bluuebunny/crossref_metadata_2025 huggingface dataset:
Label-free Quantitative Phosphoproteomics Reveals the Role of Beta-Estradiol in Sunitinib-Resistant Renal Cell Carcinoma Growth Via Perturbing Transforming Growing Factor-Beta Pathway
Authors: Ku Wei-Chi , Chen Shao-Kuan , Lin Chih-Ming , Tang Chin , Wang Yen-Chieh
Published: December 2021

Context:

Sunitinib is the first-line targeted therapy for metastatic renal cell carcinoma (RCC). However, resistance to sunitinib often occurred in patients receiving sunitinib treatment. On the other hand, 17-beta-estradiol (estrogen or E2) has been demonstrated to repress RCC growth in vitro, whether E2 can also affect the growth of sunitinib-resistant RCC remains unknown.

Aims:

In this study, the role of E2 in inhibiting sunitinib-resistant RCC growth and the underlining acting mechanisms was explored.

Settings and Design:

Sunitinib resistance was first induced in vitro in ACHN cells. The effect of E2 on cellular growth was then assayed. Label-free phosphoproteomics was also conducted.

Subjects and Methods:

ACHN cells were first challenged with 10-μM sunitinib up to 4 months to induce drug resistance. Then, E2 at different concentrations were tested in both parental and sunitinib-resistant ACHN cells. To conduct phosphoproteomics study, the total cell lysates from E2-treated ACHN cells were harvested, trypsin digested, and the phosphopeptides were enriched by Fe-IMAC.

Statistical Analysis Used:

For comparing the E2-induced cell growth inhibition, Student's t-test was used, and P < 0.05 was considered statistically significant. As for label-free phosphoproteomics, false discovery rate <0.01 and phosphosite possibility >0.75 were considered as positive identifications.

Results:

E2 at the physiological concentration, that is, 10 nM, can repress the cell growth in both parental and sunitinib-resistant ACHN cells. Further, label-free phosphoproteomics revealed that transforming growth factor beta (TGF-β) pathway, cell cycle, and cytoskeleton bindings were enhanced in sunitinib-resistant cells but can be reduced by E2 treatment. On the other hand, programmed cell death and apoptosis were repressed in sunitinib-resistant cells, and E2 at 10 nM did not reverse the effect. We further validated the expression of SMAD3, an important molecule in TGF-β pathway, and found that SMAD3 decreased in sunitinib-resistant cells but can be upregulated by E2 treatment.

Conclusions:

Our study demonstrated that E2 can inhibit the cell growth in sunitinib-resistant RCC cells at physiological concentration by upregulating SMAD3 in the TGF-β pathway, which may lead to growth inhibition in RCC.
A Lower Urine White Blood Cell Median Can be a Predictor of Undiscovered Urolithiasis in Patients with Acute Urinary Tract Symptoms
Authors: Chen Yuan , Liao Chun-Hou , Chiang Bing-Juin , Huang Hsu-Che , Chou Yu-Wei
Published: December 2021

Purpose:

Acute urinary tract infection (UTI) causes symptoms including urgency, frequency, dysuria, and pain in the lower urinary tract. However, these symptoms are not unique to infection. Urolithiasis, injury, neurological disease, and malignancy present with the same symptoms. We aimed to find predictors in urinalysis to detect underlying causes in patients with acute UTI symptoms.

Materials and Methods:

We recruited 192 patients who presented with acute UTI symptoms from a single institute between September 2012 and September 2018. Each patient received urinalysis, kidney–ureter–bladder X-ray, and kidney plus transabdominal bladder sonography as primary surveys. Patients with flank pain and hydronephrosis but without definitive radiopaque lesion received computed tomography (CT) scan as an advanced intervention. Cystoscopy was ordered by the physician if the patient had gross hematuria and was suspected to have intravesical lesion. We correlated the urine nitrate, the median of red blood cells (RBCs) and white blood cells (WBCs), and the ratio of red and WBCs with the finding on image studies, which included sonography, X-ray, and CT by statistical models.

Results:

In patients with urolithiasis detected by either X-ray or CT, logistic regression showed that higher urine RBC and lower urine WBC medians were predictors of urolithiasis. In the ROC analysis, WBC median lower than 7.75 per high power field (HPF) was a significant predicting factor for the positive finding of urolithiasis on a CT scan.

Conclusion:

When presenting with acute UTI symptoms, patients with a lower urine WBC median are correlated with a higher probability to have urolithiasis. In addition, WBC median lower than 7.75 per HPF in urinalysis is a predictor for urolithiasis found on CT in patients with flank pain or hydronephrosis.
Factors Associated with the Success of Trial Without Catheter in Acute Urinary Retention Due to Benign Prostatic Hyperplasia
Authors: Phuong Hoai Dinh Thi , Thang Tai Luu Lam , Huu Loc Tran Thai , Fadlelmola Mohamed Muawia Yousif , Ahmed Ali Mahmoud , Huy Nguyen Tien , Khanh Le Dinh
Published: December 2021

Purpose:

This study aims to evaluate the parameters that can predict the success or failure of trial without catheter (TWOC) for acute urinary retention (AUR) due to benign prostatic hyperplasia (BPH).

Materials and Methods:

A prospective cohort study was conducted to include 73 medically treated patients with AUR due to BPH. All patients underwent catheterization and were started on alfuzosin (10 mg/day), followed by TWOC. Age, international prostate symptom score (IPSS), quality of life, prostate volume, and urine volume after catheterization were analyzed.

Results:

Patients' mean age was 74.23 ± 9.63 years; the first successful and failed TWOC was reported in 47 (64.4%) and 26 patients (35.6%), respectively. On the one hand, 89.4% of the patients continued medical treatment with alfuzosin (10 mg/day) in the first successful TWOC group. On the other hand, 30.8% showed the second successful TWOC and continued medical treatment in the first TWOC failure group. The uni- and multivariable analyses in this study showed that severe lower urinary tract symptoms (IPSS ≥20 points), prostatic pain during digital rectal examination (DRE), high urine volume after catheterization (≥950 mL), and high blood urea (≥4.55 mmol/L) were the predictive factors of TWOC failure.

Conclusion:

Severe lower urinary tract symptoms, prostatic pain during DRE, large urine volume after catheterization, and high blood urea are the predictive factors for TWOC failure in AUR due to BPH.
Can Robot-assisted Radical Prostatectomy Improve Functional Outcomes Compared to Laparoscopic Radical Prostatectomy? Experience at a Laparoscopic Center
Authors: Lu Cheng-Hsin , Wu Chun-Hsien , Chen Yu-Chi , Chen Chung-Hsien , Wu Richard Chen-Yu , Lee Yeh-Hsi , Huang Ching-Yu , Yu Tsan-Jung , Lin Victor C.
Published: December 2021

Purpose:

This study compared the perioperative parameters and early functional outcomes between robot-assisted radical prostatectomy (RARP) and laparoscopic radical prostatectomy (LRP) at a urological laparoscopic center.

Materials and Methods:

Between January 2006 and May 2017, 242 patients underwent endoscopic radical prostatectomy (LRP for 208 cases; RARP for 34 cases). Patients who were followed up > 12 months were included in the study. Propensity score-matched groups of patients who underwent LRP or RARP were created based on age, body mass index, history of diabetes mellitus, history of smoking, preoperative prostate-specific antigen level, clinical T status, risk group classification, American Society of Anesthesiologists score, and whether the nerve-sparing technique was performed.

Results:

There were no significant differences in the blood transfusion rate, surgical margin status, length of stay, catheterization time, or days to oral intake for both procedures. Although RARP is more time-consuming, it provided significant benefits regarding the yield of dissected lymph nodes (19 vs. 9; P < 0.001) and early urinary continence recovery (i.e., continence rates after 1 month [56.2% vs. 21.9%; P = 0.006] and after 3 months [84.4% vs. 53.1%; P = 0.001]). No difference was observed for early complications, although the RARP group had more late complications.

Conclusion:

Our experience indicated that RARP could provide less blood loss and faster recovery of urinary continence and yield more dissected lymph nodes compared to LRP. Further studies are needed to determine whether the long-term clinical, functional, and oncological outcomes are superior.
Effect of Hydroalcoholic Extract of Cyperus Rotundus L. Rhizome against Ethylene Glycol and Ammonium Chloride-Induced Urolithiasis in Male Sprague-Dawley Rats
Authors: Jahan Nasreen , Bano Humaira , Ahmed Makbul Shaikh Ajij , Kumar B. N. , Mushir Ansari
Published: December 2021

Background:

Cyperus rotundus L. is used in various dosage forms by Unani physicians in the treatment of urolithiasis.

Aims and Objectives:

The present study aims to evaluate the effect of hydroalcoholic extract of Cyperus rotundus in nephrolithiatic male Sprague Dawley rats.

Materials and Methods:

The animals were divided into 6 groups of 6 each. Group I received regular rat food and drinking water ad libitum. Group II to VI were treated with Ethylene glycol (0.75%, V/V) and Ammonium chloride (1%, W/V) in drinking water for 7 days to induce urolithiasis. Group II was sacrificed after 7 days administration of lithogenic agents however, from 8th day, group IV was treated with Cystone (750 mg/kg) and group V and VI with hydroalcoholic extract of Cyperus rotundus (100 mg/kg and 170 mg/kg, respectively) for further 14 days. Group III left untreated after 7 days administration of lithogenic agent till 14 days and sacrificed on 22nd day. Urine, biochemical parameters, kidney homogenate analysis and histopathology were carried out. Crystalluria analysed by light microscopy.

Results:

The test drug at both the doses showed significant reduction (P < 0.001) in number of urinary crystals. Test groups showed significant reduction in urine sodium (P < 0.05) and calcium (P < 0.001) while increased in urine magnesium. Serum creatinine (P < 0.01) and urea (P < 0.05) level significantly reduced in test groups. Histopathology of kidney showed almost normal kidney architecture. Kidney homogenate analysis showed significant reduction (P < 0.05) of calcium in group VI.

Conclusion:

The results showed that test extract has significant antilithiatic effect in terms of solute balance, reduction in crystal numbers and improvement in renal cell derangement.
Presence of Residual Stones is Not a Contraindication for Tubeless Percutaneous Nephrolithotomy
Authors: Chang Shun-Kai , Lin Chang-Te , Kang Chun-Hsiung , Cheng Ming-Chin , Jou Yeong-Chin , Shen Cheng-Huang , Chen Pi-Che , Lai Wei-Hong
Published: December 2021

Objective:

The objective of this study was to evaluate the safety of performing tubeless percutaneous nephrolithotomy (PCNL) for patients with residual stones.

Materials and Methods:

This study was conducted between 2007 and 2015, and a total of 815 patients were included in this study who underwent tubeless PCNL. Postoperatively, 591 patients were found to be stone free (Group 1), whereas residual stones were noted in 224 patients (Group 2). The hospital course and postoperative complications up to 3 months were analyzed by retrospective review. The complications were analyzed by Clavien–Dindo classification and grouped to severe/life-threatening complications (≥Grade 4) and none or nonsevere complications (≤3). All the demographic variables were scrutinized by regression analysis.

Results:

The mean days of hospital stay were 3.15 and 3.70 in Group 1 and Group 2, respectively (P < 0.001). Sixty-seven patients from Group 1 (11.3%) and 65 patients from Group 2 (29%) suffered postoperative complication (P < 0.001). A multivariate logistic regression model confirmed a higher risk of complications for the residual stone group versus the stone-free stone group (odds ratio [OR]: 2.37,P < 0.001). However, life-threatening complication rate reveals no difference between the two groups (1.4% vs. 3.1%,P = 0.093). Sixteen patients (2.7%) from Group 1 and 12 patients (5.4%) from Group 2 were rehospitalized in 3 months; however, the difference was not statistically significant (P = 0.064). The adjusted logistic regression model also established a nonelevated risk of rehospitalization (OR: 1.11, P = 0.823). Ninety-seven patients in the residual stone group received secondary stone managements in 3 months, but none of them underwent secondary PCNL.

Conclusion:

Patients from the residual stone group had remarkably longer hospital stay and higher postoperative complication rate because of more complicated stone nature. However, there was no significant difference in the incidence of severe complication and rehospitalization in both the groups. Tubeless PCNL is a relatively safe procedure and not contraindicated for patients with residual stones.
Cavernous Hemangioma of Ureter Masquerading as Malignancy – A Rare Case Report
Authors: Sajitha K. , Kishan Prasad H. L. , Pradeep Ashwathy , Rajeev T. P. , Mathias Michelle , Shetty K. Jayaprakash
Published: December 2021

Hemangiomas of the genitourinary tract are rare. They may be clinically silent or present with profuse or recurrent hematuria. They result from embryological remains of unipotent angioblastic cells that show anomalous development within the blood vessels. They can be single or multiple. Multiple hemangiomas are called cutaneous angiomatosis, occurring in the setting of genetic disorders such as Klippel–Trenaunay syndrome or Sturge–Weber syndrome. Careful correlation between the clinical, radiological, and histological findings may help in avoiding unnecessary radical procedures. Here, we present a case of cavernous hemangioma occurring in the proximal ureter, causing hydronephrosis and posing a diagnostic challenge.
Sonography-Assisted Seldinger Wire Technique
Authors: Chen Chao-An , Chang Yu-Jun , Lio Man-Lok , Chiang Heng-Chieh , Wang Bai-Fu , Chen Pao-Hwa
Published: December 2021

Context:

In Changhua Christian Hospital (CCH), the urology division is a branch of the surgical department. The urology residents in this division are, on average, off duty for 10 days/month; surgical residents from other divisions usually lack training to practice urology. Therefore, attending urology doctors or visiting urology staff members in CCH branches must be on call during off-duty periods in case a patient is indicated for suprapubic cystostomy.

Aims:

This study aims to promote a safe and efficient approach to train rotating residents to perform suprapubic catheterization.

Subjects and Methods:

On the basis of ultrasound-guided central venous catheter insertion, we designed training sessions for suprapubic cystostomy for rotating surgical residents during their urology course.

Participants and Methods:

From 2016 to 2018, senior residents or attending doctors of urology evaluated the clinical skills of rotating residents by using the direct observation of procedural skills tool before and after the training course.

Statistical Analysis Used:

Mann–Whitney U-test, Wilcoxon signed rank test, and multiple linear regression analysis.

Results:

The trainees were separated into different groups according to their sex, year of residency, and previous urology training in the postgraduate year (PGY). All groups had significant gain scores. Our multiple linear regression analysis revealed a relationship between previous urology training in the PGY and gain scores and between overall pretest score and gain scores.

Conclusions:

Real-time ultrasound-guided catheterization with a Seldinger wire is a safe and efficient approach to train rotating residents to perform suprapubic catheterization.
A Rare Case of Prolapsed and Everted Bladder through a Widely Patent Urachus with an Absent Omphalocele
Authors: Hamzah Azhar Amir , Khan Amer Hayat , Bitar Ahmad Naoras
Published: December 2021

A prolapsed and everted bladder through a widely patent urachus with an absent omphalocele is considered as an extremely rare and unique case, which requires emergency treatment and surgical intervention. A newly born baby was born at term and then referred from a district hospital for a mass at the umbilical region. She was referred as a case of gastroschisis, but she was eventually found to have a rare patent urachus with bladder eversion and prolapse onto the abdominal wall. The prolapsed bladder was repaired without any complications, and an umbilicoplasty was performed successfully. The infant recovered uneventfully and without any difficulty in voiding. A significant reduction in bladder dome inflammation as well as in mucosal necrosis can be obtained by performing the repair procedure as soon as possible.
Comparative Assessment of Monopolar Versus Bipolar Transurethral Resection of Prostate for the Management of Benign Prostatic Enlargement
Authors: Raghuvanshi Kshitij , Raval Abid , Jain Devendra Kumar , Vartak Ketan P , Patil Sachin , Iqbal Shams , Dhake Rajesh , Deshmukh Hrishikesh
Published: December 2021

Objectives:

The objective is to compare monopolar transurethral resection of the prostate (M-TURP) versus bipolar TURP (B-TURP).

Methods:

In this prospective comparative study, 102 patients scheduled to undergo transurethral resection of prostate were enrolled and table randomized to surgery by M-TURP or B-TURP. International Prostate Symptom Score (IPSS), uroflowmetry, ultrasonography (kidney-ureter-bladder), prevoid, postvoid and laboratory investigations (for preanesthetic fitness) were done preoperative and 3-month postsurgery.

Results:

Patients were divided into two groups namely M-TURP and B-TURP. The mean age of patients was comparable between both groups. There is a significantly lower mean resection time in M-TURP compared to B-TURP. IPSS, postvoid residual volume, and Qmaximproved in both groups, and it was statistically insignificant. Drop in hemoglobin levels (g/dl) in patients of M-TURP was higher compared than B-TURP.

Conclusions:

Both M-TURP and B-TURP are safe and effective modality. However, B-TURP will surely replace M-TURP as gold standard.
The Incremental Benefit of Upfront Surgery in Renal Cell Carcinoma with Venous Tumor Thrombus of the Inferior Venae Cavae
Authors: Huned Daanesh , Carsen John Allen , Huang Hong Hong , Lee Lui Shiong
Published: December 2021

Background:

Surgical extirpation for renal cell carcinoma (RCC) with inferior venae cavae (IVC) thrombi is the standard of care. The incremental impact of upfront surgery has not been well described.

Objective:

We aim to quantify the overall survival (OS) benefit of upfront surgery in RCC with IVC thrombi when compared to a conservative approach and also analyze perioperative outcomes.

Materials and Methods:

Patients with RCC with IVC thrombus between January 1, 2001, and December 31, 2014, in a single institution were identified, and data reviewed for demographics, performance status, and tumor thrombus levels. Pathological and operative outcomes were analyzed in the surgical cohort (Sx). Survival outcomes were computed with Kaplan–Meier analysis. Prognostic factors were determined using univariate and multivariate analyses. Statistical significance was defined as P < 0.1.

Results:

There were 51 patients identified, comprising 31 and 20 in the Sx and nonsurgical (NSx) cohorts. For the Sx cohort, 5-year OS and recurrence-free survival were 48% and 45%, respectively, with a median OS of 51.7 months. Nodal involvement was an independent predictor for OS (P < 0.1) on multivariate analysis. In the NSx cohort, 75% (15/20) had distant metastasis at diagnosis, with a 5-year OS of 13.4 months. Patients with better baseline ECOG statuses had better survival outcomes (P < 0.1). The mean OS of patients (n = 5) with M0 disease was 18.8 months. The advantage conferred by surgery was a 38.2-month longer median OS (P < 0.0001). In the Sx cohort, 87% had no or minor perioperative complications.

Conclusion:

Nephrectomy and IVC thrombectomy have an OS survival advantage of 38.2 months with acceptable perioperative morbidity. Therefore, it is preferred over an initial nonsurgical approach where possible.
Evaluation of Modified STONE Score in Patients Presenting to the Emergency Department with Flank Pain
Authors: Uzun Ahmet , Korkut Mustafa , Kartal Mutlu , Bedel Cihan
Published: December 2021

Purpose:

Renal colic due to urinary system stone disease is one of the main complaints in emergency department (ED) admissions. The STONE score is the most used model. The “race” item in the nomogram is not useful for communities where the Black race is not dominant. Therefore, we aimed at investigating the diagnostic value of a new modified scoring system, in which we replaced the “race” item in the original nomogram by “obstruction = pelvicalyceal dilation.”

Materials and Methods:

The study included patients who were admitted to a tertiary university ED with flank pain and underwent ultrasonography (US) from June 2017 to November 2017. Patients' demographic data such as US findings and the STONE score parameters were recorded. “Obstruction (pelvicalyceal dilation)” replaced the “race” item of the original STONE score. The diagnostic value of the modified system was investigated by categorizing the scores as low risk (0–5 points), moderate risk (6–9 points), and high risk (10–13).

Results:

The study included 305 patients who met the inclusion criteria. The mean age was 39.45 ± 13.83 years, and 170 patients (55.7%) were male. Pelvicalyceal dilation was detected on US at a statistically significantly higher percentage in patients with stones compared to stone-free patients (P < 0.001). The modified STONE score was statistically significantly higher in patients with stones compared to stone-free patients (P < 0.001).

Conclusion:

We suggest that the replacement of the race parameter of the original STONE score by the US finding of pelvicalyceal dilation will enhance the diagnostic value of scoring in societies mostly comprising a non-Black population.
Combination Alpha Blocker and Phosphodiesterase 5 Inhibitor Versus Alpha-Blocker Monotherapy for Lower Urinary Tract Symptoms Associated with Benign Prostate Hyperplasia
Authors: Chen Po-Cheng , Wang Chung-Cheng , Tu Yu-Kang
Published: December 2021

Purpose:

The prevalence of erectile dysfunction (ED) is higher in patients with lower urinary tract symptoms (LUTS). Phosphodiesterase 5 inhibitors (PDE5is) can improve both ED and LUTS and therefore is useful for these patients. Our aim of this study is to evaluate whether combination therapy of alpha blockers and PDE5i is more effective than alpha-blockers monotherapy for the treatment of LUTS.

Materials and Methods:

A systematic review and meta-analysis were undertaken to assess the difference between the combination therapy and alpha-blockers monotherapy by searching published randomized controlled trials from electronic databases PubMed, Embase, and the Cochrane Library up to April 2018.

Results:

A total of 13 randomized controlled studies with 1173 patients were included in our meta-analysis. Compared with alpha-blocker monotherapy, the combination therapy obtained a significantly better improvement in International Prostate Symptom Score (IPSS) (1.73, 95% confidence interval [CI]: 1.1–2.35), voiding subscore (0.99, 95% CI: 0.54–1.44), storage subscore (0.57, 95% CI: 0.03–1.1), peak flow rate (0.69 cc/s, 95% CI: 0.27–1.1), and erectile function (EF) symptom score. Meta-regression showed that baseline IPSS, baseline peak flow rate, baseline prostate volume, age, baseline EF symptom score, and dosage of PDE5is were not associated with the difference in IPSS improvement.

Conclusion:

A combination of alpha blockers and PDE5is has better therapeutic effects than alpha-blocker monotherapy on LUTS related to benign prostate hyperplasia.
The Impact of the Fine Ambient Particle on Infertile Male's Sperm Quality
Authors: Chen Yuan , Chang Hong-Chiang , Liao Chun-Hou , Chiang Bing-Juin , Chang Yi-Kai
Published: December 2021

Introduction:

Infertility has been a major problem for several years. Previously, infertility was often attributed to female factors. Recently, however, male factors have been found to contribute to 50% of the infertility cases overall. Male infertility is a multifactorial issue. A genetic disorder, abnormal endocrine system, structural anomaly, and environmental causes could lead to male infertility. Studies have revealed a link between fine air particles and decreased fertility. The aim of this study was to discover the effect of particulate matter 2.5 (PM2.5), representing environmental fine particles, on male infertility.

Materials and Methods:

We retrospectively collected data from patients diagnosed as having infertility and visited National Taiwan University Hospital from January 2015 to October 2017. We recorded each patient's body weight, height, basic blood test, sperm analysis, and sex hormone profile. Air quality data, especially PM2.5 concentration, were acquired from the Environmental Protection Administration of Taiwan. A total of 78 monitoring stations throughout Taiwan record PM2.5 concentrations (μg/m3) each hour automatically. Multivariate linear regression was used to detect independent factors affecting sperm count, concentration, motility, and morphology and sex hormone profile. Results:We observed regional and seasonal differences in the distributions of PM2.5 concentrations. In nearly all cities in Taiwan, the PM2.5 concentrations increased during early winter and continued to increase until next spring, with a peak around January and February. In particular, regional differences were observed in winter. The peak PM2.5 concentrations in southern and northern cities in Taiwan ranged between 35 and 40 μg/m3 and between 18 and 23 μg/m3, respectively. PM2.5 in central Taiwan reached as high as 30 μL/m3. By contrast, the eastern part of Taiwan had the lowest peak PM2.5, which was mostly <15 μg/m3. The average 24-month PM2.5 concentration had a negative effect on sperm count, but the result was nonsignificant. Additionally, the effect of PM2.5 on sperm motility and morphology was minimal.

Conclusion:

In infertile Taiwanese men, there is a trend of a negative association between exposure to PM2.5 and sperm concentration and total sperm count. Exposure to ambient fine particles, especially PM2.5, might have a negative correlation with sperm quality, sex hormone balance, and the testicular microenvironment through different mechanisms.
Smoking History, Smoking Intensity, and Type of Cigarette as Risk Factors of Bladder Cancer
Authors: Pramod Sawkar Vijay , Safriadi Ferry , Hernowo Bethy S , Dwiyana Reiva Farah , Batista Baskara
Published: December 2021

Smoking is a major risk factor that plays a role in the incidence of bladder cancer. Carcinogens from cigarettes are excreted through the urine, so direct contact with the urinary tract occurs and increases the risk of malignancy. Literature is obtained from the search results of PubMed, Medscape, and Science Direct electronic databases with some keywords used. Starting in 2009, 88 literature results were collected through the electronic databases of PubMed, Medscape, and Science Direct. After applying the exclusion criteria, 12 articles are included in this literature review with 536,989 bladder cancer patients and 52,753 controls in total. High clove cigarette smoking intensity (>40 cigarettes/day) is a risk of causing urothelial carcinoma bladder cancer. Clove cigarettes pose the highest risk of bladder cancer. Compared to clove cigarette, cigars, and tobacco pipes have relatively lower risk of causing bladder cancer. Meanwhile, other types of cigarettes, such as shisha and electronic cigarettes, do not eliminate the risk of bladder cancer. Smoking is a modifiable risk factor for bladder cancer. The current smoking history was associated with a higher risk of bladder cancer compared to the former history of smoking. Different types of smoking have different risks of bladder cancer.
Surgical and Functional Outcomes of Robotic-Assisted Radical Prostatectomy in Patients with Previous Transurethral Resection of the Prostate
Authors: Chen Sih-Han , Wu Chun-Hsien , Wu Richard Chen-Yu , Kuo Wade Wei-Ting , Lee Yen-Hsi , Li Ryh-Chyr , Lin Yung-Yao , Lin Victor Chia-Hsiang
Published: December 2021

Purpose:

The purpose of this study was to assess the surgical and functional outcomes of robotic-assisted radical prostatectomy (RARP) in patients with previous transurethral resection of the prostate (TURP).

Materials and Methods:

The present article studies 99 patients who underwent RARP, including 13 patients with previous TURP at a single institution, in the period from April 2016 to February 2019. Propensity score matching 1:1 was performed to identify 13 patients with no previous TURP. The matched variables were age and preoperative prostate-specific antigen level. Surgical and functional outcomes were compared between the two groups. Descriptive statistics were evaluated using the Chi-square test. t-test was performed for continuous variables.

Results:

Regarding preoperative characteristics, no previous TURP group had a higher clinical stage (P = 0.026). The nerve-sparing procedure was similar between the two groups. Concerning intraoperative outcomes for the group with previous TURP history, the operating room time was increased by 25 min (P = 0.140), and the estimated blood loss was increased by 50 ml (P = 0.192). As for the postoperative pathological characteristics, there was no significant difference in the positive surgical margin rate between the two groups. The continence rate in the 3rd month for the group with previous TURP history was 69.2% versus 92.3% for the group with no previous TURP history, and after the 1st year, the rates were 100% versus. 92.3%. There was no significant difference in the potence recovery rate between the two groups after 1-year follow-up.

Conclusion:

RARP is safe and feasible in patients with localized prostate cancer with previous TURP history. Functional outcomes after 1-year follow-up were comparable for patients with previous TURP.
Using R.E.N.A.L. Nephrometry and Preoperative Aspects and Dimensions Employed for Anatomical Classification to Evaluate Perioperative Outcomes of Renal Tumors Greater than 4 cm in Patients Who Underwent Minimally Invasive Partial Nephrectomy in a Single Center
Authors: Mai Hsing-Chia , Wu Chun-Hsien , Lin Yung-Yao , Kuo Wade Wei-Ting , Lee Yen-Hsi , Li Ryh-Chyr , Wu Richard C. , Lin Victor C.
Published: December 2021

Purpose:

The R.E.N.A.L. (radius, exophytic/endophytic tumor properties, nearness of tumor to deepest portion of collecting system or sinus, anterior/posterior descriptor, and location relative to the polar line) and preoperative aspects and dimensions used for an anatomical (PADUA) (tumor size and position, relationship with the renal sinus or the urinary collecting system, and the grade of deepness into the kidney) nephrometry scoring systems are frequently used in predicting the perioperative outcomes of nephron-sparing surgery (NSS). Minimally invasive NSS on renal masses beyond 4 cm in diameter remains challenging and may result in the significant complications. We aimed to evaluate the associations of both scoring systems with perioperative outcomes for minimally invasive NSS on renal masses larger than 4 cm in diameter.

Materials and Methods:

We retrospectively reviewed patients who received robot-assisted partial nephrectomy (PN) or laparoscopic PN for renal tumors larger than 4 cm in diameter in our institution between January 2008 and March 2019. Computed tomography scan and magnetic resonance imaging were the standard cross-section imaging modalities done before surgery and both R.E.N.A.L. and PADUA scores were calculated in every case accordingly. The correlation between each scoring system and the perioperative and renal functional outcomes was analyzed by logistic regression models.

Results:

A total of 93 cases were enrolled in this study. The mean tumor size was 6.1 ± 2.03 cm in the largest dimension. A higher R.E.N.A.L. score was significantly correlated with longer warm ischemia time (WIT) (r = 0.267, P = 0.021), prolonged hospital stays (r = 0.258, P = 0.013), and poorer renal functional outcome at 1 year (r = 0.421, P = 0.003). Meanwhile, a higher PADUA score was significantly correlated with longer operation time (r = 0.255, P = 0.014), longer WIT (r = 0.278, P = 0.016), and poorer renal function after 1 year (r = 0.615, P < 0.001). Neither scoring system correlated with estimated blood loss (P = 0.510 and 0.5466, respectively). The R.E.N.A.L. score, PADUA score, patient age, body mass index, Charlson comorbidity index, tumor size, and American Society of Anesthesiologists score were not associated with surgical complications as well.

Conclusion:

Both the R.E.N.A.L. and PADUA scoring systems were associated with WIT and renal functional outcomes, but the latter was more relevant. When performing minimal invasive NSS on renal masses beyond 4 cm, both systems can provide valuable risk stratification, but PADUA was found to be superior in the current study.
The Value of Prostate-Specific Antigen-Age Volume Score in Predicting Prostate Cancer in Taiwan
Authors: Lin Chun-Hsuan , Chang Che-Wei , Li Wei-Ming , Wen Shen-Chen , Huang Shu-Pin , Li Ching-Chia , Wu Wen-Jeng , Ke Hung-Lung , Lee Yung-Chin , Jhan Jhen-Hao
Published: December 2021

Purpose:

Whether the predictive utility of prostate-specific antigen-age volume (PSA-AV) score can surpass serum total PSA, age-adjusted PSA, or PSA density (PSAD) has remained unclear based on previous reports. The aims of this study were to assess the predictive value of PSA-AV score in a Taiwanese population.

Materials and Methods:

We retrospectively reviewed the medical data of patients who underwent transrectal ultrasound-guided prostate biopsy between 2007 and 2013 at our institution. The ability of serum PSA, age-adjusted PSA, PSAD, and PSA-AV to predict prostate cancer was tested using receiver operating characteristic (ROC) curves.

Results:

A total of 415 biopsy specimens were included in the study, of which 75 (18.1%) were diagnosed with prostate cancer. The discriminative performance of serum PSA, age-adjusted PSA, PSAD, and PSA-AV for predicting prostate cancer was evaluated in the study cohort. The areas under ROC curve were determined for the four tests as follows: for serum PSA (95% confidence interval [CI]: 0.723–0.852), for age-adjusted PSA (95% CI: 0.719–0.888), for PSAD (95% CI: 0.673–0.877), and for the formula PSA-AV (95% CI: 0.783–0.884), they were 0.787, 0.804, 0.775, and 0.834, respectively. Comparing other tests, the novel formula PSA-AV was significantly better than the other three PSA-derived tests and reached statistical significance (P < 0.05). At this cutoff value (PSA-AV <200), the sensitivity was 74.7% and the specificity was 77.4%.

Conclusion:

The use of the formula PSA-AV in Taiwan was superior in the prediction of prostate biopsy findings compared to serum PSA, age-adjusted PSA, and PSAD according to our data, particularly in older patients or patients with a larger prostate volume.
A Tertiary Center Experience of Fracture Penis
Authors: Kumar Lalit , Tiwari Rahul , Arya M. C. , Sandhu Amit , Vasudeo Vivek , Baid Mayank
Published: December 2021

Introduction:

Fracture penis is uncommon and often a result of sexual trauma. Diagnosis remains clinical and early surgical management is advocated. Herein, we share our experience of 20 such cases.

Materials and Methods:

Twenty fracture penis patients presented between August 2014 and April 2017 were included. Patients' data were retrieved retrospectively using case sheets and followed by outpatient department visits and telephonically. Eighteen patients had penile exploration while two patients were managed conservatively. Erectile and voiding functions were assessed by asking single question to the patient, which was limited to only two options in the form of normal and abnormal. All patients were followed up for a minimum of up to 6 months.

Results:

The patients were aged between 20 and 60 years (mean 37.7 years). Mean timing of presentation was 28.8 h (range 2 h to 7 days). Mean follow-up was 22.5 months (6–42 months). There were no long-term postoperative complications. Eighteen patients had coital trauma, one unmarried patient had a history of manipulation of erect penis, while one patient had a fall-on erect penis. Three patients had associated urethral injury. All patients had almost the same potency as preoperatively, but for one who had erectile dysfunction for a short period recovered spontaneously on tablet sildenafil. No patient had long-term voiding dysfunction, penile curvature, or sexual dysfunction.

Conclusion:

History and clinical examination clinch the diagnosis. Considering it as a urological emergency, radiological imaging is not required routinely. Early surgical repair preserves the potency and voiding functions.
Accidentally Found Metastatic Adenocarcinoma of Prostate in an Incised Inguinal Hernia Sac
Authors: Zhong Shang-Rong , Lai Yu-Wei , Wu Yih-Yiing
Published: December 2021

An 83-year-old male patient received hernioplasty, and the submitted specimen was incidentally found to microscopically have adenocarcinoma of prostatic. He received transrectal ultrasound-guided prostate biopsy and prostate adenocarcinoma with confirmed Gleason score 4 + 5. Inguinal hernia sacs obtained from hernioplasty are routinely sent for pathological examination in some medical facilities although meaningful results are rare. A retrospective study released in 2014 presented only 11 cases (0.35%) of malignancy in a total of 3117 specimens, while one-third of the patients had preexisting malignancies before operations. There were only sporadic cases reports on the prostate cancer disclosed in hernia sacs, while nearly all cases displayed metastasis that was found in the inguinal hernia sac. These findings suggested the advanced nature of the disease and diminished survival time. This report reminds us of the polymorphic characteristics of prostate cancer and its possibility of metastasis in an unusual way.
A Single-Institution Experience with Laparoendoscopic Single-Site Retroperitoneal Adrenalectomy
Authors: Chen Yu-Chen , Lee Hsiang-Ying , Chen Hao-Wei , Yeh Hsin-Chih , Tsai Chia-Chun , Chueh Kuang-Shun , Chou Yii-Her , Huang Chun-Nung , Wu Wen-Jeng , Hou Nien-Ting , Lin Yech-Huei , Li Ching-Chia
Published: December 2021

Aims:

Laparoendoscopic single-site (LESS) adrenalectomy has become a feasible choice for adrenal lesions and can substitute for conventional open adrenalectomy. This report shares our surgical experience and describes the characteristics of adrenal tumors after LESS retroperitoneal adrenalectomy.

Subjects and Methods:

Between January 2010 and August 2016, 123 patients underwent an LESS adrenalectomy by retroperitoneal approach in our hospital. We retrospectively reviewed the records of these patients and analyzed the characteristics of adrenal tumors. The incision is below the 12th rib in the posterior axillary line and is about 2.3–3.2 cm in length. A 5 mm 30° rigid laparoscope and other conventional laparoscopic instruments are manipulated through a commercial port. No postoperative drain is placed.

Results:

Among 123 patients, the mean operative time was 114.1 ± 31.1 min, and mean blood loss was 65.1 ± 68.7 ml. Mean hospital stay was 5.4 ± 1.2 days. The postoperative course was uneventful without complications. Among all adrenal tumors undergoing surgery, Conn's disease is the most common (68.3% Conn's disease, 19.5% nonfunctioning, 4.9% Cushing's disease, 3.3% pheochromocytoma, and 0.8% malignancy). We found that left-side adrenal tumors (64.2%) were more common than right-side tumors (35.8%).

Conclusions:

Our experience shows that retroperitoneal LESS adrenalectomy is promising. Conn's disease accounts for more than half of adrenal tumors undergoing surgery. In the future, further comparative study is warranted to define the role of LESS in adrenal surgery.
ANALISIS RASIO AKTIVITAS PADA PT KINO INDONESIA, Tbk
Authors: Suardi Suardi
Published: December 2021

ABSTRAK

Penelitian ini dilakukan di PT KINO Indonesia Tbk untuk mengetahui Rasio Aktivitas dari laporan keuangan tahun 2016 s.d 2018. Tujuan dari penelitian ini untuk mengetahui tingkat Receivable Turn Over, Inventory Turn Over dan Working Capital Turn Over pada PT KINO Indonesia Tbk. Alat yang digunakan adalah Rasio Keuangan. Dalam penelitian ini peneliti menggunakan data kuantitatif. Metode penelitian yang peneliti gunakan dalam penelitian ini yaitu metode penelitian deskriptif. Dalam penelitian ini penulis menggunakan variabel tunggal, yang menjadi variabel adalah Rasio Aktivitas. Jenis-jenis rasio yang digunakan adalah  rasio Receivable Turn Over (Perputaran Piutang), Rasio Inventory Turn Over (Perputaran Sediaan) Dan Working Capital Turn Over (Perputaran Modal Kerja). Untuk mengetahui hasil analisis rasio Aktivitas pada PT KINO Indonesia Tbk sesuai rata-rata standar industri. Hasil penelitian ini menunjukan bahwa tingkat Receivable Turn Over (perputaran piutang) pada PT KINO Indonesia Tbk belum bisa dikatakan baik karena masih berada di bawah rata-rata standar industri. Tingkat Inventory Turn Over (perputaran sediaan) juga masih belum bisa dikatakan baik karena masih di bawah rata-rata standar industri. Sedangkan Working Capital Turn Over (perputaran modal kerja) juga masih belum bisa dikatakan baik karena masih di bawah rata-rata standar industri.

Kata Kunci : Perputaran Piutang, Perputaran Persediaan dan Perputaran Modal Kerja
PENETAPAN HARGA JUAL DALAM MENINGKATKAN KEPUTUSAN KONSUMEN TERHADAP KEPUTUAN PEMBELIAN
Authors: Blantianus Novi  , Usman Usman
Published: December 2021

Penelitian ini dilatarbelakangi oleh adanya proses transaksi antara penjual dan pembeli pada toko sembako Age Adup. Adapun penelitian ini di lakukan tepat di dusun Baremada, Desa Lamolda, Kecamatan Lumar, Kabupaten Bengkayang. Adapun dalam penelitian ini diambil sampel 9 orang konsumen ataupun pembeli yang diwawancarai. Dalam penelitian ini teknik pengumpulan dengan melakukan observasi secara langsung pada toko sembako Age Adup, wawancara dan dokumentasi. Selanjutnya penulis menganalisis data dengan metode deskriftif kualitatif. Dari hasil peneltian yang  telah  dilakukan  pada toko  sembako  Age  Adup  terhadap  konsumen terkait  Penetapan  Harga  Jual  Dalam Meningkatkan  Kepuasan  Konsumen Terhadap Keputusan Pembelian. Harga yang diterapkan oleh toko sembako Age Adup sudah tepat dimana sebanding dengan kualiatas dan mutu produk. Selain itu harga jual barang juga cukup kompetetif dengan pesaing dimana harga jual yang diterapkan tidak memiliki selisih yang begitu jauh dengan harga pasaran. Namun ada beberapa barang yang memang lebih rendah harganya  dibandingkan  dengan  pesaing.  Dengan  adanya  penetapan  harga yang tepat tentunya hal tersebut dapat berdampak bagi konsumen ataupun pembeli   yang  dimana   hal   tersebut   menciptakan   suatu   kepuasan   bagi konsumen hal  tersebut  dapat  di  lihat  dari  hasil  wawancara  terhadap    9 narasumberdimana mereka mengatakan bahwa mereka sangat puas terhadap penetapan   harga   yang   ada,   dimana   hal   tersebut   menunjukan   bahwa penetapan  harga  yang telah  dilakukan  oleh  pemilik  toko  sembako  Age Adup  sudah  tepat.  Dengan  demikian hal tersebut  juga memberikan  suatu dampak  terhadap  keputusan  pembelian  bagi konsumen agar tetap kembali berbelanja pada toko sembako Age Adup
ANALISIS CUSTOMER PROFITABILITY PADA KOPERASI SIMPAN PINJAM “DIASPORA”
Authors: Wijayanti Sinta , Sadewo Yosua Damas
Published: December 2021

The purpose of this study was to analyze Customer Profitability in the Diaspora Savings and Loans Cooperative (Credit Union). This research is a comparative quantitative research. The consumers studied were limited to debtor customers only. There are 4 consumer groups studied, where each group consists of 30 customers. Data were collected by using a documentary study technique by examining credit contracts and financial statements of each customer. The data were analyzed by means of a mean difference test with an independent sample t-test technique. The results showed that the groups of consumers who gave the highest profitability were the cheap and passive groups. Meanwhile, the consumer group that tends to harm the cooperative is the aggressive group. Thus, it is suggested to the cooperative manager to increase the number of consumers in the cheap and passive groups and reduce the number of consumers in the aggressive group.
CONCEPT OF RASAYANA IN MANAGEMENT OF STHOULYA
Authors: Gunjigonvi Jayashree , V Joshi Prasan
Published: December 2021

Immunity is a protective mechanism of the body; weak immunity may give rise to so many health conditions. The immunity of the person cannot be defined by personal appearance, as a lean body person may have stronger immunity compared to an obese person. The immunity depends upon proper nourishment of body tissues and lack of proper nourishment leads to a decrease in the person strength and lifespan. Sthoulya is one of the conditions where there is increased nourishment of only Medadhatu with lack of nourishment of other Rasadidhatu which further give rise to so many complications. Rasayana is one of the peculiar concepts of Ayurveda known for its Rejuvenation, Immunebooster, and antioxidant properties. As the name itself suggests it is the procedure with specific dravyas for the nourishment of Rasadidhatu. In Sthoulya as it is vruddi (Increased) of Shleshma, Vatadosha and Medadhatu with lack of nourishment of other dhatu occur so the use of Dravya having Rasayana, shleshmahara, Medohara and Vatagna properties are more beneficial.
Keywords: Rasayana, Sthoulya, Shleshmahara, Medohara, Vatagna
CULTURAL, ARCHITECTURAL, ‘SENSE OF PLACE’ AND SUFISTIC BELIEFS IN MOSQUE TOURISM CASE STUDY: MASJID AR-RAHMAN, PULAU GAJAH, KELANTAN
Authors:   Universiti Sains Malaysia, Bahauddin Azizi , Zakaria Safial Aqbar ,   Universiti Sains Malaysia
Published: December 2021

The mosque is a sacred important religious symbol for bringing Muslims together as demonstrated during the time of Prophet Muhammad (PBUH). This paper investigates the potential of Masjid Ar-Rahman of Pulau Gajah, Kelantan as a spot for mosque tourism. Although this mosque was constructed in 2016, it has demonstrated a simplicity in its scale and traditional image. It has value as a hybrid assimilation of HinduBuddhist syncretism and tolerance, and has coined the term Nusantara to denote its hybridised Malay and Javanese architectural styles. The typology of this humble Malay Mosque architecture is of medium-scale and reflects the Sufistic contextual value beliefs of encouraging religious and architectural tourism alike. The conceptual framework capitalises on the research gap found in mosque cultural, architectural and Sufistic beliefs. Research by further delving into constructing the “Sense of Place” in relation to the “Sacred Places”. This research employs qualitative methods of interviewing visitors, applying phenomenological and case study approaches supported by architectural documentation in emphasising the symbolic and semiotic aesthetics aspects in constructing the “Sense of Place” bonded by Sufistic symbolic aesthetics. The theory is constructed in the deeply rooted Islamic Mosque architecture via Sufistic beliefs that provides a platform for mosque tourism activities.