Sung-Lang Chen - Academia.edu (original) (raw)
Papers by Sung-Lang Chen
Healthcare
Obstructive sleep apnea (OSA), lower urinary tract symptoms (LUTS), and erectile dysfunction (ED)... more Obstructive sleep apnea (OSA), lower urinary tract symptoms (LUTS), and erectile dysfunction (ED) are chronic conditions that seriously affect middle-aged men. This study aimed to evaluate the changes in the presence of these conditions after transoral robotic surgery (TORS) for OSA. This prospective observational study recruited 48 men with moderate-to-severe OSA (mean age 40.6 ± 8.1 years) who underwent TORS from October 2019 to November 2021 at a tertiary center. Baseline polysomnographic parameters, Epworth Sleepiness Scale (ESS), and demographic characteristics were measured. The evaluations of LUTS and ED were based on self-administered International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF-5) questionnaires, respectively, before TORS. The treatment outcomes were assessed three months postoperatively in the patients undergoing TORS due to moderate-to-severe OSA. There was significant Apnea-Hypopnea Index (AHI) reduction from 53.10 ± 25.7...
PloS one, 2016
This study compares heart rate variability (HRV) and systolic blood pressure (SBP) changes of spi... more This study compares heart rate variability (HRV) and systolic blood pressure (SBP) changes of spinal cord injury (SCI) patients during urodynamic study (UDS) with able-bodied controls. Twenty four complete suprasacral SCI patients (12 tetraplegia and 12 paraplegia) and 12 age-matched able-bodied volunteers received BP and HRV evaluation throughout urodynamic examination. We chose seven time points during the examinations: resting, Foley catheter insertion, start of infusion, and infused volume reaching 1/4, 2/4, 3/4 and 4/4 of maximal capacity. At each time point, electrocardiogram with a duration of 5 min was used for power spectral density analysis of HRV. Only control subjects displayed significant elevation of SBP during Foley catheter insertion compared to resting values. Both control and tetraplegic groups experienced significant elevation of SBP at maximal bladder capacity compared to resting values. Tetraplegic values were also significantly greater than the other two groups...
Journal of rehabilitation medicine, 2022
OBJECTIVE To investigate the effects of concomitant injections of botulinum toxin-A (BoNT-A) into... more OBJECTIVE To investigate the effects of concomitant injections of botulinum toxin-A (BoNT-A) into the detrusor and external urethral sphincter muscles in suprasacral spinal cord injured patients with detrusor overactivity and detrusor sphincter dyssynergia. DESIGN An open treatment trial with pre- and posttreatment evaluations. SUBJECTS Male suprasacral spinal cord injury patients (n = 20) with neurogenic detrusor overactivity and detrusor sphincter dyssynergia who emptied their bladder by reflex voiding and were unwilling to increase the frequency of intermittent catheterization. METHODS Cystoscopic guidance of 200 U BoNT-A injections into the detrusor muscle and 100 U into external urethral sphincter muscles were applied. The urodynamic parameters, voiding diaries and quality of life scores using Urinary Distress Inventory, Short Form (UDI-6) and Incontinence Impact Questionnaire, Short Form (IIQ-7) were compared. RESULTS All participants experienced a significant mean reduction i...
Cancer Letters, 2022
Intravesical instillation (IVI) of Bacillus Calmette-Guerin (BCG) can prevent bladder cancer recu... more Intravesical instillation (IVI) of Bacillus Calmette-Guerin (BCG) can prevent bladder cancer recurrence, but this agent has been out of stock in recent years. IVI of other agents, like chidamide, a histone deacetylase (HDAC) inhibitor, may have the potential to exert a therapeutic effect against bladder cancer by modifying the gene expression profiles associated with histone modifications that occur during cancer tumorigenesis. Here, we investigated the in vitro therapeutic effect of chidamide and/or mitomycin C in bladder cancer cell lines and screened related molecular pathways using an antibody array. We also quantitatively analyzed the synergistic effect of IVI of chidamide and mitomycin C in vivo in an N-methyl-N-nitrosourea (MNU)-induced rat bladder cancer model. The synergistic cytotoxic effect of chidamide plus mitomycin C was confirmed in both T24 and UMUC3 cells (combination index <0.6), with significantly greater induction of apoptosis elicited with chidamide plus mitomycin C than with either drug alone. The antibody array identified the Axl signaling pathway as the key target of the synergistic effect. Expression of Axl and its related downstream molecules, including claspin and survivin, was significantly suppressed. In the rat bladder cancer model, IVI of chidamide plus mitomycin C reduced tumor burden (Ki67 index) to a greater extent than either drug alone (p < 0.01). Our results suggest that chidamide and mitomycin act synergistically to reduce MNU-induced bladder cancer. These findings provide new insights into a new and potentially effective approach to treating bladder cancer.
Cancers, 2021
Azacitidine, an inhibitor of DNA methylation, shows therapeutic effects against several malignanc... more Azacitidine, an inhibitor of DNA methylation, shows therapeutic effects against several malignancies by inducing apoptosis and inhibiting tumor cell proliferation. However, the anti-tumor effects of azacitidine on urinary bladder urothelial carcinoma (UBUC), especially following intravesical instillation (IVI), are not established. Here, UBUC cell lines were used to analyze the in vitro therapeutic effects of azacitidine. Potential signaling pathways were investigated by antibody arrays and Western blotting. The N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN)-induced rat UBUC model was used for in vivo quantitative analysis of tumor burden. Azacitidine significantly inhibited DNMT expression in UBUC cell lines and reduced cell viability and clonogenic activity, as determined by MTT and colony formation assays, while also inducing significant cytotoxic effects in the form of increased sub-G1 and Annexin V-PI populations (all p < 0.05). Antibody arrays confirmed the in vitro suppressi...
PloS one, 2021
The association between bladder cancer mortality-to-incidence ratios (MIRs) and healthcare dispar... more The association between bladder cancer mortality-to-incidence ratios (MIRs) and healthcare disparities has gender differences. However, no evidence supports gender as an issue in the association between changes in the MIR and health expenditures on bladder cancer. Changes in the MIR were defined as the difference in data from the years 2012 and 2018, which was named δMIR. Current health expenditures (CHE) and the human development index (HDI) were obtained from the World Health Organization and the Human Development Report Office. The association between variables was analyzed by Spearman's rank correlation coefficient. In total, 55 countries were analyzed according to data quality and the exclusion of missing data. Globally, the MIR changed according to the HDI level in both genders. Among the 55 countries studied, a high HDI and CHE were significantly associated with a favorable age-standardized rate-based MIR (ASR-based MIR) in both genders and the subgroups according to gend...
Ureteral catheterization is widely used in patient after kidney transplantation. The catheters ar... more Ureteral catheterization is widely used in patient after kidney transplantation. The catheters are radiopaque in order to check by radiography. A 52-year-old man underwent kidney transplantation presented a radiolucent ureteral catheter during follow-up. The forgotten double-J catheter complicated with stone encrustation. Further surgical treatment for removal of this catheter was also presented.
International Journal of Environmental Research and Public Health, 2019
The mortality-to-incidence ratio (MIR) is associated with the clinical outcomes of different type... more The mortality-to-incidence ratio (MIR) is associated with the clinical outcomes of different types of cancer as well as the ranking of health care systems. However, the association between MIRs for testicular cancer and health care disparities, including differences in expenditures and health system rankings, has not yet been reported. We used the Spearman’s rank correlation coefficient (CC) to analyze the correlation between testicular cancer MIRs and both total expenditures on health/gross domestic product (e/GDP) and the World Health Organization’s (WHO) health system rankings. After screening the data for quality and missing information, 57 countries were chosen for analysis. Generally, developed countries and regions had relatively high rates of incidence/mortality, but with a favorable MIR. Among the continents, Europe had the highest incidence rates, whereas the highest MIRs were in Africa. Globally, favorable testicular cancer MIRs were observed in countries with both a high...
Journal of Clinical Medicine, 2021
Background: Upper urinary tract urothelial carcinoma (UTUC) is the most common malignancy occurri... more Background: Upper urinary tract urothelial carcinoma (UTUC) is the most common malignancy occurring after kidney transplantation (KT) in Taiwan. The aim of this study was to investigate the association between native kidney hydronephrosis and UTUC in post-KT patients. Methods: From 2003 to 2018, we conducted a retrospective cohort study that enrolled 1005 post-KT patients, 67 of whom were subsequently diagnosed with UTUC. We divided patients into two groups based on whether or not they had UTUC. Multivariate analysis and Kaplan-Meier plot were used to evaluate if native kidney hydronephrosis was associated with post-KT UTUC. Results: The total cohort consisted of 612 men (60.9%) and 393 women (39.1%) with a mean age of 48.2 ± 12.0 at KT. The mean follow-up time was 118.6 ± 70.2 months, and mean time from KT to UTUC was 7.53 years. There was a significant gender difference with a female predominance among the UTUC patients (73.1% versus 26.9%, p < 0.001). Native kidney hydronephro...
International Journal of Environmental Research and Public Health, 2019
Mortality-to-incidence ratios (MIRs) are alternative parameters used to evaluate the prognosis of... more Mortality-to-incidence ratios (MIRs) are alternative parameters used to evaluate the prognosis of a disease. In addition, MIRs are associated with the ranking of health care systems and expenditures for certain types of cancer. However, a lack of association between MIRs and pancreatic cancer has been noted. Given the poor prognosis of brain and nervous system cancers, similar to pancreatic cancer, the relation of MIRs and health care disparities is worth investigating. We used the Spearman’s rank correlation coefficient (CC) to analyze the correlation between the MIRs in brain and nervous system cancers and inter-country disparities, including expenditures on health and human development index. Interestingly, the MIRs in brain and nervous system cancers are associated with the human development index score (N = 157, CC = −0.394, p < 0.001), current health expenditure (CHE) per capita (N = 157, CC = −0.438, p < 0.001), and CHE as percentage of gross domestic product (N = 157, ...
Medicina, 2019
Prostate cancer (PCa) is a common malignancy in males and has a relatively slower progression tha... more Prostate cancer (PCa) is a common malignancy in males and has a relatively slower progression than other cancers. Our goal was to evaluate the clinical role of SPARC (secreted protein acidic and cysteine rich, osteonectin), cwcv, and kazal-like domains’ proteoglycan 1 (SPOCK1) in PCa. SPOCK1 expression was studied through the immunohistochemical staining of specimens from 71 patients with PCa. The correlation between SPOCK1 expression and clinicopathological features was quantitatively analyzed. We used Kaplan–Meier analysis and Cox proportional hazard models to analyze the prognostic value. Of 71 PCa patients, high SPOCK1 expression was more likely to be seen in those with an advanced stage (p = 0.018) of the disease and an advanced tumor (T) value (p = 0.014). Patients in Gleason grade groups 3 and 4 had significantly higher SPOCK1 expression (p = 0.044 and 0.003, respectively) compared to those of Gleason grade group 1. However, this trend was not observed in patients in Gleason ...
Journal of Investigative Medicine, 2018
Tuberous sclerosis complex (TSC) is a rare disease that causes multisystem benign neoplasm, induc... more Tuberous sclerosis complex (TSC) is a rare disease that causes multisystem benign neoplasm, induced by dysregulation of the mammalian target of the rapamycin pathway (mTOR). This study aimed to examine the effects of continuous low-dose everolimus, a potent and selective inhibitor of mTOR, on the treatment of TSC-associated renal angiomyolipoma (AML). Between July 2013 and August 2017, 11 patients with TSC-AML were enrolled for an everolimus therapy protocol. An oral everolimus dose starting at 2.5 mg daily was gradually increased to 5.0 mg daily. All patients were evaluated using MRI or CT scanning at baseline, 12, 24, 36 and 48 months after the start of treatment for measuring changes of renal AML mass volume. Everolimus therapy resulted in significant shrinkage of TSC-AML volume after 48 months follow-up. Serum levels of everolimus were subdivided into group I (<8 ng/mL, n=6) and group II (>8 ng/mL, n=5). The volume reduction rates were 10.6%–65.2% in group I and 42.5%–70.6...
Urological Science, 2017
The aim of this study was to compare the effectiveness of electromagnetic stimulation (EMS) versu... more The aim of this study was to compare the effectiveness of electromagnetic stimulation (EMS) versus electrostimulation plus biofeedback (ESB) for the treatment of refractory chronic pelvic pain syndrome (CPPS) in men. Materials and Methods: A total of 23 male refractory CPPS patients were included in the study. EMS was applied for 30 minutes, three times weekly, for 6 weeks, for pelvic floor rehabilitation. We retrospectively compared the outcomes with 22 male refractory CPPS patients treated with ESB twice a week for 2 weeks, and later once a week for 4 weeks. Each ESB session lasted 45 minutes, including biofeedback (15 minutes) followed by electrostimulation (30 minutes). The outcome measures included the National Institutes of Health Chronic Prostatitis Symptoms Index (NIH-CPSI), International Prostate Symptom Score (IPSS), and a visual analogue score for pain from baseline to 12 weeks after completion of treatment. Results: Significantly reduced pain, improved quality of life (QoL), and lowered total score of the NIH-CPSI were observed in both groups (all p < 0.05). The ESB group also demonstrated improvement in the urinary subscore of the NIH-CPSI. No significant differences were found between the groups in the urinary score measures of the NIH-CPSI. The mean pain score (p ¼ 0.035), QoL (p ¼ 0.012), and total score (p ¼ 0.009) improved significantly in the ESB group compared with EMS group. Total IPSS and visual analogue score improved significantly after treatment in both groups. However, no significant differences were noted between the groups in the total and subdomain sums of the IPSS. Conclusion: Both EMS and ESB physical therapy of the pelvic floor muscle effectively reduce pain, increase the QoL, and improve urinary tract symptoms in male CPPS patients who are refractory to medical treatments. The combination therapy of ES plus biofeedback demonstrates additional benefits in pain and QoL when compared with EMS alone.
Scientific reports, Jan 28, 2017
The variation in the mortality-to-incidence ratio (MIR) between countries and genders reflects th... more The variation in the mortality-to-incidence ratio (MIR) between countries and genders reflects the complex etiology and intervention of bladder cancer. In this study, we investigated the MIR variation between genders and health care disparities among countries. Cancer incidence and mortality were obtained from the GLOBOCAN 2012 database. The ranking and the total expenditure on health of countries were obtained from the World Health Organization. Linear regression was used to estimate the significance between variables. We estimated the role of MIRs from 33 countries. Bladder cancer incidence and mortality rates were higher in more developed regions, Europe, and the Americas. The MIRs were higher in less developed regions. Analysis according to country revealed Germany to have the lowest MIR. High relative MIRs (female MIR/male MIR) for bladder cancer were noted in many developed countries. A correlation between MIR and health care disparities among countries was indicated by a sign...
Urological Science, 2016
Purpose: Renal angiomyolipomas (AML) are benign tumors composed of blood vessels, smooth muscle c... more Purpose: Renal angiomyolipomas (AML) are benign tumors composed of blood vessels, smooth muscle cells and fat cells. AML-related chronic kidney disease and tumor bleeding are the main cause of mortality. AML are highly associated with Tuberous Sclerosis Complex (TSC) and mostly be treated by mammalian target of rapamycin inhibitor (mTORi) therapy or transarterial embolization (TAE). Materials and Methods: Here we present our cases of TSC-associated renal AMLs treated with monotherapy or combined treatment of mTORi and TAE. A total of 19 patients (4 males and 15 females) were included. There were 10 patients treated by mTORi only and 9 by combined therapy with mTORi and TAE. Results: The mean age of the patients was 34.5 (14e72) years. The maximal diameters of renal AMLs were from 1.5 to 20.9 (9.3±6.1) cm. During a mean follow-up duration of 43 (6e81) months, the size of AMLs decreased 15e33% in 8 patients receiving combination therapy. Two patients undergone monotherapy experienced 30-50% increase of tumor diameter. The tumor size of other patients showed no statistically significant change. Conclusion: TSC-associated AMLs are quite common in this hereditary, complex syndrome. They are usually multiple and bilateral. The lesion usually progress over time and complicated with flank pain, hemorrhage, and even renal deterioration. TSC-associated AMLs can be treated by medication or minimally invasive therapy. Our result discovered although the tumor size may not shrink, TAE still play an important role in management of tumor bleeding with acceptable complications. In our study, combination therapy showed better control of tumor size than monotherapy alone in TSC-associated AMLs.
International journal of molecular sciences, Jan 19, 2016
STEAP1 (six transmembrane epithelial antigen of the prostate 1) is a transmembrane protein that f... more STEAP1 (six transmembrane epithelial antigen of the prostate 1) is a transmembrane protein that functions as a potential channel or transporter protein. It is overexpressed in certain cancers and is viewed as a promising therapeutic target. However, the prognostic role of STEAP1 is still controversial, and no role for STEAP1 has yet been indicated in colorectal cancer. The aim of this study was to investigate the possible association of STEAP1 expression with colorectal cancer prognosis. STEAP1 expression was analyzed by immunohistochemical staining of a tissue array of 165 cancer specimens from primary colorectal cancer patients. The mean and medium follow-up times after surgery were 5.1 and 3.9 years, respectively. A total of 139 patients died during the 13 years of follow-up in the survey period. The prognostic value of STEAP1 with respect to overall survival was analyzed by Kaplan-Meier analysis and Cox proportional hazard models. In total, 164 samples displayed detectable STEAP...
Urological Science, 2015
endothelial growth factor (VEGF) and SHH in the ISV of patients with varicocele. Materials and Me... more endothelial growth factor (VEGF) and SHH in the ISV of patients with varicocele. Materials and Methods: The study specimens were 1 cm of internal spermatic vein (ISV) obtained from 20 patients during left varicocele repair. The control samples of 1 cm ISV were obtained from 8 male patients who underwent left inguinal herniorrhaphy. We analyzed for VEGF and SHH protein expression by immunoblotting, immunohistochemical (IHC) staining, double immunofluorescent staining and confocal laser scanning microscopy. The data were analyzed using the Student's t test. Results: Higher expression of VEGF and SHH proteins in varicocele veins than in the control group (P<.05) which located over muscle layers and endothelium were demonstrated by IHC staining. Both proteins co-localizated predominantly in endothelium of diseased veins under confocal laser scanning microscopy. Conclusion: This is the first reporting the SHH expression in varicocele veins of humans. Our findings revealed the higher expression of SHH and VEGF in muscle layer and endothelium of varicocele veins than in control group. Both proteins co-localized predominantly in the endothelium of these diseased veins.
The Scientific World Journal, 2013
Objective. To compare efficacy of desmopressin for treatment of nocturia between patients with no... more Objective. To compare efficacy of desmopressin for treatment of nocturia between patients with normal and high nocturnal bladder capacity index (NBCi).Methods. Retrospective analysis of adult patients treated with desmopressin for nocturia. Patients were analyzed according to high or normal NBCi value before treatment.Results. 55 patients were identified, aged 49–84, 47 males, 8 females, who started desmopressin 0.2 mg nocte between 2009 and 2011. Two groups (N: normal and H: high NBCi) were similar regarding number, gender, age, 24 h urine volume, and nocturnal urine volume. On treatment, nocturnal volume decreased by mean of 364 mL. Number of nightly voids decreased in N group from 3.11 to 1.50, in H from 3.96 to 1.44. Nocturnal polyuria and nocturia indices also decreased significantly. NBCi remained the same in N group (0.56 on therapy) and in H group decreased to mean 0.63. All on-treatment values were statistically similar in N and H groups. Pretreatment differences were aboli...
Urological Science, 2013
Abstract Few cases of abdominal wall metastasis from a urothelial carcinoma were reported in the ... more Abstract Few cases of abdominal wall metastasis from a urothelial carcinoma were reported in the literature, and those were mostly attributed to iatrogenic implantation after laparoscopic surgery or a percutaneous nephrostomy. An 85-year-old man presented with an infraumbilical mass 6 months after transurethral resection of a bladder tumor (TURBt) for a T4 urinary bladder urothelial carcinoma. Abdominal sonography disclosed a 1.6 cm × 1.5 cm subcutaneous hypoechoic lesion. Wide excision of the mass was performed, and skin flaps were used for skin coverage. A combination of the patient's clinical history, tumor morphology, and immunostaining results were compatible with the pathologic characteristic of his previous bladder urothelial carcinoma. We present this rare case of solitary abdominal wall mass metastasis from a urothelial carcinoma of the urinary bladder.
Healthcare
Obstructive sleep apnea (OSA), lower urinary tract symptoms (LUTS), and erectile dysfunction (ED)... more Obstructive sleep apnea (OSA), lower urinary tract symptoms (LUTS), and erectile dysfunction (ED) are chronic conditions that seriously affect middle-aged men. This study aimed to evaluate the changes in the presence of these conditions after transoral robotic surgery (TORS) for OSA. This prospective observational study recruited 48 men with moderate-to-severe OSA (mean age 40.6 ± 8.1 years) who underwent TORS from October 2019 to November 2021 at a tertiary center. Baseline polysomnographic parameters, Epworth Sleepiness Scale (ESS), and demographic characteristics were measured. The evaluations of LUTS and ED were based on self-administered International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF-5) questionnaires, respectively, before TORS. The treatment outcomes were assessed three months postoperatively in the patients undergoing TORS due to moderate-to-severe OSA. There was significant Apnea-Hypopnea Index (AHI) reduction from 53.10 ± 25.7...
PloS one, 2016
This study compares heart rate variability (HRV) and systolic blood pressure (SBP) changes of spi... more This study compares heart rate variability (HRV) and systolic blood pressure (SBP) changes of spinal cord injury (SCI) patients during urodynamic study (UDS) with able-bodied controls. Twenty four complete suprasacral SCI patients (12 tetraplegia and 12 paraplegia) and 12 age-matched able-bodied volunteers received BP and HRV evaluation throughout urodynamic examination. We chose seven time points during the examinations: resting, Foley catheter insertion, start of infusion, and infused volume reaching 1/4, 2/4, 3/4 and 4/4 of maximal capacity. At each time point, electrocardiogram with a duration of 5 min was used for power spectral density analysis of HRV. Only control subjects displayed significant elevation of SBP during Foley catheter insertion compared to resting values. Both control and tetraplegic groups experienced significant elevation of SBP at maximal bladder capacity compared to resting values. Tetraplegic values were also significantly greater than the other two groups...
Journal of rehabilitation medicine, 2022
OBJECTIVE To investigate the effects of concomitant injections of botulinum toxin-A (BoNT-A) into... more OBJECTIVE To investigate the effects of concomitant injections of botulinum toxin-A (BoNT-A) into the detrusor and external urethral sphincter muscles in suprasacral spinal cord injured patients with detrusor overactivity and detrusor sphincter dyssynergia. DESIGN An open treatment trial with pre- and posttreatment evaluations. SUBJECTS Male suprasacral spinal cord injury patients (n = 20) with neurogenic detrusor overactivity and detrusor sphincter dyssynergia who emptied their bladder by reflex voiding and were unwilling to increase the frequency of intermittent catheterization. METHODS Cystoscopic guidance of 200 U BoNT-A injections into the detrusor muscle and 100 U into external urethral sphincter muscles were applied. The urodynamic parameters, voiding diaries and quality of life scores using Urinary Distress Inventory, Short Form (UDI-6) and Incontinence Impact Questionnaire, Short Form (IIQ-7) were compared. RESULTS All participants experienced a significant mean reduction i...
Cancer Letters, 2022
Intravesical instillation (IVI) of Bacillus Calmette-Guerin (BCG) can prevent bladder cancer recu... more Intravesical instillation (IVI) of Bacillus Calmette-Guerin (BCG) can prevent bladder cancer recurrence, but this agent has been out of stock in recent years. IVI of other agents, like chidamide, a histone deacetylase (HDAC) inhibitor, may have the potential to exert a therapeutic effect against bladder cancer by modifying the gene expression profiles associated with histone modifications that occur during cancer tumorigenesis. Here, we investigated the in vitro therapeutic effect of chidamide and/or mitomycin C in bladder cancer cell lines and screened related molecular pathways using an antibody array. We also quantitatively analyzed the synergistic effect of IVI of chidamide and mitomycin C in vivo in an N-methyl-N-nitrosourea (MNU)-induced rat bladder cancer model. The synergistic cytotoxic effect of chidamide plus mitomycin C was confirmed in both T24 and UMUC3 cells (combination index <0.6), with significantly greater induction of apoptosis elicited with chidamide plus mitomycin C than with either drug alone. The antibody array identified the Axl signaling pathway as the key target of the synergistic effect. Expression of Axl and its related downstream molecules, including claspin and survivin, was significantly suppressed. In the rat bladder cancer model, IVI of chidamide plus mitomycin C reduced tumor burden (Ki67 index) to a greater extent than either drug alone (p < 0.01). Our results suggest that chidamide and mitomycin act synergistically to reduce MNU-induced bladder cancer. These findings provide new insights into a new and potentially effective approach to treating bladder cancer.
Cancers, 2021
Azacitidine, an inhibitor of DNA methylation, shows therapeutic effects against several malignanc... more Azacitidine, an inhibitor of DNA methylation, shows therapeutic effects against several malignancies by inducing apoptosis and inhibiting tumor cell proliferation. However, the anti-tumor effects of azacitidine on urinary bladder urothelial carcinoma (UBUC), especially following intravesical instillation (IVI), are not established. Here, UBUC cell lines were used to analyze the in vitro therapeutic effects of azacitidine. Potential signaling pathways were investigated by antibody arrays and Western blotting. The N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN)-induced rat UBUC model was used for in vivo quantitative analysis of tumor burden. Azacitidine significantly inhibited DNMT expression in UBUC cell lines and reduced cell viability and clonogenic activity, as determined by MTT and colony formation assays, while also inducing significant cytotoxic effects in the form of increased sub-G1 and Annexin V-PI populations (all p < 0.05). Antibody arrays confirmed the in vitro suppressi...
PloS one, 2021
The association between bladder cancer mortality-to-incidence ratios (MIRs) and healthcare dispar... more The association between bladder cancer mortality-to-incidence ratios (MIRs) and healthcare disparities has gender differences. However, no evidence supports gender as an issue in the association between changes in the MIR and health expenditures on bladder cancer. Changes in the MIR were defined as the difference in data from the years 2012 and 2018, which was named δMIR. Current health expenditures (CHE) and the human development index (HDI) were obtained from the World Health Organization and the Human Development Report Office. The association between variables was analyzed by Spearman's rank correlation coefficient. In total, 55 countries were analyzed according to data quality and the exclusion of missing data. Globally, the MIR changed according to the HDI level in both genders. Among the 55 countries studied, a high HDI and CHE were significantly associated with a favorable age-standardized rate-based MIR (ASR-based MIR) in both genders and the subgroups according to gend...
Ureteral catheterization is widely used in patient after kidney transplantation. The catheters ar... more Ureteral catheterization is widely used in patient after kidney transplantation. The catheters are radiopaque in order to check by radiography. A 52-year-old man underwent kidney transplantation presented a radiolucent ureteral catheter during follow-up. The forgotten double-J catheter complicated with stone encrustation. Further surgical treatment for removal of this catheter was also presented.
International Journal of Environmental Research and Public Health, 2019
The mortality-to-incidence ratio (MIR) is associated with the clinical outcomes of different type... more The mortality-to-incidence ratio (MIR) is associated with the clinical outcomes of different types of cancer as well as the ranking of health care systems. However, the association between MIRs for testicular cancer and health care disparities, including differences in expenditures and health system rankings, has not yet been reported. We used the Spearman’s rank correlation coefficient (CC) to analyze the correlation between testicular cancer MIRs and both total expenditures on health/gross domestic product (e/GDP) and the World Health Organization’s (WHO) health system rankings. After screening the data for quality and missing information, 57 countries were chosen for analysis. Generally, developed countries and regions had relatively high rates of incidence/mortality, but with a favorable MIR. Among the continents, Europe had the highest incidence rates, whereas the highest MIRs were in Africa. Globally, favorable testicular cancer MIRs were observed in countries with both a high...
Journal of Clinical Medicine, 2021
Background: Upper urinary tract urothelial carcinoma (UTUC) is the most common malignancy occurri... more Background: Upper urinary tract urothelial carcinoma (UTUC) is the most common malignancy occurring after kidney transplantation (KT) in Taiwan. The aim of this study was to investigate the association between native kidney hydronephrosis and UTUC in post-KT patients. Methods: From 2003 to 2018, we conducted a retrospective cohort study that enrolled 1005 post-KT patients, 67 of whom were subsequently diagnosed with UTUC. We divided patients into two groups based on whether or not they had UTUC. Multivariate analysis and Kaplan-Meier plot were used to evaluate if native kidney hydronephrosis was associated with post-KT UTUC. Results: The total cohort consisted of 612 men (60.9%) and 393 women (39.1%) with a mean age of 48.2 ± 12.0 at KT. The mean follow-up time was 118.6 ± 70.2 months, and mean time from KT to UTUC was 7.53 years. There was a significant gender difference with a female predominance among the UTUC patients (73.1% versus 26.9%, p < 0.001). Native kidney hydronephro...
International Journal of Environmental Research and Public Health, 2019
Mortality-to-incidence ratios (MIRs) are alternative parameters used to evaluate the prognosis of... more Mortality-to-incidence ratios (MIRs) are alternative parameters used to evaluate the prognosis of a disease. In addition, MIRs are associated with the ranking of health care systems and expenditures for certain types of cancer. However, a lack of association between MIRs and pancreatic cancer has been noted. Given the poor prognosis of brain and nervous system cancers, similar to pancreatic cancer, the relation of MIRs and health care disparities is worth investigating. We used the Spearman’s rank correlation coefficient (CC) to analyze the correlation between the MIRs in brain and nervous system cancers and inter-country disparities, including expenditures on health and human development index. Interestingly, the MIRs in brain and nervous system cancers are associated with the human development index score (N = 157, CC = −0.394, p < 0.001), current health expenditure (CHE) per capita (N = 157, CC = −0.438, p < 0.001), and CHE as percentage of gross domestic product (N = 157, ...
Medicina, 2019
Prostate cancer (PCa) is a common malignancy in males and has a relatively slower progression tha... more Prostate cancer (PCa) is a common malignancy in males and has a relatively slower progression than other cancers. Our goal was to evaluate the clinical role of SPARC (secreted protein acidic and cysteine rich, osteonectin), cwcv, and kazal-like domains’ proteoglycan 1 (SPOCK1) in PCa. SPOCK1 expression was studied through the immunohistochemical staining of specimens from 71 patients with PCa. The correlation between SPOCK1 expression and clinicopathological features was quantitatively analyzed. We used Kaplan–Meier analysis and Cox proportional hazard models to analyze the prognostic value. Of 71 PCa patients, high SPOCK1 expression was more likely to be seen in those with an advanced stage (p = 0.018) of the disease and an advanced tumor (T) value (p = 0.014). Patients in Gleason grade groups 3 and 4 had significantly higher SPOCK1 expression (p = 0.044 and 0.003, respectively) compared to those of Gleason grade group 1. However, this trend was not observed in patients in Gleason ...
Journal of Investigative Medicine, 2018
Tuberous sclerosis complex (TSC) is a rare disease that causes multisystem benign neoplasm, induc... more Tuberous sclerosis complex (TSC) is a rare disease that causes multisystem benign neoplasm, induced by dysregulation of the mammalian target of the rapamycin pathway (mTOR). This study aimed to examine the effects of continuous low-dose everolimus, a potent and selective inhibitor of mTOR, on the treatment of TSC-associated renal angiomyolipoma (AML). Between July 2013 and August 2017, 11 patients with TSC-AML were enrolled for an everolimus therapy protocol. An oral everolimus dose starting at 2.5 mg daily was gradually increased to 5.0 mg daily. All patients were evaluated using MRI or CT scanning at baseline, 12, 24, 36 and 48 months after the start of treatment for measuring changes of renal AML mass volume. Everolimus therapy resulted in significant shrinkage of TSC-AML volume after 48 months follow-up. Serum levels of everolimus were subdivided into group I (<8 ng/mL, n=6) and group II (>8 ng/mL, n=5). The volume reduction rates were 10.6%–65.2% in group I and 42.5%–70.6...
Urological Science, 2017
The aim of this study was to compare the effectiveness of electromagnetic stimulation (EMS) versu... more The aim of this study was to compare the effectiveness of electromagnetic stimulation (EMS) versus electrostimulation plus biofeedback (ESB) for the treatment of refractory chronic pelvic pain syndrome (CPPS) in men. Materials and Methods: A total of 23 male refractory CPPS patients were included in the study. EMS was applied for 30 minutes, three times weekly, for 6 weeks, for pelvic floor rehabilitation. We retrospectively compared the outcomes with 22 male refractory CPPS patients treated with ESB twice a week for 2 weeks, and later once a week for 4 weeks. Each ESB session lasted 45 minutes, including biofeedback (15 minutes) followed by electrostimulation (30 minutes). The outcome measures included the National Institutes of Health Chronic Prostatitis Symptoms Index (NIH-CPSI), International Prostate Symptom Score (IPSS), and a visual analogue score for pain from baseline to 12 weeks after completion of treatment. Results: Significantly reduced pain, improved quality of life (QoL), and lowered total score of the NIH-CPSI were observed in both groups (all p < 0.05). The ESB group also demonstrated improvement in the urinary subscore of the NIH-CPSI. No significant differences were found between the groups in the urinary score measures of the NIH-CPSI. The mean pain score (p ¼ 0.035), QoL (p ¼ 0.012), and total score (p ¼ 0.009) improved significantly in the ESB group compared with EMS group. Total IPSS and visual analogue score improved significantly after treatment in both groups. However, no significant differences were noted between the groups in the total and subdomain sums of the IPSS. Conclusion: Both EMS and ESB physical therapy of the pelvic floor muscle effectively reduce pain, increase the QoL, and improve urinary tract symptoms in male CPPS patients who are refractory to medical treatments. The combination therapy of ES plus biofeedback demonstrates additional benefits in pain and QoL when compared with EMS alone.
Scientific reports, Jan 28, 2017
The variation in the mortality-to-incidence ratio (MIR) between countries and genders reflects th... more The variation in the mortality-to-incidence ratio (MIR) between countries and genders reflects the complex etiology and intervention of bladder cancer. In this study, we investigated the MIR variation between genders and health care disparities among countries. Cancer incidence and mortality were obtained from the GLOBOCAN 2012 database. The ranking and the total expenditure on health of countries were obtained from the World Health Organization. Linear regression was used to estimate the significance between variables. We estimated the role of MIRs from 33 countries. Bladder cancer incidence and mortality rates were higher in more developed regions, Europe, and the Americas. The MIRs were higher in less developed regions. Analysis according to country revealed Germany to have the lowest MIR. High relative MIRs (female MIR/male MIR) for bladder cancer were noted in many developed countries. A correlation between MIR and health care disparities among countries was indicated by a sign...
Urological Science, 2016
Purpose: Renal angiomyolipomas (AML) are benign tumors composed of blood vessels, smooth muscle c... more Purpose: Renal angiomyolipomas (AML) are benign tumors composed of blood vessels, smooth muscle cells and fat cells. AML-related chronic kidney disease and tumor bleeding are the main cause of mortality. AML are highly associated with Tuberous Sclerosis Complex (TSC) and mostly be treated by mammalian target of rapamycin inhibitor (mTORi) therapy or transarterial embolization (TAE). Materials and Methods: Here we present our cases of TSC-associated renal AMLs treated with monotherapy or combined treatment of mTORi and TAE. A total of 19 patients (4 males and 15 females) were included. There were 10 patients treated by mTORi only and 9 by combined therapy with mTORi and TAE. Results: The mean age of the patients was 34.5 (14e72) years. The maximal diameters of renal AMLs were from 1.5 to 20.9 (9.3±6.1) cm. During a mean follow-up duration of 43 (6e81) months, the size of AMLs decreased 15e33% in 8 patients receiving combination therapy. Two patients undergone monotherapy experienced 30-50% increase of tumor diameter. The tumor size of other patients showed no statistically significant change. Conclusion: TSC-associated AMLs are quite common in this hereditary, complex syndrome. They are usually multiple and bilateral. The lesion usually progress over time and complicated with flank pain, hemorrhage, and even renal deterioration. TSC-associated AMLs can be treated by medication or minimally invasive therapy. Our result discovered although the tumor size may not shrink, TAE still play an important role in management of tumor bleeding with acceptable complications. In our study, combination therapy showed better control of tumor size than monotherapy alone in TSC-associated AMLs.
International journal of molecular sciences, Jan 19, 2016
STEAP1 (six transmembrane epithelial antigen of the prostate 1) is a transmembrane protein that f... more STEAP1 (six transmembrane epithelial antigen of the prostate 1) is a transmembrane protein that functions as a potential channel or transporter protein. It is overexpressed in certain cancers and is viewed as a promising therapeutic target. However, the prognostic role of STEAP1 is still controversial, and no role for STEAP1 has yet been indicated in colorectal cancer. The aim of this study was to investigate the possible association of STEAP1 expression with colorectal cancer prognosis. STEAP1 expression was analyzed by immunohistochemical staining of a tissue array of 165 cancer specimens from primary colorectal cancer patients. The mean and medium follow-up times after surgery were 5.1 and 3.9 years, respectively. A total of 139 patients died during the 13 years of follow-up in the survey period. The prognostic value of STEAP1 with respect to overall survival was analyzed by Kaplan-Meier analysis and Cox proportional hazard models. In total, 164 samples displayed detectable STEAP...
Urological Science, 2015
endothelial growth factor (VEGF) and SHH in the ISV of patients with varicocele. Materials and Me... more endothelial growth factor (VEGF) and SHH in the ISV of patients with varicocele. Materials and Methods: The study specimens were 1 cm of internal spermatic vein (ISV) obtained from 20 patients during left varicocele repair. The control samples of 1 cm ISV were obtained from 8 male patients who underwent left inguinal herniorrhaphy. We analyzed for VEGF and SHH protein expression by immunoblotting, immunohistochemical (IHC) staining, double immunofluorescent staining and confocal laser scanning microscopy. The data were analyzed using the Student's t test. Results: Higher expression of VEGF and SHH proteins in varicocele veins than in the control group (P<.05) which located over muscle layers and endothelium were demonstrated by IHC staining. Both proteins co-localizated predominantly in endothelium of diseased veins under confocal laser scanning microscopy. Conclusion: This is the first reporting the SHH expression in varicocele veins of humans. Our findings revealed the higher expression of SHH and VEGF in muscle layer and endothelium of varicocele veins than in control group. Both proteins co-localized predominantly in the endothelium of these diseased veins.
The Scientific World Journal, 2013
Objective. To compare efficacy of desmopressin for treatment of nocturia between patients with no... more Objective. To compare efficacy of desmopressin for treatment of nocturia between patients with normal and high nocturnal bladder capacity index (NBCi).Methods. Retrospective analysis of adult patients treated with desmopressin for nocturia. Patients were analyzed according to high or normal NBCi value before treatment.Results. 55 patients were identified, aged 49–84, 47 males, 8 females, who started desmopressin 0.2 mg nocte between 2009 and 2011. Two groups (N: normal and H: high NBCi) were similar regarding number, gender, age, 24 h urine volume, and nocturnal urine volume. On treatment, nocturnal volume decreased by mean of 364 mL. Number of nightly voids decreased in N group from 3.11 to 1.50, in H from 3.96 to 1.44. Nocturnal polyuria and nocturia indices also decreased significantly. NBCi remained the same in N group (0.56 on therapy) and in H group decreased to mean 0.63. All on-treatment values were statistically similar in N and H groups. Pretreatment differences were aboli...
Urological Science, 2013
Abstract Few cases of abdominal wall metastasis from a urothelial carcinoma were reported in the ... more Abstract Few cases of abdominal wall metastasis from a urothelial carcinoma were reported in the literature, and those were mostly attributed to iatrogenic implantation after laparoscopic surgery or a percutaneous nephrostomy. An 85-year-old man presented with an infraumbilical mass 6 months after transurethral resection of a bladder tumor (TURBt) for a T4 urinary bladder urothelial carcinoma. Abdominal sonography disclosed a 1.6 cm × 1.5 cm subcutaneous hypoechoic lesion. Wide excision of the mass was performed, and skin flaps were used for skin coverage. A combination of the patient's clinical history, tumor morphology, and immunostaining results were compatible with the pathologic characteristic of his previous bladder urothelial carcinoma. We present this rare case of solitary abdominal wall mass metastasis from a urothelial carcinoma of the urinary bladder.