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Crohn disease is a chronic, transmural, inflammatory disease of the gastrointestinal tract with unknown etiology. It can affect any part of the gastrointestinal tract and may cause fistula, stricture, or abscess formation with disease progression. The preoperative diagnosis and definite management of this rare complication are challenges for physicians, urologists, and surgeons.

To present oncologic results of laparoscopic radical prostatectomy (LRP) monotherapy for men with high-risk, localized prostate cancer, and to find factors associated with a good prognosis via surgery alone.Between 2002 and 2009, 241 men underwent LRP at an Asian tertiary referral center. Among them, we retrospectively identified 85 (35.3%) men who met the D'Amico's high-risk criteria: Prostate-specific antigen level20 ng/mL, Gleason score of 8 to 10, or clinical stage ≥T2c. Perioperative parameters were analyzed against biochemical recurrence (BCR)-free survival.At a median follow-up of 54 months, BCR developed in 28 (34.1%), with an actuarial BCR-free survival rate of 63.3% at 5 years. Pathologically, 37.6% of the men had organ-confined (OC) disease. Positive surgical margins (PSM) were identified in 49.4% of the patients. A favorable pathologic outcome, defined as OC(+)PSM(-), was observed in 24 patients and associated with a 5-year BCR-free survival rate of 87.0%, compared with 100%, 54.0%, and 46.4% in men with OC(+)PSM(+), OC(-)PSM(-) and OC(-)PSM(+) disease (log-rank, P=0.008). The overall positive lymph node rate was 14.1%. Men (65.9%) with only one D'Amico risk factor had a 5-year BCR-free survival rate of 76.9%, compared with 34.6% in men (34.1%) with ≥2 risk factors (log-rank, P0.001).Radical prostatectomy monotherapy performed laparoscopically or robotically appears to be an option for high-risk prostate cancer, especially in men with a single D'Amico risk factor. Men with ≥2 risk factors are more prone for BCR to develop after surgery and may need second-line therapy.

Background: Pivotal phase III data have shown the efficacy and safety of degarelix (240 mg starting dose/80 mg maintenance dose [240/80 mg]) in North American and European patients with prostate cancer (PCa). This open-label, multicenter, single-arm trial has evaluated the efficacy and safety of degarelix in Taiwanese patients with PCa.Methods: Eligible patients received degarelix 240/80 mg monthly for 6 months. The primary objective was the efficacy of degarelix in achieving and maintaining serum testosterone below castrate levels (≤0.5 ng/mL). Secondary objectives included changes in serum testosterone and PSA, and safety.Results: One hundred and ten patients were allocated to treatment. Over six months, degarelix maintained serum testosterone at castrate levels; from Days 28-168, the cumulative probability of sustained castrate level testosterone was 97.2% (95% CI: 91.6-99.1%), meeting the primary objective. Degarelix rapidly suppressed serum testosterone levels, with castrate levels achieved by Days 3 in 93.5% of patients. PSA decreased rapidly from baseline, with a median reduction of 92.4% by Day 28. Degarelix was well tolerated, with the most frequent adverse events (AEs) being mild to moderate injection site reactions (ISRs), occurring mostly with the initial dose of degarelix. There were no immediate-onset systemic hypersensitivity reactions observed.Conclusions: In Taiwanese patients with PCa, a monthly degarelix 240/80 mg/mL dose regimen rapidly decreased testosterone and PSA levels, and maintained testosterone at castrate levels (≤ 0.5 ng/ mL) over 6 months. The safety profile of degarelix was consistent with that expected for elderly men with PCa undergoing androgen deprivation therapy (ADT).

The aim of this study was to investigate prognostic molecular targets for selecting patients with muscle-invasive bladder cancer undergoing bladder-preserving therapy. Pretreatment biopsy samples from patients with muscle-invasive bladder cancer receiving trimodality bladder-preserving therapy were analyzed for expression levels of p53, p16, human epidermal growth factor receptor-2 (Her-2), epidermal growth factor receptor (EGFR), nuclear factor-kappa B (NF&kappa, B, p65), E-cadherin, matrix metalloproteinase-9 (MMP9), meiotic recombination 11 homolog (MRE11), programmed death-1 ligand (PD-L1), and mismatch repair proteins (MLH1, PMS2, MSH2, and MSH6) by immunohistochemical (IHC) staining. The correlations between these molecular markers with local progression-free survival (LPFS), distant metastasis-free survival (DMFS), and overall survival (OS) were explored. Biopsy samples from 41 out of 60 patients were evaluated using IHC. Univariate analysis revealed that the high expression of NF&kappa, B is associated with significantly worse LPFS, DMFS, and OS, and low expression of p16 is associated with significantly lower LPFS. Upon further multivariate analysis including sex, age, stage, and selected unfavorable factors in the model, NF&kappa, B and p16 independently remained significant. The investigational in vitro study demonstrated that irradiation induces up-regulation of NF&kappa, B signaling. Irradiated bladder cancer cells showed increased invasion capability and clonogenic survival, inhibition of NF&kappa, B signaling by an NF&kappa, B inhibitor, SC75741, or RNA interference reversed the observed increases. NF&kappa, B expression (p65) is associated with prognostic significance for both LPFS and DMFS in patients treated with bladder-preserving therapy, with consistent impact on cell viability of bladder cancer cells. NF&kappa, B may be a putative molecular target to help with outcome stratification.

e16550 Background: Prostate cancer (PC) is generally resistant to current immune checkpoint blockade. Reduced expression of human leukocyte antigen-A (HLA-A) and b2-microglobulin (B2M) of cancer cells can cause deficit immune recognition and attack by cytotoxic T cells, and may be the major mechanism of intrinsic resistance to immune checkpoint blockade in PC patients. Methods: Formalin-fixed paraffin-embedded tissue of human localized or metastatic PC was used for evaluation of expression of HLA-A and B2M by Immunohistochemical staining. The expression was scored as: 0, no tumor cells stained; 1+, < 10% of tumor cells stained; 2+, 10-50% of tumor cells stained; and 3+, > 50% of tumor cells stained. Differences in HLA-A or B2M expression among groups were assessed by Chi-Square or Fisher’s exact test. Results: A total of 134 PC specimens [69 localized PC (LPC), 32 metastatic castration-naïve PC (mCNPC), and 33 metastatic castration-resistant PC (mCRPC)] from 115 patients were assessed. Significant loss (0 or 1+) of HLA-A was found in 56 (81.2%) LPCs, 30 (93.8 %) mCNPCs and 29 (87.9%) mCRPCs; while significant loss of B2M was found in 22 (32.6%) LPC, 11 (34.4%) mCNPCs, and 17 (51.2%) mCRPCs. In localized PCs, the expression of HLA-A or B2M was similar between high-grade prostate intraepithelial neoplasia foci and corresponding malignant counterpart, and did not significantly correlate to biochemical failure. In 14 patients with paired CN and CR PC specimens, significant loss of HLA-A was found in all tumors. B2M expression varied between CN and CR PCs, and progressive loss of B2M was found in 7 (50%) patients. Among 3 patients receiving immune checkpoint blockade, 1 patient with intact expression of HLA-A and B2M in pre-treatment tumor specimen achieved partial response; whereas the others with reduced expression of HLA-A (0) and B2M (1+) did not. Conclusions: Reduced expression of HLA-A or B2M is an early event in prostate carcinogenesis.

Transrectal ultrasound-guided prostate (TRUS-P) needle biopsy is a common procedure for detection of prostate cancer. Complications associated with TRUS-P biopsy are almost always minor and do not require hospitalization. Pelvic hematoma following TRUS-P biopsy is an extremely rare complication. Only a few cases have been reported in the past. Here we report the case of a 67-year-old man diagnosed with pelvic hematoma following TRUS-P biopsy who presented with tenderness in the lower abdomen and ecchymosis in the paraumbilical region, lower abdomen, and scrotum. To our knowledge, no other case has been reported in Taiwan. Therefore, we discuss this case report and review the literature associated with complication of TRUS-P biopsies.

Aldosterone-producing adenoma (APA) and bilateral adrenal hyperplasia are the two characteristic types of primary aldosteronism. Dysregulation of adrenal cortical cell proliferation contributes to both diseases. We previously demonstrated that APA expressed less dopamine D2 receptor than the respective non-tumor tissue and might contribute to the overproduction of aldosterone. As activation of D2 receptor inhibits the proliferation of various cells, downregulation of D2 receptor in APA may play a role in the tumorigenesis of APA. In this study, we demonstrate that D2 receptor plays a role in angiotensin II (AII)-stimulated adrenal cortical cell proliferation. The D2 receptor agonist, bromocriptine, inhibited AII-stimulated cell proliferation in primary cultures of the normal human adrenal cortex and APA through attenuating AII-induced phosphorylation of PK-stimulated cyclin D1 protein expression and cell proliferation. D2 receptor also inhibited AII-induced ERK1/2 phosphorylation. Our results demonstrate that, in addition to inhibiting aldosterone synthesis/production, D2 receptor exerts an anti-proliferative effect in adrenal cortical and APA cells by attenuating PKCμ and ERK phosphorylation. The lower level of expression of D2 receptor in APA may augment cell proliferation and plays a crucial role in the tumorigenesis of APA. Our novel finding suggests a new therapeutic target for primary aldosteronism.

Nuclear factor-kappa B (NF-κB) transcription factors have been suggested to be involved in prostate cancer progression. Activated NF-κB translocates to the nucleus, binds to NF-κB binding sites and regulates target gene expression, leading to the given physiological response. It was hypothesised that the sequence variants in NF-κB binding sites might affect prostate cancer progression. We systematically evaluated 15 single-nucleotide polymorphisms (SNPs) within NF-κB binding sites those were predicted using a genome-wide database in a cohort of 1024 prostate cancer patients. Associations of these SNPs with prostate cancer characteristics and clinical outcomes after radical prostatectomy (RP) for localised disease, and after androgen-deprivation therapy (ADT) for advanced disease were assessed by Kaplan-Meier analysis and Cox regression model. We found that PSMD7 rs2387084 and MYCN rs1429409 were significantly related to earlier onset of prostate cancer and advanced clinical stage, respectively. No SNPs were significantly associated with disease recurrence after RP. Four and three SNPs were notably associated with prostate cancer-specific mortality (PCSM) and all-cause mortality (ACM), respectively, after ADT. LSAMP rs13088089, CCL17 rs223899, PSMD7 rs2387084 and MON1B rs284924 remained the significant predictors for PCSM whilst PSMD7 rs2387084 remained a significant predictor for ACM in multivariate models including clinical predictors. Moreover, we also noted that there were strong effects of the combined genotype on PCSM and patients with a greater number of unfavourable genotypes had a shorter time to PCSM during ADT (P for trend0.001). It was concluded that SNPs inside NF-κB binding sites might be useful to improve outcome prediction in prostate cancer patients.

Background/PurposeCigarette smoking, exposure to secondhand smoke, and arsenic exposure are well known risk factors for developing urothelial carcinoma (UC). We investigated the combined effects of cigarette smoking, exposure to secondhand smoke, and the presence of urinary total arsenic on the risk of developing UC.MethodsWe conducted a hospital-based, case–control study involving 261 UC patients and 672 cancer-free control individuals between September 2002 and May 2009.ResultsIndividuals who had smoked 100 cigarettes in their lifetime (ever smokers) and had a high urinary total arsenic level, had increased risks of developing UC (3.20-fold and 6.45-fold greater), respectively, compared to individuals who were never smokers and had a low urinary total arsenic level. Individuals who had high urinary total arsenic levels and had been exposed to secondhand smoke, and individuals with high urinary arsenic levels who had not been exposed to secondhand smoke, had increased chances (2.71-fold and 5.00-fold greater, respectively) of developing UC, compared to individuals who were not exposed to secondhand smoke and had low urinary total arsenic levels. Ever smokers who had been exposed to secondhand smoke and had a high urinary total arsenic level had the greatest increased risk for developing UC (10.82-fold greater).ConclusionIndividuals in a Taiwanese population who smoked cigarettes, were exposed to secondhand smoke, and a high urinary total arsenic level, had a significant risk for developing UC.

Objectives Emphysematous pyelonephritis is a severe necrotizing infection of the renal parenchyma and perirenal tissues that is caused by gas-producing bacterial pathogens. The aim of the present study was to determine the clinical characteristics and prognostic factors of patients with emphysematous pyelonephritis. Methods We retrospectively analyzed the clinical and laboratory data, imaging findings, and outcomes of 32 patients with emphysematous pyelonephritis. Receiver operating characteristic curve analysis was carried out on variables that were significantly associated with patient mortality. Results The overall survival rate was 87.5% (28/32). Escherichia coli (43.6%) was the most common organism cultured from urine and blood specimens. Hypoalbuminemia, shock as the presenting feature, bacteremia, need for hemodialysis and polymicrobial infection were significantly more common in cases resulting in death. The area under the receiver operating characteristic curve was 0.96. The cut-off point determined by the maximum Youden index (0.93) for three of these five factors yielded a sensitivity of 1.00 and specificity of 0.93. Shock as an initial presentation (P = 0.039) and polymicrobial infection (P = 0.010) were significantly associated with poor outcome. There were no significant differences in the clinical or laboratory features of the patients who did or did not undergo nephrectomy. Conclusion Hypoalbuminemia, shock as an initial presentation, bacteremia, indications for hemodialysis and polymicrobial infection represent prognostic factors for mortality in patients with emphysematous pyelonephritis. Patients presenting with more than two of these prognostic factors carry the highest risk of mortality, and they require timely diagnosis and aggressive management.

Purpose Hepatocellular carcinoma (HCC) is one of the most common and lethal human malignancies. Lack of efficient therapy for advanced HCC is a pressing problem worldwide. This study aimed to determine the efficacy and mechanism of combined sorafenib and radiation therapy treatment for HCC. Methods and Materials HCC cell lines (PLC5, Huh-7, Sk-Hep1, and Hep3B) were treated with sorafenib, radiation, or both, and apoptosis and signal transduction were analyzed. Results All 4 HCC cell lines showed resistance to radiation-induced apoptosis; however, this resistance could be reversed in the presence of sorafenib. Inhibition of phospho-STAT3 was found in cells treated with sorafenib or sorafenib plus radiation and subsequently reduced the expression levels of STAT3-related proteins, Mcl-1, cyclin D1, and survivin. Silencing STAT3 by RNA interference overcame apoptotic resistance to radiation in HCC cells, and the ectopic expression of STAT3 in HCC cells abolished the radiosensitizing effect of sorafenib. Moreover, sorafenib plus radiation significantly suppressed PLC5 xenograft tumor growth. Conclusions These results indicate that sorafenib sensitizes resistant HCC cells to radiation-induced apoptosis via downregulating phosphorylation of STAT3 in vitro and in vivo.

To investigate the role of lymphadenectomy in uterine endometrioid carcinoma based on the 2009 FIGO staging system.Using an institution-maintained cancer registry database, all patients who were treated surgically for endometrial cancer from 1991 to 2008 in two medical centers were analyzed. Kaplan-Meier and Cox proportional hazards methods were used to determine the role of lymphadenectomy.From 961 women with uterine endometrioid carcinoma, 680 underwent lymphadenectomy and 281 did not. Young age, early-stage disease, low-grade tumor, and lymphadenectomy were favorable independent prognostic factors. The five-year disease-specific survival (DSS) of stages IA, IB, II, and III, and the two-year DSS of stage IV patients who underwent lymphadenectomy were 97.8%, 88.3%, 91.5%, 70.5%, and 32.1%, respectively, compared to 98.7%, 70.0%, 73.3%, 42.9%, and 16.6% in those without lymphadenectomy (p0.05 for stage IA; p0.01 for stages IB-IV, log-rank test). In high-risk patients (i.e., poorly-differentiated, outer-half myometrial invasion, and stages II-IV), more extensive lymph node resection was associated with an improved five-year DSS, from 71.3% (1-10 nodes removed) and 85.3% (11-20 nodes removed) to 86.8% (20 nodes removed) (p = 0.02, log-rank test). For stage IIIC-IV patients with nodal metastasis, the extent of node resection also significantly improved the five-year DSS, from 34.4% (1-10 nodes removed) and 62.4% (11-20 nodes removed) to 79.6% (20 nodes removed) (p = 0.04, log-rank test).Lymphadenectomy improves the survival of patients with uterine endometrioid carcinoma stage IB to stage IV. The extent of lymphadenectomy also improves the survival of high-risk patients and those with nodal disease.

Aristolochic acid (AA), a component of all Aristolochia-based herbal medicines, is a potent nephrotoxin and human carcinogen associated with upper urinary tract urothelial carcinoma (UUC). To investigate the clinical and pathological characteristics of AA-induced UUC, this study included 152 UUC patients, 93 of whom had been exposed to AA based on the presence of aristolactam-DNA adducts in the renal cortex. Gene sequencing was used to identify tumors with A:T-to-T:A transversions in TP53, a mutational signature associated with AA. Cases with both aristolactam-DNA adducts and A:T-to-T:A transversions in TP53 were defined as AA-UUC, whereas patients lacking both of these biomarkers were classified as non-AA-UUC. Cases with either biomarker were classified as possible-AA-UUC. Forty (26%), 60 (40%), and 52 (34%) patients were classified as AA-UUC, possible-AA-UUC and non-AA-UUC, respectively. AA-UUC patients were younger (median ages: 64, 68, 68 years, respectively; p=0.189), predominately female (65%, 42%, 35%, respectively; p=0.011), had more end-stage renal disease (28%, 10%, 12%, respectively; p=0.055), and were infrequent smokers (5%, 22%, 33%, respectively; p=0.07) compared to possible-AA-UUC and non-AA-UUC patients. All 14 patients who developed contralateral UUC had aristolactam-DNA adducts; ten of these also had signature mutations. The contralateral UUC-free survival period was shorter in AA-UUC compared to possible- or non-AA-UUC (p=0.019 and 0.002, respectively), whereas no differences among groups were observed for bladder cancer recurrence. In conclusion, AA-UUC patients tend to be younger and female, and have more advanced renal disease. Notably, AA exposure was associated with an increased risk for developing synchronous bilateral and metachronous contralateral UUC.

Cyclin D1 (CCND1) is an important cell-cycle regulator involved in carcinogenesis and progression of prostate cancer. We tested whether genetic variations within the CCND1 gene are related to clinical outcomes in prostate cancer patients receiving radical prostatectomy.A total of 320 clinical localized prostate cancer patients who underwent radical prostatectomy in Taiwan were prospectively follow-up in this study. A total of 5 tagged single-nucleotide polymorphisms that captured the genetic variability across the CCND1 gene were genotyped, and the prognostic significance on prostate-specific antigen (PSA) recurrence was assessed using the Kaplan-Meier analysis and Cox regression model.We found a polymorphism, rs9344, and 2 haplotypes, GAGG and CTGG, consisting of rs667515, rs2450254, rs9344, and rs678653, were associated with PSA recurrence (P ≤ 0.033). After adjusting for other clinicopathologic predictors, including age, PSA levels, pathologic stage, Gleason score, and surgical margin, rs9344 and the haplotype CTGG remained significant (P ≤ 0.044). The model based on clinical variables plus CCND1 rs9344 or haplotype showed improvement over the model without genetic information, as indicated by ≥ 7.2 % net reclassification improvement (P ≤ 0.040), integrated discrimination index (P ≤ 0.041), and likelihood ratio test (P ≤ 0.028).Our data suggest that the CCND1 rs9344 and a specific haplotype CTGG may be prognostic factors for PSA recurrence after radical prostatectomy.

Inter-individual variation in the metabolism of xenobiotics, caused by factors such as cigarette smoking or inorganic arsenic exposure, is hypothesized to be a susceptibility factor for urothelial carcinoma (UC). Therefore, our study aimed to evaluate the role of gene–environment interaction in the carcinogenesis of UC. A hospital-based case–control study was conducted. Urinary arsenic profiles were measured using high-performance liquid chromatography–hydride generator-atomic absorption spectrometry. Genotyping was performed using a polymerase chain reaction-restriction fragment length polymorphism technique. Information about cigarette smoking exposure was acquired from a lifestyle questionnaire. Multivariate logistic regression was applied to estimate the UC risk associated with certain risk factors. We found that UC patients had higher urinary levels of total arsenic, higher percentages of inorganic arsenic (InAs%) and monomethylarsonic acid (MMA%) and lower percentages of dimethylarsinic acid (DMA%) compared to controls. Subjects carrying the GSTM1 null genotype had significantly increased UC risk. However, no association was observed between gene polymorphisms of CYP1A1, EPHX1, SULT1A1 and GSTT1 and UC risk after adjustment for age and sex. Significant gene–environment interactions among urinary arsenic profile, cigarette smoking, and GSTM1 wild/null polymorphism and UC risk were observed after adjustment for potential risk factors. Overall, gene–environment interactions simultaneously played an important role in UC carcinogenesis. In the future, large-scale studies should be conducted using tag-SNPs of xenobiotic-metabolism-related enzymes for gene determination.

Folate metabolism has been associated with cancers via alterations in nucleotide synthesis, DNA methylation, and DNA repair. We hypothesized that genetic variants in methylenetetrahydrofolate reductase (MTHFR), a key enzyme of folate metabolism, would affect the prognosis of prostate cancer. Three haplotype-tagging single-nucleotide polymorphisms (SNPs) across the MTHFR gene region were genotyped in a cohort of 458 patients with clinically localized prostate cancer treated with radical prostatectomy. One SNP, rs9651118, was associated with disease recurrence, and the association persisted after multivariate analyses adjusting for known risk factors. Public dataset analyses suggested that rs9651118 affects MTHFR expression. Quantitative real-time polymerase chain reaction analysis revealed that MTHFR expression is significantly upregulated in prostate tumor tissues when compared with adjacent normal tissues. Furthermore, overexpression of MTHFR correlates with cancer recurrence and death in two independent publicly available prostate cancer datasets. In conclusion, our data provide rationale to further validate the clinical utility of MTHFR rs9651118 as a biomarker for prognosis in prostate cancer.

Radium-223 is a first-in-class α-emitting radiopharmaceutical that targets bone metastases associated with metastatic castration-resistant prostate cancer (mCRPC). In the pivotal phase III trial ALSYMPCA, radium-223 significantly increased overall survival (OS), compared with placebo (median 14.9 vs 11.3 months; hazard ratio 0.70; 95% CI 0.58–0.83; p

Aberrant Wnt signaling has been associated with many types of cancer. However, the association of inherited Wnt pathway variants with clinical outcomes in prostate cancer patients receiving androgen deprivation therapy (ADT) has not been determined. Here, we comprehensively studied the contribution of common single nucleotide polymorphisms (SNPs) in Wnt pathway genes to the clinical outcomes of 465 advanced prostate cancer patients treated with ADT. Two SNPs, adenomatous polyposis coli (APC) rs2707765 and rs497844, were significantly (p ≤ 0.009 and q ≤ 0.043) associated with both prostate cancer progression and all-cause mortality, even after multivariate analyses and multiple testing correction. Patients with a greater number of favorable alleles had a longer time to disease progression and better overall survival during ADT (p for trend ≤ 0.003). Additional, cDNA array and in silico analyses of prostate cancer tissue suggested that rs2707765 affects APC expression, which in turn is correlated with tumor aggressiveness and patient prognosis. This study identifies the influence of inherited variants in the Wnt pathway on the efficacy of ADT and highlights a preclinical rationale for using APC as a prognostic marker in advanced prostate cancer.

This study investigated whether plasma selenium levels modified the risk for prostate cancer (PC) related to arsenic exposure. We conducted a case-control study that included 318 PC patients and 318 age-matched, healthy control subjects. Urinary arsenic profiles were examined using HPLC-HG-AAS and plasma selenium levels were measured by ICP-MS. We found that plasma selenium levels displayed a significant dose-dependent inverse association with PC. The odds ratio (OR) and 95% confidence interval (CI) for PC was 0.07 (0.04–0.13) among participants with a plasma selenium level >28.06 μg/dL vs. ≤19.13 μg/dL. A multivariate analysis showed that participants with a urinary total arsenic concentration >29.28 μg/L had a significantly higher OR (1.75, 1.06–2.89) for PC than participants with ≤29.89 μg/L. The combined presence of a low plasma selenium level and a high urinary total arsenic concentration exponentially increased the OR for PC, and additively interacted with PSA at levels ≥20 ng/mL. This is the first epidemiological study to examine the combined effects of plasma selenium and urinary total arsenic levels on the OR for PC. Our data suggest a low plasma selenium level coupled with a high urinary total arsenic concentration creates a significant risk for aggressive PC.

The benefit of androgen-deprivation therapy (ADT) in combination with dose-escalated radiotherapy (DERT) for localized prostate cancer has not been determined in randomized studies. In this study, the benefit of ADT was assessed in patients uniformly treated with dose-escalated intensity-modulated radiation therapy (IMRT) to the prostate and seminal vesicles but not pelvis. In all, 419 patients with localized prostate adenocarcinoma underwent definitive IMRT (cumulative dose 78 Gy), with 32.6%, 33.1%, 32.1%, and 2.1% having T1 through T4 disease, respectively, and 51.2% having high-risk disease. ADT was given to 76.1% of patients. With a median follow-up of 60 months, 5-year biochemical failure-free, disease-free, and overall survival rates were 87%, 86%, and 87%, respectively. T stage was an independent predictor of all three rates. Five-year pelvic nodal recurrence rate was 2.9%. ADT improved biochemical failure-free and disease-free survival but not overall survival. ADT showed benefit in high-risk disease but not intermediate-risk disease. Late gastrointestinal and genitourinary toxicities ≥ grade 2 occurred in 11.0% and 6.7%, respectively. In conclusion, DERT with 78 Gy yields good disease control and low rate of pelvic nodal recurrence. ADT improves disease-free survival in patients with high-risk but not intermediate-risk disease.

Sketch-based data streaming algorithms are used in many network traffic monitoring applications to obtain accurate estimates of traffic flow. However, the flexibility is limited as hardware implementation of sketch counters may not be re-used for different measurement tasks. In this paper, we develop a generic hardware infrastructure for collecting flow statistics. The purpose is to achieve the goal of adopting various sketch-based algorithms with arbitrary flow aggregations for monitoring applications and measurement tasks in a flexible manner. Multiple-choice hashing with linear probing scheme is utilized for high-speed counter update process. Simulation results based on real traffic traces for monitoring applications are presented. The proposed hardware infrastructure is implemented on the NetFPGA-10G platform. The system is capable of processing network traffic at 53 Gbps in a worst-case scenario of 64-byte minimum-sized Ethernet frame.

This study aimed to examine this association by comparing the risk of prior irritable bowel syndrome (IBS) between patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and matched controls in Taiwan. Data were retrieved from the Longitudinal Health Insurance Database 2005. This study included 4870 cases with CP/CPPS and 4870 age-matched controls. Conditional logistic regressions were conducted to examine associations of CP/CPPS with previously diagnosed IBS. We found that a total of 753 (7.7%) of the 9740 sampled patients had IBS prior to the index date; IBS was found in 497 (10.2%) cases and in 256 (5.3%) controls. Conditional logistic regression revealed a higher odds ratio (OR) of prior IBS (OR 2.05, 95% CI = 1.75–2.40) for cases than controls. Furthermore, after adjusting for the patients’ monthly income, geographical location, urbanization level and hypertension and coronary heart disease, the conditional logistic regression analysis indicated that cases were more likely than controls to have prior IBS (OR = 1.96, 95% CI = 1.67–2.29). Furthermore, we found that CP/CPPS was consistently and significantly associated with prior IBS regardless of age group. We concluded that the diagnosis of CP/CPPS was associated with previously diagnosed IBS. Urologists should be aware of the association between CP/CPPS and IBS when treating patients.

Backgroud: Increasing evidence suggests the involvement of chronic inflammation in the progression of prostate cancer, and prostaglandin-endoperoxide synthase 2 (PTGS2), also known as cyclooxygenase-2, catalyzes the rate-limiting steps of the pathway. We hypothesized that genetic variants of PTGS2 can influence the outcome of prostate cancer patients. Methods: We genotyped five haplotype-tagging single-nucleotide polymorphisms (SNPs) to detect common genetic variations across the PTGS2 region in 458 prostate cancer patients treated with radical prostatectomy. Results: One SNP, rs4648302, was associated with disease recurrence. Five-year recurrence-free survival rate increased according to the number of variant alleles inherited (55.6%, 70.7%, and 100.0% for patients with different genotypes; P = 0.037), and the effect was maintained in multivariable analysis. Public dataset analyses also suggested that PTGS2 expression was correlated with prostate cancer prognosis. Conclusion: Our results indicated that PTGS2 could be a potential prognostic marker to improve the prediction of disease recurrence in prostate cancer patients.

Objective Our aims were to investigate the correlations between polymorphisms in the cell cycle regulatory genes (aurora kinase A [AURKA], survivin, p21, and p53) and UC risk and prognosis. Patients and methods This study recruited 185 patients with UTUC, 46 patients with bladder cancer, and 188 hospital controls. Demographic data and possible confounding factors were collected using a standardized questionnaire. Genotyping was determined by real-time polymerase chain reaction and TaqMan probe methods. Results Compared to the UTUC group, the control group had significantly more alcohol drinkers and coffee drinkers but not cigarette smokers. Statistical analyses showed that UTUC risk correlated with AURKA rs2273535 (adjusted odds ratio = 2.51, 95% CI = 1.07–6.15) and with survivin rs9904341 (adjusted odds ratio = 1.82, 95% CI = 1.03–3.26) polymorphisms but not with p21 and p53 polymorphisms. The bladder cancer risk showed no significant correlations with the 4 polymorphisms. In both the UTUC and UC groups, disease-free survival and overall survival were significantly longer in patients with the rs1801270CC genotype compared to those with CA+AA genotypes. Poor prognosis did not correlate with polymorphisms in AURKA, survivin, and p53 genes. Conclusion These results suggest that cell cycle regulatory gene polymorphisms rs2273535 and rs9904341 may contribute to UTUC susceptibility; gene polymorphism rs1801270 may contribute to prognosis of UTUC and prognosis of UC. The p53 polymorphisms may not correlate with UTUC susceptibility and prognosis of UTUC or UC. Further well-designed, large-scale studies are needed to clarify these findings.

Sketch-based data streaming algorithms are capable of summarizing high-speed network traffic in real-time without packet sampling. Therefore, they are used in many networking applications to make accurate estimates of traffic flow statistics. However, fixed hardware implementation of the sketch counters limits the flexibility of re-using the same data structure for various monitoring applications. In this paper, we propose a generic scheme for collecting flow-level data using high-speed memories on the NetFPGA-10G platform. The purpose is to enable sketch-based algorithms making statistics measurements in various network monitoring applications in a flexible manner. Experiments using real Internet traces are conducted for entropy estimation, superspreader detection, and change detection applications. The results show that the proposed scheme can support flexible selection of keys and counters for the monitoring applications achieving high measurement accuracy.

Background/purpose To retrospectively evaluate the failure patterns of multimodality bladder-preserving therapy in patients with muscle-invasive bladder cancer. Methods Patients with muscle-invasive bladder cancer underwent maximal transurethral resection of bladder tumor and induction chemotherapy, followed by concurrent chemoradiotherapy (CCRT). Radiotherapy was given with 45 Gy to the pelvis, 50.4 Gy to the bladder, and 64.8 Gy to the tumor bed. Three protocols of trimodality treatment were used: Protocol A, three cycles of cisplatin and fluorouracil (CF), followed by CCRT with 6 weekly cisplatin; Protocol B, three cycles of weekly paclitaxel plus CF, followed by CCRT with 6 weekly paclitaxel and cisplatin; Protocol C, three cycles of gemcitabine and cisplatin, followed by CCRT with 6 weekly cisplatin. Interval cystoscopy confirmed complete response (CR) after induction chemotherapy and 40–50 Gy of radiotherapy. Patients without CR were referred for salvage cystectomy. Results A total of 60 patients were enrolled, including 11 patients with unfavorable factors defined as hydronephrosis and/or pelvic nodal involvement. After a median follow-up of 86.7 months, the 5-year overall, progression-free, and bladder preservation-specific survival rates were 76.3%, 62.9%, and 71.5%, respectively. Three patients underwent salvage cystectomy for invasive bladder recurrence. Of 45 surviving patients, 42 patients (93.3%) retained functioning bladders. Patients with unfavorable factors had significantly lower metastasis-free survival ( p = 0.002), but not bladder preservation-specific survival ( p = 0.25). Conclusion With trimodality treatment involving visually complete transurethral resection of bladder tumor, cisplatin-based induction chemotherapy, and CCRT, patients with unfavorable factors maintained satisfactory bladder preservation but not systemic control.

Previous studies investigated the impacts of a partial nephrectomy (PN) or radical nephrectomy (RN) on cardiovascular events and death. However, the association between the type of nephrectomy (PN vs. RN) and cardiovascular disease is still equivocal. This retrospective cohort study aimed to compare the risk of coronary heart disease (CHD) between patients who underwent a PN and those who underwent an RN. We used data from the Taiwan Longitudinal Health Insurance Database 2005. In total, 60 patients who underwent a PN and 545 patients who underwent an RN were included. Each patient was tracked for 1-, 2-, 3-, and 5-year periods to identify those who were subsequently diagnosed with CHD. Cox proportional hazard regression analyses were used to calculate hazard ratios (HRs) for CHD during 1-, 2-, 3-, and 5-year follow-up periods between these two cohorts. For the 1-year follow-up period, the adjusted HR was 0.39 (95% CI: 0.05~2.90, p = 0.355) for patients who underwent a PN compared to those who underwent an RN. Additionally, the adjusted HRs of CHD in patients who underwent a PN for 2-, 3- and 5-year follow-up periods were 1.40 (95% CI: 0.62~3.16, p = 0.417), 1.09 (95% CI: 0.52~2.31, p = 0.814), and 1.02 (95% CI: 0.48~2.18, p = 0.961), respectively, compared to those who underwent an RN. We concluded that there was no significant difference in the risk of CHD between patients who underwent a PN and those who underwent an RN.

Ultraconserved regions (UCRs) are DNA segments of longer than 200 bp in length that are completely conserved between human, rat, and mouse genomes. Recent studies have shown that UCRs are frequently located at fragile sites involved in cancers, and their levels of transcription can be altered during human tumorigenesis. We systematically evaluated 14 common single-nucleotide polymorphisms (SNPs) within UCRs in three cohorts of prostate cancer patients, to test the hypothesis that these UCR SNPs might influence clinical outcomes. Examination using multivariate analysis adjusted for known clinicopathologic factors found association between rs8004379 and recurrence in localized disease [hazard ratio (HR) 0.61, 95% confidence interval (CI) 0.41–0.91, P = 0.015], which was confirmed in the replication set (HR 0.70, 95% CI 0.51–0.96, P = 0.027). Remarkably, a consistent association of rs8004379 with a decreased risk for prostate cancer-specific mortality was also observed in the advanced prostate cancer patient group (HR 0.48, 95% CI 0.32–0.70, P in silico analysis suggests that rs8004379 tends to affect NPAS3 expression, which in turn was found to be correlated with patient prognosis. In conclusion, our findings suggest that SNPs within UCRs may be valuable prognostic biomarkers for assessing prostate cancer treatment response and survival.

Cigarette smoking interacts with the urinary arsenic profile to modify the risk of urothelial carcinoma. NNK (4-[methylnitrosamino]-1-[3-pyridyl]-1-butanone) and its metabolite NNAL (4-[methylnitrosamino]-1-[3-pyridyl]-1-butanol) are biomarkers for cigarette smoking exposure. We explored the joint effects of urinary NNK metabolites and arsenic species on urothelial carcinoma risk.We recruited 137 pairs of urothelial carcinoma cases and matched healthy participants for a hospital based case-control study. Participants completed questionnaires and provided 50 ml urine samples. Urine samples were analyzed for free NNAL and NNAL-glucuronides using liquid chromatography-tandem mass spectrometry. Samples were analyzed for arsenic species using high performance liquid chromatography hydride generator atomic absorption spectrometry.Overall, subjects with high urinary total NNAL and high total arsenic had a greater urothelial carcinoma risk than those with a low total NNAL and low total arsenic. Subjects with a lower ratio of NNAL-glucuronides-to-free NNAL and higher total arsenic had a greater urothelial carcinoma risk than those with a higher NNAL-glucuronides-to-free NNAL ratio and lower total arsenic.This is the first study to our knowledge to demonstrate a significant trend of progressively increased risk of urothelial carcinoma in subjects who had none, one or both of the factors of urinary total arsenic and total NNAL or urinary total arsenic and the ratio of NNAL-glucuronides-to-free NNAL.

8-Hydroxydeoxyguanosine (8-OHdG) is one of the most reliable and abundant markers of DNA damage. The study was designed to explore the relationship between urinary 8-OHdG and renal cell carcinoma (RCC) and to investigate whether individuals with a high level of 8-OHdG would have a modified odds ratio (OR) of arsenic-related RCC. This case–control study was conducted with 132 RCC patients and 245 age- and sex-matched controls from a hospital-based pool between November 2006 and May 2009. Pathological verification of RCC was completed by image-guided biopsy or surgical resection of renal tumors. Urinary 8-OHdG levels were determined using liquid chromatography with tandem mass spectrometry (LC–MS/MS). Concentrations of urinary arsenic species, including inorganic arsenic, monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA), were determined by a high performance liquid chromatography-linked hydride generator and atomic absorption spectrometry. Level of urinary 8-OHdG was significantly associated with the OR of RCC in a dose–response relationship after multivariate adjustment. Urinary 8-OHdG was significantly related to urinary total arsenic. The greatest OR (3.50) was seen in the individuals with high urinary 8-OHdG and high urinary total arsenic. A trend test indicated that the OR of RCC was increased with one of these factors and was further increased with both ( p = 0.002). In conclusion, higher urinary 8-OHdG was a strong predictor of the RCC. High levels of 8-OHdG combined with urinary total arsenic might be indicative of arsenic-induced RCC.

Background/purpose To evaluate the efficacy of ketoconazole in castration-resistant prostate cancer. Materials and methods We reviewed the medical records of consecutive patients with pathologically confirmed prostate cancer from May 2006 to December 2008. The inclusion criteria were: (1) receiving 200 or 400 mg ketoconazole three times daily and replacement doses of prednisolone; (2) antiandrogen withdrawal for at least 2 months before ketoconazole treatment; and (3) no prior cytotoxic agents or other CYP17 inhibitors. Treatment consisted of ketoconazole at 200 mg three times daily (Group A) and 400 mg three times daily (Group B). Patients' characteristics, time to prostate-specific antigen (PSA) progression, duration of PSA response, and adverse events were evaluated. Results Of the 37 patients in Group A, 14 (37.8%) experienced a PSA response. Of the seven patients in Group B, four (57.1%) experienced a PSA response. Median durations of time to progression in those who experienced a > 50% PSA decline were 7.5 and 11.5 months in Group A and Group B, respectively. Median duration of PSA response was 5.5 and 9.0 months in Group A and Group B, respectively. There was no difference in the PSA response or time to progression between the two groups. Orchiectomy had a borderline unfavorable effect on the PSA response rate ( p = 0.067). Conclusion The present study demonstrated that ketoconazole contributed to the PSA response in patients with castration-resistant prostate cancer. The efficacy and toxicity profiles were comparable to those in previous studies. Orchiectomy had a borderline unfavorable effect on PSA response rate. Further studies are required to confirm the efficacy of ketoconazole therapy in surgically castrated patients.

Approximately one-third of patients with prostate cancer show prostate-specific antigen (PSA) recurrence (biochemical failure) after a radical prostatectomy and are prone to developing metastasis with significant mortality. Although several clinicopathologic indicators, such as the PSA level, Gleason score, pathologic stage, and surgical-margin status, are used to predict outcomes after a curative-intended radical prostatectomy for localized prostate cancer, new biomarkers are still required to improve the prognosis and plan appropriate adjuvant therapy, particularly for patients at high risk of recurrence. DNA-based genetic biomarkers have several advantages over clinicopathologic indicators because they can be preoperatively examined, are easily evaluated, and can be interpreted more objectively without individual bias. In this study, the literature was reviewed from the PubMed database using the keywords “genetic polymorphisms” and “radical prostatectomy” from 1985 to April 2011. The results showed that genetic variants discovered from genome-wide association studies (such as rs1447295, rs1447295, rs6983561, rs13254738, Broad11934905, rs6983267, and rs7000448 at 8q24, rs7920517 and rs10993994 at 10q11, rs10486567 in the 7JAZF1, rs198977 in the KLK2, rs9282861 in the SULT1A1, and rs1536889 in the TLR4 gene) and single-nucleotide polymorphisms (SNPs) in important pathways (RUNX1, FGFR4, EGFR, VEGF, TNFRSF11B, vitamin D receptor, p53, WNT, inflammatory, androgen synthesis, and metabolism pathways) on prostate cancer occurrence and progression could serve as biomarkers to predict PSA recurrence after a radical prostatectomy. Including the genetic information might improve predictions of PSA recurrence after a radical prostatectomy. Future studies can be dedicated to confirming these findings in other ethnic cohorts and clarifying the roles of these SNPs/genes in the course of prostate cancer progression after a radical prostatectomy through functional analyses.

Even though epididymoorchitis and testicular cancer (TC) may have similar pathophysiological pathways, no prior study has attempted to determine the association between these two diseases. This case-control study investigated the relationship between TC and prior epididymoorchitis by using a large population-based database. We used the Taiwan Longitudinal Health Insurance Database 2005 to select 372 patients who had received a diagnosis of TC and 3,720 age-matched controls without TC. We found that of the total sample of 4,092 patients, 53 (1.3%) had received a diagnosis of epididymoorchitis prior to the index date. Patients with TC had a higher prevalence of prior epididymoorchitis than that of patients without TC (11.0% vs. 0.3%, p

The results of our previous study suggested that high urinary total arsenic levels were associated with an increased risk of renal cell carcinoma (RCC). Germline genetic polymorphisms might also affect cancer risk and clinical outcomes. Vascular endothelial growth factor (VEGF) plays an important role in vasculogenesis and angiogenesis, but the combined effect of these factors on RCC remains unclear. In this study, we explored the association between the VEGF-A -2578C>A, -1498T>C, -1154G>A, -634G>C, and +936C>T gene polymorphisms and RCC. We also evaluated the combined effects of the VEGF-A haplotypes and urinary total arsenic levels on the prognosis of RCC. This case-control study was conducted with 191 RCC patients who were diagnosed with renal tumors on the basis of image-guided biopsy or surgical resections. An additional 376 age- and gender-matched controls were recruited. Concentrations of urinary arsenic species were determined by a high performance liquid chromatography-linked hydride generator and atomic absorption spectrometry. Genotyping was investigated using fluorescent-based TaqMan allelic discrimination. We observed no significant associations between VEGF-A haplotypes and RCC risk. However, the VEGF-A ACGG haplotype from VEGF-A -2578, -1498, -1154, and -634 was significantly associated with an increased recurrence of RCC (OR = 3.34, 95% CI = 1.03-10.91). Urinary total arsenic level was significantly associated with the risk of RCC in a dose-response manner, but it was not related to the recurrence of RCC. The combination of high urinary total arsenic level and VEGF-A risk haplotypes affected the OR of RCC recurrence in a dose-response manner. This is the first study to show that joint effect of high urinary total arsenic and VEGF-A risk haplotypes may influence the risk of RCC recurrence in humans who live in an area without obvious arsenic exposure.

In previous studies, benign prostatic enlargement (BPE) and urinary tract symptoms were demonstrated to be associated with depressive symptoms. However, no longitudinal follow-up study to date has evaluated the relationship between BPE and the subsequent risk of developing depressive disorder. This nationwide, population-based study aimed to prospectively examine the relationship between a history of BPE and the risk of developing depressive disorder.A total of 16,130 adult patients diagnosed with BPE for the first time between 2005 and 2007 were recruited along with a comparison cohort of 48,390 matched enrollees without a history of BPE. All the subjects were tracked for a one-year period following their index date to identify those who subsequently developed a depressive disorder. The Cox proportional hazards model was utilized to compute the risk difference for depressive disorder between cohorts.Of 64,520 sampled patients, 325 (2.01%) from the BPE cohort, and 531 (1.10%) from the comparison cohort were subsequently diagnosed with depressive disorder during the follow-up period. The risk of developing depressive disorder within one-year following diagnosis with BPE was found to be 1.87 (95% CI=1.63-2.16, p0.001) times the risk in absence of BPE after adjusting for the patients' monthly income, and the geographical location and urbanization level of their place of residence.Our results suggest that patients with BPE are at an increased risk for contracting depressive disorder.

Objective To determine the incidence of cervical cancer and the age-specific survival from small cell cervical carcinoma in Taiwan. Design Retrospective study. Setting. Taiwan. Population Women diagnosed with cervical cancer from 1991 to 2005. Methods Analysis of data from the National Cancer Registration System and National Death Certification System. Main outcome measures Incidence and age at diagnosis of cervical carcinoma and age-specific and overall survival from small cell cervical carcinoma. Results During the study period, 36 122 women were diagnosed with cervical cancer, and 81.8% had squamous cell carcinoma (SCC). For the periods 1991-1995, 1996-2000 and 2001-2005, the mean age at diagnosis increased from 53.9 ± 13.3 to 55.0 ± 14.9 and then to 56.7 ± 14.7 years, respectively. The incidence of SCC decreased from 1991 to 2005. During the same period, non-significant increases of adenocarcinoma and small cell carcinoma were noted. For SCC, occurrence peaked in 1991-1995 in patients 50-59 years of age. From 1996 to 2005, it peaked in patients 40-49 years of age. For cervical adenocarcinoma, occurrence peaked in patients 40-49 years of age, with a steady increase in this age group from 1991 to 2005. Occurrence of small cell cervical carcinoma peaked in the period 1991-1995 in patients 30-39 years of age. During the 15 years of the study, the overall mortality rate of the 198 patients with small cell cervical carcinoma was 65.7%. Conclusions In Taiwan, the incidence of small cell cervical carcinoma and adenocarcinoma tended to increase, but the incidence of squamous cell cervical carcinoma significantly decreased during the period 1991-2005.

This study reports an alternative method for measuring the magnetoresistance of unpatterned magnetic tunnel junctions similar to the current-in-plane tunneling (CIPT) method. Instead of using microprobes, a series of point contacts with different spacings are coated on the top surface of the junctions and R-H loops at various spacings are then measured by the usual four-point probe method. The values of magnetoresistance and resistance-area products can be obtained by fitting the measured data to the CIPT theoretical model. The test results of two types of junctions were highly similar to those obtained from standard CIPT tools. The proposed method may help to accelerate the process for evaluating the quality of magnetic tunnel junctions when commercial CIPT tools are not accessible.

This study aimed to evaluate the feasibility and safety of totally extraperitoneal (TEP) endoscopic hernia surgery after previous lower abdominal surgery, which may preclude preperitoneal dissection.All 331 consecutive patients undergoing TEP surgery between January 2008 and December 2010 were included in a prospective cohort study. This case-control study included a study group and a comparison group. The study group consisted of 23 patients with a history of previous lower abdominal surgery before undergoing TEP endoscopic hernia repair. For the comparison group, 46 patients were randomly selected (two for every patient in the study group) and matched with the study cohort in terms of age, gender, and laterality of inguinal hernia. Perioperative data were obtained for all the patients including demographic data, operation time, length of hospital stay, narcotic dose, conversions, and complications.A total of 69 patients with inguinal hernias underwent TEP surgery: 23 patients with previous abdominal surgery (study group) and 46 patients without such surgery (control group). No conversions were necessary in the control group, but one case (4.4%) in the study group was converted to transabdominal preperitoneal hernia repair (TAPP) (P = 0.33). Peritoneal injury requiring intracorporeal repair was encountered in six study group patients and eight control group patients (P = 0.53). No differences were observed between the two groups in terms of operative times, analgesic use, hospital stay, return to daily activities, or postoperative complications.In experienced hands, TEP hernia repair for patients with previous lower abdominal surgery can be performed safely. In this study, the operative outcomes were comparable with those for patients who had no history of lower abdominal surgery.

BACKGROUND The influence of PSA kinetics on the outcome of metastatic prostate cancer after androgen deprivation therapy (ADT) is not well understood. We evaluated the prognostic significance of PSA nadir and time to PSA nadir as well as their potential interactive effect on the progression of disease after ADT. METHODS A total of 650 men with advanced or metastatic prostate cancer treated with ADT were studied. The prognostic significance of PSA nadir and time to PSA nadir on disease progression were analyzed using Kaplan–Meier analysis and the Cox regression model. RESULTS We found that both PSA nadir and time to PSA nadir were independent and significant predictors of disease progression. Patients with higher PSA nadir (≥0.2 ng/ml) and shorter time to PSA nadir (

Objective: To present the initial experience of laparoendoscopic single-site (LESS) nephroureterectomy via the transperitoneal approach using the Alexis wound retractor and bladder cuff resection by endoloop. Methods: Two patients received LESS nephroureterectomies and bladder cuffs resection with homemade single ports, which were created by using an Alexis wound retractor as an access platform through a 4-cm incision. Distal ureters were resected through the same incision with endoloop. No additional ports were used and both procedures were completed successfully. Results: Both LESS procedures were completed successfully without traditional laparoscopic conversion or complication. LESS nephreoureterectomy with bladder cuff excision was performed in 165 and 325 minutes with estimated blood loss of 30 and 65 mL, respectively. Patients were discharged on postoperative days 3 and 7, respectively. Conclusions: The initial results demonstrated that LESS technique of nephroureterectomy and bladder cuff resection with endoloop is a safe and feasible procedure for urothelial carcinoma of upper urinary tract.

Highly ordered nanowires with multilayer structure of Ni/Cu, have been successfully prepared by pulsed chemical electrodeposition into nanoporous templates and the diameter (35 and 200 nm) of wires can be easily controlled by pore size of template. The nanowires have been characterized by transmission electron microscopy (TEM), magnetic force microscopy (MFM), and vibrating sample magnetometer (VSM) and high magnetic perpendicular anisotropy can be achieved by modulating the shape of nanowires. It was found that the coercivity (Hc) and squarness (S: Mr/Ms) of the nanowires are strongly dependent on the diameter and aspect ratio as well as on dipolar coupling between the ferromagnetic segments and the nanowires (aspect ratio: 11.4) can be obtained high perpendicular magnetic anisotropy with Hc: 895 Oe and S: 0.77 of Ni/Cu nanowires. The magnetoresistance ratios along the parallel and perpendicular axes of nanowires are 23.4% and 7.2% respectively. Owing to its high bit density, the structure may be suitable for ultrahigh-density magnetic recording media.