual tumor size was determined using the RECIST criteria, by measuring the longest dimension shown on MRI. When there was no enhancement (or, with a faint enhancement equal to the background normal tissue enhancement), the case was determined as complete clinical response (CCR). Pathological complete response (pCR) was defined as no residual invasive cancer cells, with or without DCIS. In cases with residual invasive cancer, the pathological size was determined as the longest dimension, either the longest dimension on H&E-stained slide or from the number of blocks (each 5 mm) where the malignant invasive tumor was detected, whichever was greater. For residual tumor showing as scattered cancer cells/nests, the longest dimension was estimated from the involved blocks.
RESULTS: MRI diagnosed 12 complete clinical response and 30 cases with residual cancers. In pathological examination, 12 were pCR (29%). Overall, comparing MRI diagnosis to pCR diagnosis, there were 27 true positive, 9 true negative, 3 false negative, and 3 false positive. The three false positive cases all had residual DCIS-so although MRI did not predict pCR it correctly diagnosed residual DCIS. The three false negative cases were all non-mass lesions, in which pathology showed scattered small cancer foci in 3, 14, and 14 cm areas, respectively. The sensitivity, specificity, and accuracy of MRI were 90%, 75%, and 86%. Overall, the correlation between MRI and pathologic size was higher for mass lesions than for non-mass-like lesions (r=0.80 vs. r=0.67), and similar between Her-2 positive and negative lesions (r=0.82 vs. r=0.84). The discrepancy between MRI and pathological size was larger for non-mass lesions than for mass lesions (0.6-14 cm vs. 0-3 cm).
CONCLUSIONS: Similar to 1.5T, high resolution 3T MRI has limitations for the non-mass-like lesions that break into small foci and scattered cells. This might be due to that small tumor foci have lowered angiogenic activity, limiting MR contrast agent uptake, thus lowering the detection rate. For mass lesions, MR residual tumor size was highly correlated with pathological size. Understanding the accuracy and limitations of 3T MRI for NAC patients may aid in designing an improved NAC protocol and a better surgical planning.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-02-11.
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Chung SD, Huang CY, Wang SM, Chueh SC, Hung SF, Tsai YC, Yu HJ. Laparoendoscopic Single-Site (LESS) Nephroureterectomy and En Bloc Resection of Bladder Cuff With a Novel Extravesical Endoloop Technique. Surg Innov 2010; 17:361-5. [DOI: 10.1177/1553350610387282] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To present the initial experience of laparoendoscopic single-site (LESS) nephroureterectomy via the transperitoneal approach using the Alexis wound retractor and bladder cuff resection by endoloop. Methods: Two patients received LESS nephroureterectomies and bladder cuffs resection with homemade single ports, which were created by using an Alexis wound retractor as an access platform through a 4-cm incision. Distal ureters were resected through the same incision with endoloop. No additional ports were used and both procedures were completed successfully. Results: Both LESS procedures were completed successfully without traditional laparoscopic conversion or complication. LESS nephreoureterectomy with bladder cuff excision was performed in 165 and 325 minutes with estimated blood loss of 30 and 65 mL, respectively. Patients were discharged on postoperative days 3 and 7, respectively. Conclusions: The initial results demonstrated that LESS technique of nephroureterectomy and bladder cuff resection with endoloop is a safe and feasible procedure for urothelial carcinoma of upper urinary tract.
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Lee KL, Dong CS, Chen MY, Ho CH, Tai HC, Hung SF, Yu HJ. Multifactorial causes of irritating bladder symptoms in patients with sjögren's syndrome. Neurourol Urodyn 2010; 30:97-101. [DOI: 10.1002/nau.20887] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Accepted: 12/15/2009] [Indexed: 12/28/2022]
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Ho CH, Chang TC, Lin HH, Liu SP, Huang KH, Yu HJ. Solifenacin and Tolterodine are Equally Effective in the Treatment of Overactive Bladder Symptoms. J Formos Med Assoc 2010; 109:702-8. [DOI: 10.1016/s0929-6646(10)60114-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2009] [Revised: 09/16/2009] [Accepted: 11/03/2009] [Indexed: 11/25/2022] Open
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Chen CH, Yang HJ, Shun CT, Huang CY, Huang KH, Yu HJ, Pu YS. A cocktail regimen of intravesical mitomycin-C, doxorubicin, and cisplatin (MDP) for non-muscle-invasive bladder cancer. Urol Oncol 2010; 30:421-7. [PMID: 20870427 DOI: 10.1016/j.urolonc.2010.06.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 05/18/2010] [Accepted: 06/17/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To compare the efficacy and toxicity profiles of 3 intravesical regimens, including doxorubicin alone, bacillus Calmette-Guerin (BCG), and a cocktail regimen, in the prevention of bladder cancer recurrence. MATERIALS AND METHODS Two hundred ninety patients with newly diagnosed non-muscle-invasive bladder cancer treated with transurethral resection (TUR) between March 1996 and December 2004 were analyzed retrospectively. Each cycle of the cocktail regimen contained 30 mg each of sequential weekly intravesical mitomycin-C (MMC), doxorubicin, and cisplatin (MDP). Two cycles of MDP were given within the first 6 weeks of TUR, followed by 1 cycle each at 3, 6, and 12 months, and every 6 months until 36 months after a negative cystoscopy. Doxorubicin and BCG alone was given at similar time points as the MDP and BCG protocols. RESULTS There were no demographic differences among the 3 groups. The median follow-up duration was 50 months. Dropout rates due to intolerance and/or poor compliance with the BCG, doxorubicin, and MDP protocols were 22.5%, 16.8%, and 11.0%, respectively. The MDP and BCG groups had similar bladder recurrence rates (37.9% vs. 33.9% at 5 years, respectively; P = 0.69). The doxorubicin group had significantly more recurrences than the BCG or MDP groups (HR = 1.9 (vs. BCG; P = 0.02) and 1.8 (vs. MDP; P = 0.01)). MDP was associated with less major adverse events than BCG (5.8% vs. 15.0%, respectively; P = 0.02). CONCLUSIONS Compared with maintenance BCG, the MDP group had a similar recurrence rate but less side effects. Large randomized study is warranted to further determine the benefit of MDP adjuvant intravesical therapy.
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Chen SC, Hsieh JT, Yu HJ, Chang HC. Appropriate cut-off value for follicle-stimulating hormone in azoospermia to predict spermatogenesis. Reprod Biol Endocrinol 2010; 8:108. [PMID: 20825644 PMCID: PMC2944172 DOI: 10.1186/1477-7827-8-108] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Accepted: 09/08/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study was undertaken to determine the optimal cut-off value for FSH to predict the presence of spermatogenesis in patients with non-obstructive azoospermia. METHODS A total of 206 non-obstructive azoospermic men were enrolled in this prospective study. By using receiver operating characteristic (ROC) curves, we determined the optimal cut-off value for FSH and evaluated whether the test could adequately predict successful sperm retrieval. RESULTS There were 108 non-obstructive azoospermic patients who had evidence of spermatogenesis (group A) and achieved success in sperm retrieval. Another 98 non-obstructive azoospermic patients (group B) failed in sperm retrieval. The mean value of serum FSH in group B was significantly higher than in group A (28.03 +/- 14.56 mIU/mL vs 7.94 +/- 4.95 mIU/mL, p < 0.01; respectively). The area under the receiver operating characteristic curves were 0.939 +/- 0.02 and a cut-off value of 19.4 mIU/mL discriminated between group A and B with a sensitivity of 70%. The positive predictive value for failed sperm retrieval (group B) can reach 100%. CONCLUSIONS Elevated plasma levels of FSH of more than 19.4 mIU/mL could be used as a reliable criterion for a trial of sperm retrieval from testes in artificial reproductive techniques.
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Chie WC, Yu CC, Yu HJ. Reliability and Validity of the Taiwan Chinese Version of the EORTC QLQ-PR25 in Assessing Quality of Life of Prostate Cancer Patients. UROLOGICAL SCIENCE 2010. [DOI: 10.1016/s1879-5226(10)60026-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Ho CH, Tai HC, Yu HJ. Urodynamic findings in female diabetic patients with and without overactive bladder symptoms. Neurourol Urodyn 2010; 29:424-7. [PMID: 19283863 DOI: 10.1002/nau.20727] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
AIMS The purpose was to analyze urodynamic findings in female diabetic patients with OAB symptoms. METHODS Data from 94 female diabetic patients who underwent urodynamic studies in evaluation of various LUTS were retrospectively reviewed. Urodynamic findings, demographic data, and clinical symptoms were compared between patients with and without OAB. RESULTS Among the 94 subjects analyzed, 34 (36.2%) were diagnosed as OAB. Demographic data were similar between the patients with and without OAB. In the OAB group, patients had significantly higher storage symptom scores and marginally higher voiding symptom scores. On cystometry, the OAB group had a higher percentage of increased bladder sensation (41.2% vs 11.7%, P = 0.001) and detrusor overactivity (29.4% vs 10.0%, P = 0.023). The OAB group had lower peak flow rate (16.2 +/- 5.9 vs 19.3 +/- 6.3 ml/s, P = 0.023), greater PVR volume (60.3 +/- 29.4 vs 45.0 +/- 25.1 ml, P = 0.009), and lower bladder voiding efficiency (BVE, 75.2 +/- 2.8 vs 81.5 +/- 2.9%, P < 0.001). On pressure-flow studies, the OAB group had a higher percentage of BOO (26.5% vs 6.7%, P = 0.008). CONCLUSIONS Our study shows that the most frequent urodynamic finding of OAB in female diabetic patients is increased bladder sensation, followed by detrusor overactivity. Compared to those without OAB, female diabetic patients with OAB are more likely to have impaired voiding function, characterized by lower peak flow rate, greater PVR volume, lower BVE, and a higher percentage of BOO. In these patients, BOO not only causes voiding difficulty but may also contribute to the development of OAB.
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Huang SP, Huang CY, Liu CC, Yu CC, Pu YS, Chueh SC, Yu HJ, Wu TT, Li CC, Huang CH, Wu WJ. Clinical outcome of Taiwanese men with clinically localized prostate cancer post-radical prostatectomy: a comparison with other ethnic groups. Aging Male 2010; 13:10-7. [PMID: 19883296 DOI: 10.3109/13685530903294370] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Prostate cancer incidence varies significantly among different ethnic groups. However, the report concerning the clinical outcome after radical prostatectomy (RP) in the low incidence Asian population is still limited. We aimed to compare the clinical outcome in patient treated with RP among different ethnic groups and to identify significant prognostic factors in Taiwanese patients. METHODS A total of 341 patients with clinical localized prostate cancer undergoing curative RP in three medical centers in Taiwan were included in this study. Ethnic group comparison was performed using the CaPSURE, SEARCH databases from United States (US) and one large European series. The Kaplan-Meier analysis and Cox proportional hazard model were used to identify significant predictors for prostate-specific antigen (PSA) recurrence. RESULTS Compared to the Caucasian white population in the US and Europe studies, the Taiwanese population have higher age at surgery and higher pre-operative PSA level. With mean and median follow-up of 39.1 months and 31.0 months (range 5-120 months), 127 men (37.2%) had PSA recurrence which was significant higher than the Western series. Significant predictors for PSA recurrence identified in the post-operative overall model were PSA level, pathological Gleason Score, pathological tumor stage and lymph node metastasis. CONCLUSIONS The clinical outcome of Taiwanese male with prostate cancer post-RP appears inferior to the Western country, which is largely due to delay surgery at higher PSA level. Earlier diagnosis and treatment may improve the cancer control of RP.
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Hung SF, Liu KL, Yu HJ, Huang KH. Emphysematous cystitis. Int J Infect Dis 2010; 14:e269-70. [DOI: 10.1016/j.ijid.2009.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2009] [Accepted: 04/13/2009] [Indexed: 11/17/2022] Open
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Tai HC, Chung SD, Ho CH, Tai TY, Yang WS, Tseng CH, Wu HP, Yu HJ. Metabolic syndrome components worsen lower urinary tract symptoms in women with type 2 diabetes. J Clin Endocrinol Metab 2010; 95:1143-50. [PMID: 20103655 DOI: 10.1210/jc.2009-1492] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT Diabetic women are more susceptible to develop lower urinary tract symptoms (LUTS), especially overactive bladder (OAB). However, data regarding the effect of components of metabolic syndrome (MS) on this association are conflicting. OBJECTIVE The objective of the study was to examine the potential role of MS in the development of LUTS in diabetic women. DESIGN The study was a prevalence study conducted between 2005 and 2007. SETTING The study was conducted in a university hospital. PARTICIPANTS A total of 518 women with type 2 diabetes aged 50-75 yr were included. They were subgrouped as MS (47.5%) and non-MS (52.5%) groups according to whether they fulfilled the criteria of MS. MAIN OUTCOME MEASURE We used American Urological Association Symptom Index (AUA-SI) to evaluate LUTS and Indevus Urgency Severity Scale to evaluate OAB, respectively. RESULTS Women in the MS group had significantly higher storage and total AUA-SI scores as well as a higher prevalence of LUTS and OAB. Most intriguingly, the number of MS components was strongly associated with the LUTS severity because the AUA-SI scores increased in parallel to the number of components were present. Similar results were found between MS and OAB. Multivariate analysis revealed that peripheral neuropathy, but not MS, significantly predicted LUTS in diabetic women after age adjustment. However, MS remained significantly predictive for LUTS and OAB after additional adjustment for neuropathy. CONCLUSIONS Our results suggest that MS may especially influence LUTS and OAB in diabetic women, probably by compounding the effect of peripheral neuropathy.
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Hung SF, Chung SD, Chung SD, Wang SM, Wu IH, Yu HJ, Chang HC. Iliac artery aneurysm mistaken for distended bladder. J Am Geriatr Soc 2010; 57:2350-1. [PMID: 20169628 DOI: 10.1111/j.1532-5415.2009.02578.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chung SD, Chen KH, Lai MK, Chang HC, Huang CY, Yu HJ. Intrathoracic kidney with right Bochdalek’s hernia. Kidney Int 2010; 77:166. [DOI: 10.1038/ki.2009.336] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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98
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Hung SF, Chung SD, Wang SM, Yu HJ, Huang HS. Chronic kidney disease affects the stone-free rate after extracorporeal shock wave lithotripsy for proximal ureteric stones. BJU Int 2009; 105:1162-7. [PMID: 19930180 DOI: 10.1111/j.1464-410x.2009.08974.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To investigate the effect of renal function on the stone-free rate (SFR) of proximal ureteric stones (PUS) after extracorporeal shock wave lithotripsy (ESWL), as urinary obstruction caused by PUS can impair renal function, and elevated serum creatinine levels are associated with decreased ureteric stone passage. PATIENTS AND METHODS From January 2005 to December 2007, 1534 patients had ESWL for urolithiasis, 319 having ESWL in situ for PUS; they were reviewed retrospectively. Patients requiring simultaneous treatment of kidney stones, placement of a double pigtail stent, or percutaneous pigtail nephrostomy tube were excluded. We divided patients into groups by chronic kidney disease (CKD) stage according to the estimated glomerular filtration rate (eGFR) of ≥ 60 and <60 mL/min/1.73 m(2). Stone-free status was defined as no visible stone fragments on a plain abdominal film at 3 months after ESWL. A logistic regression model was used to evaluate the possible significant factors that influenced the SFR of PUS after ESWL, and to develop a prediction model. RESULTS The overall SFR of PUS (276/319 patients) was 86.5%; the SFR was 93% in patients with an eGFR of ≥ 60 and 50% in those with an eGFR of <60 (P < 0.001). After univariate and multivariate analysis, the three significant factors affecting SFR were an eGFR of ≥ 60, stone width, and gender, with odds ratios (95% confidence intervals) of 19.54 (8.25-46.30) (P < 0.001), 0.67 (0.55-0.82) (P < 0.001) and 0.16 (0.05-0.50 (P = 0.002), respectively. A logistic regression model was developed to estimate the probability of SFR after ESWL, the equation being 1/(1 + exp [-(3.8137 - 0.3967 × (stone width) + 2.9724 × eGFR - 1.8120 × Male)]), where stone width is the observed value (mm), eGFR = 1 for eGFR ≥ 60 and 0 for <60, and male = 1 for male, 0 for female. CONCLUSIONS Gender, eGFR ≥ 60 and a stone width of >7 mm were significant predictors affecting the SFR after one session of ESWL for PUS.
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Ho CH, Huang CY, Lin WC, Chueh SC, Pu YS, Lai MK, Yu HJ, Huang KH. Radical Cystectomy in the Treatment of Bladder Cancer: Oncological Outcome and Survival Predictors. J Formos Med Assoc 2009; 108:872-8. [DOI: 10.1016/s0929-6646(09)60419-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Liao CH, Chung SD, Lai MK, Yu HJ, Chueh SC. Laparoscopic simultaneous bilateral partial and total adrenalectomy: a longer follow-up. BJU Int 2009; 104:1269-73. [DOI: 10.1111/j.1464-410x.2009.08523.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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