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Browse Health

Credentials

Education ?

Medical School Score
Loma Linda University (1995)
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Awards & Distinctions ?

Awards  
Patients' Choice Award (2013)
Compassionate Doctor Recognition (2015)
Top 10 Doctor - City (2014)
Philadelphia, PA
Urologist
Appointments
University of Pennsylvania
Assistant Professor of Surgery Chief, Division of Urology, Penn Presbyterian Medical Center
Associations
American Board of Urology
Laser.understandbph.com (holmiumforbph)
American Urological Association
Understandbph.com (prolieve)

Affiliations ?

Dr. Lee is affiliated with 12 hospitals.

Hospital Affiliations

Score

Rankings

  • Hospital of the University of PA
    3400 Spruce St, Philadelphia, PA 19104
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    Top 25%
  • Pennsylvania Hospital University PA Health System
    Urology
    800 Spruce St, Philadelphia, PA 19107
    •  
    Top 25%
  • University of PA Medical Center/Presbyterian
    Urology
    51 N 39th St, Philadelphia, PA 19104
    •  
    Top 50%
  • Graduate Hospital
    1800 Lombard St, Philadelphia, PA 19146
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  • Clinical Practices of the University of Pennsylvania
  • Barnes Jewish Hospital
  • Penn Presbyterian Medical Center - UPHS *
  • Pennsylvania Hospital
  • Healthsouth City View
  • Baylor All Saints Fort Worth & Cityview
  • Presbyterian Hospital
  • University of Penn Med Center-Presb Med Group
  • * This information was reported to Vitals by the doctor or doctor's office.

    Publications & Research

    Dr. Lee has contributed to 95 publications.
    Title Bladder Neck Plication Stitch: a Novel Technique During Robot-assisted Radical Prostatectomy to Improve Recovery of Urinary Continence.
    Date March 2012
    Journal Journal of Endourology / Endourological Society
    Excerpt

    Efforts to improve postprostatectomy incontinence have led to many modifications in surgical technique. We present our experience with a novel technique to improve continence outcomes in patients who are undergoing robot-assisted radical prostatectomy (RARP).

    Title Remifentanil Alleviates Transient Cerebral Ischemia-induced Memory Impairment Through Suppression of Apoptotic Neuronal Cell Death in Gerbils.
    Date November 2011
    Journal Korean Journal of Anesthesiology
    Excerpt

    During neurosurgical procedures, patients are often exposed to hypoxic and ischemic brain damage. Cerebral ischemia leads to neuronal cell death and eventually causes neurological impairments. Remifentanil is a new ultra-short acting phenylpiperidine opioid analgesic. In this study, we evaluated remifentanil to determine if it exerts an anti-apoptotic effect in the hippocampal dentate gyrus following transient global ischemia in gerbils.

    Title Future Perspectives in Robotic Surgery.
    Date October 2011
    Journal Bju International
    Excerpt

    • Robotics of the current day have advanced significantly from early computer-aided design/manufacturing systems to modern master-slave robotic systems that replicate the surgeon's exact movements onto robotic instruments in the patient. • Globally >300,000 robotic procedures were completed in 2010, including ≈98,000 robot-assisted radical prostatectomies. • Broadening applications of robotics for urological procedures are being investigated in both adult and paediatric urology. • The use of the current robotic system continues to be further refined. Increasing experience has optimized port placement reducing arm collisions to allow for more expedient surgery. Improved three-dimensional camera magnification provides improved intraoperative identification of structures. • Robotics has probably improved the learning curve of laparoscopic surgery while still maintaining its patient recovery advantages and outcomes. • The future of robotic surgery will take this current platform forward by improving haptic (touch) feedback, improving vision beyond even the magnified eye, improving robot accessibility with a reduction of entry ports and miniaturizing the slave robot. • Here, we focus on the possible advancements that may change the future landscape of robotic surgery.

    Title Myocardial Remodeling is Controlled by Myocyte-targeted Gene Regulation of Phosphodiesterase Type 5.
    Date February 2011
    Journal Journal of the American College of Cardiology
    Excerpt

    we tested the hypothesis that bi-directional, gene-targeted regulation of cardiomyocyte cyclic guanosine monophosphate-selective phosphodiesterase type 5 (PDE5) influences maladaptive remodeling in hearts subjected to sustained pressure overload.

    Title The Current State of Robot Assisted Radical Prostatectomy.
    Date January 2011
    Journal Minerva Urologica E Nefrologica = The Italian Journal of Urology and Nephrology
    Excerpt

    The introduction of robotics in the operating room made its first major impact in the arena of prostate cancer. Robot assisted radical prostatectomy (RARP) is the most commonly performed surgery for prostate cancer in the United States.

    Title Sublingual Grass Pollen Immunotherapy is Associated with Increases in Sublingual Foxp3-expressing Cells and Elevated Allergen-specific Immunoglobulin G4, Immunoglobulin A and Serum Inhibitory Activity for Immunoglobulin E-facilitated Allergen Binding to B Cells.
    Date August 2010
    Journal Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology
    Excerpt

    The mechanisms of sublingual immunotherapy (SLIT) are less well understood than those of subcutaneous immunotherapy (SCIT).

    Title Pde5a Suppression of Acute Beta-adrenergic Activation Requires Modulation of Myocyte Beta-3 Signaling Coupled to Pkg-mediated Troponin I Phosphorylation.
    Date May 2010
    Journal Basic Research in Cardiology
    Excerpt

    Phosphodiesterase type 5A (PDE5A) inhibitors acutely suppress beta-adrenergic receptor (beta-AR) stimulation in left ventricular myocytes and hearts. This modulation requires cyclic GMP synthesis via nitric oxide synthase (NOS)-NO stimulation, but upstream and downstream mechanisms remain un-defined. To determine this, adult cardiac myocytes from genetically engineered mice and controls were studied by video microscopy to assess sarcomere shortening (SS) and fura2-AM fluorescence to measure calcium transients (CaT). Enhanced SS from isoproterenol (ISO, 10 nM) was suppressed >or=50% by the PDE5A inhibitor sildenafil (SIL, 1 microM), without altering CaT. This regulation was unaltered despite co-inhibition of either the cGMP-stimulated cAMP-esterase PDE2 (Bay 60-7550), or cGMP-inhibited cAMP-esterase PDE3 (cilostamide). Thus, the SIL response could not be ascribed to cGMP interaction with alternative PDEs. However, genetic deletion (or pharmacologic blockade) of beta3-ARs, which couple to NOS signaling, fully prevented SIL modulation of ISO-stimulated SS. Importantly, both PDE5A protein expression and activity were similar in beta3-AR knockout (beta3-AR(-/-)) myocytes as in controls. Downstream, cGMP stimulates protein kinase G (PKG), and we found contractile modulation by SIL required PKG activation and enhanced TnI phosphorylation at S23, S24. Myocytes expressing the slow skeletal TnI isoform which lacks these sites displayed no modulation of ISO responses by SIL. Non-equilibrium isoelectric focusing gel electrophoresis showed SIL increased TnI phosphorylation above that from concomitant ISO in control but not beta3-AR(-/-) myocytes. These data support a cascade involving beta3-AR stimulation, and subsequent PKG-dependent TnI S23, S24 phosphorylation as primary factors underlying the capacity of acute PDE5A inhibition to blunt myocardial beta-adrenergic stimulation.

    Title Robot-assisted Ureteroureterostomy in the Adult: Initial Clinical Series.
    Date April 2010
    Journal Urology
    Excerpt

    To report what we believe is the first series of robot-assisted ureteroureterostomy (RAUU) in adults with greater than 24-month follow-up because ureteral stricture disease can be difficult to manage.

    Title Developing Neuropathic Pain Treatment Guidelines for Asia Pacific.
    Date October 2009
    Journal Pain Practice : the Official Journal of World Institute of Pain
    Title Electrical Bistabilities and Memory Stabilities of Nonvolatile Bistable Devices Fabricated Utilizing C(60) Molecules Embedded in a Polymethyl Methacrylate Layer.
    Date September 2009
    Journal Nanotechnology
    Excerpt

    Current-voltage (I-V) measurements on Al/fullerene (C(60)) molecules embedded in polymethyl methacrylate/Al devices at 300 K showed a current bistability due to the existence of the C(60) molecules. The on/off ratio of the current bistability for the memory devices was as large as 10(3). The retention time of the devices was above 2.5 x 10(4) s at room temperature, and cycling endurance tests on these devices indicated that the ON and OFF currents showed no degradation until 50,000 cycles. Carrier transport mechanisms for the nonvolatile bistable devices are described on the basis of the I-V experimental and fitting results.

    Title Training, Credentialing, Proctoring and Medicolegal Risks of Robotic Urological Surgery: Recommendations of the Society of Urologic Robotic Surgeons.
    Date September 2009
    Journal The Journal of Urology
    Excerpt

    With the exponential growth of robotic urological surgery, particularly with robot assisted radical prostatectomy, guidelines for safe initiation of this technology are a necessity. Currently no standardized credentialing system exists to our knowledge to evaluate surgeon competency and safety with robotic urological surgery performance. Although proctoring is a modality by which such competency can be evaluated, other training tools and guidelines are needed to ensure that the requisite knowledge and technical skills to perform this procedure have been acquired. We evaluated the current status of proctoring and credentialing in other surgical specialties to discuss and recommend its application and implementation specifically for robot assisted radical prostatectomy.

    Title Robotic Prostatectomy: What We Have Learned and Where We Are Going.
    Date August 2009
    Journal Yonsei Medical Journal
    Excerpt

    Radical prostatectomy became a mainstay of treatment for prostate cancer in the United States after the pioneering work of Walsh in defining the nerve sparing technique. Efforts to reproduce this operation in a minimally invasive fashion resulted in slow progress that recently have flourished with the application of the daVinci Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) by Menon and colleagues. This article summarizes the origins of robotic prostatectomy, some of the current data regarding this operation and potential future directions.

    Title The Role of Vacuum Erection Devices in Penile Rehabilitation After Radical Prostatectomy.
    Date June 2009
    Journal International Journal of Impotence Research
    Excerpt

    Even nerve-sparing radical prostatectomy damages the cavernous nerves and leads to temporary erectile dysfunction (ED) in men recovering from prostate cancer surgery. Historically, patients recovering from prostate cancer surgery have been advised that the return of erectile function (EF) can take from 6 to 18 months, or even longer. Unfortunately, the return of sexual function in these patients remains variable, but is generally thought to be dependent on the individual patient's pre-surgery EF, as well as the degree of cavernous nerve disruption during prostate removal. Recently, there has been a growing movement to proactively treat patients postoperatively for presumed nerve damage to stimulate nerve recovery and possibly reduce the degree of irreversible damage. This would reduce the on-demand therapy these patients would require, and hopefully remove the requirement for an implantable prosthesis. The underlying hypothesis is that the artificial induction of erections shortly after surgery facilitates tissue oxygenation, reducing cavernosal fibrosis in the absence of nocturnal erections, potentially increasing the likelihood of preserving EF. Vacuum erection devices (VED), because of their ability to draw blood into the penis regardless of nerve disturbance, have become the centerpiece of penile rehabilitation protocols. This review will discuss the pathophysiology of radical prostatectomy induced ED and the rationale for rehabilitation. It will then discuss current protocols, including those involving the VED.

    Title Measurement of Surface Adhesion Force of Adhesion Promoter and Release Layer for Uv-nanoimprint Lithography.
    Date June 2009
    Journal Journal of Nanoscience and Nanotechnology
    Excerpt

    In this work, we investigated the effect of surface treatment as release layer and adhesion promoter for UV-Nanoimprint lithography and measured the surface adhesion force by using tensile separation force of Instron equipment. Several Self-Assembled Monolayers (SAMs) of 3-Acryloxypropyl methyl dichlorosilane (APMDS) 3-Aminopropyl-triethoxysilane (APTS), and 3-Glycidoxypropyltrimethoxysilane (GPTS) as adhesion promoters and (1H,1H,2H,2H-perfluorooctyl)trichlorosilane (FOTS) as release layer were fabricated by vapor deposition method and were compared with oxygen plasma treatment. APMDS could strongly improve the adhesion force between UV-curable acrylate resin and silicon substrate because of strong covalent bonding. Finally, we could successfully fabricate various imprint patterns by using proper surface treatment of SAMs.

    Title Activation of (na+ + K+)-atpase Modulates Cardiac L-type Ca2+ Channel Function.
    Date April 2009
    Journal Molecular Pharmacology
    Excerpt

    Cellular Ca(2+) signaling underlies diverse vital biological processes, including muscle contractility, memory encoding, fertilization, cell survival, and cell death. Despite extensive studies, the fundamental control mechanisms that regulate intracellular Ca(2+) movement remain enigmatic. We have found recently that activation of the (Na(+)+K(+))-ATPase markedly potentiates intracellular Ca(2+) transients and contractility of rat heart cells. Little is known about the pathway responsible for the activation of the (Na(+)+K(+))-ATPase-initiated Ca(2+) signaling. Here, we demonstrate a novel mechanism in which activation of the (Na(+)+K(+))-ATPase is coupled to increased L-type Ca(2+) channel function through a signaling cascade involving Src and ERK1/2 but not well established regulators of the channel, such as adrenergic receptor system or activation of PKA or CaMKII. We have also identified Ser(1928), a phosphorylation site for the alpha1 subunit of the L-type Ca(2+) channel that may participate in the activation of the (Na(+)+K(+))-ATPase-mediated Ca(2+) signaling. The findings reported here uncover a novel molecular cross-talk between activation of the (Na(+)+K(+))-ATPase and L-type Ca(2+) channel and provide new insights into Ca(2+) signaling mechanisms for deeper understanding of the nature of cellular Ca(2+) handling in heart.

    Title Stamping-based Planarization of Flexible Substrate for Low-pressure Uv Nanoimprint Lithography.
    Date March 2009
    Journal Journal of Nanoscience and Nanotechnology
    Excerpt

    Patterning flexible substrates in nano scale is an important and challenging issue in the fabrication of next-generation devices based on a non-silicon substrate. Step and Flash imprint lithography (S-FIL) which is a room temperature and low pressure process offers several important advantages, such as the use of a smaller and therefore cheaper stamp or the possibility of the overlay imprinting, as a transparent stamp is utilized. However, it is very difficult to perform S-FIL on a flexible substrate successfully due to the high waviness. The waviness of a flexible substrate is not a constant value in contrast to a rigid substrate. It depends on the imprint pressure applied onto the substrate. In this paper, in section two, the effect of the imprint pressure on the waviness of the surface of the flexible substrate is examined. It is proved that the waviness of the surface of the flexible substrate could not be reduced sufficiently to assure a successful imprint at low imprint pressures. In the third section, a method of patterning polymer substrates using ultra-violet nanoimprint lithography (UV-NIL) is presented. The method consists of two stages, stamping-based planarization and S-FIL. In stamping-based planarization, a planarization layer of transparent polymer is formed onto the flexible substrate. Waviness of the blank stamp (in this study, glass wafer) is transferred to the planarization layer. S-FIL is performed with the nanoimprint tool IMPRIO100 directly onto the planarization layer employing a 1 x 1 in. quartz stamp. Optical microscope and SEM images of the successfully imprinted patterns were also presented.

    Title Phospholamban Thiols Play a Central Role in Activation of the Cardiac Muscle Sarcoplasmic Reticulum Calcium Pump by Nitroxyl.
    Date January 2009
    Journal Biochemistry
    Excerpt

    Nitroxyl (HNO) donated by Angeli's salt activates uptake of Ca(2+) by the cardiac SR Ca(2+) pump (SERCA2a). To determine whether HNO achieves this by a direct interaction with SERCA2a or its regulatory protein, phospholamban (PLN), we measured its effects on SERCA2a activation (as reflected in dephosphorylation) using insect cell microsomes expressing SERCA2a with or without PLN (wild-type and Cys --> Ala mutant). The results show that activation of SERCA2a dephosphorylation by HNO is PLN-dependent and that PLN thiols are targets for HNO. We conclude that HNO produces a disulfide bond that alters the conformation of PLN, relieving inhibition of the Ca(2+) pump.

    Title Dendritic Cell Vaccines for the Treatment of Prostate Cancer.
    Date January 2009
    Journal Urologic Oncology
    Excerpt

    Advanced prostate cancer remains a disease with few options beyond palliation. Over the past few decades, our understanding of immunology has led to the development of novel therapies for the treatment of many malignancies, including prostate cancer. These generally aim to induce T-cell responses against tumor specific antigens to both reduce tumor mass and potentially avoid relapse. One promising technique is to use autologous dendritic cells, the most potent antigen presenting cell. These can be loaded ex vivo with a given antigen and subsequently injected back into the patient to stimulate the desired effect. Recent trials using these techniques have shown promise in extending survival in patients with prostate cancer. This review will discuss relevant biology behind dendritic cell therapy and highlight the key trials found in the literature.

    Title Pulmonary Sequestration with Right Coronary Artery Supply.
    Date October 2008
    Journal Yonsei Medical Journal
    Excerpt

    Pulmonary sequestration is an unusual malformation consisting of isolated nonfunctioning lung segments lacking communication with functional tracheobronchial trees. Systemic blood supply is commonly from the thoracic aorta, but arteries occasionally arise from other sites. We report a rare form of pulmonary sequestration with arterial supply from the right coronary artery.

    Title Oxidation of 17alpha-ethinylestradiol with Mn(iii) and Product Identification.
    Date July 2008
    Journal Journal of Hazardous Materials
    Excerpt

    With increasing concern about the contamination of aquatic environments by estrogenic pollutants, removal of synthetic estrogens such as 17alpha-ethinylestradiol (EE2) has been widely studied, especially with respect to the treatment methods. However, the degradation products have rarely been identified. The purpose of this study was to identify structurally the oxidation products of EE2. Mn(III) was used as an oxidizing agent. To obtain sufficient oxidation products for HPLC, LC-MS and NMR spectroscopy, a highly concentrated solution of EE2 (1mM) was prepared in a mixture of water and a water-miscible organic solvent. From HPLC of the reaction products, a single compound (I) was found to be predominant. From LC-MS, its molecular mass was found to be 294, and two hydrogens were believed to have been removed from EE2 (M.W. 296) to form a C=C . The structure of compound I (position of the double bond) was determined using 1H NMR, 13C NMR, H-H COSY, HSQC and HMBC. As minor products, isomeric dimers (M.W. 590) of EE2, as well as the products (M.W. 588) in which EE2 was coupled to compound I were also formed during the Mn(III)-mediated oxidation of EE2.

    Title Mechanisms of Resistance and Adaptation to Thapsigargin in Androgen-independent Prostate Cancer Pc3 and Du145 Cells.
    Date September 2007
    Journal Archives of Biochemistry and Biophysics
    Excerpt

    Cells with increasing resistance to the sarcoplasmic/endoplasmic reticulum Ca(2+)-ATPase (SERCA) inhibitor thapsigargin (TG), ranging from 60-fold (PC3/TG(10) cells) to 1350-fold (PC3/TG(2000) cells), were derived from PC3 cells. SERCA2 is overexpressed in all PC3/TG cells but retains sensitivity to TG. siRNA-mediated downregulation of SERCA completely or partially reverses TG resistance in PC3/TG(10) or PC3/TG(2000) cells, respectively; thus SERCA overexpression mediates resistance in PC3/TG(10) cells but is not the only resistance mechanism in PC3/TG(2000) cells. By contrast, SERCA is not overexpressed in TG-resistant DU145/TG cells derived from DU145 cells. DU145/TG cells retain resistance while in PC3/TG cells resistance decreases upon removal of TG selection. The transport proteins PGP/BCRP/MRP1 and anti-apoptotic proteins Bcl2/Bcl(XL) are not involved in mediating resistance in either cell line. PARP and caspase 3 cleavage in response to other drugs demonstrate that the apoptotic pathways tested remain intact in these cells. Further, no cross-resistance occurs to other drugs. Thus, novel TG-specific resistance mechanisms are recruited by these cancer cells.

    Title Phenylephrine Hypertrophy, Ca2+-atpase (serca2), and Ca2+ Signaling in Neonatal Rat Cardiac Myocytes.
    Date August 2007
    Journal American Journal of Physiology. Cell Physiology
    Excerpt

    We endeavored to use a basic and well-controlled experimental system to characterize the extent and time sequence of sarco(endo)plasmic reticulum Ca(2+)-ATPase (SERCA) involvement in the development of cardiac hypertrophy, including transcription, protein expression, Ca(2+) transport, and cytoplasmic Ca(2+) signaling. To this end, hypertrophy of neonatal rat cardiac myocytes in culture was obtained after adrenergic activation with phenylephrine (PE). Micrographic assessment of myocyte size, rise of [(14)C]phenylalanine incorporation and total protein expression, and increased transcription of atrial natriuretic factor demonstrated unambiguously the occurrence of hypertrophy. An early and prominent feature of hypertrophy was a reduction of the SERCA2 transcript, as determined by RT-PCR with reference to a stable marker such as glyceraldehyde-3-phosphate dehydrogenase. Reduction of Ca(2+)-ATPase protein levels and Ca(2+) transport activity to approximately 50% of control values followed with some delay, evidently as a consequence of a primary effect on transcription. Cytosolic Ca(2+) signaling kinetics, measured with a Ca(2+)-sensitive dye after electrical stimuli, were significantly altered in hypertrophic myocytes. However, the effect of PE hypertrophy on cytosolic Ca(2+) signaling kinetics was less prominent than observed in myocytes subjected to drastic SERCA2 downregulation with small interfering RNA or inhibition with thapsigargin (10 nM). We conclude that SERCA2 undergoes significant downregulation after hypertrophic stimuli, possibly due to lack of SERCA gene involvement by the hypertrophy transcriptional program. The consequence of SERCA2 downregulation on Ca(2+) signaling is partially compensated by alternate Ca(2+) transport mechanisms. These alterations may contribute to a gradual onset of functional failure in long-term hypertrophy.

    Title Virtual Reality-assisted Robotic Surgery Simulation.
    Date June 2007
    Journal Journal of Endourology / Endourological Society
    Excerpt

    For more than a decade, advancing computer technologies have allowed incorporation of virtual reality (VR) into surgical training. This has become especially important in training for laparoscopic procedures, which often are complex and leave little room for error. With the advent of robotic surgery and the development and prevalence of a commercial surgical system (da Vinci robot; Intuitive Surgical, Sunnyvale, CA), a valid VR-assisted robotic surgery simulator could minimize the steep learning curve associated with many of these complex procedures and thus enable better outcomes. To date, such simulation does not exist; however, several agencies and corporations are involved in making this dream a reality. We review the history and progress of VR simulation in surgical training, its promising applications in robotic-assisted surgery, and the remaining challenges to implementation.

    Title Entangled Photon Absorption in an Organic Porphyrin Dendrimer.
    Date January 2007
    Journal The Journal of Physical Chemistry. B
    Excerpt

    Two-photon absorption spectroscopy is an intensity dependent nonlinear effect related to the excitation of virtual intermediate states. The classical two-photon absorption has an extremely low efficiency which is quantified by its cross-section (delta approximately 10(-48) cm4 s at 800 nm). To overcome this limitation, we demonstrate a novel effect of the two-photon absorption method utilizing the high degree of quantum optical correlation between photon pairs created by the process of spontaneous parametric downconversion. A large entangled two-photon absorption cross-section (delta(e) approximately 10(-17) cm2 at 800 nm) was measured in an organic porphyrin dendrimer. We also discuss the nonmonotonic behavior of variation of the entangled two-photon absorption cross-section by controlling the entanglement time. This novel effect may open new avenues for ultrasensitive detection in chemical and biological systems. TPA spectroscopy has been considered as a powerful tool in physics, chemistry, and biology. The inherent nonlinear process of the classical TPA is distinguishable from the single photon absorption (SPA) linear process. Although the benefits of greater penetration depth and better control and reduction of scattering, the TPA spectroscopy has been restricted by the necessity of a high power optical source due to the low efficiency of the TPA effect. The use of entangled photons from a correlated source for the purpose of the two-photon effect is promising in this regard as one may obtain two-photon effects with very small numbers of photons.

    Title Thapsigargin Resistance in Human Prostate Cancer Cells.
    Date September 2006
    Journal Cancer
    Excerpt

    BACKGROUND: Thapsigargin (TG) is a potent inhibitor of sarcoplasmic/endoplasmic reticulum Ca2+ ATPases (SERCAs). TG-based prodrugs are being developed for the treatment of prostate cancer (PC). To develop optimal TG-based therapeutics it is important to understand the mechanisms of resistance to TG that may potentially occur in cancer cells. METHODS: DU145/TG and PC3/TG cells were derived from human PC DU145 and PC3 cells, respectively, by incremental exposure to TG. Growth assays, Western blot analyses, cDNA microarrays, semiquantitative and real-time polymerase chain reaction (PCR), Northern blot analyses, and immunohistochemistry were used to study these cells. RESULTS: DU145/TG cells are 1100-fold and PC3/TG cells are 1350-fold resistant to TG. Although expression of both SERCA and p-glycoprotein can mediate TG resistance in hamster cells, neither is modulated in DU145/TG cells. In contrast, in PC3/TG cells, SERCA, and not p-glycoprotein, is significantly overexpressed but cannot by itself account for the 1350-fold resistance to TG in these cells. Several genes not previously identified to be altered by TG selection are modulated in DU145/TG and PC3/TG cells. Furthermore, the spectrum of genes modulated in DU145/TG cells are distinct from that in PC3/TG cells, even though both cells are of prostate origin and share the same TG-resistant phenotype. CONCLUSIONS: PC cells can adapt to SERCA inhibition by TG. However, they demonstrate cell type-specific plasticity with respect to gene expression upon TG selection. Further, previously not described mechanisms of resistance appear to be recruited in the TG-resistant PC cells, which provide a novel model to study mechanisms of resistance and adaptation in PC on TG-mediated dysregulation of Ca2+ homeostasis.

    Title Molecular Cloning and Characterization of a Large Subunit of Salmonella Typhimurium Glutamate Synthase (gogat) Gene in Escherichia Coli.
    Date August 2006
    Journal Journal of Microbiology (seoul, Korea)
    Excerpt

    Two pathways of ammonium assimilation and glutamate biosynthesis have been identified in microorganisms. One pathway involves the NADP-linked glutamate dehydrogenase, which catalyzes the amination of 2-oxoglutarate to form glutamate. An alternative pathway involves the combined activities of glutamine synthetase, which aminates glutamate to form glutamine, and glutamate synthase, which transfers the amide group of glutamine to 2-oxoglutarate to yield two molecules of glutamate. We have cloned the large subunit of the glutamate synthase (GOGAT) from Salmonella typhimurium by screening the expression of GOGAT and complementing the gene in E. coli GOGAT large subunit-deficient mutants. Three positive clones (named pUC19C12, pUC19C13 and pUC19C15) contained identical Sau3AI fragments, as determined by restriction mapping and Southern hybridization, and expressed GOGAT efficiently and constitutively using its own promoter in the heterologous host. The coding region expressed in Escherichia coli was about 170 kDa on SDS-PAGE. This gene spans 4,732 bases, contains an open reading frame of 4,458 nucleotides, and encodes a mature protein of 1,486 amino acid residues (Mr = 166,208). The FMN-binding domain of GOGAT contains 12 glycine residues, and the 3Fe-4S cluster has 3 cysteine residues. The comparison of the translated amino acid sequence of the Salmonella GOGAT with sequences from other bacteria such as Escherichia coli, Salmonella enterica, Shigella flexneri, Yersinia pestis, Vibrio vulnificus and Pseudomonas aeruginosa shows sequence identity between 87 and 95%.

    Title Laparoscopic Radical Prostatectomy: Review and Assessment of an Emerging Technique.
    Date April 2006
    Journal Surgical Endoscopy
    Excerpt

    BACKGROUND: Several recent reports have affirmed the feasibility of the laparoscopic approach for radical prostatectomy. In this review, we discuss the morbidities associated with this technique and compare outcomes and convalescence with standard open radical prostatectomy. METHODS: We reviewed all currently published data on laparoscopic radical prostatectomy and our series of 45 robotic-assisted radical prostatectomies and compared them to several landmark series of open retropubic and perineal radical prostatectomies. RESULTS: Although the initial series reported long operating times, these times have been significantly reduced in more recent series. Data on blood loss, convalescence, impotence, and incontinence rates have also been promising. CONCLUSIONS: Although follow-up has been short thus far, laparoscopic radical prostatectomy has been shown to be similar to open radical prostatectomy in several areas.

    Title Effect of Temperature and Free Ammonia on Nitrification and Nitrite Accumulation in Landfill Leachate and Analysis of Its Nitrifying Bacterial Community by Fish.
    Date April 2006
    Journal Bioresource Technology
    Excerpt

    The cause of seasonal failure of a nitrifying municipal landfill leachate treatment plant utilizing a fixed biofilm was investigated by wastewater analyses and batch respirometric tests at every treatment stage. Nitrification of the leachate treatment plant was severely affected by the seasonal temperature variation. High free ammonia (NH3-N) inhibited not only nitrite oxidizing bacteria (NOB) but also ammonia oxidizing bacteria (AOB). In addition, high pH also increased free ammonia concentration to inhibit nitrifying activity especially when the NH4-N level was high. The effects of temperature and free ammonia of landfill leachate on nitrification and nitrite accumulation were investigated with a semi-pilot scale biofilm airlift reactor. Nitrification rate of landfill leachate increased with temperature when free ammonia in the reactor was below the inhibition level for nitrifiers. Leachate was completely nitrified up to a load of 1.5 kg NH4-N m(-3)d(-1) at 28 degrees C. The activity of NOB was inhibited by NH3-N resulting in accumulation of nitrite. NOB activity decreased more than 50% at 0.7 mg NH3-N L(-1). Fluorescence in situ hybridization (FISH) was carried out to analyze the population of AOB and NOB in the nitrite accumulating nitrifying biofilm. NOB were located close to AOB by forming small clusters. A significant fraction of AOB identified by probe Nso1225 specifically also hybridized with the Nitrosomonas specific probe Nsm156. The main NOB were Nitrobacter and Nitrospira which were present in almost equal amounts in the biofilm as identified by simultaneous hybridization with Nitrobacter specific probe Nit3 and Nitrospira specific probe Ntspa662.

    Title Docetaxel Followed by Castration Improves Outcomes in Lncap Prostate Cancer-bearing Severe Combined Immunodeficient Mice.
    Date February 2006
    Journal Clinical Cancer Research : an Official Journal of the American Association for Cancer Research
    Excerpt

    PURPOSE: Androgen ablation is the standard initial treatment for advanced prostate cancer; however, tumors eventually develop androgen independence and become incurable. Chemotherapy is commonly used after hormone treatment fails but has not shown significant survival benefit. Studies suggest that androgen ablation can select for a population of hormone-independent cells that are also relatively chemotherapy resistant. Thus, it may be therapeutically advantageous to target prostate cancer with chemotherapy before hormone ablation. This study was undertaken to determine the relative efficacy of such an approach in a preclinical model of prostate cancer. EXPERIMENTAL DESIGN: Severe combined immunodeficient mice bearing human LNCaP prostate tumors were treated with docetaxel and/or surgical castration applied singly, concurrently, or in different sequences. Treatment efficacy was determined by tumor volume and growth delay measurements. The extent of apoptosis in tumors in response to treatments was assessed via terminal deoxynucleotidyl transferase-mediated nick-end labeling (TUNEL) assays. In addition, Western blots were done to study the relative expression of Bcl-2 and Bax in the tumors. RESULTS: Docetaxel followed by castration showed the most potent antitumor effects. In contrast, with the exception of castration alone, castration followed by docetaxel produced the least antitumor activity. TUNEL assays confirmed that the density of apoptotic tumor cells was significantly greater for docetaxel followed by castration than for any other treatment. In tumors of mice treated with single modality therapies, Bax to Bcl-2 ratios decreased significantly after castration, whereas this ratio remained high after docetaxel treatment. CONCLUSION: A treatment sequence of docetaxel followed by hormone ablation may be more effective in treating prostate cancer than concurrent docetaxel/hormone therapy or hormone ablation followed by docetaxel.

    Title Potential Effects of Microglial Activation Induced by Ginsenoside Rg3 in Rat Primary Culture: Enhancement of Type A Macrophage Scavenger Receptor Expression.
    Date December 2005
    Journal Archives of Pharmacal Research
    Excerpt

    Brain microglia are phagocytic cells that are the major inflammatory response cells of the central nervous system and widely held to play important pathophysiologic roles in Alzheimer's disease (AD) in both potentially neurotoxic responses and potentially beneficial phagocytic responses. In the study, we examined whether ginsonoside Rg3, a by-product of red ginseng, enhances the microglial phagocytosis of Abeta. We found that Rg3 promoted Abeta uptake, internalization, and digestion. Increased maximal Abeta uptake was observed at 4 and 8 h after Rg3 pre-treatment (25 microg/mL), and the internalized Abeta was almost completely digested from cells within 36 h when pretreated with Rg3 comparing with single non-Rg3-treated groups. The expression of MSRA (type A MSR) was also up-regulated by Rg3 treatment in a dose- and time-dependent manner which was coincidently identified in western blots for MSRA proteins in cytosol. These results indicate that microglial phagocytosis of Abeta may be enhanced by Rg3 and the effect of Rg3 on promoting clearance of Abeta may be related to the MSRA-associated action of Rg3. Thus, stimulation of the MSRA might contribute to the therapeutic potentials of Rg3 in microglial phagocytosis and digestion in the treatment of AD.

    Title Improvement of Menopausal Signs by Isoflavones Derived from Sophorae Fructus in Ovariectomized Female Rats and the Antioxidant Potentials in Bv2 Cells.
    Date August 2005
    Journal Archives of Pharmacal Research
    Excerpt

    The aim of this study was to determine if the isoflavones from Sophorae fructus (SISO) have potential clinical benefit in hormone replacement therapy (HRT) for the treatment of menopausal signs, such as the levels of total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL) and follicle stimulating hormone (FSH). An additional aim was to present the potential antioxidant effect of SISO in a microglial cell line. For the animal model, the ovaries were removed from adult rats and the indicators of menopause were measured at the pre- and post-administration time points. Although no statistically significant correlation was found, SISO tended to decrease the TC level (p=0.15) and the FSH level (p=0.36), but to increase the HDL level (p=0.303). SISO (< 5 microg/mL) also exerted antioxidant activity on BV-2 microglial cells by inhibiting lipopolysaccharide-induced nitric oxide. This cytoprotective effect was confirmed by trypan blue staining, which was used to test for cellular damage from H2O2. In conclusion, this study highlights the anti-menopausal and antioxidant effect of SISO in an ovariectomized rat model, as well as in microglial cells, and provides new clinical targets for the screening of phytoestrogens as potential candidates for HRT in menopausal women.

    Title Reciprocal Activity of Ginsenosides in the Production of Proinflammatory Repertoire, and Their Potential Roles in Neuroprotection in Vivo.
    Date August 2005
    Journal Planta Medica
    Excerpt

    Ginsenosides, the active compounds inherent to most Ginseng species [e. g., Panax ginseng (Araliaceae)], have recently been the focus of increased attention, due to both their purported CNS, antineoplastic and immunomodulatory effects, and their ability to stimulate phagocytosis. In this study, we attempted to determine the effects of ginsenosides Rb1 and Rg1 in a rat model, with specific emphasis on nitric oxide and cytokines, which have been implicated in chronic brain inflammation. We discovered that Rb1 and Rg1 exert opposite effects in a dose-dependent manner (50-250 microg/mL). Whereas Rg1 stimulated nitric oxide and proinflammatory cytokines (IL-1beta, IL-6, and TNF-alpha), Rb1 exerted a significant inhibitory effect on this proinflammatory repertoire. In addition, the genetic expression of bcl-2 and bax, both of which have been implicated in apoptosis, was regulated by treatment with Rb1 and Rg1, at a concentration of 250 microg/mL. Moreover, when combined treatment with equal doses of Rb1 and Rg1 was given, Rb1 significantly counteracted the stimulatory effects of Rg1, as evidenced by an NO assay. This effect persisted stably for 72 h. In conclusion, neurodegenerative diseases such as Alzheimer's disease, which is caused primarily by cell death due to chronic inflammation and cell stress, might be controlled by proper doses of non-toxic, natural Rg1 and Rb1.

    Title What Happens to Hemostatic Agents in Contact with Urine? An in Vitro Study.
    Date August 2005
    Journal Journal of Endourology / Endourological Society
    Excerpt

    As the indications for topical hemostatic agents increase in urology, the question arises: what happens to these agents when they enter the urinary collecting system? To answer this question, we performed a series of in-vitro experiments mixing three hemostatic agents with normal and sanguineous urine.

    Title Robotic Radical Prostatectomy: a Technique to Reduce Pt2 Positive Margins.
    Date July 2005
    Journal Urology
    Excerpt

    OBJECTIVES: To describe a technique using the da Vinci robotic system that enhances one's ability to visualize and dissect the apex and reduce surgical margins. An important outcome of radical prostatectomy is the reduction of iatrogenic positive margins in organ-confined prostate cancer. TECHNICAL CONSIDERATIONS: The clinical data of our first 140 consecutive robot-assisted radical prostatectomies were divided into two groups: group 1, cases 1 to 50; and group 2, cases 51 to 140. After reviewing the surgical margin data and appropriate video clips of our initial 50 patients, we altered our technique. Initially, we had used two sutures to control the dorsal venous complex (DVC), one proximally and distally. The prostate was freed, and, finally, the DVC and urethra were divided. However, a bundle of fat obscured the apex, leading to positive apical margins. We developed the following method. First, we removed all of the fat overlying the DVC and prostate. Second, we divided the puboprostatic ligaments and dissected the levator fibers to expose and increase the DVC length fully. Finally, we stapled and divided the DVC using a vascular stapler. RESULTS: The two groups were clinically comparable. Overall, the pathologic margin rate improved from 36% in group 1 to 16.7% in group 2. In group 1, 9 (27.3%) of 33 pT2 tumors had positive margins versus 3 (4.7%) of 64 pT2 tumors in group 2 (P = 0.003). CONCLUSIONS: The data demonstrate that this change in technique for robotic prostatectomy resulted in a more defined apical dissection and a statistically significant reduction in positive margins in patients with organ-confined disease.

    Title The Potential Anti-hbv Effect of Amantadine in Combination with Ursodeoxycholic Acid and Biphenyl Dimethyl Dicarboxylate in Hepg2 2.2.15 Cells.
    Date July 2005
    Journal Archives of Pharmacal Research
    Excerpt

    Experimental studies have demonstrated that the triple combination of amantadine (A)/ ursodeoxycholic acid (UDCA, U)/ biphenyl dimethyl dicarboxylate (DDB, D) might have a preferential antiviral effect compared with that observed in interferon-induced antiviral signal pathways, such as those of STAT1alpha and the 6-16 genes. To confirm the result, this study examined whether the signal transduction for the antiviral activity in HepG2 2.2.15 was induced dependently or independently of interferon. To accomplish this, the correlation between the STAT1alpha and 6-16 genes, and nitric oxide, for the mediation of the antiviral activity was assessed. The increase in nitric oxide in the UDCA groups suggests that the inhibition of viral gene replication was enhanced by the amantadine combinations (AU and AUD), and might be more effective if incubated for longer periods. It was found that STAT1alpha was activated by the amantadine combination, although to a lesser extent than that of interferon-alpha, and the primary endpoints examined for the inhibition of gene expression (HBsAg and HBcAg) were remarkably well regulated. This suggests that the amantadine triple, or at least the double, combination had better clinical benefits than those of IFN-alpha and the nucleoside analogue single treatment. This demonstrates that the amantadine combination might be a substitute for the existing HBV therapy if the results of in vivo and in vitro studies concur.

    Title Ecological Modeling for Water Quality Management of Kwangyang Bay, Korea.
    Date June 2005
    Journal Journal of Environmental Management
    Excerpt

    This study estimated the appropriate pollutant load reduction from point sources in Kwangyang Bay, Korea, using an eco-hydrodynamic model. The total chemical oxygen demand (COD), nitrogen (TN), and phosphorus (TP) loads from rivers and ditches that provide input to the bay were approximately 2.8x10(4), 2.5x10(4), and 5.9x10(2) kg day-1, respectively. Wastewater discharge from industrial complexes was the greatest contributor to pollutant loads in the inner part of the bay. COD values in the inner part of the bay were greater than 3.0 mg l-1, and exceeded Korean seawater quality grade III limits. A residual current was simulated, using a hydrodynamic model, to have a slightly complicated pattern in the inner part of the bay, ranging from 0.001 to 8 cm s-1. In the outer part of the bay, the simulated current flowed out to the South Sea with a southward flow at a maximum of 15 cm s-1. The results of the ecological model simulation of COD levels showed high concentrations, exceeding 4 mg l-1, in the southwest of the Myodo, an area of wastewater discharge, and lower levels, approaching less than 1 mg l-1, closer to the outer part of the bay. Engineering countermeasures to reduce the organic and inorganic material loads from point sources by more than 45% were required to keep the COD levels below 2 mg l-1.

    Title Bone Loss Preventing Effect of Sophorae Fructus on Ovariectomized Rats.
    Date June 2005
    Journal Archives of Pharmacal Research
    Excerpt

    The preventive effects of Sophorae Fructus extracts (I: hot water extract and II: combination product using I) on bone loss in ovariectomized (OVX) rats were investigated. Sophorae Fructus extracts were orally administrated to OVX rats for 9 weeks. Ovariectomy caused the increase of body weight and deoxypyridinoline (Dpd: bone resorption marker) and decrease of calcium (Ca: bone formation marker) level in serum. Dpd level were significantly decreased and Ca levels were elevated at 9 weeks in Sophorae Fructus extracts administered groups after ovariectomy at a dose of 0.556 g/kg/day compared with control group. In administered groups, trabecular bone area (TBA) in the tibia and lumbar were also increased compared with control group in histomorphological analysis. The preventive or treatment effects of Sophorae Fructus extracts on bone loss in OVX rats appears to be due to suppression of bone turnover.

    Title Effect of Urine Specific Gravity on Effectiveness of Shockwave Lithotripsy.
    Date May 2005
    Journal Journal of Endourology / Endourological Society
    Excerpt

    To determine the effect of urine specific gravity (SG) and radiographic contrast medium on the efficiency of extracorporeal shockwave lithotripsy (SWL) fragmentation using a previously published in vitro model.

    Title Impact of a Double-pigtail Stent on Ureteral Peristalsis in the Porcine Model: Initial Studies Using a Novel Implantable Magnetic Sensor.
    Date May 2005
    Journal Journal of Endourology / Endourological Society
    Excerpt

    BACKGROUND AND PURPOSE: The effect of stents on ureteral peristalsis in vivo is not entirely clear. We sought to develop a minimally invasive method for its study. MATERIALS AND METHODS: In female domestic pigs, electrical potentials from the ureter were measured by bipolar steel-wire electromyography electrodes delivered laparoscopically. Mechanical movement was measured by giant magneto resistive sensors mounted on custom-made aluminum strips. After baseline values were obtained, the animals were randomized to receive silicone or polyurethane stents, and ureteral peristalsis was measured for 8 hours acutely and for 4 hours 1 week later. RESULTS: Implantation of the devices took an average of 30 minutes. A consistent correlation was found between laparoscopically observed peristaltic waves and the peristalsis detected by the two measuring devices. The devices themselves did not affect peristalsis. Stent insertion increased peristaltic activity initially but later reduced or stopped it. There was no difference in the effects of the two types of stents. CONCLUSIONS: The new technique permits close monitoring of ureteral peristalsis in vivo. Smaller stents appear to have less immediate effect than larger ones, but all type of stents tested eventually caused aperistalsis.

    Title Fibrin Glue-oxidized Cellulose Sandwich for Laparoscopic Wedge Resection of Small Renal Lesions.
    Date May 2005
    Journal The Journal of Urology
    Excerpt

    We present our experience with standard laparoscopic wedge resection of small renal tumors using a fibrin glue-oxidized cellulose sandwich for hemostasis.

    Title Hand-assisted Laparoscopic Nephrectomy in Autosomal Dominant Polycystic Kidney Disease.
    Date March 2005
    Journal Journal of Endourology / Endourological Society
    Excerpt

    Among patients with renal insufficiency secondary to autosomal dominant polycystic kidney disease (ADPKD), the onset of refractory urinary infection, hypertension, pain, or hematuria often necessitates a nephrectomy. However, the huge size of these kidneys makes a standard laparoscopic approach difficult, and the increased fragility of these patients makes an open nephrectomy risky. A compromise position has been found in the realm of hand-assisted laparoscopic techniques, especially for patients in need of a bilateral nephrectomy.

    Title Anatomic Guide for Port Placement for Davinci Robotic Radical Prostatectomy.
    Date March 2005
    Journal Journal of Endourology / Endourological Society
    Excerpt

    BACKGROUND AND PURPOSE: At present, robotic arm port placement for daVinci trade mark robot-assisted laparoscopic radical prostatectomy is based on the umbilicus. However, the robotic arm has a maximum manufactured required working distance of 25 cm. Accordingly, normal variability of patient height, weight, and umbilical location can leave the working arms too short to reach the membranous urethra. We present data to support port placement using the pubis, rather than the umbilicus, as the landmark. MATERIALS AND METHODS: If we assume the 25-cm working distance of the robot arm (Z) equals the hypotenuse of a triangle and the Y axis is the sum of the distance from the membranous urethra to the skin (Y1) plus the displacement of the skin secondary to CO(2) insufflation (Y2), then the horizontal distance X is from the robot port site to the pubis. To ascertain Y1, we randomly selected the CT scans of 25 men and measured the depth from the skin over the pubis to the membranous urethra. To determine Y2, we measured the change in height from the table of the port site after CO(2) insufflation in 11 robotic laparoscopic prostatectomies. RESULTS: The average distance of Y1 was 11 cm; Y2 was 6 cm. Using the formula (Z(2) - (Y1 + Y2)(2))(1/2), the maximum distance X from the port site to the pubis, for an average man, should not exceed 18 cm. CONCLUSION: The optimal landmark for calculating the placement of ports for the daVinci robotic arm placement should be the pubis and not the umbilicus. Tall men (>72 inches) are at risk for exceeding functional robot arm length, and in these men, port sites should not be more than 18 cm from the pubis.

    Title Percutaneous Approaches to Renal Cryoablation.
    Date February 2005
    Journal Journal of Endourology / Endourological Society
    Excerpt

    Minimally invasive approaches to small renal tumors continue to evolve. Cryotherapy is an attractive modality in that it can be delivered in a number of different ways, including laparoscopically and percutaneously. This article addresses the current state of percutaneous approaches to renal masses.

    Title Potential Role of Ursodeoxycholic Acid in Suppression of Nuclear Factor Kappa B in Microglial Cell Line (bv-2).
    Date February 2005
    Journal Archives of Pharmacal Research
    Excerpt

    Expression of the NF-kappaB-dependent genes responsible for inflammation, such as TNF-alpha, IL-1beta, and nitric oxide synthase (NOS), contributes to chronic inflammation which is a major cause of neurodegenerative diseases (i.e. Alzheimer's disease). Although NF-kappaB plays a biphasic role in different cells like neurons and microglia, controlling the activation of NF-kappaB is important for its negative feedback in either activation or inactivation. In this study, we found that ursodeoxycholic acid (UDCA) inhibited IkappaB alpha degradation to block expression of the NF-kappaB-dependent genes in microglia when activated by beta-amyloid peptide (A beta). We also showed that when microglia is activated by A beta42, the expression of A20 is suppressed. These findings place A20 in the category of "protective" genes, protecting cells from pro-inflammatory repertoires induced in response to inflammatory stimuli in activated microglia via NF-kappaB activation. In light of the gene and proteins for NF-kappaB-dependent gene and inactivator for NF-kappaB (IkappaB alpha), the observations now reported suggest that UDCA plays a role in supporting the attenuation of the production of pro-inflammatory cytokines and NO via inactivation of NF-kappaB. Moreover, an NF-kappaB inhibitor such as A20 can collaborate and at least enhance the anti-inflammatory effect in microglia, thus giving a potent benefit for the treatment of neurodegenerative diseases such as AD.

    Title Anti-inflammatory Effect of Bee Venom on Type Ii Collagen-induced Arthritis.
    Date February 2005
    Journal The American Journal of Chinese Medicine
    Excerpt

    Bee venom (BV) has been used to relieve pain and reduce inflammation in traditional Oriental medicine, especially in chronic inflammatory diseases such as rheumatoid arthritis (RA). We previously reported that the BV injection into a traditional acupuncture point (Zusanli) reduced arthritis-associated edema and nociceptive responses in Freund's adjuvant-induced arthritis in rats (Kwon et al., 2001). This study was designed to evaluate the anti-inflammatory and anti-cytokine effect of BV on a murine type-II collagen-induced arthritis (CIA) model. Male mice were immunized by spontaneous injection of 100 microg of an emulsion of bovine type-II collagen and complete Freund's adjuvant (CFA), with a booster injection after 2 weeks. In the experimental group, 0.1 ml BV was injected at acupuncture point (Zusanli) near both knees twice a week for a total of 5 times. In the control group, normal saline was injected at the same frequencies. These injections began 5 weeks after the first collagen injection. Starting the 3rd week after the first collagen injection, we examined limb swelling and severity of arthritis twice a week. At 8 weeks, mice were sacrificed and synovial tissue was examined with the light microscope and serum cytokines (IL-1beta and TNF-alpha) were measured by ELISA. The incidence of arthritis, the mean arthritis index and the number of arthritic limbs were significantly lower in the treatment compared to the control group (63% versus 75%, 3.4% versus 8.5%, 23% versus 75%, respectively). Among the serum proinflammatory cytokines, the production of TNF-alpha in the BV group was suppressed compared to the control group (59 +/- 4.5 versus 99.5 +/- 6.5, p < 0.05), but IL-1beta was not suppressed. The examination of the histopathology of the joints of murine CIA showed decreased inflammation signs and less lymphocyte infiltration after BV acupuncture therapy. Acupuncture therapy with BV suppressed the development of arthritis and caused inhibition of the immune responses in type-II collagen-induced arthritis.

    Title Isoflavones Extracted from Sophorae Fructus Upregulate Igf-i and Tgf-beta and Inhibit Osteoclastogenesis in Rat Bone Marrow Cells.
    Date November 2004
    Journal Archives of Pharmacal Research
    Excerpt

    Isoflavones have been a central subject in research on the natural phytoestrogens found in Leguminosae. Their effects on bone formation and remodeling are important in that they can act like estrogen by binding on estrogen receptors on the target cell surface. We, therefore, believed that isoflavones may help in the treatment of patients with estrogen deficiency disease such as estrogen replacement therapy (ERT) for osteoporosis. As commonly known, osteoporosis is one of the hormonal deficiency diseases, especially in menopausal women. When estrogen is no longer produced in the body a remarkable bone remodeling process occurs, and the associated events are regulated by growth factors in the osteoblast lineage. In the present study, we investigated whether isoflavones (Isocal) extracted from Sophorae fructus affect the growth factors IGF-I and TGF-beta that have been known to be related with bone formation. In the study, we found that the active control (PIII) effectively enhanced the level of nitric oxide (NO) and growth factors, and thereby inhibited osteoclastogenesis. The most efficient concentration was 10(-8)% within five days, whereas the comparative control (soybean isoflavone) was not as effective even at a lower concentration. In conclusion, the products which contain enriched glucosidic isoflavone and nutrient supplements such as shark cartilage and calcium can be used for osteoporosis therapy by enhancing the production of IGF-I and TGF-beta. Furthermore, the NO produced through endothelial constitutive NO synthase (ecNOS) may play a role in inhibiting bone reabsorption.

    Title Robot-assisted Versus Open Radical Prostatectomy: a Comparison of One Surgeon's Outcomes.
    Date October 2004
    Journal Urology
    Excerpt

    OBJECTIVES: To compare internally one surgeon's standard open radical prostatectomy (RP) and robot-assisted laparoscopic RP (RLP) results. RLP, like standard laparoscopic RP, ultimately needs to produce similar or improved results compared with standard RP techniques. Little information comparing RLP with standard RP exists. METHODS: As an internal control, we selected the last 60 standard RPs performed by one surgeon (T.A.) before initiating RLPs. For the RLP group, we selected cases 46 to 105 (n = 60) after the learning curve had adequately matured. We compared the clinical characteristics, perioperative results, and early clinical outcomes. RESULTS: The study and control groups had similar clinical characteristics (age, body size, preoperative prostate-specific antigen level, clinical stage, and Gleason score). No statistically significant differences were found between groups for prostate size, pT stage, Gleason score, or margin status (16.7% versus 20%; P = nonsignificant). The RLP group had a statistically significant advantage for estimated blood loss (103 versus 418 mL), postoperative hemoglobin change (1.6 versus 3.3 mg/dL), and hospital stay (1.02 versus 2.2 days). Complete continence (0 pads) at 3 months of follow-up and the rate of postoperative complications were similar for the RLP and RP groups (76% versus 75% and 6.7% versus 10%, respectively). CONCLUSIONS: We present the results of RLP and RP performed by one surgeon. With only a 100-case experience, RLP had oncologic and urinary outcomes that were at least equal to those after RP. RLP offers the benefits of minimally invasive surgery and does not compromise clinical or pathologic outcomes.

    Title Robotic Laparoscopic Radical Prostatectomy with a Single Assistant.
    Date October 2004
    Journal Urology
    Excerpt

    INTRODUCTION: As experience with robot-assisted laparoscopic radical prostatectomy (rLRP) grows, the importance of the role of the assistant cannot be overstated. Key elements of the operation, dependent on the assistant, have not been reported. The focus of this report was to describe the key elements, which include positioning of the patient and assistant port sites, appropriate equipment, and the assistant-dependent steps of the procedure. TECHNICAL CONSIDERATIONS: During the course of the initial 100 cases, we reviewed the patient and port site positioning and reviewed the videotapes to identify key elements of the assistant's role that facilitate rLRP. We identified three important elements pertaining to patient positioning. In contrast to standard port site recommendations, we found that dominant and nondominant handedness dictate the assistant port site locations. Finally, we identified specific steps of the procedure that require the assistant to have laparoscopic skills necessary for the console surgeon to dissect the bladder neck, seminal vesicles, rectum, and neurovascular bundles. CONCLUSIONS: The assistant in rLRP is critical to the success of rLRP, especially in the learning phases. Right or left-handed dominance determines on which side the assistant should be positioned. In contrast to the console surgeon, the assistant should have intermediate to advanced laparoscopic skills.

    Title Inhibition of Il-1beta and Il-6 in Osteoblast-like Cell by Isoflavones Extracted from Sophorae Fructus.
    Date August 2004
    Journal Archives of Pharmacal Research
    Excerpt

    Osteoporosis is recognized as one of the major hormonal deficiency diseases, especially in menopausal women and the elderly. When estrogen is reduced in the body, local factors such as IL-1beta and IL-6, which are known to be related with bone resorption, are increased and promote osteoclastogenesis, which is responsible for bone resorption. In the present study, we investigated whether glucosidic isoflavones (Isocal, PIII) extracted from Sophorae fructus affect the proliferation of osteoblasts and prevent osteoclastogenesis in vitro by attenuating upstream cytokines such as IL-1beta and IL-6 in a human osteoblastic cell line (MG-63) and in a primary osteoblastic culture from SD rat femurs. Interestingly, IL-1beta and IL-6 mRNA were significantly suppressed in osteoblast-like cells treated with 17beta-estradiol (E2) and PIII when compared to positive control (SDB), and this suppression was more effective at 10(-8)% than at the highest concentration of 10(-4)%. In addition, these were confirmed in protein levels using ELISA assay. In the cell line, the cells showed that E2 was the most effective in osteoblastic proliferation over the whole range of concentration (10(-4)%-10(-12)%), even though PIII also showed the second greatest effectiveness at 10(-8)%. Nitric oxide (NO) was significantly (p<0.05) upregulated in PIII and E2 over the concentration range 10(-6)% to 10(-8)% when compared to SDB, without showing any dose dependency. In bone marrow primary culture, we found by TRAP assay that PIII effectively suppressed osteoclastogenesis next to E2 in comparison with SDB and culture media (control). In conclusion, these results suggest that local bone-resorbing cytokines can be regulated by PIII at lower concentrations and that, therefore, PIII may preferentially induce anti-osteoporosis response by attenuating osteoclastic differentiation and by upregulating NO.

    Title Ursodeoxycholic Acid Inhibits Pro-inflammatory Repertoires, Il-1 Beta and Nitric Oxide in Rat Microglia.
    Date August 2004
    Journal Archives of Pharmacal Research
    Excerpt

    Ursodeoxycholic acid (UDCA) is a non-toxic, hydrophilic bile acid in widespread clinical use mainly for acute and chronic liver disease. Recently, treatment with UDCA in hepatic graft-versus-host disease has been given in immunosuppressive therapy for improvement of the biochemical markers of cholestasis. Moreover, it has been reported that UDCA possesses immunomodulatory effects by the suppression of cytokine production. In the present study, we hypothesized that UDCA may inhibit the production of the pro-inflammatory cytokine, IL-1beta, and nitric oxide (NO) in microglia. In the study, we found that 100 microg/mL UDCA effectively inhibited these two pro-inflammatory factors at 24 h and 48 h, compared to the Abeta42-pretreated groups. These results were compared with the LPS+UDCA group to confirm the UDCA effect. As microglia can be activated by several stimulants, such as Abeta42, in Alzheimers brain and can release those inflammatory factors, the ability to inhibit or at least decrease the production of IL-1beta and NO in Alzheimers disease (AD) is essential. Using RT-PCR, ELISA and the Griess Reagent System, we therefore found that UDCA in Abeta42 pre-treated cultures played a significant role in suppressing the expression or the production of IL-1beta and NO. Similarly, lipopolysaccharide (LPS) did not activate microglia in the presence of UDCA. Moreover, we found that UDCA exhibits a prolonged effect on microglial cells (up to 48 h), which suggests that UDCA may play an important role in chronic cell damage due to this long effect. These results further imply that UDCA could be an important cue in suppressing the microglial activation stimulated by massive Aâ peptides in the AD progressing brain.

    Title In Vitro Comparison of Burst Tension and Puncture Pressure in Commonly Used Organ Retrieval Bags.
    Date August 2004
    Journal Journal of the American College of Surgeons
    Title One-knot Pyeloplasty.
    Date August 2004
    Journal Journal of Endourology / Endourological Society
    Excerpt

    Laparoscopic pyeloplasty represents one of the more advanced reconstructive procedures for the urologist. While early reports were replete with long operative times, there have been several changes that have added to the efficiency of the procedure. In our practice, we have found three changes to be of greatest value: (1) an upper-midline port placement; (2) use of a continuous suture for the anastomosis with a double-armed, knotted suture; and (3) antegrade stent placement.

    Title Hematopoietic Effect of Ginsenoside Rg3 in Icr Mouse Primary Cultures and Its Application to a Biological Response Modifier.
    Date July 2004
    Journal Fitoterapia
    Excerpt

    Ginsenoside Rg3, which is obtained as a by-product during the steaming of red ginseng, at 300 microg/ml enhanced the proliferation of the total spleen and bone marrow (BM) cells in both the cyclophosphamide (CYC)-treated and non-CYC-treated groups.

    Title Laparoscopic Mid Sagittal Hemicystectomy and Bladder Reconstruction with Small Intestinal Submucosa and Reimplantation of Ureter into Small Intestinal Submucosa: 1-year Followup.
    Date July 2004
    Journal The Journal of Urology
    Excerpt

    PURPOSE: We evaluated the long-term results of laparoscopic hemicystectomy and bladder replacement with small intestinal submucosa (SIS) with ureteral reimplantation into the SIS material. MATERIALS AND METHODS: A total of 12 minipigs underwent laparoscopic hemicystectomy. Six pigs underwent bladder reconstruction with SIS and ipsilateral ureteral reimplantation. The remaining 6 control pigs underwent hemicystectomy and primary bladder closure with ipsilateral nephroureterectomy. Preoperative and followup evaluations included blood chemistry, radiography and urodynamic evaluations. The 6, 3, 6 and 9-week, and 12-month followup evaluations included biopsies. At 1 year the animals were sacrificed. Histopathological and contractility studies, and reverse transcriptase-polymerase chain reaction for growth factors and basement membrane components were performed. RESULTS: Bladder capacity and bladder compliance were similar in the 2 groups at all time points. One pig per group died, that is a control at the 9-month evaluation due to an anesthetic complication and an SIS pig 7 months after bladder reconstruction due to spontaneous bladder rupture at the anastomotic site. In the SIS group 4 of 5 surviving pigs had unobstructed reimplanted ureters without evidence of hydroureteronephrosis, while 1 had high grade obstruction at the reimplantation site. Histopathology study after 1 year revealed muscle at the graft periphery and center but it consisted of small fused bundles with significant fibrosis. Nerves were present at the graft periphery and center but they were decreased in number. CONCLUSIONS: Laparoscopic SIS bladder reconstruction and ureteral reimplantation into the SIS after hemicystectomy are technically feasible. However, compared to primary bladder closure no advantage in bladder capacity or compliance was documented.

    Title Intraoperative Catheter Management During Laparoscopic Excision of a Giant Bladder Diverticulum.
    Date June 2004
    Journal Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
    Excerpt

    Massive bladder diverticula present a technical challenge to the laparoscopic surgeon. We describe a laparoscopic approach to transperitoneal diverticulectomy, using a specific catheter arrangement to allow excellent control of the various portions of the procedure.

    Title Use of Gelatin Matrix to Rapidly Repair Diaphragmatic Injury During Laparoscopy.
    Date June 2004
    Journal Urology
    Title Prospective Comparison of the Immunological and Stress Response Following Laparoscopic and Open Surgery for Localized Renal Cell Carcinoma.
    Date May 2004
    Journal The Journal of Urology
    Excerpt

    PURPOSE: We prospectively compared the systemic immune and stress response of patients who underwent laparoscopic total nephrectomy (LRN) (14) and open nephrectomy (ON) (10) for renal cell carcinoma. The ON group comprised open radical (4), open total (2) and open partial (4) nephrectomy cases. MATERIALS AND METHODS: Only patients with no history of cancer or autoimmune disease and American Society of Anesthesiologists score 2 or less who were not using immunosuppressive drugs were selected. Peripheral venous blood was collected preoperatively and intraoperatively, and 24 hours, 2 weeks, 4 weeks and 3 months postoperatively. Blood was analyzed for stress markers (adrenalin, noradrenalin and cortisol), inflammatory response markers (C-reactive protein, white blood count and leukocyte count), lymphocytic response markers (CD3, CD4 and CD8), cytokines interleukin-2 and 4, interferon-alpha and tumor necrosis factor-alpha), HLA-DR expression and the proliferative response to mitogen stimulation using concanavalin A, phytohemagglutinin 10, and pokeweed mitogen. RESULTS: Mean tumor size +/- SD for ON and LRN was 5.6 +/- 2.4 and 4.5 +/- 1.6 cm, respectively (p = 0.21). The trends with time for all measured postoperative parameters were similar in the 2 groups. Inflammatory and stress response markers were statistically similar for in the groups at all time points. A significant difference between the groups was noted for the percentage of CD4+ and CD8+ lymphocytes. However, this difference was present preoperatively and there was no significant absolute change in these 2 parameters. The cytokine response and HLA-DR expression were similar in the 2 groups at all time points. Likewise, the lymphocytic stimulation index for concanavalin A, phytohemagglutinin and pokeweed mitogen were statistically similar for LRN and ON at all time points. CONCLUSIONS: The immunological and stress response after LRN and ON for renal cell carcinoma is similar. The few differences observed in measured parameters likely reflect preoperative differences in baseline and/or the contributory effect of anesthesia.

    Title Ureteroscopes: Flexible, Rigid, and Semirigid.
    Date April 2004
    Journal The Urologic Clinics of North America
    Excerpt

    Since its introduction, the ureteroscope has undergone significant improvements. Using the currently available rigid, semirigid, and flexible ureteroscopes and working instruments, urologists can diagnose and treat lesions throughout the upper urinary tract. Over the past 25 years, the ureteroscope in combination with shock wave lithotripsy has transformed the diagnosis and treatment of more than 90% of upper urinary tract pathology from an open to an endourologic procedure. With endoscope manufacturers continually incorporating new technology into their ureteroscopes, future models will undoubtedly provide better optics, increased durability, and improved capabilities, resulting in greater success when urologists perform endoscopic forays into the upper urinary tract.

    Title Age-related Changes of Parvalbumin Immunoreactive Neurons in the Rat Main Olfactory Bulb.
    Date March 2004
    Journal Molecules and Cells
    Excerpt

    Parvalbumin (PV) is found in the olfactory system, including the main olfactory bulb, and is thought to be one of the neuroactive substances in olfaction. Changes in PV immunoreactivity in the olfactory system during aging have not been examined. We investigated such changes in the main olfactory bulb (MOB) of the rat at postnatal month 1 (PM 1), PM 3, PM 6, PM 12 and PM 24. PV-IR neurons were almost completely restricted to the external plexiform layer. At PM 1 there were only a few PV-IR neurons; at PM 3, the number of PV-IR neurons was at its greatest but they were not well developed morphologically. At PM 6, the number of PV-IR neurons was similar to that at PM 3 and they had satellite somata with well-developed processes with many varicosities. By PM 12 the number of neurons and processes had declined, and by PM 24, they had fallen even further and the remaining processes had lost most of their varicosities. We conclude that age-related degeneration of PV-IR neurons in the MOB may reduce calcium buffering and affect olfactory function in senile species.

    Title Sealing Percutaneous Nephrolithotomy Tracts with Gelatin Matrix Hemostatic Sealant: Initial Clinical Use.
    Date February 2004
    Journal The Journal of Urology
    Excerpt

    Tubeless percutaneous nephrolithotomy (PCNL) has been performed at several centers with good success. However, these cases have been carefully selected with regard to short duration and smaller stone burden to prevent complications associated with the loss of access to the collecting system. We describe the use of gelatin matrix hemostatic sealant (FloSeal Baxter Medical, Fremont, California) as an adjunct to tubeless percutaneous nephrolithotomy to help preclude bleeding complications.

    Title Laparoscopic Cyst Decortication in Autosomal Dominant Polycystic Kidney Disease: Impact on Pain, Hypertension, and Renal Function.
    Date January 2004
    Journal Journal of Endourology / Endourological Society
    Excerpt

    In patients with autosomal dominant polycystic kidney disease (ADPKD), laparoscopic cyst decortication (LCD) has been proposed as a means to relieve chronic cyst-related pain. We present our 7-year experience with LCD for ADPKD with regard to pain relief, hypertension, and renal function.

    Title Developmental Toxicity Evaluation of Elf Magnetic Fields in Sprague-dawley Rats.
    Date January 2004
    Journal Bioelectromagnetics
    Excerpt

    To identify possible effects of horizontally polarized magnetic field (MF) exposure on maintenance of pregnancy and embryo-fetal development, an MF exposure system was designed and constructed and 96 time-mated female Sprague-Dawley (SD) rats (24/group) received continuous exposure to 60 Hz MF at field strengths of 0 (sham control) and 5, 83.3, or 500 microT (50, 833, or 5000 mG). Dams received MF or sham exposures for 22 h/day on gestational day 6-20. MF was monitored continuously throughout the study. There were no evidences of maternal toxicity or developmental toxicity in any MF exposed groups. Mean maternal body weight, organ weights, and hematological and serum biochemical parameters in groups exposed to MF did not differ from those in sham control. No exposure related differences in fetal deaths, fetal body weight, and placental weight were observed between MF exposed groups and sham control. External, visceral, and skeletal examination of fetuses demonstrated no significant differences in the incidence of fetal malformations between MF exposed and sham control groups. In conclusion, exposure of pregnant rats to 60 Hz at MF strengths up to 500 microT during gestation day 6-20 did not produce any biologically significant effect in either dams or fetuses.

    Title Robotic Revelation: Laparoscopic Radical Prostatectomy by a Nonlaparoscopic Surgeon.
    Date November 2003
    Journal Journal of the American College of Surgeons
    Title Nitrification of High Strength Ammonia Wastewater and Nitrite Accumulation Characteristics.
    Date August 2003
    Journal Water Science and Technology : a Journal of the International Association on Water Pollution Research
    Excerpt

    Biological nitrogen removal via the nitrite pathway in wastewater treatment is very important in saving the cost of aeration and as an electron donor for denitrification. Wastewater nitrification and nitrite accumulation were carried out in a biofilm airlift reactor with autotrophic nitrifying biofilm. The biofilm reactor showed almost complete nitrification and most of the oxidized ammonium was present as nitrite at the ammonium load of 1.5 to 3.5 kg N/m3 x d. Nitrite accumulation was stably achieved by the selective inhibition of nitrite oxidizers with free ammonia and dissolved oxygen limitation. Stable 100% conversion to nitrite could also be achieved even under the absence of free ammonia inhibition on nitrite oxidizers. Batch ammonium oxidation and nitrite oxidation with nitrite accumulating nitrifying biofilm showed that nitrite oxidation was completely inhibited when free ammonia is higher than 0.2 mg N/L. However, nitrite oxidation activity was recovered as soon as the free ammonia concentration was below the threshold level when dissolved oxygen concentration was not the limiting factor. Fluorescence in situ hybridization analysis of cryosectioned nitrite accumulating nitrifying biofilm showed that the beta-subclass of Proteobacteria, where ammonia oxidizers belong, was distributed outside the biofilm whereas the alpha-subclass of Proteobacteria, where nitrite oxidizers belong, was found mainly in the inner part of the biofilm. It is likely that dissolved oxygen deficiency or limitation in the inner part of the nitrifying biofilm, where nitrite oxidizers exist, is responsible for the complete shut down of the nitrite oxidizers activity under the absence of free ammonia inhibition.

    Title Evaluation of Overall Costs of Currently Available Small Flexible Ureteroscopes.
    Date August 2003
    Journal Urology
    Excerpt

    To perform a meta-analysis of the currently available data regarding the durability of flexible ureteroscopes to establish cost estimates for the purchase and use of five currently available, smaller than 9F, ureteroscopes. Healthcare costs have become increasingly germane to the determination of disease management strategies. Improved ureteroscope technology has expanded the role of these instruments. However, the initial purchase costs and high maintenance costs have become problematic with these fragile instruments.

    Title Characterization of Intrapelvic Pressure During Ureteropyeloscopy with Ureteral Access Sheaths.
    Date August 2003
    Journal Urology
    Excerpt

    OBJECTIVES: To evaluate the impact of the ureteral access sheath on intrarenal pressures during flexible ureteroscopy in light of the recent resurgence in their use. As such, using human cadaveric kidneys, we studied changes in intrarenal pressure in response to continuous irrigation at different pressures with and without access sheaths of various sizes and lengths. METHODS: This study was performed using seven cadaveric kidneys. In three kidneys the study was done in situ with a 7.5F flexible ureteroscope (URS) passed by itself and then passed through a 10/12F sheath (35 and 55 cm in length), whereas, in four kidneys, due to narrowing of the intramural ureter, the study was done ex vivo using the unsheathed URS and then passing the 7.5F flexible URS via the 10/12F, 12/14F, and 14/16F sheaths (all 35 cm in length). A 10F Cope loop pyelostomy was placed to measure intrapelvic renal pressure. Three sets of 3-minute readings (ie, flow and intrarenal pressure) were taken with the tip of the URS at the distal ureter, middle ureter, and renal pelvis (just above the ureteropelvic junction); the entire process was done at three different irrigant pressure settings: 50, 100, and 200 cm H(2)O. Irrigant flow and intrarenal pressures were measured at all three settings using the URS passed without a sheath and then with the URS passed through the various sheaths positioned at the distal ureter, middle ureter, and renal pelvis. RESULTS: With all of the sheaths, intrapelvic pressure remained low (less than 30 cm H(2)O), and there was a 35% to 80% increase in irrigant flow versus the control unsheathed URS. With the sheath in place, the majority of the irrigant drained alongside the URS and out the sheath. Flow and pressure with the 12/14F sheath were equivalent to the 14/16F sheath. CONCLUSIONS: The 12/14F access sheath provides for maximum flow of irrigant while maintaining a low intrarenal pelvic pressure. Even with an irrigation pressure of 200 cm H(2)O, renal pelvic pressure remained below 20 cm H(2)O.

    Title Novel Approach to Minimizing Trocar Sites During Challenging Hand-assisted Laparoscopic Surgery Utilizing the Gelport: Trans-gel Instrument Insertion and Utilization.
    Date June 2003
    Journal Journal of Endourology / Endourological Society
    Excerpt

    We present a novel technique for modified application of a hand-assist device, the Gelport (Applied Medical Resources, Rancho Santa Margarita, CA), which uses a gel for intra-abdominal access.

    Title Immunoactivation of Lectin-conjugated Praecoxin A on Il-6, Il-12 Expression.
    Date June 2003
    Journal Archives of Pharmacal Research
    Excerpt

    Lectin-conjugated praecoxin A is a compound, which is combined Wheat Germ Agglutinin (WGA) Lectin with praecoxin A and also known to have an anti-tumor activity. In our lab, in order to investigate its immune reaction other than the anti-tumor activity ever known, we examined cytokines such as IL-6 and IL-12 through their mRNA expressions, which are generally secreted by macrophage both in vivo and in vitro. To analyze, we used RT-PCR for total RNAs of macrophages. As a result, we obtained that both in vitro and in vivo, lectin-conjugated praecoxin A showed an interesting increase on IL-6 and IL-12 even though it may be little hard to say the conjugated form is absolutely more effective than that of lectin or praecoxin A alone for immune response activities. Those results suggest that the conjugated form may give an additional opportunity in a future therapeutic use over its immuno activation properties.

    Title Retroperitoneal Laparoscopic Cryoablation of Small Renal Tumors: Intermediate Results.
    Date March 2003
    Journal Urology
    Excerpt

    OBJECTIVES: To present our experience with laparoscopic renal cryoablation with up to 3 years of follow-up. Laparoscopic renal cryoablation remains a viable option for the treatment of small peripheral renal masses in patients with significant comorbidities. Although partial nephrectomy has been shown to be a safe and reliable method of renal parenchymal preservation, laparoscopic cryoablation still requires longer term data to prove its efficacy. METHODS: Twenty patients with small renal masses (1.4 to 4.5 cm) underwent laparoscopic renal cryosurgery at our institution. A retroperitoneal laparoscopic approach was used to expose the kidney. Intraoperative ultrasound guidance was used to localize the lesions and monitor iceball formation. A double-freeze technique was used. Needle biopsies of solid masses were performed intraoperatively. RESULTS: Renal biopsies revealed renal cell carcinoma in 11 of the 20 patients. Of these 11 patients, none had evidence of recurrent disease at last follow-up, and follow-up scans showed no enhancement of any lesions. Of the 8 patients with follow-up of 2 years or greater, 4 had complete resolution of the renal lesions. The remainder had lesions that were reduced and stable in size. Complications included surgical re-exploration to evaluate pancreatic injury in 1 patient and failure to ablate a lesion in another. CONCLUSIONS: Laparoscopic renal cryoablation appears to be an effective tool for ablation of small renal lesions. A moderate length of follow-up continues to demonstrate efficacy because no patients had growth of treated pathologic lesions or developed metastasis to date. Continued maturation of data is necessary to determine the long-term efficacy.

    Title Augmentation of Macrophage Antitumor Activities and Nitric Oxide Production by Oregonin.
    Date March 2003
    Journal Archives of Pharmacal Research
    Excerpt

    Oregonin, a diarylheptanoid derivative from Alnus hirsuta Turcz, Betulaceae, was evaluated for its antitumor activity. Oregonin, known to have an antitumor function, and is a novel immunomodulator, which may augment macrophage activity. MTT assays and NO production tests were performed in order to investigate the cytotoxicity of oregonin in tumor cells and to examine its influence on macrophage in detail. In this study, the tumoricidal activity was also evaluated by a MTT assay. The cytotoxicity measurements in the oregonin-treated group both in vitro and in vivo showed a significant difference from that of the control group. In vivo, oregonin significantly increased NO production in a dose-dependent manner, and in vitro, the thioglycolate-induced inflammatory macrophages increased NO production in a dose-dependent manner after incubation. These results suggest that oregonin reacts with both the inflammatory and non-inflammatory macrophages in a similar way.

    Title Enhancement of Nk Cytotoxicity, Antimetastasis and Elongation Effect of Survival Time in B16-f10 Melanoma Cells by Oregonin.
    Date March 2003
    Journal Archives of Pharmacal Research
    Excerpt

    We investigated the antitumor activity of oregonin, a diarylheptanoid derivative purified from Alnus hirsuta Turcz, Betulaceae. Oregonin is a potential novel immunomodulator, which augments the activation of natural killer (NK) cells, and thereby leads to a powerful antitumor activity. To evaluate the cytotoxicity of oregonin against tumor cells, we examined the effectiveness of NK cells and determined that oregonin could increase NK cell cytotoxicity. This was confirmed by MTT assay. In addition, the survival time of C57BL/6 mice were measured by inoculating B16-F10 melanoma cells to mice via intra muscular (i.m.) injection. Oregonin treatment after 10 hours of inoculation at 10 mg/kg dosage showed a significant extension of survival time by up to 51.32%, when compared to the control group. Moreover, oregonin significantly reduced the incidence of pulmonary metastasis, which may be developed from B16-F10 melanoma cells. These findings suggest that oregonin may be classified as a new and novel immunomodulator due to its potential antitumor activity.

    Title Comparison of Intrarenal Pressure and Irrigant Flow During Percutaneous Nephroscopy with an Indwelling Ureteral Catheter, Ureteral Occlusion Balloon, and Ureteral Access Sheath.
    Date January 2003
    Journal Urology
    Excerpt

    OBJECTIVES: To determine the differential effects on renal pressures and irrigation flow associated with the application of different ureteral catheters during percutaneous nephrolithotomy. METHODS: Using ex vivo fresh cadaveric tissue, we established a percutaneous nephrolithotomy model. After obtaining lower pole percutaneous access, we recorded the pressure and irrigant flow measurements. Measurements were made with an empty ureter, 6F ureteral catheter, occlusion balloon catheter, and ureteral access sheaths (10/12F and 12/14F). Three 1-minute trials for each condition were recorded in each of four kidneys. RESULTS: Ureteral catheterization with both the 10/12F and the 12/14F ureteral access sheaths resulted in significantly decreased intrarenal pressures in the pressure range tested compared with an empty ureter, a ureteral catheter, or an occlusion balloon application. Total irrigant flow for the 12/14F ureteral access sheath was significantly higher than for the empty ureter, ureteral catheter, or occlusion balloon in the entire pressure range evaluated. CONCLUSIONS: In this in vitro cadaveric model, application of the ureteral access sheath during percutaneous nephrolithotomy resulted in decreased intrarenal pressures and increased irrigant flow.

    Title Combined Percutaneous and Retrograde Approach to Staghorn Calculi with Application of the Ureteral Access Sheath to Facilitate Percutaneous Nephrolithotomy.
    Date January 2003
    Journal The Journal of Urology
    Excerpt

    PURPOSE: We describe our technique and clinical experience with application of the ureteral access sheath for single access ablation of staghorn and partial staghorn calculi. MATERIALS AND METHODS: We retrospectively reviewed our experience with 9 patients who underwent percutaneous nephrolithotomy for staghorn (6) or partial staghorn (3) renal calculi using a combined antegrade and retrograde approach. Patient data, operative parameters, efficacy of stone ablation and convalescence parameters were reviewed. RESULTS: Mean operative time for the primary procedure was 3.1 hours with a mean estimated blood loss of 290 ml. Postoperatively, the mean analgesic requirement was 33.2 mg. MSO(4) equivalents. Hospital stay was 3.2 days. There were no major and 4 minor (44%) complications. No patient required transfusion. Complete stone clearance was achieved in 7 of the 9 cases (78%) using a single percutaneous nephrostomy tract. CONCLUSIONS: Our preliminary clinical experience using the ureteral access sheath during percutaneous nephrolithotomy for simultaneous antegrade and retrograde stone treatment has been favorable. A large renal stone burden can be successfully managed with a single percutaneous access and limited blood loss.

    Title Bare Naked Baskets: Ureteroscope Deflection and Flow Characteristics with Intact and Disassembled Ureteroscopic Nitinol Stone Baskets.
    Date June 2002
    Journal The Journal of Urology
    Excerpt

    PURPOSE: Lower pole renal access during flexible ureterorenoscopy is often limited by the active deflection capabilities of the ureteroscope. Deterioration in the deflection and flow capabilities of ureteroscopes occurs with the passage of instrumentation through the working channel. We performed in vitro evaluation of a novel technique using unsheathed nitinol baskets to minimize the deterioration in deflection and maximize the irrigant flow associated with instrument passage through the working channel during flexible ureterorenoscopy. MATERIALS AND METHODS: Alterations in the irrigant flow and active deflection of 4 ureteroscopes from different manufacturers were evaluated. Each ureteroscope was evaluated with an empty working channel, and then with sheathed and unsheathed 2.2, 3 and 3.2Fr (Cook Urological, Inc., Indianapolis, Indiana), 2.4 and 3Fr (Microvasive Urology, Natick, Massachusetts) nitinol baskets in the working channel. RESULTS: With all baskets tested and in all ureteroscopes the deterioration in active deflection and irrigant flow was improved with the unsheathed baskets. The disassembled basket within the working channel allowed an additional 15 to 20 degrees of active deflection. In addition, the disassembled basket allowed for a 2 to 30-fold increase in irrigant flow compared with an intact basket. CONCLUSIONS: The combination of improved deflection and irrigant flow with this technique may improve ureteroscopic access to lower pole renal calculi.

    Title Endoplasmic Reticulum Calcium Pool Depletion-induced Apoptosis is Coupled with Activation of the Death Receptor 5 Pathway.
    Date May 2002
    Journal Oncogene
    Excerpt

    Thapsigargin (TG), by inducing perturbations in cellular Ca(2+) homeostasis, has been shown to induce apoptosis. The molecular mechanisms of Ca(2+) perturbation-induced apoptosis are not fully understood. In this study, we demonstrate for the first time that TG-mediated perturbations in Ca(2+) homeostasis are coupled with activation of the death receptor 5 (DR5)-dependent apoptotic pathway in human cancer cells. TG selectively upregulated DR5 but had no effect on the expression of the other TRAIL receptor, DR4. TG also upregulated the expression of the DR5 ligand TRAIL (tumor necrosis factor-related apoptosis inducing ligand), albeit in a cell-type specific manner. TG-induced apoptosis has been shown to be associated with activation of the mitochondrial pathway. We found that TG upregulation of DR5 and TRAIL was coupled with caspase 8 activation and Bid cleavage, suggesting that the TG-regulated DR5 pathway could be linked to the mitochondrial pathway. TG enhanced not only DR5 mRNA stability but also increased induction of the DR5 genomic promoter-reporter gene. The TG-induced increase in DR5 expression appeared to occur as a consequence of TG-induced endoplasmic reticulum (ER) Ca(2+) pool depletion. Thus, we report our novel findings that ER Ca(2+) pool depletion-induced apoptotic signals are mediated, at least in part, via a DR5-dependent apoptotic pathway and there appears to be a cross-talk between the death receptor and mitochondrial pathways.

    Title Long-term Effects of Ureteroscopic Laser Lithotripsy on Glomerular Filtration Rate in the Face of Mild to Moderate Renal Insufficiency.
    Date March 2002
    Journal Journal of Endourology / Endourological Society
    Excerpt

    BACKGROUND AND PURPOSE: Ureteroscopic laser treatment of calculi in the upper urinary tract was examined in regard to its effect on renal function in the setting of mild renal insufficiency. Percutaneous nephrolithotomy (PCNL) and SWL have been previously shown not to adversely affect the glomerular filtration rate (GFR) in renal insufficiency, but to our knowledge, the effect of ureteroscopic laser lithotripsy on GFR has not been previously reported. PATIENTS AND METHODS: A retrospective review of all cases of ureteroscopic laser lithotripsy at our institution was performed. A total of 18 patients with a baseline serum creatinine of > or = 1.5 mg/dL were found. The mean follow-up after treatment was 18.0 months (range 4-39 months). The change in the reciprocal of serum creatinine was used as an indicator of change in the GFR. Deterioration of 20% was considered significant. RESULTS: The overall mean change in treated patients was a 5.9% improvement. Patients with a preoperative creatinine of < 2.0 mg/dL improved 7.6% and those with creatinine of > or = 2.0 mg/dL increased 3.9%. Other factors such as the size of the stone, location of the stone, and total joules used during treatment were not significant. CONCLUSION: This examination suggests that ureteroscopic laser lithotripsy has no ill effects on renal function in the face of mild to moderate renal insufficiency.

    Title Intraoperative Mild Hypothermia Does Not Increase the Plasma Concentration of Stress Hormones During Neurosurgery.
    Date October 2001
    Journal Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
    Excerpt

    PURPOSE: To determine how mild hypothermia (34 degrees C) affects the hemodynamic and the stress hormonal responses intraoperatively and during extubation in patients undergoing cerebral aneurysm surgery. METHODS: After induction, anesthesia was maintained with 1.2% isoflurane and 50% nitrous oxide. For the normothermia and the hypothermia groups, the body temperature was maintained at 36.9 +/- 0.3 degrees C and 34.2 +/- 0.2 degrees C respectively up to the recovery room. Hemodynamic changes were recorded continuously. Stress hormones comprising epinephrine, norepinephrine, ADH, ACTH, and cortisol were measured at the awake control, intraoperative, and extubation periods. RESULTS: Vital signs of the intraoperative and postextubation time periods were not significantly different between the normothermia and hypothermia groups except for a statistically lower pulse rate intraoperatively in the hypothermia group (P <0.05). In the control awake state, all five hormonal concentrations were similar between the two groups. Intraoperatively, all of the hormonal levels tended to be lower in the hypothermia group compared to the normothermia group, but only the epinephrine level decreased sufficiently to reach statistical significance (P <0.05). During extubation, all stress hormone concentrations, except norepinephrine, were lower in the hypothermia group (epinephrine: P <0.05; ADH: P <0.05; ACTH: P <0.05; cortisol: P <0.05). CONCLUSIONS: Our data suggest that intraoperative mild hypothermia neither significantly affects the blood pressure response nor increases the concentrations of stress hormones intraoperatively. Furthermore, mild hypothermia significantly decreased the plasma concentrations of stress hormones during the extubation period.

    Title Flail Aortic Valve and Acute Aortic Regurgitation Due to Spontaneous Localized Intimal Tear of Ascending Aorta.
    Date September 2001
    Journal Echocardiography (mount Kisco, N.y.)
    Excerpt

    This report describes the transesophageal echocardiographic findings of acute severe aortic regurgitation resulting from localized transverse intimal tear of ascending thoracic aorta which could not be suspected as a cause of flail aortic valve preoperatively. In patients with chest pain and acute aortic regurgitation associated with flail aortic valve, localized intimal tear of aorta should be considered as a possible cause of flail aortic valve.

    Title Experience with Endoluminal Ultrasonography in the Urinary Tract.
    Date June 2001
    Journal Journal of Endourology / Endourological Society
    Excerpt

    Ultrasonography has been an invaluable tool in the field of urology for its noninvasiveness, safety, and relatively low cost. However, examination of the ureter with ultrasound is difficult because of the distance of the transducer from the ureter and because of intervening structures such as nonconductive bowel gas. As smaller probes have become available, attempts have been made to apply them to endoluminal use. Endoluminal ultrasonography has been employed in urology to examine the proper placement of injected collagen, diagnose urethral diverticula, diagnose and stage upper tract transitional-cell carcinoma, locate crossing vessels to guide endopyelotomy, diagnose submucosal calculi, and examine the severity and length of ureteral strictures.

    Title Muc1 Mucins on the Cell Surface Are Adhesion Sites for Pseudomonas Aeruginosa.
    Date January 2001
    Journal American Journal of Physiology. Lung Cellular and Molecular Physiology
    Excerpt

    Recently, we cloned and characterized a full-length cDNA of the hamster Muc1 gene, the expression of which appears to be associated with secretory cell differentiation (Park HR, Hyun SW, and Kim KC. Am J Respir Cell Mol Biol 15: 237-244, 1996). The role of Muc1 mucins in the airway, however, is unknown. In this study, we investigated whether cell surface mucins are adhesion sites for Pseudomonas aeruginosa. Chinese hamster ovary (CHO) cells not normally expressing Muc1 mucin were stably transfected with the hamster Muc1 cDNA, and binding to P. aeruginosa was examined. Our results showed that 1) stably transfected CHO cells expressed both Muc1 mRNA and Muc1 mucins based on Northern and Western blot analyses, 2) Muc1 mucins present on the cell surface were degraded by neutrophil elastase, and 3) expression of Muc1 mucins on the cell surface resulted in a significant increase in adhesion of P. aeruginosa that was completely abolished by either proteolytic cleavage with neutrophil elastase or deletion of the extracellular domain by mutation. We conclude that Muc1 mucins expressed on the surface of CHO cells serve as adhesion sites for P. aeruginosa, suggesting a possible role for these glycoproteins in the early stage of airway infection and providing a model system for studying epithelial cell responses to bacterial adhesion that leads to airway inflammation in general and cystic fibrosis in particular.

    Title The Effects of Morphine on Blood-brain Barrier Disruption Caused by Intracarotid Injection of Hyperosmolar Mannitol in Rats.
    Date March 2000
    Journal Anesthesia and Analgesia
    Excerpt

    This study was performed to evaluate whether morphine could alter the degree of disruption of the blood-brain barrier (BBB) caused by hyperosmolar mannitol. Under isoflurane anesthesia, rats in a control group were infused with 25% mannitol into the internal carotid artery before measuring the transfer coefficient (Ki) of (14)C-alpha-aminoisobutyric acid. Infusion of morphine 3 mg/kg in the small-dose morphine group and 10 mg/kg in the large-dose morphine group was completed, 10 min before administering mannitol. There were no statistical differences in systemic blood pressures between these three groups of animals. In the control group, the Ki of the ipsilateral cortex where mannitol was injected, increased to 4.6 times that of the contralateral cortex (19.5 +/- 8.5 vs 4.2 +/- 1.2 microL. g(-1). min(-1), P < 0.002). The Ki of the ipsilateral cortex of the small-dose morphine group was 13.5 +/- 7.6 microL. g(-1). min(-1). The Ki of the ipsilateral cortex of the large-dose morphine group was 9.2 +/- 4.5 microL. g(-1). min(-1) and was smaller than that of control animals (P < 0.05). There was no significant difference in the Ki of the contralateral cortex among the three groups. In conclusion, morphine attenuated BBB disruption induced by hyperosmolar solution without significant effects on systemic blood pressure. IMPLICATIONS: Our study suggests that morphine may be effective in reducing the blood-brain barrier disruption by hyperosmolar mannitol without significant effects on systemic blood pressure.

    Title Double-orifice Mitral Valve.
    Date July 1999
    Journal Clinical Cardiology
    Title Transesophageal Echocardiographic Identification of Left Upper Pulmonary Venous Obstruction Caused by Compression by Spontaneous Pseudoaneurysm of the Descending Thoracic Aorta.
    Date January 1999
    Journal Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
    Excerpt

    Pseudoaneurysm of the aorta usually occurs as a complication of nonpenetrating trauma or deceleration injuries. Spontaneous pseudoaneurysm of the aorta is, however, extremely rare. Pulmonary veins can be affected in this situation because of the anatomic proximity. However, it is often overlooked during clinical examination, during routine echocardiography, and even at invasive angiography. This report describes the importance of transesophageal echocardiography in the detection of pulmonary vein compression, which is not suspected during other noninvasive and invasive diagnostic tests, in a patient with spontaneous pseudoaneurysm of the descending thoracic aorta.

    Title Identification and Characterization of High Molecular-mass Mucin-like Glycoproteins in the Plasma Membrane of Airway Epithelial Cells.
    Date November 1998
    Journal American Journal of Respiratory Cell and Molecular Biology
    Excerpt

    A previous lectin binding study demonstrated the presence of high molecular-mass mucin-like glycoproteins (HMGP) on the surface of hamster tracheal surface epithelial (HTSE) secretory cells (Proc. Natl. Acad. Sci. USA 1987;84:9304). In the present study, we intended to isolate and characterize these HMGP from the plasma membrane of the primary HTSE cells and then to determine whether or not these membrane HMGP are Muc-1 mucins, a type of mucins originally discovered on the surface of some carcinomas. A subcellular fraction enriched with the plasma membrane was obtained using a sucrose density gradient centrifugation. This fraction contained high molecular-mass glycoconjugates which were excluded from Sepharose CL-4B gel. Biochemical characterization of these glycoconjugates revealed the following characteristics: (1) susceptibility to both pronase and mild alkaline treatments, but totally resistant to proteoglycan-digesting enzymes; (2) partitioning in the detergent phase of Triton X-114 and resistance to digestion by phosphatidylinositol phospholipase C or D; (3) a buoyant density of 1.5 g/ml based on CsCl density gradient centrifugation; (4) polydispersity in terms of both size and charge density; and (5) lack of immunoreactivity with an anti-Muc-1 mucin antibody. We conclude that the plasma membrane of HTSE cells at confluence contains HMGP, which seem to be the integral membrane proteins but different from Muc-1 mucins, and that these membrane HMGP appear to share some similarities with secreted mucins in terms of size and charge.

    Title Cloning and Characterization of Cdnas Coding for Heavy and Light Chains of a Monoclonal Antibody (maba34) Specific for Human Plasma Apolipoprotein A-i.
    Date December 1996
    Journal Gene
    Excerpt

    We have determined the nucleotide (nt) sequences encoding the heavy (H)- and light (L)-chains of the Fab fragment of a murine monoclonal antibody, MabA34 (gamma1, kappa), which is specific for human plasma apolipoprotein A-I of high-density lipoproteins. The variable (V) regions of the H- and L-chains were revealed to be members of mouse H-chain subgroup II(A) and kappa L-chain subgroup II, respectively. A few unusual amino acids in the V region of the H-chain, and nt residues probably introduced by somatic mutations from germline genes were also identified.

    Title Cloning and Characterization of Cdnas Coding for Heavy and Light Chains of a Monoclonal Antibody (mabb23) Specific for Human Plasma Apolipoprotein B-100.
    Date July 1996
    Journal Gene
    Excerpt

    We have determined the nucleotide sequences encoding the heavy and light chains of the Fab fragment of murine monoclonal antibody MabB23(gamma2b,lambda), which is specific for human plasma apolipoprotein B-100 of low-density lipoproteins. The sequence analyses revealed that the variable regions of the heavy and light chains are members of mouse heavy-chain subgroup I(B) and lambda light-chain, respectively. A few unusual amino acids in the framework and constant regions of the heavy-chain were also noticed.

    Title Species-specific Oligodeoxynucleotide Probes for the Identification of Periodontal Bacteria.
    Date April 1990
    Journal Journal of Clinical Microbiology
    Excerpt

    Oligodeoxynucleotide probes were developed for identification of the periodontal bacteria Actinobacillus actinomycetemcomitans, Bacteroides gingivalis, B. intermedius types I and II, B. forsythus, Eikenella corrodens, Fusobacterium nucleatum, Haemophilus aphrophilus, Streptococcus intermedius, and Wolinella recta. Probes were designed by sequencing the 16S rRNA for each bacterium, identifying hypervariable regions, and chemically synthesizing species-specific probes. These probes were specific when tested against a panel of nucleic acids from closely related bacteria.

    Title Restricted Degradation of U6 Rna in a Nuclear Extract of Ehrlich Ascites Tumor Cells.
    Date September 1989
    Journal Journal of Biochemistry
    Excerpt

    A new nucleolytic activity that causes restricted digestion of U6 RNA was found in a nuclear extract of Ehrlich ascites tumor cells. This nucleolytic activity specifically degrades U6 RNA in the vicinity of its 3'-end with accumulation of a discrete sized degradation product of RNA of 90-95 nucleotides. Since this degradation product was not digested further by the nuclease under these conditions, this trimming of U6 RNA is supposed to be a biologically meaningful reaction. This nucleolytic activity required Mg2+, and was inhibited by Zn2+ or Ca2+.

    Title Uridylation of U6 Rna in a Nuclear Extract in Ehrlich Ascites Tumor Cells.
    Date May 1989
    Journal Journal of Biochemistry
    Excerpt

    The uridylation of U6 RNA in a nuclear extract of Ehrlich ascites tumor cells was examined. This reaction required ATP or GTP, although these nucleotides were not incorporated into U6 RNA itself. ATP and GTP could be replaced by their nonhydrolyzable analogues ATP gamma S and GTP gamma S. Therefore, hydrolysis of ATP or GTP is not necessary for the uridylation of U6 RNA, indicating that these nucleotides are effectors of this reaction. By chromatographies of a nuclear extract of Ehrlich ascites tumor cells on phosphocellulose and DEAE-cellulose, U6 RNA could be separated from an enzyme adding a uridine residue(s) to this RNA.

    Title Multi-institutional External Validation Of Seminal Vesicle Invasion Nomograms: Head-to-head Comparison of Gallina Nomogram Versus 2007 Partin Tables.
    Date
    Journal International Journal of Radiation Oncology, Biology, Physics
    Excerpt

    PURPOSE: The Partin tables represent one of the most widely used prostate cancer staging tools for seminal vesicle invasion (SVI) prediction. Recently, Gallina et al. reported a novel staging tool for the prediction of SVI that further incorporated the use of the percentage of positive biopsy cores. We performed an external validation of the Gallina et al. nomogram and the 2007 Partin tables in a large, multi-institutional North American cohort of men treated with robotic-assisted radical prostatectomy. METHODS AND MATERIALS: Clinical and pathologic data were prospectively gathered from 2,606 patients treated with robotic-assisted radical prostatectomy at one of four North American robotic referral centers between 2002 and 2007. Discrimination was quantified with the area under the receiver operating characteristics curve. The calibration compared the predicted and observed SVI rates throughout the entire range of predictions. RESULTS: At robotic-assisted radical prostatectomy, SVI was recorded in 4.2% of patients. The discriminant properties of the Gallina et al. nomogram resulted in 81% accuracy compared with 78% for the 2007 Partin tables. The Gallina et al. nomogram overestimated the true rate of SVI. Conversely, the Partin tables underestimated the true rate of SVI. CONCLUSION: The Gallina et al. nomogram offers greater accuracy (81%) than the 2007 Partin tables (78%). However, both tools are associated with calibration limitations that need to be acknowledged and considered before their implementation into clinical practice.

    Title Measuring Properties of Superposed Light Beams Carrying Different Frequencies.
    Date
    Journal Optics Express
    Excerpt

    When two electromagnetic fields of different frequencies are physically superposed, the linear superposition equation implies that the fields readjust themselves into a new mean frequency whose common amplitude undulates at half their difference frequency. Neither of these mathematical frequencies are measurable quantities. We present a set of experiments underscoring that optical fields do not interfere with each other or modify themselves into a new frequency even when they are physically superposed. The multi-frequency interference effects are manifest only in materials with broad absorption bands as their constituent diploes attempt to respond collectively and simultaneously to all the optical frequencies of the superposed fields. Interference is causal and real since the dipoles carry out the operation of summation dictated by their quantum mechanical properties.

    Title Comparison of Cognitive Effects of Lamotrigine and Oxcarbazepine in Epilepsy Patients.
    Date
    Journal Journal of Clinical Neurology (seoul, Korea)
    Excerpt

    This study compared the cognitive effects of 1 year of treatment with lamotrigine (LTG) and oxcarbazepine (OXC) in epilepsy patients.

    Title Right Ventricular Wall Hematoma Secondary to Percutaneous Coronary Intervention.
    Date
    Journal Journal of Cardiovascular Ultrasound
    Excerpt

    Intramyocardial hematoma is known to be associated with myocardial infarction, chest trauma, coronary artery bypass operation, and complication of percutaneous coronary intervention (PCI). We describe here a rare case of 50-year-old man with a huge right ventricular (RV) wall hematoma which was newly developed two hours after PCI. The patient was treated conservatively with a successful outcome. We discuss plausible mechanisms for the development of RV wall hematoma and treatment options for the case.

    Title Effect of Alnus Japonica Extract on a Model of Atopic Dermatitis in Nc/nga Mice.
    Date
    Journal Journal of Ethnopharmacology
    Excerpt

    AIM OF THE STUDY: The bark of Alnus species has long been used in traditional oriental medicine in the treatment of many pathological conditions, including fever, hemorrhage, diarrhea, alcoholism, various skin diseases (e.g. chronic herpes, eczema and prurigo), and inflammation. In order to assess the immunomodulatory efficacy of a novel herbal medicine in treating atopic dermatitis, we measured serum levels of several allergic and inflammatory biomarkers in NC/Nga mice before and after treatment with this experimental agent. MATERIALS AND METHODS: Gene and protein expression analyses of iNOS and COX-2 were quantified by real time PCR and Western blot analysis and serum levels of IL-4, -5 and -13 were also measured by ELISA, all of which were reduced after treatment with the experimental agent. Additionally, serum concentrations of IgE and blood eosinophil counts were reduced in treated mice. RESULTS: The topical application of leaf and bark extract from Alnus japonica suppressed the development of AD-like skin lesions. The percent of blood eosinophils was decreased after treatment with leaf and bark extract from Alnus japonica. The serum IgE and Th2-related cytokine levels were decreased after treatment with leaf and bark extract from Alnus japonica compared with those treated with base cream (vehicle treated AD group). The IL-4, IL-5 and IL-13 were lower than those of vehicle treated AD group. CONCLUSIONS: We contend that leaf and bark extract from Alnus japonica may prove useful in the treatment of atopic dermatitis and other allergic skin diseases, although more in-depth clinical studies are necessary before clinical implementation.

    Title Rectal Injury During Robot-assisted Radical Prostatectomy: Incidence and Management.
    Date
    Journal The Journal of Urology
    Excerpt

    Rectal injury during robot-assisted radical prostatectomy is a rare but significant complication. Since the Clavien grading classification of complications does not include intraoperative injury without further sequelae, rectal injury may be underreported in the literature. We present what is to our knowledge the largest retrospective review to date of rectal injury and subsequent management.

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