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A practical pressure measuring method for the upper urinary tract during ureteroscopy AbstractPurpose: e purpose of this study was to develop and test a method for measuring pressure in the upper urinary tract during ureteroscopic operations and to evaluate its e cacy and clinical signi cance.Methods: A total of 44 patients, each with a ureteral calculus in the proximal ureteral segment, were enrolled in the study group: 21 patients with an acute and 23 with a chronic obstruction. e ureteroscope was passed forward to the upper segment of the obstructed ureter immediately a er the calculus was broken and the intraluminal ureteral pressure was then transmitted along with the irrigant ow (0.9% sodium chloride).Results: e mean ureteral pressures of the acute obstruction subgroup, the chronic obstruction subgroup and the control group were 74.5 mmHg (22-180 mmHg), 32.5 mmHg (9-53 mmHg) and 10.2 mmHg (8-13 mmHg), respectively. A signi cant correlation was found between ureteral pressure and the following indexes: the duration of the obstruction (r=0.985), the diameter of the ureter above the calculus (r=0.878) and the depth of the hydronephrosis of the renal pelvis (r=0.862). No associations were observed between the pressure and the serum creatinine level (r=0.214) or the urinary leukocyte count (r=0.047). e intraluminal pressure correlated with the glomerular ow rate (GFR) of the a ected kidney (r =0.975, P =0.001).Conclusions: is new method is non-invasive, practical and reproducible. Measuring the intraluminal pressure of the ureter can provide a valuable index to quantify the severity of the obstruction of the upper urinary tract, which is helpful for the prediction of the affected renal function prognosis. [3][4][5], which risk invasive renal bleeding and urinary tract infection. Other methods, such as radionuclide renogram, Doppler vessel resistance and intravenous urography [6][7][8][9], lack sensitivity and speci city. A quantitative, non-invasive and e ective method is needed.Recently, ureteroscopy has become a common minimally invasive examination method in the treatment of ureteral calculi [10]. During ureteroscopy, the ureteroscope presses closely to the ureteral wall, and the intraluminal pressure of the ureter can be transmitted along with the owing of the irrigation uid. A er the ureteral calculi are fragmented, the ureteroscope passes the calculus, and the pressure of the ureter is measured by connecting the ureteroscope to a sensitive digital pressure monitor. In this study, we aimed to investigate the feasibility and e cacy of this method in patients with varying severities of calculus obstruction. Materials and Methods Clinical DataFrom July 2010 to July 2011, 44 consecutive patients, including 24 men and 20 women with an average age of 40.2 years (range 18-63 years), were enrolled in the study group. e inclusion criteria were ureteral obstruction caused by ureteral stones, accompanied by hydronephrosis or pyonephrosis. e exclusion criteria were severe de ciency of blood coagulation function and s...

The molecular impact of diabetes mellitus on prostate gland has not been elucidated. In this study, we performed a whole-genome cDNA microarray analysis using a streptozotocin-induced diabetic rat model to identify the effects of diabetes on the gene expression profiles in prostate. Our study shows that diabetes causes changes in the expression of multiple genes, particularly those related to cell proliferation and differentiation, oxidative stress, DNA damage repair, cell cycle checkpoints, angiogenesis and apoptosis. These findings were confirmed by real-time polymerase chain reaction and immunohistochemical staining using rat and human prostate tissue. We also used a cell culture model (human normal prostatic RWPE-1 cell line) to study the direct effect of high glucose. We found that high glucose caused increased intracellular oxidative stress and DNA damage, as well as downregulation of anti-oxidative enzymes and DNA damage repair genes MRE11 and XRCC3. Our findings provide important insights into understanding the pathogenesis of the diabetes-induced changes in prostate as well as identifying potential therapeutic targets for future studies.

Excess intracellular reactive oxygen species (ROS) beyond a threshold can induce apoptosis in cancer cells. However, the signal pathways that can augment the proapoptotic function of ROS remain largely unknown. We previously identified a tumor suppressor, alpha-tocopherol-associated protein (TAP), yet little is known regarding the role of TAP in the apoptotic signaling in prostate cancer. Interestingly, we recently found that exposure of prostate cancer cells to hydrogen peroxide (H 2 O 2 ) resulted in induced apoptosis as well as increased expression of TAP. Small interfering RNA (siRNA) mediated silencing of endogenous TAP expression conferred effective protection from H 2 O 2 -induced apoptosis. Further mechanistic study showed exposure of prostate cancer cells to H 2 O 2 resulted in increased phosphorylation of both JNK and c-Jun, and TAP siRNA effectively decreased H 2 O 2 -induced JNK and c-Jun phosphorylation. Immunoprecipitation experiments revealed that JNK physically associates with TAP. Furthermore, signaling downstream of JNK to the AP-1 complex and BH-3-only subfamily were found to be regulated on changing the TAP expression status. TAP could also promote the oxidative stress-induced apoptosis effect of docetaxel. In the mice xenograft model, H 2 O 2 treatment induced TAP expression, JNK phosphorylation and apoptosis of prostate cancer. Recombinant adeno-associated virus 2 (rAAV2)-TAP injection significantly sensitizes this H 2 O 2 proapoptotic effect. Together, we have identified a novel functional mechanism that the cross-talk of TAP-JNK is involved in oxidative stress-induced apoptosis in prostate cancer cells. Disrupting the redox balance of cancer cells by this signaling may enable therapeutic selectivity and provide benefit to overcome the drug resistance of prostate cancer.

Background and Purpose: Laparoendoscopic single-site (LESS) surgery through the retroperitoneal approach has been seldom reported. We aimed to compare the feasibility and outcomes of LESS and conventional laparoscopic surgery via the retroperitoneal approach in the management of large, impacted ureteral stones. Patients and Methods: From June 2010 to May 2011, LESS ureterolithotomy through the retroperitoneal approach was performed in 10 patients (the LESS group). Another 15 patients who underwent conventional retroperitoneal laparoscopic ureterolithotomy (the conventional laparoscopic group) by the same surgeon were involved and compared. The operative time, complications, and surgical outcomes were evaluated. Results: All the operations were completed successfully, without conversion to conventional laparoscopic or open surgeries. The operative time of the LESS group and of the conventional laparoscopic group were 132.7 -16.3 and 128.1 -20.1 minutes, respectively (P = 0.782). The estimated blood loss were 30.7 -5.9 vs 28.0 -4.5 mL (P = 0.620). Duration of analgesia postoperatively was 2.0 -0.8 vs 3.5 -0.5 days (P = 0.005). All targeted stones were successfully extracted without major complications. Postoperative urine leakage was noted in one patient in each group. Cosmetic results were superior in the LESS group according to both the study nurse's and the patients' assessments (8.5 vs 5.3; P = 0.012, and 8.3 vs 5.6; P = 0.025, respectively). All patients showed no obstructions or stricture formations on postoperative follow-up. Conclusions: In experienced hands, LESS for ureterolithotomy through the retroperitoneal approach is feasible and can acquire outcomes equal to those of conventional multiport laparoscopic surgery. Prospective long-term follow-up studies with a larger number of patients are needed to further evaluate its benefits.