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A single-nucleotide polymorphism (SNP) is a common DNA sequence variation in a population. Such variations can af fect susceptibilities and prognosis in various diseases. In terms of cancer, numerous efforts have been invested to identify the sources of genetic susceptibility. Through the outstanding studies of the International Human Genome Sequencing Project and the International HapMap Project, a large amount of data on genetic variations in the human genome has been accumulated, and this precious information has led to an explosion of investigations about SNPs. Prostate cancer is the most common malignancy in Western men, and the incidence of prostate cancer in Asian men is drastically increasing. More interestingly, prostate cancer shows not only a racial disparity but also a familial susceptibility in incidence, which suggests a strong influence of genetic factors. The biggest difference between prostate cancer and other malignancies is that androgens play a critical role in cancer progression from an early stage to castration-refractory prostate cancer. For this reason, numerous studies have f ocused on genetic polymorphisms of androgen and androgen receptor. Several studies have suggested that polymorphisms of repetitive CAG, GGC, and GGN repeats in the androgen receptor gene are associated with the incidence and mortality of prostate cancer, although this remains under debate [1,2,3]. In addition, genetic variations of cytochrome P450 (CYP17), which mediates activities essential for the production of sex steroids, have been reported to have borderline significant associations with the incidence of prostate cancer [4]. One important factor in the role of androgen in the prostate is 5-alpha-reductase (5-AR), which converts testosterone to dihydrotestosterone (DHT) in prostate cells. SRD5A1 and SRD5A2 encode 5-AR, and Lindstrom et al. [5] reported in a study based on 2,826 cancer cases and 1,705 controls that a polymorphism in SRD5A2 (rs623419) is associated with the risk of prostate cancer. Although this study recruited a relatively large number of cases and controls, the statistical significance was marginal, and the study did not include investigation of genetic influences on clinical or pathological outcomes. Audet-Walsh et al. [6] conducted a retrospective study in two independent cohorts composed of 526 white and 320 Asian men with localized prostate cancer, and four genetic variations (rs2208532, rs12470143, rs523349, and rs4952197 in SRD5A2) were associated with biochemical recurrence in both races. However, those investigators did not include clinical parameters such as Gleason score, prostate-specific antigen (PSA) level, or stage in their analysis. In this issue of the Journal, Choi et al. [7] report on the influence of genetic polymorphisms of SRD5A2 on prostate cancer risk and clinical outcomes in a Korean population. They selected 26 SNPs in the human SRD5A2 gene from international databases and investigated the correlations in 272 prostate cancer patients and 173 controls with benign prostatic hyperplasia. The data suggested that some SNPs and one haplotype were related to PSA levels, Gleason score, and clinical stage; however, SRD5A2 SNPs were not associated with susceptibility to prostate cancer. This study is highly informative because 26 SNPs were selected by use of comprehensive bioinformatics methods. Moreover, this case-control study included all available parameters for analysis. Advances in genotyping technologies have led to the feasibility of studying a large number of genetic polymorphisms, and the number of high-volume studies is rapidly increasing. However, we must keep in mind that the effects of genetic variation in incidence and prognosis of cancer are not outstanding and less than two folds. I believe that such genetic information should be combined with clinico-pathological variables to increase predictability, which could lead to a personalized risk classification for predicting the susceptibility and prognosis of prostate cancer.

Purpose: This study aimed to confirm the utility of the European Organization for Research and Treatment of Cancer (EORTC) and the Spanish Urological Club for Oncological Treatment (CUETO) scoring systems and to determine which model is preferred as a prognostic model in Korean patients with non-muscle-invasive bladder cancer. Materials and Methods: Between 1985 and 2011, 531 patients who were treated by transurethral resection of bladder cancer were retrospectively analyzed by use of the EORTC and CUETO models. Statistically, we performed Kaplan-Meier survival analysis; calculated Harrell’s concordance index, receiver operating characteristic (ROC) curve, and cutoff values; and performed univariate and multivariate Cox proportional hazards regression analyses. Results: For risk of recurrence, with the use of the EORTC model, all groups had statistically significant differences except between the group with a score of 0 and the group with a score of 1–4. With the use of the CUETO model, all groups differed significantly. For risk of progression, with the use of the EORTC model, significant differences were observed between all groups except between the group with a score of 2–6 and the group with a score of 7–13. With the use of the CUETO model, a significant difference was observed between the group with a score of 0 and the other groups. The concordance index of the EORTC and CUETO models was 0.759 and 0.836 for recurrence and 0.704 and 0.745 for progression, respectively. The area under the ROC curve for the EORTC and CUETO models was 0.832 and 0.894 for recurrence and 0.722 and 0.724 for progression, respectively. Conclusions: Both scoring systems, especially the CUETO model, showed value in predicting recurrence and progression in Korean patients, which will help in individualizing treatment and follow-up schedules.

Purpose: Following the introduction of medical therapy for benign prostatic hyperplasia (BPH), we determined the effect of the change in trends in medical therapy on the indication and outcome of surgical intervention for BPH. Materials and Methods: We compared the basic characteristics of, weight of resected tissue of, transfusions in, and postoperative complications of patients who underwent surgery between 1985 and 1989 (before the advent of medical therapy for BPH), between 1995 and 1999 (when medical therapy was developed and became widely used as alternative treatment), and between 2005 and 2009 (when medical therapy superseded surgical intervention to become first-line treatment and when combination therapy became widely adopted). Results: At our institution, the mean age and BMI of patients increased over the past two decades (p＜0.001). Hypertension, operation history, and other comorbidities also increased significantly (p＜0.001, p=0.005, and p＜0.001, respectively). The indications for surgery in 1985 to 1989, 1995 to 1999, and 2005 to 2009 were as follows: acute urinary retention in 34.7%, 20.2%, and 15.1% of patients and symptomatic deterioration in 61.1%, 72.3%, and 73.0% of patients, respectively. Prostate volume and the weight of resected tissue increased from 34.4±14.5 ml to 61.3±32.4 ml and from 7.2±6.4 g to 10.8±7.6 g, respectively, over two decades. Patients who underwent surgery in 2005 to 2009 had their catheters removed earlier (p＜0.001). Secondary hemorrhage within four postoperative weeks and repeat transurethral resection of the prostate within 1 year decreased significantly (p=0.03 and p=0.003, respectively). No statistically significant change in impaired detrusor contractility was found (p=0.523). Conclusions: Although patients who underwent surgery were older after widespread use of medical therapy for BPH, advancements in surgical techniques have benefitted these patients.

Purpose To analyze the independent effect of metabolic syndrome (MS) on nephrolithiasis (NL) despite differences in gender compared with the known lithogenic factors. Materials and Methods From 1995 to 2009, 40,687 Koreans were enrolled in the study and observed for the development of NL at a health promotion center. The examination included anthropometric and biochemical measurements as well as kidney ultrasonography. A student's t-test or chi-square test was used to characterize the participants and a standard Cox proportional hazards model was used to calculate the adjusted odds ratio of lithogenic risk factors in the NL model. Results The mean age of the study cohort was 44.9 years (range, 13-100 years), and 22,540 (55.4%) of the cohort was male. The incidence of NL was 1.5% (609 participants), with males exhibiting a higher incidence than females (1.9% vs 1.0%, p

Purpose To evaluate the efficacy of low-dose computed tomography (LDCT) for detecting urinary stones with the use of an iterative reconstruction technique for reducing radiation dose and image noise. Materials and Methods A total of 101 stones from 69 patients who underwent both conventional nonenhanced computed tomography (CCT) and LDCT were analyzed. Interpretations were made of the two scans according to stone characteristics (size, volume, location, Hounsfield unit [HU], and skin-to-stone distance [SSD]) and radiation dose by dose-length product (DLP), effective dose (ED), and image noise. Diagnostic performance for detecting urinary stones was assessed by statistical evaluation. Results No statistical differences were found in stone characteristics between the two scans. The average DLP and ED were 384.60±132.15 mGy and 5.77±1.98 mSv in CCT and 90.08±31.80 mGy and 1.34±0.48 mSv in LDCT, respectively. The dose reduction rate of LDCT was nearly 77% for both DLP and ED (p

Purpose: The present study aimed to determine the role played by β-defensin 124 (DEFB124) in the innate immunity of prostate epithelial RWPE-1 cells during bacterial infection. Materials and Methods: The expression of DEFB124 was examined by quantitative real-time polymerase chain reaction (PCR), Western blotting, and immunocytochemistry. Enzyme-linked immunosorbent assays and quantitative real-time PCR were performed to determine the production of cytokines and chemokines. Western blotting and chromatin immunoprecipitation studies were performed to assess the interaction between DEFB124 and nuclear factor-kappa B (NF-κB) in peptidoglycan (PGN)-stimulated RWPE-1 cells. By chemotaxis assay, we assessed the effect of DEFB124 on the migration of monocytes. Results: Exposure to PGN induced DEFB124 upregulation and NF-κB activation through IκBα phosphorylation and IκBα degradation. Bay11-7082, an NF-κB inhibitor, blocked PGN-induced DEFB124 production. Also, NF-κB was shown to be a direct regulator and to directly bind to the –3.14 kb site of the DEFB124 promoter in PGN-treated human prostate epithelial RWPE-1 cells. When DEFB124 was overexpressed in RWPE-1 cells, interestingly, the production of cytokines (interleukin [IL] 6 and IL-12) and chemokines (CCL5, CCL22, and CXCL8) was significantly increased. These DEFB124-upregulated RWPE-1 cells markedly induced chemotactic activity for THP-1 monocytes. Conclusions: Taken together, these results provide strong evidence for the first time that increased DEFB124 expression via NF-κB activation in PGN-exposed RWPE-1 cells enhances the production of cytokines and chemokines, which may contribute to an efficient innate immune defense.

Purpose: Complications after prostate biopsy have increased and various causes have been reported. Growing evidence of increasing quinolone resistance is of particular concern. In the current retrospective study, we evaluated the incidence of infectious complications after prostate biopsy and identified the risk factors. Materials and Methods: The study population included 1,195 patients who underwent a prostate biopsy between January 2007 and December 2012 at Chung-Ang University Hospital. Cases of febrile UTI that occurred within 7 days were investigated. Clinical information included age, prostate-specific antigen, prostate volume, hypertension, diabetes, body mass index, and biopsy done in the quinolone-resistance era. Patients received quinolone (250 mg intravenously) before and after the procedure, and quinolone (250 mg) was orally administered twice daily for 3 days. We used univariate and multivariate analysis to investigate the predictive factors for febrile UTI. Results: Febrile UTI developed in 39 cases (3.1%). Core numbers increased from 2007 (8 cores) to 2012 (12 cores) and quinolone-resistant bacteria began to appear in 2010 (quinolone-resistance era). In the univariate analysis, core number≥12 (p=0.024), body mass index (BMI)＞25 kg/m 2 (p=0.004), and biopsy done in the quinolone-resistance era (p=0.014) were significant factors. However, in the multivariate analysis adjusted for core number, the results were not significant, with the exception of BMI＞25 kg/m 2 (p=0.011) and biopsy during the quinolone-resistance era (p=0.035), which were significantly associated with febrile UTI. Conclusions: Quinolone resistance is the main cause of postbiopsy infections in our center. We suggest that further evaluation is required to validate similar trends. Novel strategies to find alternative prophylactic agents are also necessary.

Purpose The aim of this study was to evaluate the effectiveness of simultaneous flexible ureteroscopic removal of stones (URS) for ureteral and ipsilateral renal stones and to analyze the predictive factors for renal stone-free status. Materials and Methods We retrospectively reviewed the records of patients who underwent simultaneous flexible URS of ureteral and ipsilateral renal stones from January 2010 to May 2012. All operations used a flexible ureteroscope. We identified 74 cases of retrograde intrarenal surgery and 74 ureteral stones (74 patients). Stone-free status was respectively defined as no visible stones and clinically insignificant residual stones

Purpose The location of acetylcholinesterase-containing nerve fibers suggests a role for acetylcholine in both contractility and secretion in the prostate gland. The colocalization of nitrergic nerves with cholinergic nerves, and the cotransmission of nitric oxide with acetylcholine in cholinergic nerves, has been demonstrated in the prostate glands of various species. Thus, we investigated the effects of acetylcholine on phenylephrine-induced contraction and the correlation between cholinergic transmission and nitric oxide synthase by using isolated prostate strips of rabbits. Materials and Methods Isolated prostate strips were contracted with phenylephrine and then treated with cumulative concentrations of acetylcholine. Changes in acetylcholine-induced relaxation after preincubation with NG-nitroarginine methyl ester, 7-nitroindazole, and aminoguanidine were measured. The effects of selective muscarinic receptor antagonists were also evaluated. Results In the longitudinal phenylephrine-contracted strip, the cumulative application of acetylcholine (10-9 to 10-4 M) elicited a concentration-dependent relaxation effect. Acetylcholine-induced relaxation was inhibited not only by nitric oxide synthase inhibitors (10 µM L-NAME or 10 µM 7-nitroindazole) but also by 10 µM atropine and some selective muscarinic receptor antagonists (10-6 M 11-([2-[(diethylamino)methyl]-1-piperdinyl]acetyl)-5,11-dihydro-6H-pyrido[2,3-b][1,4]benzodiazepine-6-one and 10-6 M 4-diphenylacetoxy-N-methyl-piperidine). In contrast, relaxation was significantly increased by pretreatment of the strips with 10 mM L-arginine. Conclusions Acetylcholine relaxed phenylephrine-induced contractions of isolated rabbit prostate strips. This relaxation may be mediated via both cholinergic and constitutive nitric oxide synthase with both the M2 and M3 receptors possibly playing key roles.

Purpose We investigated the influence of overweight on 24-hour urine chemistry studies and recurrent urolithiasis (UL) in children. Materials and Methods A retrospective cohort study was designed to assess children who presented with UL at a pediatric institution between 1985 and 2010. We calculated body mass index percentile (BMIp) adjusted for gender and age according to the 2007 Korean Children and Adolescents Growth Chart and stratified the children into 3 BMI categories: lower body weight (LBW, BMIp≤10), normal BW (NBW, 10

Retrograde cystography and computed tomography (CT) are considered the gold standard for investigating bladder and pelvic bone injury. However, these methods can miss extraperitoneal bladder rupture caused by a penetrating bone fragment from a pelvic bone fracture. We experienced a routine conventional cystography and CT scan that failed to identify penetration of the bladder by a bone fragment, which thus delayed optimal treatment. Therefore, different diagnostic methods such as CT cystography or cystoscopy should be considered to rule out penetrating injury by a bony fragment in patients with extraperitoneal bladder rupture.

Purpose: We aimed to investigate the detection of nanobacteria (NB) from expressed prostatic secretions (EPS) in patients with category III chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and from vaginal swabs in patients with vaginitis by reverse transcriptase polymerase chain reaction (RT-PCR) and to evaluate the association between NB and Neisseria gonorrhea, Chlamydia trachomatis, Ureaplasma urealyticum (U. urealyticum), Mycoplasma hominis, Trichomonas vaginalis, and Mycoplasma genitalium. Materials and Methods: A group of 11 men attending a specialized CP/CPPS clinic and a group of 157 women who reported symptoms of lower genital tract infection were enrolled in this study. NB were detected by RT-PCR. A Seeplex Sexually Transmitted Disease Detection assay (Seegene Inc., Seoul, Korea) was used that could detect DNA for 6 types of sexually transmitted pathogens. Results: In EPS samples, the detection rate of NB in patients with CP/CPPS was 9.1%, and 9 (5.7%) of 157 vaginitis patients showed positive results in RT-PCR for NB in vaginal swabs. Associations observed among the 7 microorganisms included 6 (54.5%) patients who tested positive on EPS and 75 (47.8%) patients who tested positive on vaginal swabs. Five patients with vaginitis were found to have monoinfection of NB (6.7%). Conclusions: We found that conventional RT-PCR for NB was rapid, simple, low in cost, and easily available for the detection of NB, and that NB may be a possible etiological factor for vaginitis and CP/CPPS. The prevalence of U. urealyticum among the four patients with NB coinfection was 75%; the presence of U. urealyticum might therefore raise suspicion for nanobacterial infection.

Purpose The effects of leptin on female sexual behaviors are controversial, and studies on this topic are limited. The objectives of this study were to evaluate the direct effects of leptin on clitoral vasoreactivity in vitro and to determine the mechanism of action. Materials and Methods Isometric tension studies were conducted to determine the effects of pretreatment with leptin (10-8 M) on the contractile responses of rabbit clitoral corpus cavernosal smooth muscle strips. The effects of leptin were assessed on precontraction induced by phenylephrine (PE; 10-9-10-4 M) and KCl (35-140 mM). We also examined the effect of leptin on relaxation induced by acetylcholine (ACh; 10-9-10-4 M), verapamil (10-10-10-6 M), and sodium nitroprusside (10-9-10-4 M) in PE-precontracted (10-5 M) strips. Results Leptin enhanced ACh-induced relaxation in PE-precontracted strips. L-NAME pretreatment significantly reduced the effect of leptin on ACh-induced relaxation, whereas L-arginine potentiated the effect of leptin. Leptin decreased the KCl-induced contractile responses. Leptin increased verapamil-induced relaxation responses. The relaxation effects of leptin on KCl-induced contraction were inhibited by 10-5 M methylene blue and L-NAME pretreatment. Conclusions A high concentration of leptin enhances ACh-dependent relaxation in clitoral cavernosal smooth muscles. These relaxation effects of leptin may occur through an NO-dependent mechanism and voltage-dependent calcium channel blockade.

Purpose The aim of this study was to investigate the expression pattern of calcium-binding proteins S100A2 and S100A4. We also sought to determine the prognostic value of these markers for patients with prostate adenocarcinoma. Materials and Methods Immunohistochemical staining was performed to detect S100A2 and S100A4 expression in 26 tissue samples obtained during transurethral resection from patients with benign prostatic hyperplasia (BPH) and in 67 tissue samples obtained during prostate biopsy and radical prostatectomy from patients with prostate carcinoma. The immunoreactivity of these proteins was stratified on a scale of 0 to 3 and was correlated with the pathologic features of prostate adenocarcinoma. Results High expression of S100A2 was observed in the tissue of patients with BPH, whereas low or no expression was observed in prostate cancer (CaP) cells. The protein level of S100A4 was significantly higher in CaP than in BPH cells. The higher level of S100A4 observed in CaP tissue correlated with increasing tumor grade. Conclusions Decreased expression of S100A2 and increased expression of S100A4 may be important in the progression of CaP. This finding could aid in identifying aggressive CaP. The simultaneous analysis of S100A2 and S100A4 expression in prostate tissues may be a useful prognostic marker for CaP.

Purpose: The aim of this study was to investigate the changes in the clinical and prognostic parameters of prostate cancer in Korean men in the eras before and after prostate-specific antigen (PSA) testing. Materials and Methods: The medical records of 303 patients treated for prostate cancer between 1982 and 2005 were reviewed with respect to age, chief complaints, clinical stage, tumor grade, treatment options, and prognosis. We classified the patients as follows: those treated in the prePSA era (1982-1995, n=81), and those treated in the PSA era (1996-2000, PSA era phase 1, n=92; and 2001-2005, PSA era phase 2, n=130). Results: There was no significant difference in age or clinical stage between patients treated before and those treated during the PSA era, although there was a downward migration of grade. The cancer-specific survival rates were also not different in all cases and in metastatic prostate cancer cases between the pre-PSA era and the PSA era, although the overall survival rates were significantly greater in all cases in phase 2 of the PSA era than in the pre-PSA era or in phase 1 of the PSA era (p＜0.05). However, the cancer-specific survival rates for localized or locally advanced prostate cancer were significantly greater in phase 2 of the PSA era than in the pre-PSA era or in phase 1 of the PSA era (p＜0.05). Conclusions: We observed a downward migration of tumor grade, but there were no migrations in the age of patients or clinical stage, and these findings have not contributed to changes in the cancer survival of Korean men with prostate cancer after the advent of PSA testing. (Korean J Urol 2009;50:439-444)

Purpose: With the westernization of dietary life, domestic prostate cancer prevalence has remarkably increased recently. Therefore, to examine the effects of obesity on prostate cancer, we analyzed the effects of leptin and adiponectin, which are the cytokines secreted from adipocytes, on prostate cancer in vitro and confirmed the results by in vivo experiment. Materials and Methods: In vitro, the human androgen-independent prostate cancer cell line DU-145 was exposed to various concentrations of adiponectin and leptin, and their effects were measured with the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. In vivo, the effects of tumor growth were observed in xenografted nude mice with prostate cancer. Results: Adiponectin significantly repressed DU-145 cell growth in a dosedependent manner. Leptin promoted DU-145 cell growth in dose-dependent manner, but it was not significant statistically. In vivo, adiponectintreated mice demonstrated a reduced tumor volume, although it was not significant statistically. By contrast, leptin-treated mice showed a significantly increased tumor volume (p

Purpose: This study examined the significance of tubulin α and βII expression in benign prostatic hyperplasia (BPH) and prostate cancer. Materials and Methods: A total 103 cases diagnosed with either BPH or prostate cancer were divided into 4 groups: BPH (n=25), localized prostate cancer (n=41), locally advanced prostate cancer (n=18), metastatic prostate cancer (n=18). The tissues were taken through a transurethral resection of the prostate, suprapubic prostatectomy, prostatic needle biopsy or radical retropubic prostatectomy. The expression was measured by immunohistochemical staining. The degree of expression was graded on a 4-point scale. The data was compared in terms of stage, the serum prostatic specific antigen (PSA) level and Gleason score. The statistical comparisons were made using one-way ANOVA test and a Fisher's exact test. Results: The levels of tubulin α and βII expression were stronger in the patients with prostate cancer than those with BPH (p 0.05). The level of tubulin α expression was stronger in the patients with a Gleason score ≥8 than in those of Gleason score ≤7 (p

Purpose: This study aimed to investigate the effects of vasopressin and desmopressin on the contractile and relaxative responses of rabbit cavernosal smooth muscle. Materials and Methods: Isometric tension studies were conducted to investigate the effects of vasopressin (10−14-10−8M) and desmopressin (10−1410−8M) on the contraction and relaxation responses of rabbits cavernous muscle strips in an organ bath. The effects of pretreatment with phenylephrine (10−5M), L-NAME (10−5M) and indomethacin (10−5M) on the contraction and relaxation responses of the vasopressin and desmopressin were also investigated. The statistics were analyzed by Student's t-test and ANOVA. Results: Vasopressin contracted the strips in a dose-dependent manner, while desmopressin did not. The phenylephrine-induced contraction was dose-dependently increased by vasopressin, but it was dose-dependently relaxed by desmopressin. L-NAME pre-treatment did not block the relaxation response, but indomethacin pre-treatment did. Vasopressininduced contraction occurred the via V1 receptor, while desmopressininduced relaxation occurred via the V2 receptor. Conclusions: Vasopressin, in pathophysiological circumstances, would worsen erectile dysfunction. On the contrary, desmopressin, which may induce an endothelium-dependent relaxation of the cavernous smooth muscles, would be good for erectile function. (Korean J Urol 2008;49: 366-372) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Jung Hoon Kim, Soon Chul Myung From the Department of Urology, College of Medicine, Chung-Ang University, Seoul, Korea We report a case of metastatic renal cell carcinoma to the urinary bladder. A 61-year-old man presented with gross hematuria. The patient had been treated with a radical nephrectomy at 59 years of age, for renal cell carcinoma. Cystoscopy revealed two polyploid tumors protruding into to the urinary bladder. A transurethral resection was performed and the pathological diagnosis of the lesion in the urinary bladder was a renal cell carcinoma. Metastases to the paratracheal lymph nodes were confirmed on the chest computed tomography. The patient was treated with immunotherapy (5-fluorouracil, interferon-a, interleukin-2) for 20 weeks. Eleven months later, the patient is alive and well. (Korean J Urol 2007; 48:1088-1091) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Purpose: In mammals, αand β-defensins are antimicrobial peptides that are expressed in various epithelial and phagocytic cells. Human β-defensin-1 and -2 (hBD-1, hBD-2) have recently been shown to be expressed in various epithelial cells. Vaginal mucosa can be a target of vaginitis and the site of uropathogens' colonization that precedes urinary tract infections. Therefore, innate host defense mediators like antimicrobial peptides in the vaginal mucosa are important. Estrogen and progesterone receptors have been shown to be expressed in the vaginal squamous epithelium. Sex hormones like estrogen and progesterone may cause vaginal atrophy or susceptibility to uropathogens. So, we performed this study to investigate the expression patterns of hBD-1 and -2 mRNA in vaginal squamous epithelium (VSE) with using lipopolysaccharide (LPS), 17β-estradiol and progesterone. Materials and Methods: Normal VSE cells that were retrieved from vaginal tissue during vaginoplasty were primarily cultured in keratinocyte growth medium and they we allowed to undergo their 3rd passage. Modulation of the expressions of hBD-1 and -2 mRNA by various stimuli (LPS 0.5μg/ml, E2 2nM, P 1μM) was measured by semiquantitative reverse transcription polymerase chain reaction (RT-PCR). Results: HBD-1 and -2 were constitutively expressed in the normal VSE cell lines, but the hBD-2 expression was not significant. A marked increase of the constitutive expression of hBD-2 mRNA was observed upon stimulation with LPS, but not upon stimulation with E2. A moderate decrease of the constitutive expression of hBD-2 mRNA upon stimulation with LPS was observed with administering progesterone. Conclusions: These expressions of hBD-2 mRNA may have important roles in the innate host defense of the urogenital area. Artificial intake of progesterone may lead to susceptibility via a decrease of defensins. (Korean J Urol 2007;48:439-443)

Purpose: Chronic prostatitis frequently occurs in men of all ages. Recent studies suggest that fastidious microorganisms may play a role in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The aim of this study was to evaluate the usefulness and significance of multiplex polymerase chain reaction (PCR) in the diagnosis of CP/CPPS. Materials and Methods: First voided urine (FVU) and/or expressed prostatic secretions (EPS) were collected from 92 patients. Multiplex PCR, using Dual Specificity Oligo (DSO TM ) primers, was used to test for Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV) and Ureaplasma urealyticum (UU). Results: Multiplex PCR can be easily analyzed via visual comparison. Nine (39.1%) of the 23 CP/CPPS IIIa and 12 (17.4%) of the 69 IIIb patients had positive multiplex PCR, with a total of 27 microorganisms isolated, including CT, MH, MG, UU, TV and NG in 9, 7, 4, 4, 2 and 1 case, respectively. Co-infections with 2 or 3 organisms occurred in 5 cases. For the samples collected from 32 patients for both FVU and EPS, 68.7% gave the same results. Conclusions: Multiplex PCR, using DSO TM primers, can be useful for the simple detection of fastidious microorganisms in CP/CPPS. To achieve reliable results with multiplex PCR, feasible guidelines and standardization are of major importance. Further studies will be required to define the usefulness of molecular tests for CP/CPPS in clinical practice. (Korean J Urol 2007;48:304-309)

47세 남자 환자가 내원 8개월 전부터 크기가 증가한 매우 큰 우측 음낭 종물을 주소로 내원하였다. 음낭 손상, 배뇨장 애 등 다른 비뇨기과 질환은 없었으며, 체중감소 등 전신질 환 소견 및 가족력상 특이점은 없었다. 신체검사에서 좌측 고환은 정상적으로 촉지되었으나 우측 고환은 종물에 의해 촉지되지 않았으며, 종물의 크기는 18x18x10cm로 우측 서 혜부로 연장되어 있었다. 종물은 딱딱하였고, 고정되어 있 었으며, 동통 및 압통은 없었으며 투시되지 않았다. 일반 혈 액검사, 소변검사, 고환암에 대한 종양 지표 검사 등의 검사 실소견은 모두 정상이었다. 음낭 초음파 검사에서 종물은 혈관이 발달된 고형 양상 을 보였고, 촉지되지 않았던 우측 고환을 포함하여 양측 고 환은 정상적으로 관찰되었다. 복부 및 골반전산화단층촬영 에서는 8.5x6cm 크기의 조영이 증강되는 부분을 포함한 16x14cm의 저밀도 종물이 관찰되었고, 격막도 부분적으로 조영증강 소견이 나타났으며, 6.5x5.5x12cm 크기로 우측 서 혜부로 연장되어 있었다 (Fig. 1). 림프절 전이나 원격전이 소견은 관찰되지 않았다. 음낭절개를 하여 종물을 우측 고환을 포함하여 광범위하 음낭에서 발생한 침습성 혈관점액종

Purpose: Interleukin-6 (IL-6) can stimulate a variety of tumors including prostatic carcinoma. Research has recently shown that IL-6 may act to stimulate the progression of prostatic cancer. IL-6 is elevated in the sera of patients with metastatic prostatic cancer and it has been shown to be a candidate marker of disease activity. To date, little work has been performed to characterize the nature of granulocyte macrophage colonystimulating factor (GM-CSF) and the expression of IL-6. The aim of this study is to evaluate the effects of GM-CSF on the expression of IL-6 in PC-3 cells. Materials and Methods: The bone-derived PC-3 cell line was used in this study. Reverse transcription polymerase chain reaction (RT-PCR) was performed to detect the GM-CSF and also the IL-6 mRNA expression. The IL-6 protein was measured by enzyme-linked immunosorbent assay (ELISA) after treatments with the hGM-CSF. Results: hGM-CSF was expressed in the PC-3 cell line. Our data indicated that the IL-6 mRNA expression was not increased at 4, 8 and 12 hours by the hGM-CSF in comparison to the control group, but it was slightly increased at 24 and 48 hours. The expression of IL-6 protein was increased at 4, 8, 12, 24 and 48 hours after hGM-CSF treatment, in comparison with the control group. Conclusions: The IL-6 mRNA expression was slightly increased by hGMCSF at 24 and 48 hours in comparison to the control group. Yet the IL-6 protein expression increased before the IL-6 mRNA expression. Therefore, hGM-CSF may modulate the post-transcription pathway of the IL-6 expression in prostate carcinoma cells. Our data suggest that GM-CSF may have a possible IL-6 mediated pathophysiologic role in prostate cancer. (Korean J Urol 2006;47:786-790)

Purpose: The enhanced expression of the cyclooxygenase-2 (COX-2), prostaglandin E2 receptor (EPs) and endothelin-1 (ET-1) axis is known to play a significant role in the development and progression of several malignancies. To date, little work has been done to investigate the relationships between the COX-2, EPs and ET-1 axis in prostate cancer (PC) cells. The aim of this study is to investigate the expression of preproET-1 (PPET-1), ET-1 receptor A (ETAR), and endothelin converting enzyme-1 (ECE-1) in the PC cell lines and to evaluate the effects of COX-2 and EPs on the expression of PPET-1, ETAR, and ECE-1. Materials and Methods: Two PC cell lines, PC-3 and DU-145 cells were used for this study. By performing reverse transcription polymerase chain reaction (RT-PCR), the mRNA expressions of PPET-1, ETAR and ECE-1 were detected, and then the mRNA expressions of PPET-1, ETAR and ECE-1 were detected after being treating the cells with selective COX-2 inhibitor (NS-398), or EP2 (butaprost) and EP4 (misoprostol), which are both agonist of 10, 10 and 10M. Results: PPET-1, ETAR and ECE-1 mRNA were expressed in both cell lines. After NS-398 treatment, only the PPET-1 mRNA expression was decreased at 4, 8 and 12 hours in the PC-3 cells. EP2 and EP4 agonist induced an increase for the PPET-1, ETAR and ECE-1 mRNA expressions, compared with the NS-398 treated group (control), in the PC-3 cells. Conclusions: ET-1/ETAR and ECE-1, whose expressions are increased by EP2 and EP4, may play key roles in the development and progression of PC via COX-2. A combination treatment with selective inhibitors for COX-2, EPs and ETAR would be novel approach to prostate cancer therapy. (Korean J Urol 2006;47:195-200)