Search PubMed⌕ Search

Biomedical subjects

C C Chang

Publications and source records attributed to C C Chang.

At least 55 records · Page 3Linked to original sources
PubMed2001

Leukemia inhibitory factor decreases the arylamine N-acetyltransferase activity in human cumulus granulosa cells.

PURPOSE: To evaluate the activities of acetyl coenzyme A (AcCoA):arylamine N-acetyltransferase (NAT) of intact cumulus granulosa cells and the role of leukemia inhibitory factor (LIF) upon their NAT activities. METHODS: Thirty women accepted controlled ovarian hyperstimulation (COH) and oocyte retrievals. Human cumulus granulosa cells were obtained during oocyte retrievals. Using 2-aminofluorene (2-AF) and p-aminobenzoic acid (PABA) as substrates, NAT activity of all samples was determined by high pressure liquid chromatography. After the incubation with different time and concentrations of 2-AF, PABA, and LIF, 2-acetyl-aminofluorene (2-AAF) and N-acetyl-PABA (N-Ac-PABA) were measured. RESULTS: After incubation with 2.812, 5.625, 11.25, and 22.5 microM of 2-AF/PABA, their product concentrations (2-AAF/N-Ac-PABA) were 0.42/0.32, 0.76/0.58, 1.29/1.04, and 1.94/1.26 nmol/10(6) cells, respectively. After 6, 12, 18, and 24 h incubation with 11.25 microM of 2-AF/PABA, their product concentrations were 0.19/0.12, 0.56/0.4, 0.98/0.79, and 1.3/1.0 nmol/10(6) cells, respectively. After incubation with 0, 5, and 50 microM of LIF, the 2-AAF/N-Ac-PABA concentrations were 0.98/0.80, 0.70/0.52, and 0.49/0.30 nmol/10(6) cells, respectively. CONCLUSION: Intact human cumulus granulosa cells could acetylate arylamine carcinogen (2-AF) and noncarcinogens drug (PABA). LIF decreased the NAT activities. It provides a model for monitoring the effects of COH and LIF upon the oocytes.

2-Acetylaminofluorene↗
PubMed2001

Kinetics of acetyl coenzyme A: arylamine N-acetyltransferase from human cumulus cells.

PURPOSE: N-acetyltransferase (NAT) activity is involved in the detoxification of exogenous amines. We aimed to evaluate the kinetics of acetyl coenzyme A (AcCoA): arylamine NAT for human cumulus cells. METHODS: Thirty infertile women who were undergoing controlled ovarian hyperstimulation (COH) and oocyte retrievals were recruited. Human cumulus cells were obtained during oocyte retrievals. Using 2-aminofluorene (2-AF) and p-aminobenzoic acid (PABA) as substrates, NAT activity and Michaelis-Menten kinetics constants of all samples were determined by using high-pressure liquid chromatography. RESULTS: There were 6 rapid, 10 intermediate, and 14 slow acetylators. 2-AF-NAT and PABA-NAT activities were 0.97 +/- 0.74 and 0.89 +/- 0.77 nmol/min/mg protein, respectively. Km/Vmax of rapid and slow acetylators for 2-AF were (161 +/- 55)/(15.6 +/- 2.9) and (27.8 +/- 11.4)/(2.6 +/- 0.9), respectively. Km/Vmax of rapid and slow acetylators for PABA were (104 +/- 36)/(13.2 +/- 2.8) versus (20.0 +/- 10)/(2.0 +/- 0.7), respectively. Compared to slow acetylators, the rapid acetylators exhibited higher Km/Vmax values for 2-AF (5.8-/6-fold) and PABA (6-/6.6-fold), respectively. CONCLUSION: Human cumulus could acetylate arylamine carcinogen (2-AF) and noncarcinogen drug (PABA). Higher percentage of rapid acetylators established in the cumulus during COH. It provides a model for monitoring the effects of pollution or carcinogenesis upon the oocyte during COH and oocyte retrievals.

4-Aminobenzoic Acid↗
PubMed2001

Polymorphisms for interleukin-1 beta (IL-1 beta)-511 promoter, IL-1 beta exon 5, and IL-1 receptor antagonist: nonassociation with endometriosis.

PURPOSE: We aimed to investigate if interleukin-1 beta (IL-1 beta) and IL-1 receptor antagonist (IL-1Ra) gene polymorphism could be used as markers of susceptibility in endometriosis. MATERIALS AND METHODS: Women were divided into two groups: 1) endometriosis (n = 120); 2) nonendometriosis groups (n = 103). Polymorphisms for IL-1 beta-511 promoter, IL-1 beta exon 5, and IL-1Ra were detected by polymerase chain reaction. Genotypes and allelic frequencies for these polymorphisms in both groups were compared. RESULTS: Proportions of different IL-1 and IL-1Ra polymorphisms in both groups were nonsignificantly different. Proportions of C homozygote/heterozygote/T homozygote for IL-1 beta-511 promoter in both groups were 1) 21.6/59.1/19.1% and 2) 26.2/50.5/23.3%. Proportions of E1 homozygote/heterozygote/E2 homozygote for IL-1 beta exon 5 in both groups were 1) 91.6/5/3.3% and 2) 95.15/4.85/0%. Allele I/II/IV/V for IL-1Ra in both groups were 1) 92.5/5.4/1.6/0.4% and 2) 95.1/3.9/1/0%. CONCLUSIONS: Association of endometriosis with IL-1 beta-511 promoter, IL-1 beta exon 5, and IL-1 receptor antagonist gene polymorphisms doesn't exist. These polymorphisms are not useful markers for prediction of endometriosis susceptibility.

Asian People↗
PubMed2001

A novel multiparametric approach for analysis of cytoplasmic immunoglobulin light chains by flow cytometry.

We describe a novel flow cytometric approach using a two-step acquisition technique to determine the cytoplasmic immunoglobulin light chains (LC) expression. Samples were prepared by a lysed-whole-blood technique and incubated with CD38-PE (phycoerythrin) and CD45-FITC (fluorescein isothiocyanate). The cells were fixed and acquired on an FACSCalibur flow cytometer (first acquisition). The cells were then permeabilized, incubated with either kappa-FITC or lambda-FITC and reacquired (second acquisition). Analysis of the data was performed by gating on the differing intensities of CD38 and evaluating them for the presence of a shifting FITC-positive population from the first acquisition to the second acquisition. The FITC fluorescence intensity of the second acquisition was equal to the sum of surface CD45 expression obtained during the first acquisition and the cytoplasmic LC expression obtained during the second acquisition. Thus, the shifting (increase) of FITC fluorescence intensity during the second acquisition is specifically due to the cytoplasmic expression of either the kappa or lambda LC. We studied 15 multiple myeloma (MM) patients and 10 controls (samples from patients without plasma cell dyscrasias). None of the controls showed evidence of any clonal populations. Thirteen of 15 MM patients exhibited clonal plasma cells (CD38 bright), ranging from 0.01% to 34% of total events collected. In addition, we identified another minute clonal population of lymphocytes (CD38 dim, CD45 bright, low forward and side scatter) in 12 of 13 MM patients with clonal plasma cells. This population, ranging from 0.01% to 0.6% of total events collected, had the same LC restriction as the clonal plasma cells. Patients with a ratio of minor clonal population to clonal plasma cells less than 0.07 tended to remain in partial or complete remission than those with a ratio > or =0.07 (4/5 versus 1/4, P <.1, chi(2)). We conclude that this method is highly sensitive and permits us to identify the minute clonal population of lymphocytes in MM patients. Our preliminary observations with a small cohort of patients imply that this minute clonal population may have important prognostic significance. The prognostic significance should be confirmed by further studies.

ADP-ribosyl Cyclase↗
PubMed2001

Investigation of the extent of gastric metaplasia in the duodenal bulb by using methylene blue staining.

BACKGROUND AND AIMS: The existence of gastric metaplasia (GM) of the duodenal mucosa has been considered to be highly related to the recurrence of duodenal ulcers (DU). The aims of this study are to evaluate the usefulness of methylene blue staining in the detection of GM, and to clarify the relationship between GM and the deformity of the duodenal bulb. METHODS: Fifteen patients with healed DU and four patients with symptoms of dyspepsia without evidence of ulcers were enrolled into this endoscopic study. During each endoscopy, methylene blue was sprayed evenly on the duodenal bulb, and biopsies were taken from blue-stained and unstained areas. The existence and extent of GM were assessed histologically and grossly. The correlation between duodenal bulb deformity and the extent of GM was also studied. RESULTS: The mean score of methylene blue non-staining (MBNS) was 0, 1.30 +/- 0.15, and 3.00 +/- 0.00 in group A (non-ulcer patients), group B (patients with healed DU and with normal-shaped bulb) and C (patients with healed DU and with deformed duodenal bulb), respectively; showing significant differences among the groups (P < 0.05 in each). Both the existence and the grading of GM were higher in unstained specimens than in blue-stained specimens (100 vs 16.6%, P < 0.0001 and 3.62 +/- 0.09 vs 0.19 +/- 0.06, P < 0.001, respectively). CONCLUSIONS: Methylene blue non-staining can be applied to investigate the existence and extent of GM in the duodenal bulb accurately. The incidence of GM in the duodenal bulb was higher in patients with healed ulcers than in non-ulcer patients. Patients with deformed duodenal bulbs have a higher extent of GM than those without deformed duodenal bulbs.

Adult↗
PubMed2001

Longitudinal survey of blood flow at three different locations in the middle cerebral artery in normal fetuses.

OBJECTIVES: To assess vascular impedance at three different locations in the middle cerebral artery (MCA) in normal fetuses throughout gestation. MATERIALS AND METHODS: Uncomplicated singleton pregnancies at 15-40 weeks' gestation in which Doppler surveys of both MCAs could be obtained were recruited. The pulsatility index (PI) and resistance index (RI) of the proximal, mid and distal sites of both MCAs were measured. The five gestation periods at which the Doppler surveys were performed were (i) 15-19 completed weeks; (ii) 20-24 completed weeks; (iii) 25-29 completed weeks; (iv) 30-34 completed weeks; (v) 35-39 completed weeks. RESULTS: A total of 42 fetuses were recruited. The average PI/RI values of the proximal, mid and distal MCA were 1.61/0.82, 1.77/0.82, and 1.84/0.84, respectively. The PI value of the proximal MCA was lower than that of the mid and distal MCA. The PI values of the mid and distal MCA showed no difference. The RI value of the MCA from the three locations also showed no difference. The PI/RI values of MCA for each gestational phase were: (i) 1.81/0.87; (ii) 1.79/0.86; (iii) 1.78/0.86; (iv) 1.70/0.81; (v) 1.62/0.77, respectively. Decreased PI/RI values were observed after 30 weeks' gestation. CONCLUSIONS: The PI values of the proximal MCA are lower than those of the mid and distal MCA. A marked decrease in PI/RI values was observed after 30 weeks' gestation.

Adult↗
PubMed2001

Molecular cloning and functional characterization of a novel delayed rectifier potassium channel from channel catfish (Ictalurus punctatus): expression in taste buds.

The gustatory system of channel catfish is widely studied for its sensitivity to amino acids. As a first step in identifying the molecular components that play a role in taste transduction in catfish, we cloned the full-length cDNA for Kv2-catfish, a novel K(+) channel that is expressed in taste buds. The deduced amino acid sequence is 816 residues, and shares a 56-59% sequence identity with Kv2.1 and Kv2.2, the other members of the vertebrate Kv2 subfamily of voltage-gated K(+) channels. The Kv2-catfish RNA was expressed in taste buds, brain, skeletal muscle, kidney, intestine and gills, and its gene is represented as a single copy in the catfish genome. Recombinant channels expressed in Xenopus oocytes were selective for K(+), and were inhibited by tetraethylammonium applied to the extracellular side of the membrane during two-electrode voltage clamp analysis with a 50% inhibitory constant of 6.1 mM. The channels showed voltage-dependent activation, and did not inactivate within 200 ms. Functionally, Kv2-catfish is a voltage-gated, delayed rectifier K(+) channel, and its primary structure is the most divergent sequence identified among the vertebrate members of the Kv2 subfamily of K(+) channels, being related equally well to Kv2.1 and Kv2.2.

Amino Acid Sequence↗
PubMed2001

What factors influence physicians' decisions to switch from intravenous to oral antibiotics for community-acquired pneumonia?

OBJECTIVE: One of the major factors influencing length of stay for patients with community-acquired pneumonia is the timing of conversion from intravenous to oral antibiotics. We measured physician attitudes and beliefs about the antibiotic switch decision and assessed physician characteristics associated with practice beliefs. DESIGN: Written survey assessing attitudes about the antibiotic conversion decision. SETTING: Seven teaching and non-teaching hospitals in Pittsburgh, Pa. PARTICIPANTS: Three hundred forty-five generalist and specialist attending physicians who manage pneumonia in 7 hospitals. MEASUREMENTS AND RESULTS: Factors rated as "very important" to the antibiotic conversion decision were: absence of suppurative infection (93%), ability to maintain oral intake (79%), respiratory rate at baseline (64%), no positive blood cultures (63%), normal temperature (62%), oxygenation at baseline (55%), and mental status at baseline (50%). The median thresholds at which physicians believed a typical patient could be converted to oral therapy were: temperature < or =100 degrees F (37.8 degrees C), respiratory rate < or =20 breaths/minute, heart rate < or =100 beats/minute, systolic blood pressure > or =100 mm Hg, and room air oxygen saturation > or =90%. Fifty-eight percent of physicians felt that "patients should be afebrile for 24 hours before conversion to oral antibiotics," and 19% said, "patients should receive a standard duration of intravenous antibiotics." In univariate analyses, pulmonary and infectious diseases physicians were the most predisposed towards early conversion to oral antibiotics, and other medical specialists were the least predisposed, with generalists being intermediate (P <.019). In multivariate analyses, practice beliefs were associated with age, inpatient care activities, attitudes about guidelines, and agreeableness on a personality inventory scale. CONCLUSIONS: Physicians believed that patients could be switched to oral antibiotics once vital signs and mental status had stabilized and oral intake was possible. However, there was considerable variation in several antibiotic practice beliefs. Guidelines and pathways to streamline antibiotic therapy should include educational strategies to address some of these differences in attitudes.

Administration, Oral↗
PubMed2001

Spinal leptomeningeal metastases of giant cell glioblastoma associated with subarachnoid haemorrhage: case report.

A case of subarachnoid haemorrhage (SAH) due to spinal leptomeningeal metastases of a giant cell glioblastoma is described. A 51 year old male presented with a four week history of headache. Neurological examination was normal except for a slight left hemiparesis. Computed tomography (CT) revealed a large cyst with a mural nodule in the right temporal lobe. The tumour was removed followed by 60 Gy of radiation therapy. Thirty-two months later he developed headache and shoulder pain with symptoms of normal pressure hydrocephalus. Head CT showed ventriculomegaly and SAH. Magnetic resonance imaging showed spinal leptomeningeal metastases at the C4-5, T12, and L2 levels, but no local recurrence or tumour dissemination in the brain. He died 34 months after surgery. Autopsy revealed diffuse SAH over the whole brain and spinal cord, associated with spinal leptomeningeal metastases, but no cerebral aneurysms. Spinal radiotherapy and ventriculoperitoneal shunting could possibly have extended survival in this patient.

Brain Neoplasms↗
PubMed2001

Evaluation of micrometastases in sentinel lymph nodes of cutaneous melanoma: higher diagnostic accuracy with Melan-A and MART-1 compared with S-100 protein and HMB-45.

Accurate diagnosis of micrometastases in sentinel lymph nodes of cutaneous melanoma is critical for proper clinical management. S-100 protein and HMB-45 are the traditional immunomarkers widely used for this purpose. However, the interpretation of micrometastases by these markers is difficult with significant reduction in the diagnostic accuracy. S-100 protein demonstrates immunoreactivity for other nonmelanoma cells and obscures nuclear details, which are crucial for the interpretation of single cell metastases. We compared the new melanoma markers, Melan-A (clone A103) and MART-1 (clone M2-7C10), with S-100 protein and HMB-45, by examining 77 formalin-fixed paraffin-embedded sections of sentinel lymph nodes from 13 cases of primary cutaneous melanoma. CD68 (PG-M1) and hematoxylin-eosin-stained sections were also studied. Four pathologists interpreted the staining pattern after concealing the identity of each immunomarker. Az values (area under receiver operating characteristic curve) with receiver operating characteristic curve were higher with Melan-A (0.9742) and MART-1 (0.9779) compared with S-100 protein (0.8034) and HMB-45 (0.8651), demonstrating a higher diagnostic accuracy with Melan-A and MART-1 with superior detection of melanoma micrometastases. Melan-A and MART-1 showed sharp cytoplasmic immunoreactivity, almost exclusively restricted to the melanoma cells. Therefore, Melan-A and MART-1 are recommended for the evaluation of micrometastases in sentinel lymph nodes of cutaneous melanoma as a routine alternative to S-100 protein and HMB-45.

Antigens, CD↗
PubMed2001

Cerebrovascular reactivity to acetazolamide in alert patients with cerebral infarction: usefulness of first-pass radionuclide angiography using 99m Tc-HMPAO in monitoring cerebral haemodynamics.

Cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) were studied in 75 patients with cerebral infarction. All patients were alert with the symptoms of hemiparesis and/or aphasia, and were divided into two groups: 42 patients had occlusion or stenosis of >75% at the internal carotid artery or main trunk of middle cerebral artery; and 33 patients did not. Hemispheric mean CBF was measured by performing first-pass radionuclide angiography using 99mTc-hexamethylpropylene amine oxime. CVR was measured as the percentage change from the baseline mean CBF value after the administration of 500 mg acetazolamide. The CVR in both groups was significantly impaired (5.2+/-6.3%, P<0.001 and 7.7+/-6.1%, P<0.01, respectively) compared with normal controls (14.7+/-3.3%), although the mean CBF was not significantly reduced compared with age-matched controls. In the 12 patients with unilateral carotid occlusion, five patients with good collateral flow via the anterior communicating artery showed preserved CVR (11.0+/-7.8%), but those without did not (1.6+/-7.0%). CVR is impaired in alert patients with cerebral infarction, although the mean CBF is not reduced, and good collateral flow via the anterior communicating artery in patients with carotid occlusion may be a sign of well-preserved haemodynamic status.

Acetazolamide↗
PubMed2001

Large-volume liposuction: a review of 631 consecutive cases over 12 years.

Since the advent of epinephrine-containing wetting solutions and sophisticated fluid management techniques, increasingly larger and larger volumes of liposuction aspirations have been reported. Unfortunately, with these larger volumes of liposuction being routinely performed, greater rates of complications have also been reported, with the worst of these resulting in deaths. In a response to the increasing concerns over the safety of large-volume liposuction, a critical review of the senior author's own series has been performed to evaluate risks and benefits and to recommend guidelines for safe and effective large-volume liposuction. A retrospective chart review was performed on 631 consecutive patients who underwent liposuction procedures of at least 3000 cc total aspirate. All procedures were performed by the same senior surgeon between January of 1986 and March of 1998. Before September of 1996, traditional liposuction techniques were used. After September of 1996, ultrasound-assisted liposuction was performed. The superwet technique of fluid management was employed for all procedures performed after 1991. The particulars of the surgical and anesthetic techniques used are reviewed in the article. Data collection included preoperative patient demographics, preoperative and postoperative weights and measurements, and preoperative and postoperative photographs. Total aspirate volumes, fluid intakes, and fluid outputs were measured, and all complications were tallied. Average follow-up was 1 year. Results showed the majority of patients to be women, aged 17 to 74 years old. Of the preoperative weights, 98.7 percent were within 50 pounds of ideal chart weight. Total aspirate volumes ranged from 3 to 17 liters, with 94.5 percent of these under 10 liters. Fluid balance measurements showed an average of 120 cc/kg positive fluid balance at the end of the procedure, with none of these patients experiencing any significant fluid balance abnormalities. Cosmetic results were good, with a 2- to 6-inch drop from preoperative measurements, depending on the area treated. Ten percent of patients experienced minor skin contour irregularities, with most of these patients not requiring any additional surgical procedures. One year after surgery, 80 percent of patients maintained stable postoperative weights. No serious complications were experienced in this series. The majority of the complications consisted of minor skin injuries and burns, allergic reactions to garments, and postoperative seromas. The more serious complications included four patients who developed mild pulmonary edema and one patient who developed pneumonia postoperatively. These patients were treated appropriately and went on to have uneventful recoveries. The results show that large-volume liposuction can be a safe and effective procedure when patients are carefully selected and when anesthetic and surgical techniques are properly performed. Meticulous fluid balance calculations are necessary to avoid volume abnormalities, and experience is mandatory when performing the largest aspirations. Cosmetic benefits are excellent, and overall complication rates are low.

Adolescent↗
PubMed2001

Roles of acyl-coenzyme A:cholesterol acyltransferase-1 and -2.

Acyl-coenzyme A:cholesterol acyltransferase (ACAT) is an intracellular enzyme that produces cholesteryl esters in various tissues. In mammals, two ACAT genes (ACAT1 and ACAT2) have been identified. Together, these two enzymes are involved in storing cholesteryl esters as lipid droplets, in macrophage foam-cell formation, in absorbing dietary cholesterol, and in supplying cholesteryl esters as part of the core lipid for lipoprotein synthesis and assembly. The key difference in tissue distribution of ACAT1 and ACAT2 between humans, mice and monkeys is that, in adult human liver (including hepatocytes and bile duct cells), the major enzyme is ACAT1, rather than ACAT2. There is compelling evidence implicating a role for ACAT1 in macrophage foam-cell formation, and for ACAT2 in intestinal cholesterol absorption. However, further studies at the biochemical and cell biological levels are needed in order to clarify the functional roles of ACAT1 and ACAT2 in the VLDL or chylomicron synthesis/assembly process.

Animals↗
PubMed2001

Aortic valve endocarditis in a dog due to Bartonella clarridgeiae.

We report the first documented case of endocarditis associated with Bartonella clarridgeiae in any species. B. clarridgeiae was identified as a possible etiological agent of human cat scratch disease. Infective vegetative valvular aortic endocarditis was diagnosed in a 2.5-year-old male neutered boxer. Historically, the dog had been diagnosed with a systolic murmur at 16 months of age and underwent balloon valvuloplasty for severe valvular aortic stenosis. Six months later, the dog was brought to a veterinary hospital with an acute third-degree atrioventricular block and was diagnosed with infective endocarditis. The dog died of cardiopulmonary arrest prior to pacemaker implantation. Necropsy confirmed severe aortic vegetative endocarditis. Blood culture grew a fastidious, gram-negative organism 8 days after being plated. Phenotypic and genotypic characterization of the isolate, including partial sequencing of the citrate synthase (gltA) and 16S rRNA genes indicated that this organism was B. clarridgeiae. DNA extraction from the deformed aortic valve and the healthy pulmonic valve revealed the presence of B. clarridgeiae DNA only from the diseased valve. No Borrelia burgdorferi or Ehrlichia sp. DNA could be identified. Using indirect immunofluorescence tests, the dog was seropositive for B. clarridgeiae and had antibodies against Ehrlichia phagocytophila but not against Ehrlichia canis, Ehrlichia ewingii, B. burgdorferi, or Coxiella burnetii.

Animals↗
PubMed2001

Molecular evidence of Bartonella spp. in questing adult Ixodes pacificus ticks in California.

Ticks are the vectors of many zoonotic diseases in the United States, including Lyme disease, human monocytic and granulocytic ehrlichioses, and Rocky Mountain spotted fever. Most known Bartonella species are arthropod borne. Therefore, it is important to determine if some Bartonella species, which are emerging pathogens, could be carried or transmitted by ticks. In this study, adult Ixodes pacificus ticks were collected by flagging vegetation in three sites in Santa Clara County, Calif. PCR-restriction fragment length polymorphism and partial sequencing of 273 bp of the gltA gene were applied for Bartonella identification. Twenty-nine (19.2%) of 151 individually tested ticks were PCR positive for Bartonella. Male ticks were more likely to be infected with Bartonella than female ticks (26 versus 12%, P = 0.05). None of the nine ticks collected at Baird Ranch was PCR positive for Bartonella. However, 7 (50%) of 14 ticks from Red Fern Ranch and 22 (17%) of 128 ticks from the Windy Hill Open Space Reserve were infected with Bartonella. In these infected ticks, molecular analysis showed a variety of Bartonella strains, which were closely related to a cattle Bartonella strain and to several known human-pathogenic Bartonella species and subspecies: Bartonella henselae, B. quintana, B. washoensis, and B. vinsonii subsp. berkhoffii. These findings indicate that I. pacificus ticks may play an important role in Bartonella transmission among animals and humans.

Animals↗
PubMed2001

Transurethral microwave thermotherapy for symptomatic benign prostatic hyperplasia: long-term durability with Prostcare.

OBJECTIVE: To evaluate the long-term durability of transurethral microwave thermotherapy (TUMT) with Prostcare for symptomatic benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: From August 1993 to July 1994, a total of 65 patients with symptomatic BPH who underwent TUMT using the Prostcare apparatus (Bruker Spectospin, Wissembourg, France) with low-energy protocol (maximal power 52 W) were enrolled into a short-term evaluation. Subsequent follow-up information was collected in July 1999. If patients had had any further therapy for BPH, the date of retreatment was considered as an endpoint of TUMT efficacy. If no further therapy for BPH had been needed, they were re-assessed for overall satisfaction. RESULTS: The median follow-up period was 49 months. Twenty patients were excluded for various reasons, including 17 with loss of follow-up and 3 with new diseases that could affect the voiding status. Thirty-eight (84.4%) of 45 valuable patients had received further therapy for BPH, including medication (n = 21, 46.7%), and endoscopic surgery (n = 17, 37.7%). The times to pharmacologic or endoscopic retreatment after TUMT were 8.9+/-11.1 and 23.0+/-14.4 months, respectively (p = 0.0003, log rank test). Only 7 (15.5%) patients had no further treatment, with 3 having satisfactory improvements, but 4 feel dissatisfied yet not needing any further therapy. In addition, 2 patients complained of erectile dysfunction after TUMT and 1 was diagnosed with prostate cancer 50 months after TUMT. In addition, there was no significant difference for all baseline values among three groups with no retreatment or retreatment with medication or endoscopic surgery. CONCLUSION: At the 5-year follow-up, the long-term durability of low-energy TUMT with Prostcare is only exhibited in a few patients and the overall retreatment rate was 84.4%. Thus, patient should be informed of the high probability of supplementary treatment after TUMT.

Aged↗