• Journal of Yeungnam Medical Science
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• v.40 no.3
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• pp.252-258
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• 2023

Background: The purpose of this study was to investigate whether postoperative cystography findings can predict early and longterm recovery from incontinence after radical prostatectomy (RP), compared with the other cystography parameters. Methods: I retrospectively reviewed 118 patients who underwent robot-assisted RP (RARP) for localized prostate cancer at single institution between January 2016 and April 2021. One hundred and seven patients were included in the study. Postoperative cystography was routinely performed 7 days after surgery. The bladder neck to pubic symphysis ratio, vesicourethral angle, and bladder neck anteroposterior length (BNAP) ratio (the bladder neck-posterior margin distances divided by the anteroposterior lengths) were evaluated. Continence was defined as cessation of pad use. The association between these variables and urinary incontinence was also analyzed. Results: The urinary incontinence recovery rates 1, 3, 6, and 12 months after RARP were 43.92%, 66.35%, 87.85%, and 97.19%, respectively. Multivariate logistic regression analysis demonstrated that a lower BNAP ratio and wider vesicourethral angle were significantly associated with continence restoration at 1, 3, and 6 months after surgery. In addition, in terms of days of pad usage, lower BNAP ratio, wider vesicourethral angle, and bladder neck preservation were significantly associated with recovery from urinary incontinence within 12 months as assessed by Cox proportional hazard analysis. Conclusion: This study demonstrated that vesicourethral angle and BNAP ratio were independent predictors of early recovery from post-prostatectomy incontinence. I suggest that both the sagittal and coronal views of postoperative cystography help anticipate early continence restoration after RARP.

• Journal of Korean Medical Science
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• v.33 no.45
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• pp.285.1-285.10
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• 2018

Background: Robot-assisted radical prostatectomy (RARP) is a feasible treatment option for high-risk prostate cancer (PCa). While patients may achieve undetectable prostate-specific antigen (PSA) levels after RARP, the risk of disease progression is relatively high. We investigated metastasis-free survival, cancer-specific survival (CSS), and overall survival (OS) outcomes and prognosticators in such patients. Methods: In a single-center cohort of 342 patients with high-risk PCa (clinical stage ${\geq}T3$, biopsy Gleason score ${\geq}8$, and/or PSA levels ${\geq}20ng/mL$) treated with RARP and pelvic lymph node dissection between August 2005 and June 2011, we identified 251 (73.4%) patients (median age, 66.5 years; interquartile range [IQR], 63.0-71.0 years) who achieved undetectable PSA levels (< 0.01 ng/mL) postoperatively. Survival outcomes were evaluated for the entire study sample and in groups stratified according to the time to biochemical recurrence dichotomized at 60 months. Results: During the median follow-up of 75.9 months (IQR, 59.4-85.8 months), metastasis occurred in 38 (15.1%) patients, most often to the bones, followed by the lymph nodes, lungs, and liver. The 5-year metastasis-free, cancer-specific, and OS rates were 87.1%, 94.8%, and 94.3%, respectively. Multivariate Cox-regression analysis revealed time to recurrence as an independent predictor of metastasis (P < 0.001). Time to metastasis was an independent predictor of OS (P = 0.003). Metastasis-free and CSS rates were significantly lower among patients with recurrence within 60 months of RARP (log-rank P < 0.001). Conclusion: RARP confers acceptable oncological outcomes for high-risk PCa. Close monitoring beyond 5 years is warranted for early detection of disease progression and for timely adjuvant therapy.

• Journal of Yeungnam Medical Science
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• v.38 no.1
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• pp.39-46
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• 2021

Background: To determine the benefit of pelvic floor muscle exercise (PFME) with visual biofeedback on promoting patient recovery from incontinence, we investigated variables associated with the early restoration of continence for patients who underwent robot-assisted radical prostatectomy (RARP). Methods: Of the 83 patients enrolled, 41 consecutive patients completed PFME (the exercise group), and the other 42 consecutive patients just before the PFME program commenced (the control group). The primary outcome was whether PFME engagement was associated with zero pad continence restoration within 3 months of surgery. Results: Continence restoration percentages (defined as zero pads used per day) at 1, 3, and 6 months after surgery were 49.4%, 77.1%, and 94.0%, respectively. The exercise group achieved significantly higher recovery rates at 1 month (p=0.037), 3 months (p<0.001), and 6 months (p=023). Cox regression analysis demonstrated that a lower Gleason score (<8; hazard ratio [HR], 2.167), lower prostate specific antigen (<20 ng/dL; HR, 2.909), and engagement in PFME (HR, 3.731) were independent predictors of early recovery from postprostatectomy incontinence. Stratification by age showed that those younger than 65 years did not benefit significantly from exercise (log-rank test, p=0.08), but that their elderly counterparts, aged 65-70 years (p=0.007) and >70 years old (p=0.002) benefited significantly. Conclusion: This study suggests that postoperative engagement in PFME with biofeedback speeds up the recovery of continence in elderly patients (≥65 years old) that undergo RARP.

• Applied Chemistry for Engineering
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• v.27 no.1
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• pp.26-34
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• 2016

In this study, core-crosslinked amphiphilic polymer (CCAP) nanoparticles prepared using a reactive amphiphilic polymer precursor (RARP) were used for preparing some valuable compounds encapsulated polymer nanoparticles with high payload through nanoprecipitation process. Various solvents (acetone, ethanol, and THF) having different polarity and CCAP nanoparticles prepared using different amphiphilicity were used for the preparation of ${\alpha}$-tocopherol encapsulated polymer nanoparticles to investigate their effects on the encapsulation efficiency, payload, nanoparticle size, and stability. CCAP dissolved in hydrophobic solvent, THF, could form ${\alpha}$-tocopherol encapsulated polymer nanoparticles dispersed in water with the high payload of ${\alpha}$-tocopherol and encapsulation efficiency. Because of their physically and chemically robust nano-structure originated from crosslinking of the hydrophobic core, CCAP nanoparticles could encapsulate ${\alpha}$-tocopherol with the high payload (33 wt%) and encapsulation efficiency (97%), and form 70 nm-sized stable nanoparticles in water.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2591-2596
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• 2014

Purpose: To evaluate the prognostic value of the expression of excision repair cross-complementation group l (ERCC1), MutS protein homolog 2 (MSH2) and poly ADP-ribose polymerase 1 (PARP1) in non-small-cell lung cancer patients receiving platinum-based postoperative adjuvant chemotherapy. Methods: Immunohistochemistry was applied to detect the expression of ERCC1, MSH2 and PARP1 in 111 cases of non-small cell lung cancer paraffin embedded surgical specimens. Through og-rank survival analysis, we evaluated the prognostic value of the ERCC1, MSH2, PARP1 and the related clinicopathological factors. COX regression analysis was used to determine whether ERCC1, MSH2 and PARP1 were independent prognostic factors. Results: In the enrolled 111 non-small cell lung cancer patients, the positive expression rate of ERCC1, MSH2 and RARP1 was 33.3%, 36.9% and 55.9%, respectively. ERCC1 (P<0.001) and PARP1 (P=0.033) were found to be correlated with the survival time while there was no correlation for MSH2 (P=0.298). Patients with both ERCC1 and PARP1 negative cancer had significantly longer survival time than those with ERCC1 (P=0.042) or PARP1 (P=0.027) positive alone. Similalry, the survival time of patients with both ERCC1 and PARP1 positive cancer was shorter than those with ERCC1 (P=0.048) or PARP1 (P=0.01) positive alone. Conclusion: Patients with ERCC1 or PARP1 negative non-small cell lung cancer appear to benefit from platinum-based postoperative adjuvant chemotherapy.