Designing Thin, Ultrastretchable Electronics with Stacked Circuits and Elastomeric Encapsulation Materials.

Many recently developed soft, skin-like electronics with high performance circuits and low modulus encapsulation materials can accommodate large bending, stretching, and twisting deformations. Their compliant mechanics also allows for intimate, nonintrusive integration to the curvilinear surfaces of soft biological tissues. By introducing a stacked circuit construct, the functional density of these systems can be greatly improved, yet their desirable mechanics may be compromised due to the increased overall thickness. To address this issue, the results presented here establish design guidelines for optimizing the deformable properties of stretchable electronics with stacked circuit layers. The effects of three contributing factors (i.e., the silicone inter-layer, the composite encapsulation, and the deformable interconnects) on the stretchability of a multilayer system are explored in detail via combined experimental observation, finite element modeling, and theoretical analysis. Finally, an electronic module with optimized design is demonstrated. This highly deformable system can be repetitively folded, twisted, or stretched without observable influences to its electrical functionality. The ultrasoft, thin nature of the module makes it suitable for conformal biointegration.

A comparison of epididymectomy with vasectomy reversal for the surgical treatment of postvasectomy pain syndrome.

PURPOSE: To compare the outcome of epididymectomy and vasectomy reversal (VR) in patients with postvasectomy pain syndrome (PVPS) who required surgical treatment. METHODS: A total of 50 patients with PVPS who underwent epididymectomy or VR between January 2000 and January 2010 were included retrospectively. Of these, 36 (72.0%) patients completed the study questionnaire. These 36 patients completed the questionnaire either during attendance at the outpatient clinic or during a telephone interview. Twenty patients (22 cases) underwent epididymectomy, and sixteen patients (17 cases) underwent VR. Analyses were performed for (1) preoperative clinical findings, (2) preoperative and postoperative visual analogue pain scale (VAPS) scores, (3) patency and pregnancy rate in VR group, and (4) patient satisfaction with surgical treatment. RESULTS: The mean age was 48.28 ± 11.27 years, and the mean period of follow-up was 3.58 years (0.15-10.03). The mean VAPS score was 6.78 ± 0.93 preoperatively and 1.13 ± 0.72 postoperatively (p < 0.001). The difference in the mean preoperative and postoperative VAPS scores was 6.00 ± 1.34 (3-8) in the epididymectomy group and 5.50 ± 1.03 (4-8) in the VR group. However, this difference was not statistically significant (p = 0.227). No significant difference in satisfaction with surgical outcome was observed between the epididymectomy and the VR groups (p = 0.124). CONCLUSIONS: In PVPS patients requiring surgical treatment, no significant difference was observed between the epididymectomy and VR groups in either the reduction in pain or the degree of patient satisfaction with surgical outcome. Selection of the optimal surgical procedure may be dependent on specific patient characteristics.

The effects of α-defensin 1 on electrical field stimulation-induced contraction of rat bladders.

This study was designed to investigate the effects of α-defensin 1 on electrical field stimulation (EFS)-induced contractions in isolated rat bladder detrusor muscles. We evaluated the effects of α-defensin 1 (50 pM∼5 nM) on EFS-induced contractions in the detrusor smooth muscles from 35 rats (2-30 Hz). Bladder strips were pretreated with α-defensin 1 and then changes of contractions by adenosine 5'-triphosphate (ATP) were observed. Moreover, after pretreatment with α-defensin 1 for 10 min, changes in concentration-response curves to hydrogen peroxide (H2O2) were investigated. Alpha-defensin 1 has increased EFS-induced contractions, significantly, and the contractile response to ATP (1,2,5,10mM) was also increased significantly when strips were pretreated with α-defensin 1. In addition, alpha-defensin 1 increased H2O2-induced contractions. The present study demonstrates that α-defensin 1 increases EFS-induced contractions of rat detrusor muscles via purinergic contraction coupled with the Rho kinase pathway.

Efficacy and safety of solifenacin to treat overactive bladder symptoms in patients with idiopathic normal pressure hydrocephalus: an open-label, multicenter, prospective study.

AIMS: To evaluate the efficacy and safety of solifenacin 5 mg to treat voiding symptoms caused by idiopathic normal pressure hydrocephalus (iNPH) after a ventriculoperitoneal (V-P) shunt operation. METHODS: A total of 53 patients diagnosed with iNPH and complaining of voiding symptoms were enrolled. Before treatment with solifenacin (V1), 4 (V2) and 12 (V3) weeks after starting solifenacin overactive bladder symptom score (OABSS), the International Prostate Symptom Score (IPSS), Quality of Life (QoL) score, maximal urine flow rate (Q(max) ), voided volume, and post-voiding residual urine volume (PVR) were measured. An urodynamic study (UDS) was performed at V1 and V3, and the safety of solifenacin was assessed at V1, V2, and V3. RESULTS: Of the 53 patients, 38 patients (71.70%) completed the 12-week clinical trial. The mean patient age was 52.24 ± 10.08 years. OABSS and IPSS were significantly improved. The mean voided volume was 147.18 ± 61.84 ml at V1 and 160.03 ± 62.59 ml at V3 (P < 0.001), and PVR was 64.87 ± 41.11 ml at V1 and 69.05 ± 39.54 ml at V3 (P = 0.009). Of the 31 patients who underwent UDS, 26 patients (83.87%) had detrusor overactivity (DO) at V1, with a mean value of 107.67 ± 18.13 ml. Of the 26 with DO at V1, 22 (84.62%) still had DO at V3. A mean DO of 131.66 ± 15.27 ml was observed at V3 (P < 0.001). The most common adverse effects was dry mouths. CONCLUSIONS: Solifenacin is effective in the treatment of OABS in iNPH patients who underwent the V-P shunt operation. Solifenacin increases bladder capacity causing of DO at UDS.

A predictive factor in overactive bladder symptoms improvement after combined anterior vaginal wall prolapse repair: a pilot study.

PURPOSE: We aimed to determine whether a preoperative urodynamic parameter is a valuable predictor for the persistence of OAB symptoms after the AVP repair. MATERIALS AND METHODS: 65 OAB patients with concomitant POP-Q stage III, IV anterior vaginal wall prolapse underwent a surgical repair were involved. All the patients were subjected to a preoperative urodynamic study, for whom the OABSS on questionnaire were preoperatively recorded. We firstly analyzed the correlation between the BOOI and the OABSS, then randomly divided patients into two groups: the group A (high PdetQmax, BOOI≥20) and the group B (low PdetQmax, BOOI<20). In each group, the OABSS was repeatedly measured post-operatively and the change were analyzed. RESULTS: 31 patients were classified as the group A and 34 patients were classified as the group B. The group B showed significant decrease of symptom score in daytime frequency (p<0.01), urgency (p=0.04), urge incontinence (p=0.03), nocturnal frequency (p=0.01) and total score (p=0.01). The group A showed no significant decrease of symptom score in daytime frequency (p=0.42), urgency (p=0.61), urge incontinence (p=0.3), total score (p=0.15) except nocturnal frequency (p=0.01). CONCLUSIONS: A preoperative pressure-flow study can be a valuable tool in predicting the OAB symptoms change after the combined AVP repair. While the AVP repair leads to the improvement of OAB symptoms generally, some patients with a higher preoperative PdetQmax are still in need of the additional medical treatment.

A novel pathway underlying the inhibitory effects of melatonin on isolated rat urinary bladder contraction.

The aim of the present study was to elucidate the direct effects of melatonin on bladder activity and to determine the mechanisms responsible for the detrusor activity of melatonin in the isolated rat bladder. We evaluated the effects of melatonin on the contractions induced by phenylephrine (PE), acetylcholine (ACh), bethanechol (BCh), KCl, and electrical field stimulation (EFS) in 20 detrusor smooth muscle samples from Sprague-Dawley rats. To determine the mechanisms underlying the inhibitory responses to melatonin, melatonin-pretreated muscle strips were exposed to a calcium channel antagonist (verapamil), three potassium channel blockers [tetraethyl ammonium (TEA), 4-aminopyridine (4-AP), and glibenclamide], a direct voltage-dependent calcium channel opener (Bay K 8644), and a specific calcium/calmodulin-dependent kinase II (CaMKII) inhibitor (KN-93). Melatonin pretreatment (10(-8)~10(-6) M) decreased the contractile responses induced by PE (10(-9)~10(-4) M) and Ach (10(-9)~10(-4) M) in a dose-dependent manner. Melatonin (10(-7) M) also blocked contraction induced by high KCl ([KCl](ECF); 35 mM, 70 mM, 105 mM, and 140 mM) and EFS. Melatonin (10(-7) M) potentiated the relaxation response of the strips by verapamil, but other potassium channel blockers did not change melatonin activity. Melatonin pretreatment significantly decreased contractile responses induced by Bay K 8644 (10(-11)~10(-7) M). KN-93 enhanced melatonin-induced relaxation. The present results suggest that melatonin can inhibit bladder smooth muscle contraction through a voltage-dependent, calcium-antagonistic mechanism and through the inhibition of the calmodulin/CaMKII system.

Single-port transvesical enucleation of the prostate for benign prostatic hyperplasia with severe intravesical prostatic protrusion.

OBJECTIVES: To introduce the surgical techniques of a single-port transvesical enucleation of the prostate (STEP) for enlarged prostates with severe intravesical prostatic protrusion (IPP) presenting with lower urinary tract symptoms (LUTS). PATIENTS AND METHODS: Our study included 7 patients with prostates larger than 80 mL and with severe IPP who underwent STEP. All the procedures were performed using a home-made single-port device through a 3-cm midline incision at the level three fingerbreadths above the symphysis pubis. Rigid laparoscopic instruments and Harmonic Scalpels(®) were used to enucleate the large adenoma of the prostate. RESULTS: All the procedures were completed satisfactorily, with no intra and early postoperative complications. The mean resected prostatic weight was 54.14 ± 8.38 g, and the mean operative time was 191.86 ± 40.88 min. The mean time for catheterization was 5.29 ± 1.80 days. The postoperative 3-month international prostate symptoms score (IPSS) and maximal flow rate (Qmax) were improved following STEP (IPSS; 23.57 ± 2.15 vs. 11.43 ± 2.44, Qmax; 17.14 ± 3.44 mL/s vs. 6.71 ± 2.29 mL/s). CONCLUSIONS: Laparoendoscopic single-site surgery (LESS) and enucleation of the prostate with rigid laparoscopic instruments might be difficult but is feasible. STEP may be a new treatment option for use in open prostatectomies for enlarged prostates with severe IPP in carefully selected patients.

Comparative Analysis of the Efficacy and Safety of Conventional Transurethral Resection of the Prostate, Transurethral Resection of the Prostate in Saline (TURIS), and TURIS-Plasma Vaporization for the Treatment of Benign Prostatic Hyperplasia: A Pilot Study.

PURPOSE: This study was conducted to perform a comparative analysis of the efficacy and safety of conventional transurethral resection of the prostate (TUR-P), transurethral resection in saline (TURIS), and TURIS-plasma vaporization (TURIS-V) when performed by a single surgeon for benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: The clinical data of 73 consecutive men who underwent conventional TUR-P (39), TURIS (19), or TURIS-V (15) for BPH were retrospectively analyzed. All procedures were carried out by a single surgeon between October 2007 and April 2010. The patients were assessed preoperatively and perioperatively and were followed at 1, 3, and 6 months postoperatively. Patient baseline characteristics, perioperative data, and postoperative outcomes were compared, and major complications were recorded. RESULTS: In all groups, significant improvements in subjective and objective voiding parameters were achieved and were sustained throughout follow-up. TURIS-V had the shortest operation time compared with conventional TUR-P and TURIS (p=0.211). TURIS-V significantly decreased procedural irrigation fluid volume, postoperative irrigation duration, catheter duration, and hospital stay compared with conventional TUR-P and TURIS. There were no significant differences between the groups in hemoglobin levels or serum sodium levels before and after the operations. There were three transfusions and four clot retentions in the TUR-P group, and one transfusion and one clot retention in the TURIS group. The TURIS-V group had no complications. CONCLUSIONS: TURIS and TURIS-V were effective for the surgical treatment of BPH in addition to conventional TUR-P. TURIS-V was not inferior to conventional TUR-P or TURIS in terms of safety.

HNF1B polymorphism associated with development of prostate cancer in Korean patients.

OBJECTIVE: To identify whether the genetic variations in HNF1B are associated with the development of prostate cancer in Korean patients. Genome-wide association studies have found the HNF1B gene at 17q12 to be a major causal gene for the risk of prostate cancer. METHODS: We evaluated the association of 47 single nucleotide polymorphisms (SNPs) in the HNF1B gene with prostate cancer risk and clinical characteristics (Gleason score and tumor stage) in Korean men (240 case subjects and 223 control subjects) using unconditional logistic regression analysis. RESULTS: Of the 47 SNPs, 14 were associated with prostate cancer risk (P = .002-.02); 9 SNPs were associated with a lower risk of prostate cancer (odds ratio 0.67-0.71, P = .005-.05), and 5 SNPs were associated with a greater risk of disease (odds ratio 1.49-1.51, P = .002-.02). In an analysis involving only patients with prostate cancer, 1 SNP (rs11868513) in the HNF1B gene was more frequent in patients with tumors with a greater stage than in those with a lower tumor stage. Two SNPs (rs4430796 and rs2074429) and 1 haplotype (Block3_ht1) were more frequent in patients with Gleason score of ≥7 than in those with Gleason score <6. CONCLUSION: As in studies from other populations, our findings indicate that HNF1B is also associated with prostate cancer risk in the Korean population.

Laparoendoscopic single-site ureterolithotomy for upper ureteral stone disease: the first 30 cases in a multicenter study.

PURPOSE: We evaluated the usefulness of laparoendoscopic single-site (LESS) ureterolithotomy with a homemade single port device for upper ureteral stones in patients in whom previous shockwave lithotripsy or ureteroscopic stone surgery had failed or the stone was suspected to be impacted. PATIENTS AND METHODS: LESS ureterolithotomy was performed on 30 patients by using a homemade single port device composed of an Alexis wound retractor and surgical glove. The mean age of the patients was 42.47±11.15 years (range 24-65 y), and the male-to-female ratio was 13:17. The mean stone diameter was 1.77±0.47 cm. One patient underwent a bilateral operation for bilateral ureteral stones. RESULTS: The LESS surgery was converted to conventional laparoscopic surgery in one case. The mean operative time was 110.43±43.75 minutes. The mean length of hospital stay was 3.40±1.54 days. None of the patients used patient-controlled anesthesia, and none presented with major complications. The visual analog pain scale score improved significantly by postoperative day 7 (from 6.87±1.61 preoperatively to 1.67±1.16; P<0.001), and 28 (93.3%) patients said they were satisfied with the postoperative outcome. Postoperative radiologic evaluation revealed that the stones had been removed completely in 28 cases. There were no cases of urinary leakage. CONCLUSION: LESS ureterolithotomy using a homemade single port device can be considered to be a feasible and safe alternative to conventional laparoscopic ureterolithotomy.

Efficacy of epididymectomy in treatment of chronic epididymal pain: a comparison of patients with and without a history of vasectomy.

OBJECTIVES: To evaluate the surgical outcome in, and satisfaction with treatment of, patients undergoing epididymectomy for postvasectomy pain syndrome. METHODS: A total of 49 patients were included. All participants had undergone epididymectomy for chronic epididymal pain from January 2000 to June 2009. Of the 49 patients, 4 had undergone bilateral epididymectomy, and the total number of procedures was 53: 18 in patients with postvasectomy pain syndrome (group 1, n = 16), 21 in patients with chronic epididymitis and no history of vasectomy (group 2, n = 19), and 14 in patients with an epididymal cyst and no history of vasectomy (group 3, n = 14). The preoperative and postoperative pain scale scores and surgical outcome were analyzed. RESULTS: For the total patient sample, the mean age was 52.91 ± 13.51 years, and the mean body mass index was 24.10 ± 3.22 kg/m(2). The mean duration of pain was 1.3 years (range 0.25-20), and the mean duration of postoperative follow-up was 4.2 years (range 0.05-10.25). The mean preoperative pain score was 6.91 ± 0.97. The mean postoperative pain scale score was 1.92 ± 1.54 (P < .01). Statistically significant differences in the preoperative and postoperative pain scores were found for each group: group 1, 5.38 ± 1.47 (range 3-8); group 2, 4.10 ± 1.41 (range 2-6), and group 3, 5.21 ± 1.88 (range 2-8; P = .004). In group 1, excellent surgical outcomes and high patient satisfaction were reported for 94.5% (17 of 18) of the procedures performed. CONCLUSIONS: The results of our study have shown that epididymectomy is more effective in patients with a history of vasectomy than in those without.

NS-398 (a selective cyclooxygenase-2 inhibitor) decreases agonist-induced contraction of the human ureter via calcium channel inhibition.

PURPOSE: Recently, it has been demonstrated that ureteral obstruction is associated with increased cyclooxygenase (COX)-2 expression and that selective COX-2 inhibitors provide potent analgesia with fewer side effects in patients with ureteral stones. Moreover, selective COX-2 inhibitors have been shown to decrease in vitro contractility of the human ureter. We aimed at evaluating the effects of the selective COX-2 inhibitor NS-398 on human ureteral smooth muscle contractility and compare its potency with that of nonselective COX inhibitors, COX-1 inhibitors, and other COX-2 inhibitors. MATERIALS AND METHODS: Ureteral samples were obtained from human adult subjects undergoing radical nephrectomy. After isolating the upper ureteral strips, we analyzed the contractile responses of the ureteral strips to high potassium (KCl 35 mM) and Bay K 8644 and the relaxation responses of a nonspecific COX inhibitor (indomethacin), a COX-1 inhibitor (SC-560), and a COX-2 inhibitor (NS-398 and celecoxib) to KCl and Bay K 8644-induced contraction by measuring isometric tension. RESULTS: NS-398 produced dose-dependent (10⁻9-10⁻5 M) relaxation of KCl (35 mM)-precontracted strips of the ureter, whereas indomethacin (10⁻8-10⁻5 M) and SC-560 (10⁻9-10⁻5 M) did not. Both tonic and phasic contraction of Bay K 8644 (methyl-1,4-dihydro-2,6-dimethyl-3-nitro-4-2(trifluoromethylphenyl)pyridine-5-carboxylate) (1 µM) were significantly inhibited by NS-398 (10⁻5 M). Another selective COX-2 inhibitor, celecoxib, did not show potent inhibitory effects as strong as those of NS-398. CONCLUSIONS: We concluded that NS-398 reduces tonic or phasic contraction by inhibiting the action of voltage-dependent calcium channels. NS-398 has dual inhibitory effects with COX-2 inhibition on ureteral spasms due to renal or ureteral colic.

Relationship between insulin resistance, obesity and serum prostate-specific antigen levels in healthy men.

The purpose of this study was to determine the relationship between insulin resistance, obesity and serum prostate-specific antigen (PSA) levels in healthy men with serum PSA level below 4 ng mL(-1). The men included in the study cohort were 11 827 healthy male employees of the Korea Hydro and Nuclear Power Co., LTD who had undergone medical checkups including fasting glucose, fasting insulin and serum PSA between January 2003 and December 2008. Insulin resistance was calculated by homeostasis model assessment (HOMA [fasting glucose x fasting insulin]/22.5) and quantitative insulin sensitivity check index (QUICKI; 1/[log (fasting insulin) + log (fasting glucose)]). Age-adjusted body mass index (BMI) was significantly increased according to increasing quartile of insulin resistance as determined by HOMA and QUICKI, respectively, in analysis of variance (ANOVA) test and Duncan's multiple comparison test (P < 0.001), but age-adjusted serum PSA concentration was significantly decreased according to increasing quartile of insulin resistance as determined by HOMA and QUICKI (P < 0.001). Age, BMI, insulin resistance by HOMA or QUICKI were significantly independent variables to serum PSA level in a multivariate linear regression analysis (P < 0.001). Insulin resistance was a significant independent variable to serum PSA level along with BMI. Insulin resistance and BMI were negatively correlated with serum PSA level in healthy men. Insulin resistance was positively correlated with BMI.

Effect of low concentrations of hydrogen peroxide on the contractile responses of rat detrusor smooth muscle strips.

This study was designed to determine how the contractility of rat detrusor smooth muscle strips changes in the presence of low concentrations of hydrogen peroxide (H(2)O(2)). The strips were dissected from the base of Sprague-Dawley rat bladders and their contractile responses to a cumulative increase in H(2)O(2) concentration (3 x 10(-6)-3 x 10(-2)g%) were measured. How the duration of exposure to the fixed concentration of 3 x 10(-4)g% H(2)O(2) affected contractility was also examined. Moreover, the effect of 3 x 10(-4)g% H(2)O(2) pretreatment on the response to cumulative increases in the concentrations of phenylephrine or acetylcholine (10(-8)-10(-4)M) was assessed. To elucidate the mechanism by which H(2)O(2) induced contraction, we examined the effect of pretreatment with 10nM Y-27632, 10 microM indomethacin, 10 microM SQ29548, 10 microM verapamil, 10 microM vitamin E, or 1 microM Bay-K 8644 on the contractile responses generated by cumulatively increasing the concentration of H(2)O(2). H(2)O(2)-induced contractile responses in Ca(2+)-free physiological solution were also examined. Low concentrations of H(2)O(2) increased the contractile responses of the strips in a dose-dependent manner but increasing treatment duration decreased these responses. H(2)O(2)-pretreatment significantly augmented the contraction induced by phenylephrine (P<0.05) but had no effect on the response to acetylcholine. Pretreatment with Y-27632, indomethacin, vitamin E, verapamil, and Bay-K 8644 significantly inhibited the H(2)O(2)-induced contraction (P<0.05). SQ 29548-pretreatment had no effect. H(2)O(2) could not increase the contractile responses in Ca(2+)-free physiological solution. Thus, low concentrations of H(2)O(2) may directly affect detrusor smooth muscles and thereby induce detrusor overactivity.

Modulation of human beta-defensin-2 expression by 17beta-estradiol and progesterone in vaginal epithelial cells.

We investigated the expression of HBD-1 and -2 in vaginal epithelial cells treated with lipopolysaccharide (LPS) and the effects on HBD-2 expressions by 17beta-estradiol and progesterone. Primary vaginal epithelial cells were isolated from a segment of normal anterior vaginal wall obtained during vaginoplasty and were cultured in keratinocyte growth medium and were allowed to undergo their 3rd passage. Expression of HBD-1 and -2 by different stimuli using LPS 0.5 microg/ml, 17beta-estradiol 2 nM and progesterone 1 microM was measured by RT-PCR, ELISA and real-time RT-PCR, respectively. HBD-1 was produced constitutively in vaginal epithelial cells and the production of HBD-1 was not influenced by LPS, 17beta-estradiol and progesterone, but the production of HBD-2 was increased inducibly by LPS. 17beta-Estradiol and progesterone did not change the production of HBD-2 in normal state, but 17beta-estradiol increased the production of HBD-2 and progesterone suppressed the production of HBD-2 under the circumstances with infection. The HBD-2 plays an important role at innate host defense on genitourinary tract. The lacks of estrogen during menopause or uses of a progesterone-based oral contraceptive in sexually active women may influence production of HBD-2 in vaginal epithelium and may increase susceptibility to bacterial vaginitis or recurrent UTI.

Association between metabolic syndrome and chronic kidney disease in the Korean population.

AIM: We performed a retrospective study to examine the association between the metabolic syndrome (MS)and risk for the development of chronic kidney disease (CKD). METHODS: This cohort study included 60 921 healthy adults recruited from two health promotion centres.Anthropometric measures, blood pressure, fasting glucose, lipid profile and serum creatinine were evaluated. The glomerular filtration rate was estimated (eGFR) using the abbreviated equation developed by the Modification of Diet in Renal Disease (MDRD) formula. CKD was defined as an eGFR of <60 mL/min per 1.73 m2 or the presence of proteinuria. RESULTS: The prevalence of MS and CKD was 19.0% and 7.2% respectively. Those with MS had a higher prevalence of CKD (11.0% vs 6.3%, P < 0.001) than those without MS. As the number of MS components increased, the prevalence of CKD increased and the eGFR decreased. The multiple linear analyses showed that each of the components of the MS was negatively correlated with the eGFR. Unadjusted and multivariate adjusted associations were identified between MS and CKD. Individuals with MS had a multivariate adjusted odds ratio of 1.680 (95% confidence interval, 0.566-1.801) for CKD compared with those without MS. CONCLUSION: Our findings, which were obtained from a large Korean cohort, suggest that MS was associated with CKD.

The effect of endothelin-1 on the production of interleukin-6 in cultured human detrusor smooth muscle cells, and the effect of interleukin-6 on the contractile response of bladder smooth muscle strips from rats.

OBJECTIVE: To determine the effect of endothelin-1 (ET-1) on the production of interleukin-6 (IL-6) in cultured human detrusor smooth muscle cells (HDSMCs) and the effect of IL-6 on the contractile response of bladder smooth muscle strips from rats. MATERIALS AND METHODS: The expression of IL-6 mRNA and production of IL-6 protein in cultured HDSMCs treated with the different concentrations of ET-1 were assayed by reverse transcriptase-polymerase chain reaction and specific enzyme-linked immunosorbent assay, respectively. The strips from Sprague-Dawley rats were either untreated or treated with 1 ng/mL of IL-6 for 60 min. Using increasing cumulative concentrations of acetylcholine (ACh), bethanechol (BCh), or sodium nitroprusside, we assessed the concentration-contraction or the relaxation responses. In cystitis-induced strips, change of contractions induced by noradrenaline (NA) with or without treatment of IL-6 were assessed. The IL-6-treated strips were incubated for 30 min in the presence or absence indomethacin or SQ29548, and then the effects on ACh- or BCh-induced contractions were measured. RESULTS: The expression of IL-6 mRNA and the production of IL-6 protein on the cultured HDSMCs pretreated by ET-1 were significantly higher than in the control (P<0.05). The ACh- and BCh-induced contractions were increased in the IL-6 pretreated strips from both dome and trigone, regardless of the presence of urothelium (P<0.05). The presence of cystitis augmented the NA-induced contractions (P<0.05). The contractions induced by ACh and BCh were inhibited by indomethacin and SQ29548. CONCLUSIONS: ET-1 induces expression of IL-6 mRNA and production of IL-6 protein on HDSMCs. IL-6 enhances detrusor smooth muscle contractility via the muscarinic or adrenergic receptor pathway.

The clinical significance in healthy men of the association between obesity related plasma hemodilution and tumor marker concentration.

PURPOSE: We investigated the association between body mass index and the concentration of tumor markers including carcinoembryonic antigen, alpha-fetoprotein, the carbohydrate antigen 19-9 and prostate specific antigen, as well as the association between body mass index changes and tumor marker concentration changes in a population of healthy men. MATERIALS AND METHODS: We evaluated data on 8,776 men screened for tumor markers (carcinoembryonic antigen, alpha-fetoprotein, carbohydrate antigen 19-9 and prostate specific antigen) at least 3 times annually during an annual examination from 2001 to 2007. We assessed the tumor marker test findings for a trend in the age, alanine aminotransferase and creatinine adjusted tumor marker concentration by body mass index. We used multivariate regression analysis to determine whether a change in body mass index was associated with a tumor marker concentration change over time using calculated tumor markers, body mass index, creatinine and alanine aminotransferase concentration change per year. RESULTS: After adjusting for age, creatinine and alanine aminotransferase a higher body mass index was associated with lower prostate specific antigen (p for trend <0.001), carcinoembryonic antigen (p for trend <0.001) and carbohydrate antigen 19-9 (p for trend <0.001). On multivariate regression analysis each 1 kg/m(2) of body mass index gain per year was associated with a -0.011 ng/ml change in prostate specific antigen concentration, a -0.030 ng/ml change in carcinoembryonic antigen concentration and a -0.192 IU/ml change in carbohydrate antigen 19-9 concentration per year. CONCLUSIONS: In this cohort of healthy men hemodilution from increased plasma volume may be responsible for the observed decreased tumor marker concentration in men with a higher body mass index. In addition, an increase in body mass index may predict a lower tumor marker concentration in an individual.

Relationship between serum prostate-specific antigen levels and components of metabolic syndrome in healthy men.

OBJECTIVES: To assess the correlation between age, body mass index, systolic and diastolic blood pressure (BP), triglycerides, high-density lipoprotein (HDL), and fasting blood glucose (FBG) and the serum prostate-specific antigen (PSA) level and to determine the significant factors for predicting the serum PSA level in men with a low risk of prostate cancer. METHODS: A total of 38 356 healthy male employees of the Korea Electric Power Corporation who were <60 years old and had a serum PSA level of <4 ng/mL were enrolled in this study from January 2002 to December 2006. Their BP, body weight, and body height were measured, and biochemical analyses of FBG, triglycerides, HDL, and serum PSA were performed. RESULTS: The mean age +/- standard deviation was 44.38 +/- 7.90 years; the mean serum PSA level was 0.89 +/- 0.51 ng/mL; and the incidence of metabolic syndrome was 25.8%. On univariate analysis, significant correlations were noted between the serum PSA level and body mass index, diastolic BP, HDL, and FBG (P < .05). Multiple logistic regression analyses using 4 percentiles (10th, 25th, 75th, and 90th percentile) of the serum PSA level revealed trends for a positive association between older age and diastolic BP and the serum PSA level. The body mass index, HDL, and FBG correlated negatively with the serum PSA level. CONCLUSIONS: These results suggest that the serum PSA level is significantly influenced by age and some components of the metabolic syndrome (obesity, diastolic BP, HDL, and FBG).

Association between serum prostate-specific antigen level, liver function tests and lipid profile in healthy men.

OBJECTIVE: To assess the association between serum prostate-specific antigen (PSA) level and age, liver function tests (LFTs) including alkaline phosphatase (ALP), total bilirubin (TB), lipid profile (total cholesterol, TC, triglycerides, TG, high-density lipoprotein, HDL) and fasting blood sugar (FBS), and to determine the significant factors for predicting the serum PSA level in men with a low risk of having prostate cancer. SUBJECTS AND METHODS: In all, 38 157 healthy male employees of the Korea Electric Power Corporation (KEPCO) who were aged <60 years and had serum PSA levels of <4 ng/mL and serum creatinine levels of <1.4 mg/dL were enrolled between January 2002 and December 2006. Body weight and height were measured, and levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), ALP, TB, FBS, TC, TG, and HDL, and serum PSA were measured. RESULTS: The mean (sd) age of the study population was 44.4 (7.90) years and the mean PSA level 0.89 (0.51) ng/mL. In a univariate analysis there were significant interrelations between serum PSA level and age, BMI, AST, ALT, ALP, TB, HDL and FBS (P < 0.05). The multiple logistic regression analyses using four percentiles (10th, 25th, 75th, 90th percentile) of serum PSA level showed trends that being older was associated with serum PSA level, and that BMI, ALT, HDL and FBS were negatively correlated with serum PSA level. CONCLUSIONS: These results suggest that serum PSA level was significantly influenced by age, BMI, ALT, HDL and FBS. Further studies are needed to confirm our results and to explain the underlying mechanisms.