1. Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
2. Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
3. Graduate Institute of Medicine, KaohsiungMedical University, Kaohsiung, Taiwan
4. Pingtung Hospital, Department of Health, Executive Yuan, Pingtung, Taiwan
5. Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
6. Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
7. Department of Pharmacy, China Medical University, Taichung, Taiwan
Introduction: In addition to a depletion of androgen, attenuated action of androgen receptor (AR) might also contribute to andropausal symptoms.
Aim:To evaluate the interaction of AR CAG repeat polymorphism and serum testosterone levels and their effect on andropausal symptoms in aging Taiwanese men.
Methods: From August 2007 to April 2008, a free health screening for men older than 40 years was conducted by a medical center in Kaohsiung City, Taiwan. All participants received physical examination, answered questionnaires to collect their demographic information and medical histories, completed the Androgen Deficiency in the Aging Male (ADAM) questionnaire, and provided 20 cm3 whole blood samples for biochemical and genetic evaluation.
Main outcome measures: The ADAM questionnaire was used to evaluate andropausal symptoms. Serum albumin, total testosterone (TT), and sex hormone-binding globulin levels were measured. Free testosterone level was calculated. AR gene CAG repeat polymorphism was determined by direct sequencing.
Results: 702 men with the mean age of 57.2±6.5 years were included. There was no significant association between TT levels and the distribution of AR CAG repeat polymorphism. When TT levels were above 340 ng/dl, subjects with AR CAG repeat lengths 25 ≧ showed significantly higher risk of developing andropausal symptoms, as compared to those with AR CAG repeat lengths 22 ≦ ( P=0.006), but this was not observed when TT levels were 340 ng/dl or below. Age and number of comorbidities were also independent risk factors for andropausal symptoms.
Conclusions: In subjects with normal TT concentration, those with longer AR CAG repeat lengths have a higher risk of developing andropausal symptoms. Age and number of comorbidities can also influence the appearance of andropausal symptoms. In clinical practice, a multifactorial approach to evaluate andropausal symptoms and the interactions between those risk factors is suggested.
輝瑞論文獎基礎組 第一名
Curcumin Provides Potential Protection against the Activation of Hypoxia and Prolyl 4-hydroxylase Inhibitors on Prostate-specific Antigen Expression in Human Prostate Carcinoma Cells.
Li-Chuan Chung 1,2* , Ke-Hung Tsui,
3,4,5* , Tsui-Hsia Feng
6 , Shiow-Ling Lee 1 , Phei-Lang Chang
3,4, and Horng-Heng Juan 2,4,
1 Department of Bioengineering, Tatung University, Taipei, Taiwan
2 Department of Anatomy, Chang Gung University, Tao-Yuan, Taiwan
3 Department of Urology, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
4 Bioinformation Center, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
5 School of Traditional Chinese Medicine, Chang Gung University, Tao-Yuan, Taiwan
6 School of Nursing, Chang Gung University, Tao-Yuan,, Taiwan
Scope: Prostate-specific antigen (PSA) is a well-known marker for diagnosing and monitoring prostate cancer. Curcumin, a yellow curry pigment, has been reported to enhance androgen receptor (AR) degradation. We examined the effects of curcumin on increasing PSA expression by hypoxia and prolyl hydroxylase inhibitors, L-mimosine and dimethyloxalylglycine (DMOG), in human prostate carcinoma LNCaP cells.
Methods and Results: The 3 H-thymidine incorporation assay revealed that either L-mimosine or DMOG treatments attenuated cell proliferation. Immunoblot and enzyme-linked immunosorbent assays (ELISA) indicated that both L-mimosine and DMOG have an effect similar to hypoxia, which stabilized hypoxia-inducible factor-1α (HIF-1α) and induced PSA gene expression. The results of the immunoblot and transient gene expression assays indicated that induction of the PSA expression by hypoxia is both HIF-1α- and AR-dependent. Immunoblot assays revealed that a curcumin treatment (10μM) decreased the protein abundance of AR but did not significantly affect the protein levels of HIF-1α and vascular endothelial growth factor, which were induced by hypoxia. ELISA and transient gene expression assays indicated that curcumin blocked the activation of L-mimosine or DMOG treatment on PSA expression.
Conclusions: These results indicate that curcumin blocked the enhanced effect of PSA expression by L-mimosine and DMOG that induce hypoxia condition.
友華論文獎臨床組 第二名
Open-Angle Glaucoma and the Risk of Erectile Dysfunction A Population-based Case-control Study
Purpose: Open-angle glaucoma (OAG) is associated with systemic metabolic and cardiovascular disorders,and both share common risk factors with erectile dysfunction (ED). However, few studies have investigated the association of ED with OAG. This study aimed to estimate the association of ED with prior OAG by using a nationwide, population-based data with a retrospective case-control cohort design in Taiwan.
Design: Age-matched case-control study.
Participants and Controls: We identified 4605 patients with ED as the cases and randomly selected 23025 subjects as the controls (5 controls to 1 case).
Methods: We used conditional logistic regressionan alysis to estimate the odds ratio and 95% confidence interval of having previously been diagnosed with OAG according to the presence/absence of ED after adjusting for patient’s monthly income, geographical location, hypertension, diabetes, coronary heart disease, hyperlip-idemia, obesity, and alcohol abuse.
Main Outcome Measures: We identified OAG cases not only based on an International Classification of Diseases, Ninth Revision, Clinical Modification code, but also by the prescription of topical antiglaucoma medication.
Results: In total, prior OAG was found among 137 subjects (0.5 %); 53 individuals (1.1% of the ED patients) from the cases and 84 individuals (0.4% of patients without ED) from the controls. Conditional logistic regression analysis demonstrated that, after adjusting for potential confounders, patients with ED were more likely to have prior OAG than controls (odds ratio, 2.85; 95% confidence interval, 2.10 – 4.07).
Conclusions: This study identifies a novel association between ED and prior OAG.
友華論文獎基礎組 第二名
The Effects of Anti-TNF-αAntibody on Hyperprolactinemia-related Suppression of hCG-Induced Testosterone Release in Male Rats
William J.S. Huang, MD, PhD,*§ Ling-Yu Yang, MD, PhD, †¶ Hsiao-Fung Pu, PhD,
‡ Yi-Ting Tsai, MS, ‡ and Paulus S. Wang, PhD
‡ *Department of Urology, School of Medicine, National Yang-Ming University, Taipei, Taiwan;
† Department of Pediatrics, School of Medicine, National Yang-Ming University, Taipei, Taiwan;
‡ Department of Physiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan;
§ Division of Urology, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan;
¶ Division of Pediatric Immunology, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
Introduction. Hyperprolactinemia (hyperPRL)-related hypogonadism or suppression of human chorionic gonadotropin (hCG)-induced testosterone (T) release is hypothesized to be mediated by a testicular interstitial macrophage and tumor necrosis factor alpha (TNF-α)-involved blockage.
Aim. To test if the lower T response after hCG challenge in the hyperPRL rats is reversed by administrating anti-TNF-α antibody (Ab).
Methods. HyperPRL was induced by allografting two anterior pituitary (AP) glands per rat. Control rats were grafted with similar amount of cerebral cortex. The testicular interstitial cells (TIC) were isolated from the testis 6 weeks after grafting. TIC was treated with anti-TNF-α Ab with or without hCG. The other groups of rats received intra-testicular or intra-muscular anti-TNF-α Ab 7 days before in vitro study. The TIC isolated from each testis was incubated and T release with or without hCG challenge were measured.
Main Outcome Measures. Prolactin (PRL) and T were measured by radioimmunoassay. TNF-α was measured by enzyme-linked immunosorbent assay (ELISA).
Results. When low dose of anti-TNF-α Ab was administered to the TIC incubation, the effects of PRL-related suppression of hCG-stimulated T release were not significant. While a higher dose of anti-TNF-α Ab almost abolished the suppressive effects of PRL to hCG-stimulated T release. Prior intra-testicular or intra-muscular administration of anti-TNF-α Ab reversed the suppressive effects of AP grafting on TIC’s T release. This was demonstrated in groups with anti-TNF-α Ab injection both 7 and 1 day prior to TIC incubations.
Conclusions. The data support the hypothesis that the suppression of hCG-induced T release associated with hyperPRL is through a TNF-α-mediated mechanism to suppress the Leydig cells. The effect of anti-TNF-α Ab is durable for at least 7 days. Besides intra-testicular injection, there might be other ways available for administrating Ab. Anti-TNF-α Ab has a potential therapeutic application on hyperPRL-induced hypogonadism or suppression of hCG-induced T release.
財團法人鳳凰泌尿學科文教基金會論文獎-臨床組 第一名
The Comparison of the Aging Male Symptoms (AMS) Scale and Androgen Deficiency in the Aging Male (ADAM) Questionnaire to Detect Androgen Deficiency in Middle-Aged Men
KUANG-SHUN CHUEH 1 , SHU-PIN HUANG 1,2 , YUNG-CHIN LEE 1,2,3, CHII-JYE WANG 1,2, HSIN-CHIH YEH 1,3,4, WEI-MING LI
1,3,5 , WEN-JENG WU 1,2,6 , YUEH-FONG TSAI
1 , CHIA-CHUN TSAI 1,4 , HSU-CHENG JUAN 1 , CHUN-HSIUNG HUANG
1,2 AND CHIA-CHU LIU 1,2,3,5
From the
1 Department of Urology, KaohsiungMedical University Hospital, the
2 Department of Urology, Faculty of Medicine, College of Medicine, and the
3 Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; the
4 Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; the
5 Pingtung Hospital, Department of Health, Executive Yuan, Pingtung, Taiwan; and the
6 Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan.
The prevalence of androgen deficiency in men increases with aging. Two common instruments, the Aging Male Symptoms (AMS) scale and the Androgen Deficiency in the Aging Male (ADAM) questionnaire, are often used to screen for androgen deficiency in clinical practice. The aim of this study is to compare the capability of the AMS scale and the ADAM questionnaire to detect androgen deficiency in middle-aged Taiwanese men. In April 2008, a free health screening was conducted by Kaohsiung Medical University Hospital. All participants completed a health questionnaire and had blood samples drawn between 8:00 AM and noon. Serum total testosterone (TT), albumin, and sex hormone-binding globulin levels were measured. The level of free testosterone (FT) was calculated. Clinical symptoms associated with androgen deficiency were screened by using the AMS scale and ADAM questionnaire. Androgen deficiency was defined as TT < 300 ng/dL or both TT < 300 ng/dL and FT< 5 ng/dL. In total, 339 men were included in the final analysis, with the mean age of 54.6 ± 4.9 years (range, 47-65 years). Androgen deficiency was found in 75 men (22.1%) based on the criteria of TT < 300 ng/dL, and in 54 men (15.9%) based on the criteria of TT < 300 ng/dL and FT < 5 ng/dL. When detecting participants with both TT < 300 ng/dL and FT < 5 ng/dL, the sensitivity and specificity of the AMS scale were 57.4% and 48.1%, compared with 66.7% and 25.6% for the ADAM questionnaire. In a sample of middle-aged Taiwanese men, neither the AMS scale nor the ADAM questionnaire had sufficient sensitivity and specificity to detect androgen deficiency. In addition to using those 2 screening instruments, a thorough physical and biochemical workup should still be conducted in patients at risk or suspected of androgen deficiency.
財團法人鳳凰泌尿學科文教基金會論文獎-臨床組 第二名
The Impact of Systemic Lupus Erythematosus on Women's Sexual Functioning
1 Division of allergy, Immunology and Rheumatology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan,
2 Department of Urology, China Medical University Hospital; School of Medicine, China Medical University, Taichung, Taiwan;
3 Division of Urology, Department of Surgery and Division of Basic Medical Research, Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
Introduction: The effect of systemic lupus erythematosus (SLE) on women’s sexual functioning has been rarely assessed.
Aim: The aim of this study is to evaluate the impact of SLE on women's sexual functioning
Methods:A total of 302 consecutive female outpatients with SLE were provided with a questionnaire composed of the Female Sexual Function Index (FSFI), questions for sociodemographic characteristics and comorbidities. Similarly, 2,159 hospital female employees were assessed as the control group. In patients, data of SLE duration and Sjögren's syndrome were derived from the chart records and the disease activity was assessed using the SLE Disease Activity Index 2000.
Main Outcome Measures:The FSFI scores were compared between the patients and the controls. Correlates of the FSFI scores were determined in the patients.
Results:Of 302 eligible patients, 92.4% (279/302) responded, in addition to 73.2% (1580/2159) of controls. Ninety-five percent (255/268) of the respondent patients were in no-to-mild SLE disease activity. Among the respondents, 171 (61.3%) patients and 930 (58.9%) controls were sexually active in the previous month, P= 0.446. Of the sexually active patients, 52.5%(85/162) had impaired sexual function (the FSFI total score <26.55) and so did 47.1% (408/867) of the sexually active controls, P= 0.206. With adjustment of age group, marital status and education level, patients had lower FSFI scores than controls only in the domains of lubrication and pain. Significant risk factors for lower FSFI scores in the patients included persistent activity or flare of SLE, menstrual cycle disturbances and vascular disease. With further adjustment of other risk factors, only vascular disease remained significant as a risk factor for impaired sexual function (odds ratio = 5.7; 95% confidence interval 1.6-20.1).
Conclusion:When not in an exacerbation period, the impact of SLE on women's sexual functioning is not great and is related to vascular factors.