Volume 2 Issue 1
Review Article: Ischemia Time in Partial Nephrectomies for Kidney Cancer: Strategies to Preserve Parenchymal Function
Dorai T* and Grasso M
There have been significant advances in the nephron sparing surgical techniques with the main aim of preserving as much parenchymal mass as possible in the management of renal cell carcinoma. While the issue of renal ischemia during these partial nephrectomy surgeries have been debated, latest improvements in minimizing the ischemia time, scoring for the ischemic injury on the basis of serum creatinine in patients with a still functioning contralateral kidney and basic and clinical research into the molecular mechanisms and markers for acute kidney injury have given rise to a clearer prediction of functional recovery in the patient. While the surgeon assessment of volume and parenchymal mass preservation is very critical in the prognosis and functional recovery, there are several molecular parameters that are still in the realm of pre-clinical research which, properly translated, would improve the quality of the parenchymal mass preserved and aid in the functional recovery of global parenchymal function. In this review, we focus on the molecular parameters such as induction of a hypo metabolic phenotype, the basis for the induction of hypothermia, the significance of remote ischemic preconditioning, the benefit of reducing inflammation with the use of ethyl pyruvate and finally the importance of reprogramming the inflamed kidney metabolism while emphasizing the basic premise that protecting the mitochondria from the ischemic and inflammatory damages may be the key to improve the quality of the parenchyma preserved. We discuss the benefits and pitfalls in each approach that will foster further translational research, ultimately benefiting the patient.
Cite this Article: Dorai T, Grasso M. Ischemia Time in Partial Nephrectomies for Kidney Cancer: Strategies to Preserve Parenchymal Function, Am J Urol Res. 2017;2(1): 016-028.
Published: 25 July 2017
Minxiao Chen and Peng Zhong*
Cold-Inducible RNA-Binding Protein (CIRP) is a cold-shock protein which can be induced after exposure to a moderate cold-shock in different species ranging from amphibians to humans. Expression of CIRP can also be regulated by hypoxia, UV radiation, glucose deprivation, heat stress and H2O2, suggesting that CIRP is a general stress-response protein. In response to stress, CIRP can migrate from the nucleus to the cytoplasm and regulate mRNA stability through its binding site on the 3'-UTR of its targeted mRNAs. Through the regulation of its targets, CIRP has been implicated in multiple cellular processes such as cell proliferation, cell survival, and circadian modulation. Recent studies showed that CIRP upregulation is observed in a large number of solid tumors and is regarded as a new oncogene in cancer. In addition, CIRP expression is also upregulated in human prostate cancer and in-vitro studies showed that downregulation of CIRP can decrease cell growth and enhance chemosensitivity in prostate cancer cell lines. These results indicate an important role of CIRP in prostate cancer progression. Further study is needed to determine the effects of CIRP in-vivo and the clinical prognostic significance of CIRP in prostate cancer.
Keywords: CIRP; mRNA stability; Prostate cancer
Cite this Article: Chen M, Zhong P. CIRP may be a New Potential Target in Prostate Cancer, Am J Urol Res. 2017;2(1): 013-015.
Published: 12 July 2017
Jong Kwan Park, Myung Ki Kim, Jae Hyung You, Hyung Sub Park, Yu Seob Shin*
Undescended Testis (UDT) is a common anomaly encountered in urology and is estimated to affect 1-4% of full term and up to 30% of preterm male neonates. We present a case of bilateral undescended testes detected in a 21-year-old male. On the routine hematological examination levels of serum tumor maker and hormone was within normal range. On the computed tomography scan of the abdomen with contrast demonstrated that both testes were on the inguinal area with no evidence of malignancy. The patients wanted to preserve his testes. Also, our medical team thought that preservation of testes is better option, to avoid hormone replacement therapy for his whole life. Finally, bilateral orchiopexy with herniorrhaphy was performed successfully. We gave him an education to perform a monthly testicular self-examination and an annual follow up in clinics due to high possibility of malignancy development than normal patients.
Keywords: Hormone; Malignancy; Undescended testis
Cite this Article: Park JK, Kim MK, You JH, Park HS, Shin YS. What shall we do for Bilateral Undescended Testes Detected in a 21-Year-Old Male? Am J Urol Res. 2017;2(1): 010-012.
Published: 19 July 2017
Research Article: Is there any Relation between Serum PSA and Urine Flow and Post-Voiding Residual Urine in Benign Prostatic Hyperplasia Patients?
Waseem Aboul Ela*, Mahmoud Shoukry ElAdawy, Ahmed Abdel Latif and Ahmed Salem
Objective: To examine Benign Prostatic Hyperplasia (BPH) patients for the relationships between serum prostatic specific antigen (PSA) and maximum flow rate (Qmax) of uroflowmetry Urine flow, and between serum PSA and post voiding residual urine.
Patients and Methods: One hundred Egyptian BPH patients were enrolled in our prospective study. Evaluation included full medical history, thorough clinical examination, laboratory investigation (urine analysis, kidney function tests, serum PSA level), pelvi-abdominal ultrasound with estimation of post voiding residual urine, prostate size, Transrectal Ultrasound (TRUS) for prostate size and adenoma size and uroflowmetry. Patient data was analyzed statistically using SPSS statistical package version 13.
Results: Our data results revealed that the correlation between serum PSA level and Qmax of uroflowmetry was of no statistical significance (r = -0.100, p = 0.320). On the other hand, there was significant correlation between the volume of residual urine and serum PSA value (r = 0.254, p = 0.014).
Also our results revealed that there was significant correlation between the age of the 100 patients and their serum PSA level (r = 0.310, p = 0.002). Also our study showed that there was significant correlation between PSA and prostate volume (r = 0.320, p = 0.001).
Conclusions: In BPH patients with lower urinary tract symptoms, there was a significant relation between the serum PSA level and volume of post voiding residual urine, while there was no significant relation between the serum PSA level and Qmax of uroflowmetry. Further studies may be needed to confirm these results.
Cite this Article: Ela WA, ElAdawy MS, Latif AA, Salem A. Is there any Relation between Serum PSA and Urine Flow and Post-Voiding Residual Urine in Benign Prostatic Hyperplasia Patients? Am J Urol Res. 2017;2(1): 006-009.
Published: 12 July 2017
Research Article: Chronic Prostatitis and Chronic Pelvic Pain Syndrome (CP/CPPS): Epidemiological, Clinical and Therapeutic Profile
Sine B*, Fall B, Sow Y, Bagayogo NA, Thiam A, Ze Ondo C, Sarr A, Barboza D, Zakou ARH, Faye ST, Diao B, Fall PA and Ndoye AK
Aim: To report the epidemiological, clinical and therapeutic aspects of chronic category III prostatitis.
Patients and Methods: This was a retrospective study from January 1, 2011 to December 31, 2015, collating all patient files that were followed for chronic prostatitis / chronic pelvic pain syndrome (CP / CPPS). We focused on the following parameters: Patients' status, history of acute urethritis, psychological disposition, duration of symptoms, prostatorrhea, NIH score (pain, urinary signs, quality of life), other symptoms and associated disorders (Erectile dysfunction, ejaculation disorder, hemospermia, infertility of the couple), the given treatments and their results.
Results: The average age was 42.4 ± 14 years. Chronic prostatitis concerned all age groups of adult men. We found that the married were most affected by chronic prostatitis (54%). Anxiety was noted in 22 patients. Symptom duration ranged from 3 months to 10 years. Urinary problems were the most frequent reasons for consultation; (86%). The pain was reported in more than two-thirds of patients (68%). Other reasons for consultation were prostatorrhea, erectile dysfunction, ejaculation disorders and primary infertility. Suspicious prostatic induration was in 8 patients. The Cyto-Bacteriological Examination of the Urine (CBEU) was negative in all the patients as well as the spermocultures that were realized. Ultrasound of the urinary tract showed prostatic hypertrophy in 12 patients, prostate calcifications in 9 patients and a significant post-voiding residue (100cc) in 13 patients. The antibiotic, anti-inflammatory and alpha-blocking combination was the most common treatment used with our patients (86%). Thirteen (13) patients underwent surgical treatment after no improvement in urinary symptoms after medical treatment. Cure was achieved only in one-third of the patients. However, an improvement in symptoms was observed in half of the patients.
Conclusion: CP/CPPS is an uncommon condition in our practice, difficult to manage, sometimes requiring multidisciplinary care.
Cite this Article: Sine B, Fall B, Sow Y, Bagayogo NA, Thiam A, et al. Chronic Prostatitis and Chronic Pelvic Pain Syndrome (CP/CPPS): Epidemiological, Clinical and Therapeutic Profile. Am J Urol Res. 2017;1(1): 001-005.
Published: 31 May 2017
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