• Title/Summary/Keyword: Lower Urinary Tract Symptoms

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Utility of Digital Rectal Examination, Serum Prostate Specific Antigen, and Transrectal Ultrasound in the Detection of Prostate Cancer: A Developing Country Perspective

  • Kash, Deep Par;Lal, Murli;Hashmi, Altaf Hussain;Mubarak, Muhammed
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3087-3091
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    • 2014
  • Purpose: To determine the utility of digital rectal examination (DRE), serum total prostate specific antigen (tPSA) estimation, and transrectal ultrasound (TRUS) for the detection of prostate cancer (PCa) in men with lower urinary tract symptoms (LUTS). Materials and Methods: All patients with abnormal DRE, TRUS, or serum tPSA >4ng/ml, in any combination, underwent TRUS-guided needle biopsy. Eight cores of prostatic tissue were obtained from different areas of the peripheral prostate and examined histopathologically for the nature of the pathology. Results: PCa was detected in 151 (50.3%) patients, remaining 149 (49.7%) showed benign changes with or without active prostatitis. PCa was detected in 13 (56.5%), 9 (19.1%), 26 (28.3%), and 103 (74.6%) of patients with tPSA <4 ng/ml, 4-10 ng/ml, 10-20 ng/ml and >20 ng/ml respectively. Only 13 patients with PCa had abnormal DRE and TRUS with serum PSA <4 ng/ml. The detection rate was highest in patients with tPSA >20 ng/ml. The association between tPSA level and cancer detection was statistically significant (p<0.01). Among 209 patients with abnormal DRE and raised serum PSA, PCa was detected in 128 (61.2%). Conclusions: The incidence of PCa increases with increasing serum level of tPSA. The overall screening and detection rate can be further improved by using DRE, TRUS and TRUS-guided prostate needle biopsies.

Formulation and Preparation of Sustained Release Pellet for Alfuzosin HCI Using Fluid-bed coater (유동층 코팅기를 이용한 염산알푸조신의 서방형 과립 설계 및 제조)

  • Na, Jin-Sang;Yoon, Yang-No;Seo, Hui;Jeong, Sang-Young;Park, Eun-Seok;Hwan, Sung-Joo;Shin, Byung-Cheol;Kim, Sung-Hoon;Cho, Sun-Hang
    • Journal of Pharmaceutical Investigation
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    • v.38 no.6
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    • pp.387-392
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    • 2008
  • Alfuzosin, an Alphal-adrenoceptor antagonist is used for the treatment of patients with voiding and in a lesser extent storage lower urinary tract symptoms (LUTS) associated to benign prostatic hyperplasia (BPH). The objective of this study was to formulate sustained release alfuzosin HCl granules and assess their formulation variables. The $Eudragit^{(R)}$ as a polymer, sustained release membrane, and dibutyl sebacate (DBS) as a plasticizer were used. Multi-coated alfuzosin HCl delivery systems composed of sugar sphere, various excipients, $Eudragit^{(R)}$ and HPMC (hydroxy propyl methyl cellulose), Cellulose Acetate were prepared by fluid-bed coater. Membrane layer were used $Eudragit^{(R)}$ RS PO and NE 30D. And the alfuzosin HCl coated beads were coated immediate release drug layer for initial burst. Its dissolution test was carried out compared to conventional products ($XATRAL^{(R)}$ XL). The release rate of drug from coated beads was higher than that from $XATRAL^{(R)}$ XL in pH 6.8.

Albizzia julibrissin Suppresses Testosterone-induced Benign Prostatic Hyperplasia by Regulating 5α-Reductase Type 2 - Androgen Receptor Pathway

  • Hong, Geum-Lan;Kim, Hyun-Tae;Park, Se-Ra;Lee, Na-Hyun;Ryu, Kyung-A;Kim, Tae-Won;Song, Gyu-Yong;Jung, Ju-Young
    • Natural Product Sciences
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    • v.25 no.3
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    • pp.200-207
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    • 2019
  • Albizzia julibrissin (AJ) is an herbal medicine that shows low toxicity, promotes promoting blood circulation and mitigates the inflammation and has mild side effects. Benign prostate hyperplasia (BPH) is one of the most common diseases that occurs in older males and often results in lower urinary tract symptoms. This study was conducted to evaluate the protective effect of AJ against BPH using LNCaP cells and Sprague Dawley rats treated with testosterone. Treatment with AJ extract reduced the expression of androgen receptor (AR) and prostate-specific antigen (PSA) in vitro. In vivo, rats were divided into 6 groups: 1 (Normal Control); 2 (Testosterone propionate (TP) alone); 3 (TP + finasteride); 4 (TP + AJ 10 mg/kg); 5 (TP + AJ 50 mg/kg); 6 (TP + AJ 300 mg/kg). The groups treated with AJ showed reduced the relative prostate weights and BPH-related proteins were altered, with decreased AR, PSA and proliferating cell nuclear antigen (PCNA) observed by western blot. Histopathological analysis revealed the therapeutic effect of AJ, with a decreased thickness of epithelial cells and reduced level of PCNA and $5{\alpha}$-reductase type 2. These results suggest that AJ extract could ameliorate testosterone-induced benign prostatic hyperplasia.

Effects of High Concentrations of Naftopidil on Dorsal Root-Evoked Excitatory Synaptic Transmissions in Substantia Gelatinosa Neurons In Vitro

  • Uta, Daisuke;Hattori, Tsuyoshi;Yoshimura, Megumu
    • International Neurourology Journal
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    • v.22 no.4
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    • pp.252-259
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    • 2018
  • Purpose: Naftopidil ((${\pm}$)-1-[4-(2-methoxyphenyl) piperazinyl]-3-(1-naphthyloxy) propan-2-ol) is prescribed in several Asian countries for lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Previous animal experiments showed that intrathecal injection of naftopidil abolished rhythmic bladder contraction in vivo. Naftopidil facilitated spontaneous inhibitory postsynaptic currents in substantia gelatinosa (SG) neurons in spinal cord slices. These results suggest that naftopidil may suppress the micturition reflex at the spinal cord level. However, the effect of naftopidil on evoked excitatory postsynaptic currents (EPSCs) in SG neurons remains to be elucidated. Methods: Male Sprague-Dawley rats at 6 to 8 weeks old were used. Whole-cell patch-clamp recordings were made using SG neurons in spinal cord slices isolated from adult rats. Evoked EPSCs were analyzed in $A{\delta}$ or C fibers. Naftopidil or prazosin, an ${\alpha}1$-adrenoceptor blocker, was perfused at $100{\mu}M$ or $10{\mu}M$, respectively. Results: Bath-applied $100{\mu}M$ naftopidil significantly decreased the peak amplitudes of $A{\delta}$ and C fiber-evoked EPSCs to $72.0%{\pm}7.1%$ (n=15) and $70.0%{\pm}5.5%$ (n=20), respectively, in a reversible and reproducible manner. Bath application of $100{\mu}M$ prazosin did not inhibit $A{\delta}$ or C fiber-evoked EPSCs. Conclusions: The present study suggests that a high concentration of naftopidil reduces the amplitude of evoked EPSCs via a mechanism that apparently does not involve ${\alpha}1$-adrenoceptors. Inhibition of evoked EPSCs may also contribute to suppression of the micturition reflex, together with nociceptive stimulation.

A Study on Health Behaviors and Problems of Female Retail Workers (유통업 여성 근로자의 건강 문제와 건강 행위에 관한 연구)

  • Kim, Souk-Young;Yun, Soon-Nyung
    • Research in Community and Public Health Nursing
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    • v.11 no.1
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    • pp.127-145
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    • 2000
  • The objectives of this study are to identify health behaviors and health problems. and the relations between health behaviors and health problems of female workers in the retail business. The number of subjects were 200 female workers of 6 department stores in Seoul and Kyonggi area, whose jobs last more than 6 months as retail employees. The data was collected during 2 months from July 1 to August 30, 1998. The Cornell Medical Index Health Questionnaire(CMI) was used to measure their health problems, while health behaViorn were investigated in terms of 'smoking', 'alcohol', exercise', 'diet', and 'sleeping'. The data were analyzed with frequency. percentage, t-test, ANOVA test, and $X^2-test$ by SPSS PC+ program. The results of this study are as follows: 1. Out of health problems. Digestive symptoms occupied the highest percent number. nervous ones the second and cardiovascular ones the third among physical health problems of retail female workers. The most frequent mental health problem was 'adequacy' and the next, 'tension' and 'anger', 2, Health problems according to general characteristics of subjects were shown that the younger or the unmarried complained more than the older or the married, especially in the items of 'eye and ear', 'respiratory system', 'cardiovascular system', 'digestive tract', 'nervous system', 'adequacy', and 'depression'. The longer working duration they have had, the more they complained of 'respiratory system' and 'adequacy'. The lower academic careers complained of 'nervous' than the higher ones with statistical significance. 3. The analysis of daily health clinic notes showed that respiratory complaints were the highest percent, successively followed by digestive tract, nervous one, external injury, musculoskeletal system, urinary-reproductive system and others. 4. The level of their health practice was generally low in smoking, diet habit and alcohol intake, exercise, sleeping, very low especially in smoking, diet, alcohol intake, and exercise among them all. 5. Present smokers and ones with past experience complained of physical and mental health problems of 'respiratory system', 'digestive tract', 'skin', 'nervous', 'urinary-reproductive system', 'fatigability', adequacy', 'depression', 'anxiety', 'anger' and 'tension', than non smokers, with statistical difference. Workers without having breakfast and with irregular diet had more complaints on 'digestive tract', 'adequacy' and 'tension', than those who had regular dietary habit. The less the subjects slept, the more they complained of eye and ear, cardiovascular system. The subjects who drank alcohol complained more digestive problem. However, whether they exercise or not did not affect physical and mental health problems in a significant manner. 6. The subjects' age and marital status were statistically significant relating to health behaviors, as the younger or unmarried recorded a low level of health practice in smoking, drinking, dietary habit. Based on the results, the suggestions are made as follows: 1. Health education program on smoking, alcohol intake, diet habit is needed to improve health problems and health behavior of female retail workers. 2. The unmarried workers of late teen and twenties, who are transitional period from teenagers to adulthood are important targets for health promotion program especially for maternal health. 3. Better working environment with sufficient time and facilities for workers to relax is required to promote female sales workers' health. 4. Further research is required to identify the relation between workers' visual fatigue and intense lights for the display of goods.

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Urological Manifestations and Laboratory Findings in Patients with Tethered Cord Syndrome (Tethered cord 증후군에서 비뇨기계 증상 및 검사 소견)

  • Jung Tae-Sung;Kim Eun-Jung;Lee Eun-Sil;Shin Son-Moon;Moon Han-Ku;Park Yong-Hoon
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.155-160
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    • 1997
  • Purpose : Tethered cord syndrome is characterized by progressive motor and sensory disturbances in lower extremities, foot deformities caused by a pathologic fixation of spinal cord resulting in excessive stretching of the spinal cord. It is also frequently associated with urological symptoms include urinary frequency, incontinence, enuresis, urgency and recurrent urinary tract infection. Because there is few report in the literature about urological manifestations of theterd cord syndrome, we conducted a retrospective study on the patients diagnosed as tethered cord syndrome to delineate the characteristics of urologic manifestations in tethered cord syndrome and to establish the policy to evaluate patients who is suspected of tethered cord syndrome. Method : A retrospective study was conducted by reviewing the medical records of nine patients who was diagnosed as tethered cord syndrome from November 1991 to July 1996 in Yeungnam University Hospital. Result : 1) The age distribution of nine patients was as follows; 5 patients were under 2 years, 1 case from 2 to 6 years and 3 cases from 6 to 10 years. 2) Of 9 patients 6 had voiding frequency, urinary incontinence, enuresis, urgency and loss of micturation sense. Radiologic urodynamic studies revealed neurogenic bladder in 5 patients, hydronephrosis and hydroureter in 3, vesicoureteral reflux in 3. 3) Of 6 patients with urological abnormal manifestations 4 underwent spinal cord surgery (detethering). In spite of surgical intervention, the urological manifestations improved in only one patient. Conclusion : Urological abnormalities were common in tethered cord syndrome. Abnormal laboratory findings including urodynamic study were found even before the onset of urological symptoms. We have to concern tethered cord syndrome as one of common causes of voiding frequency and enuresis and to evaluate urological abnormalities as thetered cord syndrome is diagnosed.

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Image Analysis of Computer Aided Diagnosis using Gray Level Co-occurrence Matrix in the Ultrasonography for Benign Prostate Hyperplasia (전립선비대증 초음파 영상에서 GLCM을 이용한 컴퓨터보조진단의 영상분석)

  • Cho, Jin-Young;Kim, Chang-Soo;Kang, Se-Sik;Ko, Seong-Jin;Ye, Soo-Young
    • The Journal of the Korea Contents Association
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    • v.15 no.3
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    • pp.184-191
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    • 2015
  • Prostate ultrasound is used to diagnose prostate cancer, BPH, prostatitis and biopsy of prostate cancer to determine the size of prostate. BPH is one of the common disease in elderly men. Prostate is divided into 4 blocks, peripheral zone, central zone, transition zone, anterior fibromuscular stroma. BPH is histologically transition zone urethra accompanying excessive nodular hyperplasia causes a lower urinary tract symptoms(LUTS) caused by urethral closure as causing the hyperplastic nodule characterized finding progressive ambient. Therefore, in this study normal transition zone image for hyperplasia prostate and normal transition zone image is analyzed quantitatively using a computer algorithm. We applied texture features of GLCM to set normal tissue 60 cases and BPH tissue 60cases setting analysis area $50{\times}50pixels$ which was analyzed by comparing the six parameters for each partial image. Consequently, Disease recognition detection efficiency of Autocorrelation, Cluster prominence, entropy, Sum average, parameter were high as 92~98%.This could be confirmed by quantitative image analysis to nodular hyperplasia change transition zone of the prostate. This is expected secondary means to diagnose BPH and the data base will be considered in various prostate examination.

Cumulative Probability of Prostate Cancer Detection Using the International Prostate Symptom Score in a Prostate-specific Antigen-based Population Screening Program in Japan

  • Kitagawa, Yasuhide;Urata, Satoko;Narimoto, Kazutaka;Nakagawa, Tomomi;Izumi, Kouji;Kadono, Yoshifumi;Konaka, Hiroyuki;Mizokami, Atsushi;Namiki, Mikio
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7079-7083
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    • 2014
  • The International Prostate Symptom Score (IPSS) is often used as an interview sheet for assessing lower urinary tract symptoms (LUTS) at the time of prostate-specific antigen (PSA) testing during population-based screening for prostate cancer. However, the relationship between prostate cancer detection and LUTS status remains controversial. To elucidate this relationship, the cumulative probability of prostate cancer detection using IPSS in biopsy samples from patients categorized by serum PSA levels was investigated. The clinical characteristics of prostate cancer detected using IPSS during screening were also investigated. A total of 1,739 men aged 54-75 years with elevated serum PSA levels who completed the IPSS questionnaire during the initial population screening in Kanazawa City, Japan and underwent systematic transrectal ultrasonography-guided prostate biopsy between 2000 and 2013 were enrolled in the present study. Of the 1,739 men, 544 (31.3%) were diagnosed with prostate cancer during the observation period. The probability of cancer detection at 3 years in the entire study population was 27.4% and 32.7% for men with $IPSS{\leq}7$ and those with $IPSS{\geq}8$, respectively; there was no statistically significant difference between groups. In men with serum PSA levels of 6.1 to 12.0ng/mL at initial screening, the probability of cancer detection was significantly higher in men with $IPSS{\leq}7$ than in those with $IPSS{\geq}8$. There were no significant differences in clinical characteristics between groups of patients stratified by IPSS. These findings indicate that the use of IPSS for LUTS status evaluation may be useful for prostate cancer detection in the limited range of serum PSA levels.

The Significance of Renal Imaging Studies in the Diagnosis of Acute Pyelonephritis (급성 신우신염의 진단을 위한 영상 검사의 유용성)

  • Han, Hye-Jung;Kim, Ji-Hee;Lee, In-Sil;Lee, Hye-Sun
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.212-219
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    • 2007
  • Purpose : It is difficult to diagnose acute pyelonephritis(APN) in young children, because of their nonspecific symptoms. The younger the age, the higher the risk of renal scars after APN, which can be prevented by early diagnosis and treatment. We compare the significance of renal imaging studies by age for diagnosis of APN in febrile urinary tract infection(UTI) in children. Methods : Fifty-three hospitalized children(34 patients under age 2 and 19 patients over age 2) with febrile UTI and who had undergone dimercaptosuccinic acid(DMSA) scan, renal ultra sonography(RUS) and voiding cystourethrography(VCUG) during the acute stage were re-viewed. We compared the renal imaging studies between the different age groups. Results : The DMSA scan showed cortical defects in 23.5% of patients under age 2, which was significantly lower than 63.2% of patents over age 2(P<0.05). The renal cortical defects on DMSA scan were associated only with a high peripheral leukocyte count, but not with fever duration, erythrocyte sedimentation rate(ESR), and C-reactive protein(CRP). And there was no correlation between the DMSA scan, VCUG or RUS findings. Conclusions : The DMSA scan is not sensitive for diagnosis of APN in children less than 2 years of age and the findings cannot predict the presence of vesicoureteral reflux(VUR). VCUG may be necessary for proper management in this age group.

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