Effect of Bladder Neck Preservation on Long-Term Urinary Continence after Robot-Assisted Laparoscopic Prostatectomy: A Systematic Review and Meta-Analysis

This study aimed to evaluate the effect of bladder neck preservation (BNP) on long-term urinary continence after robot-assisted laparoscopic prostatectomy (RALP). We systematically searched the PubMed, Embase, and Cochrane Library databases to identify studies that assessed the difference in urinary continence and oncologic outcomes between patients who underwent RALP with BNP and those who underwent RALP without BNP. Four trials (1880 cases with BNP, 727 controls without BNP) were considered suitable for meta-analysis. BNP was associated with significantly better urinary continence outcomes at 3-4 months (odds ratio (OR), 2.88; 95% confidence interval (CI), 1.52-5.48; p = 0.001), 12 months (OR, 2.03; 95% CI, 1.10-3.74; p = 0.02), and 24 months (OR, 3.23; 95% CI, 1.13-9.20; p = 0.03) after RALP. There was no difference in the rate of overall positive surgical margin (PSM) (OR, 1.00; 95% CI, 0.72-1.39; p = 0.99) and that of PSM at the prostate base (OR, 0.49; 95% CI, 0.21-1.13; p = 0.09) between the two groups. The BNP technique during RALP leads to early return of urinary continence and long-term urinary continence without compromising the oncologic outcomes.ope

Androgen Deprivation Therapy in Patients with Prostate Cancer is Associated with the Risk of Subsequent Alzheimer's Disease but Not with Vascular Dementia

Purpose: We aimed to investigate the association between androgen deprivation therapy (ADT) and the risk of dementia according to subtypes of dementia in men with prostate cancer. Materials and methods: We performed a nationwide population-based cohort study using the nationwide claims database in Korea. A total of 195,308 men with newly diagnosed prostate cancer were identified between January 2008 and December 2017, and 132,700 men were selected for analysis after applying inclusion and exclusion criteria. The patients were divided into ADT and non-ADT groups. To adjust for imbalances in relevant comorbidities between the groups, exact matching was performed. Study events included newly developed Alzheimer's disease, vascular dementia, and overall dementia. Cox proportional hazard regression models were used. Results: After exact matching, 44,854 men with prostate cancer were selected for the main analysis. In age-adjusted Cox regression analysis, the ADT group was significantly associated with increased risks for overall dementia (hazard ratio [HR], 1.070; 95% confidence interval [CI], 1.009-1.134; p=0.0232) and Alzheimer's disease (HR, 1.086; 95% CI, 1.018-1.160; p=0.0127), compared to the non-ADT group. No difference in vascular dementia risk was observed between the two groups (HR, 0.990; 95% CI, 0.870-1.126; p=0.8792). Conclusions: The risk of overall dementia increased in men who received ADT. According to dementia subtypes, ADT was associated with an increased risk of Alzheimer's disease, but not with vascular dementia.ope

Seasonal variations in overactive bladder drug prescription rates in women: a nationwide population-based study

Purpose: Colder seasons can aggravate lower urinary tract symptoms, especially an overactive bladder (OAB). This aspect has been extensively studied in men and rarely in women. We investigated whether colder seasons influence OAB-drug prescription rates (OAB-DPRs) in women. Methods: Women aged > 18 years were selected from the Korean Health Insurance Review and Assessment Service-National Patient Sample data between 2012 and 2016. OAB-DPR was calculated according to age and seasonal groups. The prescription rates in summer (June, July, and August) and winter (January, February, and December) months were compared. Sub-analysis was performed according to age group. Results: In total, 3,061,343 adult women were included. The overall OAB-DPR was 3.75% (114,940/3,061,343). Overall OAB-DPRs in summer and winter were 1.41% (43,090/3,061,343) and 1.54% (47,038/3,061,343), respectively (p < 0.001). Seasonal variations in OAB-DPRs differed by age group (p < 0.001): OAB-DPRs were significantly lower in winter than in summer months in women aged < 50 years (odds ratio 0.942; 95% confidence interval 0.918-0.967; p < 0.001), but significantly higher in winter than in summer months in women aged ≥ 50 years (odds ratio 1.153; 95% confidence interval 1.135-1.171; p < 0.001). Conclusion: In this study, a correlation was noted between OAB-DPR and seasons. OAB-DPRs were higher in the summer in women aged < 50 years and higher in the winter in women aged ≥ 50 years. Our findings suggest that female hormonal status may be involved in the contradictory effect of seasons on OAB symptoms.restrictio

Animal model for Alzheimer’s disease and uses thereof

본 발명은 상동재조합 방법을 이용한 알츠하이머 동물모델 및 이의 용도에 관한 것으로서, 보다 구체적으로는 Presenilin 2 유전자의 141번 아미노산이 N에서 I로 치환된 Psen2 N141I 알츠하이머 동물모델 및 이의 용도에 관한 것이다. 본 발명은 동물 자체의 정상 유전자의 발현에 더해서 FAD 인간 유전자를 과발현하는 기존의 형질전환 방식의 동물 모델에 비해, 마우스의 정상 Psen2 유전자를 인간에서 보고된 치매 돌연변이와 동일한 변이를 발현하도록 치환하였고, 또 알츠하이머 환자의 돌연변이와 동일하게 이형접합 (heterozygous) 돌연변이를 도입함으로써 자연적인 발현수준을 유지하도록 하여 인간 치매를 더욱 정확하게 모델링이 가능함으로 치매 발병기전에 대한 정밀한 분석에 활용될 수 있다. 또한, LPS 복강주사를 통해 염증성 사이토카인의 발현을 통한 신경염증 유도 알츠하이머 모델을 제조함으로써 노화에 의한 치매모델과 달리 단기간 내(2개월) 치매 동물 모델을 구현할 수 있어 활용도가 높을 것으로 기대된다

Effects of Adjuvant Chemotherapy on Locally Advanced Upper Tract Urothelial Carcinoma: A Systematic Review and Meta-analysis

INTRODUCTION: We aimed to perform a systematic review and meta-analysis to evaluate the current role of adjuvant chemotherapy (ACH) after radical nephroureterectomy (RNU) in patients with locally advanced upper tract urothelial carcinoma (UTUC). MATERIALS AND METHODS: The PubMed/MEDLINE, EMBASE, and Cochrane Library databases were searched for relevant studies in English from January 1980 to April 2019. The inclusion criteria was determined based on the population, intervention, comparator, outcome, and study design. The endpoints were disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS). Hazard ratios (HRs) and 95% confidence intervals (CIs) of each endpoint were extracted from the included studies. RESULTS: A total of 11 studies were included in the final analysis to investigate the role of ACH in locally advanced UTUC. Overall, 798 patients received ACH after RNU, and 1496 patients underwent RNU alone. The pooled HRs for DFS, CSS, and OS among the studies were 0.59 (95% CI, 0.43-0.81; P = .001), 0.73 (95% CI, 0.55-0.95; P = .02), and 0.84 (95% CI, 0.59-1.19; P = .32), respectively. The quality of evidence of each outcome determined by the Grading of Recommendations, Assessments, Developments, and Evaluation approach was low for 2 outcomes and very low for the other outcome. CONCLUSIONS: ACH following RNU may improve DFS and CSS in patients with locally advanced UTUC. When comparing previously reported meta-analysis of all UTUC patients, the beneficial effects of ACH on CSS might be more pronounced in patients with locally advanced UTUC.restrictio