[Efficacy of Neoadjuvant Endocrine Therapy for Prostate Ductal Carcinoma with Large Multiple Cysts Prior to Robot-Assisted Laparoscopic Radical Prostatectomy].

A 71-year-old man with gross hematuria and urinary retention showed a 7×8 cm polycystic mass compressing the prostate on the right ventral side on pelvic magnetic resonance imaging (MRI). The prostate specific antigen (PSA) level was 6.47 ng/ml. Prostate biopsy histopathology was consistent with prostate ductal carcinoma. Considering the difficulty of surgical therapy, endocrine therapy was undertaken prior to surgery for seven months. Almost all of the cyst disappeared ; robot-assisted laparoscopic radical prostatectomy was then successfully performed. Prostate ductal carcinoma is a relatively rare pathology for which radical prostatectomy plays an important role if the disease is localized. However, when ductal carcinoma involves large cysts, surgical treatment may be difficult. This report discusses the usefulness of neoadjuvant endocrine therapy to reduce the size of the cystic lesions.

Evaluation of physical activity in sarcopenic conditions of kidney transplantation recipients.

INTRODUCTION: Sarcopenia is an involuntary decline in skeletal muscle mass, strength, and function that normally proceed with aging but may develop faster under some chronic disease conditions. In this study, we compared the physical activity between sarcopenia and non-sarcopenia subgroups in kidney transplant recipients. METHODS: Fifty-eight recipients (42 males and 16 females) were enrolled in this study. Mean age of the recipients was 46.6 ± 12.7 years. Mean duration of dialysis was 2.8 ± 4.0 years. Diagnostic criteria for sarcopenia referred to those of the Asia Working Group for Sarcopenia. The physical activity was assessed using the International Physical Activity Questionnaire, and the intensity of physical activity was expressed in metabolic equivalents (MET). RESULTS: Based on the skeletal muscle mass index (SMI) as well as functional index (HGS, walking speed), the participants were classified into the three subgroups: 12 patients (20.7%) with sarcopenia (Group 1), 25 (43.1%) with presarcopenia (Group 2), and 21 (36.2%) non-sarcopenia (Group 3). Analysis with ANOVA and pairwise comparisons showed that physical activity measured as total MET-min/week was significantly greater in Group 2 (1292 ± 633) than in Group (1484 ± 262). Moreover, physical activity of Group 3 (2461 ± 1339)-min/week was significantly greater than those of Groups 1 and 2. CONCLUSIONS: Our data indicate that physical activity is restricted under presarcopenia and sarcopenia after kidney transplantation. Considering that the recipient age is now increasing, proper management of sarcopenia may become more crucial to improve the kidney survival and lifetime prognosis of the kidney transplant recipients.