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Ketamine abusers develop severe lower urinary tract symptoms. The major aims of the present study were to elucidate ketamine-induced ulcerative cystitis and bladder apoptosis in association with oxidative stress mediated by mitochondria and the endoplasmic reticulum (ER). Sprague-Dawley rats were distributed into three different groups, which received normal saline or ketamine for a period of 14 or 28 days, respectively. Doublelabeled immunofluorescence experiments were performed to investigate tight junction proteins for urothelial barrier functions. A TUNEL assay was performed to evaluate the distribution of apoptotic cells. Western blot analysis was carried out to examine the expressions of urothelial tight junction proteins, ER stress markers, and apoptosisassociated proteins. Antioxidant enzymes, including SOD and catalase, were investigated by real-time PCR and immunofluorescence experiments. Ketamine-treated rats were found to display bladder hyperactivity. This bladder dysfunction was accompanied by disruptions of epithelial cadherin- and tight junction-associated proteins as well as increases in the expressions of apoptosis-associated proteins, which displayed features of mitochondria-dependent apoptotic signals and ER stress markers. Meanwhile, expressions of mitochondria respiratory subunit enzymes were significantly increased in ketaminetreated bladders. Conversely, mRNA expressions of the antioxidant enzymes Mn-SOD (SOD2), Cu/Zn-SOD (SOD1), and catalase were decreased after 28 days of ketamine treatment. These results demonstrate that ketamine enhanced the generation of oxidative stress mediated by mitochondria- and ER-dependent pathways and consequently contributed to bladder apoptosis and urothelial lining defects. Such oxidative stress-enhanced bladder cell apoptosis and urothelial barrier defects are potential factors that may play a crucial role in bladder overactivity and ulceration. [ABSTRACT FROM AUTHOR]

Three pregnane-type steroids, including a new metabolite, 3ß-methoxy-5,20- pregnadiene (1) along with two known analogues, 3ß-acetoxy-5,20-pregnadiene (2) and 5a-pregna-1,20-dien-3-one (3) were isolated from the soft coral Scleronephthya flexilis. Standard spectroscopic techniques were used to determine the structure of new steroid 1. The absolute stereochemistry of steroid 2 was confirmed by X-ray diffraction analysis. Steroid 3 exhibited potent activity against MOLT-4 tumor cells. [ABSTRACT FROM AUTHOR]

Antrodia camphorata (AC) is a unique mushroom of Taiwan that has been used for centuries as a traditional medical treatment for a variety of ailments from alcoholic dysfunction, hepatitis, and liver cirrhosis. Recently, a variety of compounds have been isolated from AC which appears to have many medicinal properties. Recent studies have shown extracts and other preparations from AC have anti-cancer , hepatoprotective and anti-inflammatory properties, antihepatitis B virus actions, and vaso-relaxant, antioxidant and antihypertensive activities. This review presents the scientific basis for the above medicinal claims for AC. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: The aim of this study was to identify the predictors of improved overactive bladder (OAB) symptoms after transvaginal mesh repair. Methods: Eighty women with pelvic organ prolapse (POP) stage II to IV reporting OAB symptoms were scheduled for transvaginal mesh procedures. Preoperative and postoperative assessments included a bladder diary, urodynamics, and a personal interview about urinary symptoms. Results: Sixty-three (78.8%) women experienced improvement of OAB symptoms (Improvement group), and 17 (21.2%) women remained unchanged or worsened (Persistence group) postoperatively. A univariate analysis of patients' characteristics showed no difference between two groups regarding parity, diabetes, hypertension, prolapse status, preoperative urodynamic parameters, and urinary symptoms ( P > 0.05). However, the age ( P = 0.042) and preoperative detrusor overactivity (DO) ( P = 0.03) were two significant predictors of postoperative OAB improvement. Conclusions: Women with POP may experience improvement of their OAB symptoms after transvaginal mesh repair. Both age and DO were two predictors in our univariate analysis, and the latter was the only significant predictor of symptom relief after adjusting age factor. [ABSTRACT FROM AUTHOR]

OBJECTIVE To describe the technique of laparoscopic complete urinary tract exenteration (LaCUTE), where specimens are withdrawn en bloc through the vagina, and to compare our results for patients had this procedure with those who had surgery by traditional open methods PATIENTS AND METHODS From February 2006 to June 2008, five patients had LaCUTE and three CUTE at our institute. The surgical procedure included bilateral nephroureterectomy, bilateral pelvic lymphadenectomy, radical cystourethrectomy, radical hysterectomy, bilateral salpingo-oophorectomy. RESULTS In the LaCUTE group the mean (range) patient age was 58 (46–73) years, the blood loss was 378 (290–490) mL, the operative duration was 492 (405–560) min and the hospital stay was 12.2 (9–17) days. All patients had negative surgical margins on pathological examination. The LaCUTE group had significantly less blood loss but longer surgery than the open group. At a mean follow-up of 14.5 and 16.0 months, respectively, there was no evidence of recurrent cancer in both groups. CONCLUSIONS With further experience and improvement in surgical techniques, LaCUTE with vaginal specimen en bloc withdrawal will become feasible for uraemic female patients with urothelial cancer. [ABSTRACT FROM AUTHOR]

Introduction: Parathyroid-hormone-related protein (PTHrP) is considered as an autocrine/paracrine regulator of growth and/or differentiation in normal and malignant tissues. We determined the distribution and density of the expression of PTHrP in the rabbit bladder during growth in response to partial outlet obstruction and its relation with the smooth muscle/collagen ratio. Materials and Methods: A total of 30 male New Zealand White rabbits were studied. After 7, 14, 28 or 56 days of obstruction, 6 rabbits per group were sacrificed and the bladder extracted. Six sham-operated rabbits served as controls. The expression and localization of PTHrP or collagen type III were detected by immunohistochemistry using specific antibodies. Results: The levels of PTHrP were progressively increased by 14 days of obstruction, whereas they decreased after 14 days, although the PTHrP positivity was higher than in sham controls by 28 and 56 days of obstruction. PTHrP staining was related to the smooth muscle/collagen ratio, both showing a peak in rabbits obstructed for 14 days. Conclusions: These data indicate that PTHrP may play an important regulatory role in the cellular and vascular response to partial outlet obstruction. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Purpose: To share our multicenter experience using a safe and effective method for treating large proximal ure-teral calculus by simultaneous supine percutaneous nephrolithotomy (sPCNL) and retrograde ureterolithotripsy (URSL) in the Galdakao-modified supine Valdivia position.Materials and Methods: Between December 2014 and August 2017, all patients with large proximal ureteral stones (> 15 mm) who underwent simultaneous sPCNL and retrograde URSL at three medical centers were retro-spectively reported. The ureter stone was pushed back (retrograde) with the ureteroscope and was retrieved using forceps with a nephroscope through an Amplatz sheath. Surgical methods and outcomes were described to improve our experience and management of large proximal ureteral calculi.Results: A total of 31 patients underwent simultaneous sPCNL and retrograde URSL. The mean patient age, stone size, operating time, and postoperative hospital stay were 57 years (range, 32-74 years), 20.1 mm (range, 15.0-37.9 mm), 81 minutes (range, 30-150), and 3.2 days (range, 2-7 days), respectively. There were 10 modified Clavien grade I and five grade II complications. No blood transfusions were necessary in this series. All patients were treated with double-J stents without a nephrostomy tube. Only one patient did not achieve stone-free status because of the strict stone impaction into the ureteral wall. This patient received auxiliary URSL after two months. Thereafter, the overall stone-clearance rate at three months was 100%.Conclusion: Our preliminary data showed that this modified method is safe and effective for treating large prox-imal ureteral stones. [ABSTRACT FROM AUTHOR]

Abstract This case report illustrates how the tension-free vaginal tape (TVT) procedure can be successfully combined with another gynecological intervention. A 38-year-old patient had been diagnosed with didelphys uterus during cesarean section. She came to us for treatment of confirmed genuine stress incontinence. In conjunction with the TVT procedure, we resected the congenital vaginal septum. The patient has remained continent for over 1 year. [ABSTRACT FROM AUTHOR]