Genome-wide scans for selection signatures in indigenous pigs revealed candidate genes relating to heat tolerance

Heat stress is a major problem that constrains pig productivity. Understanding and identifying adaptation to heat stress has been the focus of recent studies, and the identification of genome-wide selection signatures can provide insights into the mechanisms of environmental adaptation. Here, we generated whole-genome re-sequencing data from six Chinese indigenous pig populations to identify genomic regions with selection signatures related to heat tolerance using multiple methods: three methods for intra-population analyses (Integrated Haplotype Score, Runs of Homozygosity and Nucleotide diversity Analysis) and three methods for inter-population analyses (Fixation index (F_ST), Cross-population Composite Likelihood Ratio and Cross-population Extended Haplotype Homozygosity). In total, 1 966 796 single nucleotide polymorphisms were identified in this study. Genetic structure analyses and F_ST indicated differentiation among these breeds. Based on information on the location environment, the six breeds were divided into heat and cold groups. By combining two or more approaches for selection signatures, outlier signals in overlapping regions were identified as candidate selection regions. A total of 163 candidate genes were identified, of which, 29 were associated with heat stress injury and anti-inflammatory effects. These candidate genes were further associated with 78 Gene Ontology functional terms and 30 Kyoto Encyclopedia of Genes and Genomes pathways in enrichment analysis (P < 0.05). Some of these have clear relevance to heat resistance, such as the AMPK signalling pathway and the mTOR signalling pathway. The results improve our understanding of the selection mechanisms responsible for heat resistance in pigs and provide new insights of introgression in heat adaptation.

Cancer-specific functional profiling in microsatellite-unstable (MSI) colon and endometrial cancers using combined differentially expressed genes and biclustering analysis

Microsatellite-unstable (MSI) cancers have distinct genetic and clinical features from microsatellite-stable cancers, but the molecular functional differences between MSI cancers originating from different tissues or organs have not been well studied because the application of usual differentially expressed gene (DEG) analysis is error-prone, producing too many noncancer-specific normally functioning genes. To maximize therapeutic efficacy, biomarkers reflecting cancer-specific differences between MSI cancers of different tissue origins should be identified. To identify functional differences between MSI colon and endometrial cancers, we combined DEG analysis and biclustering instead of DEG analysis alone and refined functionally relevant biclusters reflecting genuine functional differences between the 2 tumors. Specifically, using The Cancer Genome Atlas and genome-tissue expression as data sources, gene ontology (GO) enrichment tests were performed after routinely identifying DEGs between the 2 tumors with the exclusion of DEGs identified in their normal counterparts. Cancer-specific biclusters and associated enriched GO terms were obtained by biclustering with enrichment tests for the preferences for cancer type (either colon or endometrium) and GO enrichment tests for each cancer-specific bicluster, respectively. A novel childness score was developed to select functionally relevant biclusters among cancer-specific biclusters based on the extent to which the enriched GO terms of the biclusters tended to be child terms of the enriched GO terms in DEGs. The selected biclusters were tested using survival analysis to validate their clinical significance. We performed multiple sequential analyses to produce functionally relevant biclusters from the RNA sequencing data of MSI colon and endometrial cancer samples and their normal counterparts. We identified 3066 cancer-specific DEGs. Biclustering analysis revealed 153 biclusters and 41 cancer-specific biclusters were selected using Fisher exact test. A mean childness score over 0.6 was applied as the threshold and yielded 8 functionally relevant biclusters from cancer-specific biclusters. Functional differences appear to include gland cavitation and the TGF-β receptor, G protein, and cytokine pathways. In the survival analysis, 6 of the 8 functionally relevant biclusters were statistically significant. By attenuating noise and applying a synergistic contribution of DEG results, we refined candidate biomarkers to complement tissue-specific features of MSI tumors.

Epidemiologic study of bladder and urethral injury in Korea: A nationwide population-based study

Purpose

We aimed to analyze the characteristics and management of bladder and urethral injuries in Korea by use of the National Health Insurance Service (NHIS) database.

Materials and Methods

Data from the NHIS database representative of all cases of Korean bladder injury (n=4,631) and urethral injury (n=17,858) reported between 2012 and 2016 were analyzed. We used the International Classification of Diseases, 10th revision, clinical modification codes to identify the diagnoses.

Results

A total of 491 males (1.97/100,000) and 590 females (2.39/100,000) experienced bladder injury in 2012, and 449 males (1.76/100,000) and 624 females (2.47/100,000) in 2016. The risk of bladder injury was higher in female than in male (hazard ratio [HR], 1.267; p<0.001). The annual incidence of bladder injury did not increase (HR, 0.992; p=0.409). A total of 2,886 (62.3%) patients were managed with conservative treatment, and 1,745 (37.7%) patients underwent surgical treatment. A total of 4,114 males (16.5/100,000) and 285 females (1.2/100,000) had urethral injury in 2012, while 4,465 males (17.5/100,000) and 303 females (1.2/100,000) had urethral injury in 2016. The incidence of urethral injury is increasing annually (HR, 1.010; p=0.036).

Conclusions

The incidence of urethral injury increased continuously over the years studied, whereas that of bladder injury remained unchanged in Korea. The incidence of bladder injury was higher in females, and more than 90% of total urethral injuries were reported in males. This is the first study to evaluate the epidemiology of bladder and urethral injury using a nationwide population database.

Refinement of recto-sigmoid colon vaginoplasty using a three-dimensional laparoscopic technique

To investigate the feasibility, safety, and outcomes of three-dimensional (3D) laparoscopic vaginoplasty with a rectosigmoid colon flap for vaginal reconstruction.Following appropriate preoperative patient counseling, 17 consecutive patients underwent vaginoplasty using a 3D laparoscopic system. Perioperative and postoperative outcomes were retrospectively evaluated.Between September 2016 and February 2020, 17 patients underwent 3D laparoscopic vaginoplasty with a rectosigmoid colon flap. Of them, 15 (88%) were transgender female patients, and 2 (12%) were cisgender female patients with congenital deformities. Among the 15 transgender patients, 12 (80%) underwent de novo surgeries and 3 (20%) underwent re-do surgeries. The mean age at the time of operation was 33.0 years, and the mean total operation time was 529 ± 128 minutes. The initial intraoperative mean vaginal depth was 15.2 ± 1.3 cm, and the 30-day readmission rate was 5.9% (1/17 cases). The mean follow-up duration was 24.8 months.Perioperative and postoperative outcomes suggest that 3D laparoscopic rectosigmoid colon vaginoplasty is a potentially acceptable, effective, and safe method for vaginal reconstruction.

Efficacy and Safety of X-incision with Inversed Morcellation in Holmium Laser Enucleation of the Prostate: Comparison to Conventional Morcellation

Background

Three-quarters of aged men experience lower urinary tract symptoms with benign prostate hypertrophy (BPH). Transurethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP) are standard endosurgical procedures in patients with BPH. Previous studies reported better results in patients undergoing HoLEP than in those undergoing TURP.

Methods

This study compared the efficiency and safety of conventional morcellation and morcellation performed after X-incision during enucleation, a newly added technique in HoLEP. Overall, 174 patients were selected as the final study population. The populations were stratified with respect to resected volumes. A t-test were used to compare the conventional morcellation and X-incision procedure groups.

Results

In morcellation times and rates, there were significant differences in stratified resected mass (g) between the groups. The results also showed a decreased incidence of bladder injury as a surgical complication.

Conclusion

We believe morcellation performed after X-incision procedure during enucleation is efficient and safe for older adults with BPH.

The retinoblastoma 1 gene (RB1) modulates the proliferation of chicken preadipocytes

1. The objective of this study was to reveal the role of chicken RB1 (Gallus gallus RB1, gRB1) in the proliferation of preadipocytes. 2. To measure gene expression of gRB1 in the proliferation of chicken preadipocyte, quantitative real-time PCR was used. The expression levels of gRB1 transiently increased during this process. 3. To detect the effect of gRB1 on the proliferation of chicken preadipocyte, MTT assay and cell-cycle analysis were performed. MTT assay showed that overexpression of gRB1 significantly suppressed (P < 0.05) the proliferation of chicken preadipocytes, and knockdown of gRB1 promoted the proliferation of chicken preadipocytes. Cell-cycle analysis showed that the proportion of preadipocytes in the G1 and G2 phases significantly increased (P < 0.05), and the proportion of preadipocytes in the S phase significantly decreased (P < .05) after up-regulation of the expression of gRB1. The proportion of preadipocytes in the S phase significantly increased (P < 0.05) after down-regulation of gRB1. 4. Quantitative real-time PCR was used to detect the effect of gRB1 on the expression of genes related to proliferation of chicken preadipocytes. Gene expression analysis showed that gRB1 knockdown promoted markers indicating proliferation of Ki-67 (MKi67) expression at 96 h (P < 0.05), and overexpression of gRB1 reduced MKi67 expression at 72 h (P < 0.05). 5. This study demonstrated that gRB1 inhibited preadipocyte proliferation at least in part by inhibiting the G1 to S phase transition.

Experimental infection of clade 1.1.2 (H5N1), clade 2.3.2.1c (H5N1) and clade 2.3.4.4 (H5N6) highly pathogenic avian influenza viruses in dogs

Since the emergence of highly pathogenic avian influenza (HPAI) H5N1 in Asia, the haemagglutinin (HA) gene of this virus lineage has continued to evolve in avian populations, and H5N1 lineage viruses now circulate concurrently worldwide. Dogs may act as an intermediate host, increasing the potential for zoonotic transmission of influenza viruses. Virus transmission and pathologic changes in HPAI clade 1.1.2 (H5N1)-, 2.3.2.1c (H5N1)- and 2.3.4.4 (H5N6)-infected dogs were investigated. Mild respiratory signs and antibody response were shown in dogs intranasally infected with the viruses. Lung histopathology showed lesions that were associated with moderate interstitial pneumonia in the infected dogs. In this study, HPAI H5N6 virus replication in dogs was demonstrated for the first time. Dogs have been suspected as a "mixing vessel" for reassortments between avian and human influenza viruses to occur. The replication of these three subtypes of the H5 lineage of HPAI viruses in dogs suggests that dogs could serve as intermediate hosts for avian-human influenza virus reassortment if they are also co-infected with human influenza viruses.

Medical expulsive therapy for ureter stone using naftopidil: A multicenter, randomized, double-blind, and placebo-controlled trial

Objectives

A prospective, multicenter, randomized, double-blind, placebo-controlled trial evaluated the effects of naftopidil 75 mg for medical expulsive therapy for a single ureter stone.

Materials and methods

Patients diagnosed with a ureter stone were prescribed aceclofenac 100 mg or a combined medication of tramadol 37.5 mg and acetaminophen 325 mg. Patients then randomly received either naftopidil 75 mg or placebo. Primary endpoint was the stone passage rate at 14 days after medication.

Results

The 150 patients enrolled in 6 institutions randomly received either naftopidil (n = 75) or placebo (n = 75). The percentages of ureter stone passed spontaneously 14 days after medication was 60.9% in the naftopidil group and 53.3% in the placebo group. Stone-free rates and the total use of analgesics showed no significant differences between the two groups. Stone-free rates at 14 days after medication were decreased when maximal stone size was increased: 39.4% (≥ 5 mm), 15.5% (≥ 6 mm), and 7.0% (≥ 7 mm).

Conclusions

The use of naftopidil 75 mg once daily was not effective in increasing spontaneous stone passage rates or reducing analgesic use. The maximal stone size < 6 mm and the follow-up for two weeks would be appropriate for applying medical expulsive therapy to patients with a single ureter stone.

Dissecting the relationships of IgG subclasses and complements in membranous lupus nephritis and idiopathic membranous nephropathy

Membranous lupus nephritis (MLN) and idiopathic membranous nephropathy (IMN) are kidney diseases with similar morphology, but distinct etiologies, both producing glomeruli with immune deposits. Immunoglobulins and complements, the main components of the deposits, can be detected by immunofluorescence (IF) microscopy. Previous researches characterized the immune deposits only individually, but not the interactions between them. To study these relationships we analyzed an IF profile of IgG subclasses and complements (IgG1, IgG2, IgG3, IgG4, C3, C1q, and C4) in 53 and 95 cases of biopsy-confirmed MLNs and IMNs, respectively, mainly using information theory and Bayesian networks. We identified significant entropy differences between MLN and IMN for all markers except C3 and IgG1, but mutual information (a measure of mutual dependence) were not significantly different for all the pairs of markers. The entropy differences between MLN and IMN, therefore, were not attributable to the mutual information. These findings suggest that disease type directly and/or indirectly influences the glomerular deposits of most of IgG subclasses and complements, and that the interactions between any pair of the markers were similar between the two diseases. A Markov chain of IgG subclasses was derived from the mutual information about each pair of IgG subclass. Finally we developed an integrated disease model, consistent with the previous findings, describing the glomerular immune deposits of the IgG subclasses and complements based on a Bayesian network using the Markov chain of IgG subclasses as seed. The relationships between the markers were effectively explored by information theory and Bayesian network. Although deposits of IgG subclasses and complements depended on both disease type and the other markers, the interaction between the markers appears conserved, independent from the disease type. The disease model provided an integrated and intuitive representation of the relationships of the IgG subclasses and complements in MLN and IMN.

Detection of Severe Acute Respiratory Syndrome-Like, Middle East Respiratory Syndrome-Like Bat Coronaviruses and Group H Rotavirus in Faeces of Korean Bats

Bat species around the world have recently been recognized as major reservoirs of several zoonotic viruses, such as severe acute respiratory syndrome coronavirus (SARS‐CoV), Middle East respiratory syndrome coronavirus (MERS‐CoV), Nipah virus and Hendra virus. In this study, consensus primer‐based reverse transcriptase polymerase chain reactions (RT‐PCRs) and high‐throughput sequencing were performed to investigate viruses in bat faecal samples collected at 11 natural bat habitat sites from July to December 2015 in Korea. Diverse coronaviruses were first detected in Korean bat faeces, including alphacoronaviruses, SARS‐CoV‐like and MERS‐CoV‐like betacoronaviruses. In addition, we identified a novel bat rotavirus belonging to group H rotavirus which has only been described in human and pigs until now. Therefore, our results suggest the need for continuing surveillance and additional virological studies in domestic bat.

Pandemic influenza virus, pH1N1, induces asthmatic symptoms via activation of innate lymphoid cells

BACKGROUND

The pandemic strain of the influenza A virus (pH1N1) in 2009 caused many complications in patients. In this study, we introduce asthmatic symptoms as a complication of pH1N1 infection in children, not having a relationship with asthma history. The aim of this study was to quantify asthmatic symptoms in pH1N1-infected children and elucidate the underlying mechanisms of airway hyper-responsiveness (AHR) induced in a murine model of pH1N1 infection.

METHODS

As a retrospective study, pH1N1-infected children who were hospitalized with moderate to severe acute asthmatic symptoms were enrolled and administered a methacholine challenge test (MCT) at 3 months post-discharge. Additionally, the induction of AHR by pH1N1 infection was measured by MCT in wild-type and Rag1(-/-) mice. The effect of the innate immune response on the development of AHR following pH1N1 infection was investigated.

RESULTS

More than 70% of the pH1N1-infected children without a pre-infection diagnosis of asthma had a negative response on the MCT. None of these children had recurrent wheezing or asthma during the 3 years following pH1N1 infection. The development of AHR in pH1N1-infected mice was associated with an elevation in IL-33 and innate lymphoid cells 2 (ILC2).

CONCLUSIONS

This study demonstrates that pH1N1 infection directly induces transient asthmatic symptoms in patients regardless of their medical history. pH1N1 infection was shown to stimulate the rapid development of AHR and Th2-type cytokine secretion in mice via the activation of ILC2; it may be activated independently of adaptive immunity.

Microarray analysis of differentially expressed genes in the liver between Bai'er layers and broilers

In this study, we profiled gene expression in chicken liver and screened differentially expressed genes in the Bai'er layers and fat line broilers. Birds were derived from the 14th generation of Northeast Agricultural University fat broiler lines and Bai'er layers. Chicken genome arrays were used to screen differentially expressed genes in liver tissue from the Bai'er layers and fat line broilers. We screened 671 differentially expressed genes between broilers and layers at the ages of 2 and 4 weeks. We observed enrichment of a series of significant pathways, including the mitogen-activated protein kinase signaling pathway, cell cycle, mammalian target of rapamycin signaling pathway, and p53 signaling pathway. At 2 and 4 weeks, 94 shared differentially expressed genes were observed. We speculated that these genes regulate chicken lipid metabolism.

Differentially expressed genes in the liver of lean and fat chickens

This study aimed to investigate gene expression in the chicken liver for lean and fat broiler lines. Birds used in this study were 2 and 4 weeks of age; they were derived from the 14th generation of Northeast Agricultural University broiler lines, which were divergently selected based on abdominal fat content. Chicken Genome Arrays were used to screen differentially expressed genes in the liver tissue from lean and fat birds. At 2 and 4 weeks of age, 770 and 452 genes were differentially expressed between the 2 lines, respectively. The differentially expressed genes were involved in Wnt, insulin signaling, and cell cycle pathways. At 2 and 4 weeks, 42 shared, differentially expressed genes were revealed by the analysis. We speculate that these genes might regulate chicken lipid metabolism.

Application of the modified clavien classification system to 402 cases of holmium laser enucleation of the prostate for benign prostatic hyperplasia

PURPOSE

We attempted to evaluate the perioperative complications of holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia by using the modified Clavien classification system (MCCS).

MATERIALS AND METHODS

Targeting 402 patients who underwent HoLEP for benign prostatic hyperplasia performed by a single surgeon between July 2008 and January 2011, we investigated complications that occurred during and within 1 month after surgery and classified them into grade I to grade V on the basis of the MCCS. If two or more complications occurred in one patient, each complication was graded and counted.

RESULTS

The mean age, prostate volume, operation time, hospital stay, and average follow-up period of 402 patients who underwent HoLEP were 68.8 years (range, 52-84 years), 53.2 g (range, 23-228 g), 58.2 minutes (range, 20-230 minutes), 4.5 days (range, 2-7 days), and 9 months (range, 4-27 months), respectively; 78 complications occurred in 71 of the patients (morbidity rate, 17.6%). In MCCS grade I, complications occurred in 54 cases (69.2%); in grade II, complications occurred in 19 cases (24.3%); in grade III, complications occurred in 4 cases (5.1%); and in grade IV, 1 patient required intensive care unit care because of cerebral infarction (1.2%). There were no grade V complications.

CONCLUSIONS

The HoLEP-based MCCS complications classification was performed very quickly. However, MCCS, when compared with other measures of endoscopic prostate surgery experiences, including HoLEP, exposed the lack of accuracy in low grade classification and the inability to include late complications.

Holmium laser enucleation of the prostate: modified morcellation technique and results

PURPOSE

We developed an inverse technique for tissue morcellation by modifying the conventional upward technique and then examined its safety and efficiency.

MATERIALS AND METHODS

From July 2008 to December 2010, a total of 389 consecutive patients treated with holmium laser enucleation of the prostate (HoLEP) were enrolled in this study. For tissue morcellation, we used an upward technique for an initial series of 84 patients and an inverse technique for a consecutive series of 305 patients. We compared efficiency and safety between the inverse technique and the upward technique.

RESULTS

There were no significant differences in mean age or prostate volume between the two groups. The mean morcellation efficiency was higher in the inverse technique group. The incidence of severe bladder injury was significantly higher in the upward technique group. Regarding the site of bladder injury, 7 and 4 cases of bladder injury occurred in the bladder dome and posterior wall, respectively, in the upward technique group. In the inverse technique group, however, the site of bladder injury was limited to the trigone. We divided our clinical series of patients into the upward technique group and three inverse technique groups on the basis of the timing. The mean morcellation efficiency was significantly higher in all three inverse technique groups than in the upward technique group. However, there was no significant difference in mean morcellation efficiency between the three inverse technique groups.

CONCLUSIONS

In conclusion, the inverse technique might be a more effective, safer, and more excellent method of morcellation than the conventional upward technique.

Prognostic value of body mass index in korean patients with castration-resistant prostate cancer

Purpose

We investigated the correlation between body mass index (BMI) and the prognosis of castration-resistant prostate cancer (CRPC) in patients who received docetaxel treatment.

Materials and Methods

A retrospective study was conducted of 55 patients who were diagnosed with CRPC and received docetaxel treatment between 2003 and 2009 at our institution. Patients with a normal or lower BMI (<23.0 kg/m²) were categorized as group I and patients with an overweight or greater BMI (≥23.0 kg/m²) were categorized as group II. Clinicopathological features and survival rates were evaluated by using the Kaplan-Meier method and Cox proportional hazards models.

Results

On the basis of BMI, 27 patients (49.1%) belonged to group I and 28 (50.9%) patients belonged to group II. Mean follow-up periods were 30 months and 34.2 months, respectively (p=0.381). There were no significant differences between the two groups in terms of age, prostate-specific antigen (PSA), Gleason score, Eastern Cooperative Oncology Group Performance Status, hemoglobin level, alkaline phosphatase level, distant metastasis, radiation treatments, or performance of radical prostatectomy (p>0.05). In the univariate analysis for predicting survival rates, BMI (p=0.005; hazard ratio [HR], 0.121), logPSA (p=0.044; HR, 2.878), and alkaline phosphatase level (p=0.039; HR, 8.582) were significant factors for prediction. In the multivariate analysis, BMI (p=0.005; HR, 0.55), logPSA (p=0.008; HR, 7.836), Gleason score (p=0.018; HR, 6.434), hemoglobin (p=0.006; HR, 0.096), alkaline phosphatase level (p=0.005; HR, 114.1), and metastasis to the internal organs (p=0.028; HR, 5.195) were significant factors for prediction.

Conclusions

Better effects on the cancer-specific survival rate were observed in cases with higher BMI.

Cervical thymic cyst presenting as a possible cystic nodal metastasis of papillary carcinoma in a 53-year-old man

Cervical thymic cysts are rare embryonic remnants that develop along the course of thymic migration in the neck. They usually occur during infancy and childhood, and they are extremely rare in adults. We report a case of cervical thymic cyst in a 53-year-old man. The patient presented with a small mass of the thyroid gland and a cystic mass at the left level II area of the neck. On histopathology, the thyroid mass was identified as a papillary carcinoma and the left-sided neck mass was diagnosed as a cervical thymic cyst lined with nonkeratinizing, flattened squamous epithelium. The cyst wall contained atrophic thymic tissue composed of lymphoid cells, epithelial cords, and Hassall corpuscles. Although it is rare, cervical thymic cyst should be considered in the differential diagnosis of a lateral cystic neck mass in an adult.

Interval from Prostate Biopsy to Robot-Assisted Laparoscopic Radical Prostatectomy (RALP): Effects on Surgical Difficulties

Purpose

Traditionally, an interval of 4 to 6 weeks has been recommended after prostate biopsy before open radical prostatectomy. However, such an interval is not explicitly specified in robot-assisted laparoscopic radical prostatectomy (RALP). This study was designed to determine whether the interval from prostate biopsy to RALP affects surgical difficulties.

Materials and Methods

Between January 2008 and May 2009, a total of 237 men underwent RALP in our institution. The interval from biopsy to RALP was categorized as follows: ≤ 2 weeks, >2 to ≤ 4 weeks, >4 to ≤ 6 weeks, >6 to ≤ 8 weeks, and >8 weeks. Multivariate analysis was used to identify whether the interval from prostate biopsy to RALP was an independent predictor of operative time, estimated blood loss (EBL), margin positivity, continence, and potency.

Results

Among the 5 groups, there were no significant differences in age, body mass index (BMI), preoperative serum prostate-specific antigen (PSA), prostate volume, or preoperative International Index of Erectile Dysfunction-5 score (all p>0.05). In the multivariate analysis, operative time was significantly associated with prostate volume. EBL was associated with prostate volume and BMI. Margin positivity was associated with preoperative serum PSA, prostate volume, and biopsy Gleason score. Postoperative continence and potency were significantly associated with age. However, in univariate and multivariate analyses, the interval from biopsy to RALP was not significantly associated with operative time, EBL, margin positivity, postoperative continence, or potency (all p>0.05).

Conclusions

Our data suggest that the interval from prostate biopsy to RALP is not related to surgical difficulties.

Are there risk factors for persistent urge urinary incontinence after the transobturator tape (TOT) procedure in mixed urinary incontinence?

Purpose

We wanted to identify factors predicting persistent urge urinary incontinence (UUI) after the transobturator tape (TOT) procedure in patients with mixed urinary incontinence (MUI).

Materials and Methods

Of 293 patients who underwent a TOT procedure from May 2007 to August 2010, 175 MUI patients had at least one 6-month follow-up visit. Preoperative evaluations including history taking, physical examination, urinalysis, urine culture, uroflowmetry, postvoid residual (PVR), urodynamic studies (UDS), and symptom questionnaire were performed. After the operation, surgical outcome and patient satisfaction were assessed by symptom questionnaire, uroflowmetry, PVR, and stress test. Statistical analysis was carried out to determine the possible factors influencing persistent UUI after the TOT procedure.

Results

Of 175 patients with MUI, 51 (29.1%) had persistent UUI after the TOT procedure. In a univariate analysis, age (p=0.012) and previous anticholinergic use (p=0.040) were found to be associated with persistent UUI. However, only age (adjusted odds ratio, 3.317; 95% confidence interval, 1.015-12.060; p=0.036) was an independent risk factor in the multivariate analysis.

Conclusions

Our findings suggested that women who are older than 65 years may have an increased likelihood of persistent UUI after a TOT procedure. Clinicians should consider the possibility of persistent postoperative UUI in elderly women with mixed incontinence.

Prognostic associations of clinical and histopathological features in renal amyloidosis

AIM

This retrospective study was conducted to assess the relationship between renal functional parameters and histolopathological findings in patients with renal amyloidosis.

METHODS

A total of 40 patients with biopsy-proven renal amyloidosis, which was diagnosed at the Department of Pathology, Hanyang University Hospital, between 1986 and 2010, were investigated. Renal biopsy specimens were evaluated in various histochemical and immunohistochemical stains using light, immunofluorescence and electron microscopes, and renal function was determined by estimated glomerular filtration rate (eGFR) (ml/min/1.73 m(2)) using the method proposed by the Modification of Diet in Renal Disease study. Glomerular amyloid deposits were classified into four groups: none, mild, segmental and diffuse types. The vascular, tubular and interstitial deposits were subdivided into the negative and positive groups.

RESULTS

In simple regression analysis, 24-hour protein excretion, serum blood urea nitrogen and eGFR were found to significantly correlate with the increased extent of glomerular amyloid deposit. In multiple regression analysis, a decrease in eGFR was significantly associated with an increase in glomerular amyloid deposits (p=0.024), but there was no significant correlation with an increase in 24-hour protein excretion and blood urea nitrogen (p=0.119 and 0.184, respectively).

CONCLUSION

The results of this study demonstrate that the increased extent of glomerular amyloid deposits may be associated with the decline of GFR in patients with renal amyloidosis.

Polymorphisms of XRCC1 gene and risk of gastric cardiac adenocarcinoma

X-ray repair cross complementing 1 (XRCC1) protein plays an important role in base excision repair. Single nucleotide polymorphisms (SNPs) in XRCC1 gene may affect DNA repairing ability and genetic susceptibility to cancer. This study was designed to investigate the correlation of XRCC1 Arg194Trp Arg280His and Arg399Gln SNPs with the risk of gastric cardiac adenocarcinoma (GCA). Genotypes were analyzed by polymerase chain reaction-restriction fragment length polymorphism assay in 455 patients with GCA and 650 age and sex-matched controls. We did not find any significant difference in allele and genotype distributions of Arg194Trp Arg399Gln between the groups (P > 0.05). However, a significant increase in GCA risk was seen among smokers if they carried at least one XRCC1 280His (Arg280His + His280His) genotype (odds ratio = 1.59, 95%confidence interval = 1.01-2.51) compared with smokers not carrying these genotype. Our results indicated that XRCC1 Arg194Trp and Arg399Gln SNPs might not be associated with the risk of GCA. However, smokers with His allele at codon 280 had a significantly increased risk of GCA.

Dumbbell shaped exophytic and endobronchial lipomatous hamartoma

A 63-year-old man presented with a dumbbell-shaped mass obstructing his left upper lobe. He underwent a left upper lobectomy for suspected malignancy. An unexpected pathological diagnosis of endobronchial lipomatous hamartoma was made. Only 6 other cases have been reported in the English literature and only two cases were both endobronchial and exophytic.

Reduced expression of Apaf-1 in colorectal adenocarcinoma correlates with tumor progression and aggressive phenotype

BACKGROUND

Apoptotic protease activating factor-1 (Apaf-1) is one of the key regulators in the mitochondrial apoptotic pathway, and the loss of Apaf-1 leads to cellular resistance against the apoptotic signals. We investigated the expression of Apaf-1 in colorectal tissues corresponding to the multistep carcinogenesis model to determine correlations between the clinicopathologic characteristics and the expression of this molecule and to evaluate the role of Apaf-1 in the development and progression of colorectal adenocarcinoma.

METHODS

Immunohistochemistry for Apaf-1 was performed on the tissue microarray of 38 normal mucosal tissues, 46 adenomatous polyps, 529 colorectal adenocarcinomas, and 76 metastatic tumors.

RESULTS

Normal colonic mucosa tissues and adenomas were positive for Apaf-1 with no exceptions (100%). However, in colorectal adenocarcinomas, 119 of 529 cases (22.5%) were positive and 410 cases (77.5%) were negative. Moreover, 67 of 76 metastatic cases (88.2 %) were negative and only nine cases (11.8%) were positive for Apaf-1 expression. In the analyses between Apaf-1 expression and clinicopathologic parameters, reduced expression of Apaf-1 correlated with left colon location (p < 0.001), deeper tumor invasion (p < 0.001), frequent lymph node metastasis (p = 0.021), higher American Joint Committee on Cancer (AJCC) and Dukes' stage (p = 0.02 and p = 0.001, respectively) and poorer differentiation (p < 0.001). The patient survival was significantly associated with age, histological grade, AJCC stage, and lymphovascular invasion, but not Apaf-1 expression (p = 0.478).

CONCLUSIONS

The results suggest that the loss of Apaf-1 expression is a relatively frequent late event and the loss of Apaf-1 expression may play an important role in tumorigenesis and tumor progression in colorectal adenocarcinoma.

p16(CDKN2) gene polymorphism: association with histologic subtypes of epithelial ovarian cancer in China

p16 is an important tumor suppressor gene, which is inactivated in many kinds of tumors. The common variants of p16 may be associated with the risk of certain tumors development. We analyzed the frequency of two adjacent polymorphisms in p16 exon 3 (540C-->G and 580C-->T) and their haplotype in blood samples from epithelial ovarian cancer (EOC) patients and healthy controls using polymerase chain reaction-restriction fragment length polymorphism. The results showed that the genotype frequency of p16 580C-->T polymorphism was significantly different among histologic subtypes of EOC (P= 0.02). T allele carriers significantly reduced the risk of serous EOC; the adjusted odds ratio was 0.40 (95% CI = 0.19-0.84). There are neither association between p16 540C-->G polymorphism and EOC development, progression, nor association between the haplotypes of two single nucleotide polymorphisms and the tumor development. Our results suggested that the p16 580C-->T polymorphism might affect the individual susceptibility to specific subtypes of EOC. Different types of ovarian cancer might adopt distinct carcinogenetic pathways. However, this result may be further validated in a larger sample of patients.