Extended use of Prostate Health Index and percentage of [-2]pro-prostate-specific antigen in Chinese men with prostate specific antigen 10–20 ng/mL and normal digital rectal examination

Peter Ka-Fung Chiu,Jeremy Yuen-Chun Teoh,Wai-Man Lee,Chi-Hang Yee,Eddie Shu-Yin Chan,See-Ming Hou,Chi-Fai Ng 대한비뇨의학회 2016 Investigative and Clinical Urology Vol.57 No.5

Purpose: We investigated the extended use of Prostate Health Index (PHI) and percentage of [-2]pro-prostate-specific antigen (%p2PSA) in Chinese men with prostate-specific antigen (PSA) 10–20 ng/mL and normal digital rectal examination (DRE). Materials and Methods: All consecutive Chinese men with PSA 10–20 ng/mL and normal DRE who agreed for transrectal ultrasound (TRUS)-guided 10-core prostate biopsy were recruited. Blood samples were taken immediately before TRUS-guided prostate biopsy. The performances of total PSA (tPSA), %free-to-total PSA (%fPSA), %p2PSA, and PHI were compared using logistic regression, receiver operating characteristic, and decision curve analyses (DCA). Results: From 2008 to 2015, 312 consecutive Chinese men were included. Among them, 53 out of 312 (17.0%) men were diagnosed to have prostate cancer on biopsy. The proportions of men with positive biopsies were 6.7% in PHI<35, 22.8% in PHI 35–55, and 54.5% in PHI>55 (chi-square test, p<0.001). The area under curves (AUC) of the base model including age, tPSA and status of initial/repeated biopsy was 0.64. Adding %p2PSA and PHI to the base model improved the AUC to 0.79 (p<0.001) and 0.78 (p<0.001), respectively, and provided net clinical benefit in DCA. The positive biopsy rates of Gleason 7 or above prostate cancers were 2.2% for PHI<35, 7.9% for PHI 35–55, and 36.4% for PHI>55 (chi-square test, p<0.001). By utilizing the PHI cutoff of 35 to men with PSA 10–20 ng/mL and normal DRE, 57.1% (178 of 312) biopsies could be avoided. Conclusions: Both PHI and %p2PSA performed well in predicting prostate cancer and high grade prostate cancer. The use of PHI and %p2PSA should be extended to Chinese men with PSA 10–20 ng/mL and normal DRE.

The Risk of Upper Urinary Tract Involvement in Patients With Ketamine-Associated Uropathy

Chi-Hang Yee,Jeremy Yuen-Chun Teoh,Pui-Tak Lai,Vivian Yee-Fong Leung,Winnie Chiu-Wing Chu,Wai-man Lee,Yuk-Him Tam,Chi-Fai Ng 대한배뇨장애요실금학회 2017 International Neurourology Journal Vol.21 No.2

Purpose: The aims of this study were to investigate the prevalence of upper tract involvement in ketamine-associated uropathy, and to determine the predictors of hydronephrosis in patients with a history of ketamine abuse. Methods: This was a cross-sectional study of a prospective cohort of patients with ketamine-associated uropathy. Data including demographics, pattern of ketamine abuse, pelvic pain and urgency or frequency (PUF) symptom score, uroflowmetry (UFM) parameters, serum renal function, and liver function tests were collected. Upon consultation, ultrasonography was performed to assess the function of the urinary system. Results: From December 2011 to October 2015, we treated 572 patients with ketamine-associated uropathy. Of these patients, 207 (36.2%) had managed to achieve abstinence at the time of their first consultation. Ninety-six patients (16.8%) in the cohort were found to have hydronephrosis on ultrasonography. Univariate analysis identified age, duration of ketamine abuse, PUF symptom score, voided volume on UFM, serum creatinine levels >100 μmol/L, and an abnormal serum liver enzyme profile as factors associated with hydronephrosis. Logistic regression revealed the following parameters to be statistically related to hydronephrosis: age (adjusted odds ratio [OR], 1.090; 95% confidence interval [CI], 1.020–1.166; P=0.012), functional bladder capacity (adjusted OR, 0.997; 95% CI, 0.995–0.999; P=0.029), serum creatinine >100 μmol/L (adjusted OR, 3.107; 95% CI, 1.238–7.794; P=0.016, and an abnormal serum liver enzyme profile (adjusted OR, 1.967; 95% CI, 1.213–3.187; P=0.006). Conclusions: Ketamine-associated uropathy can involve the upper urinary tract. Patient demographics as well as investigations of UFM, renal function tests, and liver function tests may allow us to identify at-risk patients.

The effect of renal cortical thickness on the treatment outcomes of kidney stones treated with shockwave lithotripsy

Chi-Fai Ng,Sylvia Luke,Jeremy Y.C. Teoh,Ka-Tak Wong,Simon S.M. Hou,Peter K.F. Chiu 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.5

Purpose: Because the shock wave passes through various body tissues before reaching the stone, stone composition may affect the treatment efficacy of shock wave lithotripsy (SWL). We investigated the effect of various tissue components along the shock wave path on the success of SWL. Materials and Methods: From October 2008 to August 2010, a total of 206 patients with kidney stones sized 5 to 20 mm were prospectively recruited for a study of the factors that affect the outcome of treatment with a Sonolith Vision lithotripter. Successful SWL was defined as either stone-free status or residual fragments <4 mm at 12 weeks. Logistic regression analysis was performed to assess the factors that predicted treatment outcomes. Potential predictors included the patient’s age, shock wave delivery rate, stone volume (SV), mean stone density (MSD), skin-to-stone distance (SSD), and the mean thickness of the three main components along the shock wave path: renal cortical thickness (KT), muscle thickness (MT), and soft-tissue thickness (ST). Results: The mean age of the patients was 53.8 years (range, 25–82 years). The overall treatment success rate after one session of SWL was 43.2%. The mean KT, MT, and ST were 26.9, 16.6, and 40.8 mm, respectively. The logistic regression results showed that a slower shock wave delivery rate, smaller SV, a lower MSD, and a thicker KT were found to be significant predictors for successful SWL. SSD, MT, and ST were not predictors of successful treatment. Conclusions: Among the main tissue components along the shock wave path, a thicker KT was a favorable factor for successful SWL after adjustment for SV, MSD, and the shock wave delivery rate.

Effect of weight reduction on the severity of lower urinary tract symptoms in obese male patients with benign prostatic hyperplasia: A randomized controlled trial

Chi-Hang Yee,Wing-Yee So,Sidney KH Yip,Edwin Wu,Phyllis Yau,Chi-Fai Ng 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.3

Purpose: We assessed whether weight reduction is an effective intervention for the management of lower urinary tract symptoms (LUTS) and investigated the relationship between obesity and LUTS. Materials and Methods: This was a prospective randomized controlled trial that enrolled obese men older than 50 years with LUTS. The study period was 52 weeks. All patients received standardized alpha-adrenergic blocker therapy for the treatment of benign prostatic hyperplasia (BPH) during the run-in period. Patients were randomized to receive either a standardized prerecorded video program on the general principle of weight reduction or a comprehensive weight reduction program. Patients were assessed at different time points with symptom assessment, uroflowmetry, transrectal ultrasound, and metabolic assessment. Results: Sixty-five patients were allocated to each study arm. After the study period, no significant difference in weight reduction was found between the two arms. When the pre- and postintervention parameters were compared, none were statistically different between the 2 arms, namely nocturia, International Prostate Symptom Score, quality of life assessment, and uroflowmetry parameters. When the whole study population was taken as a single cohort, these parameters were also not significantly different between the group with a body mass index of 25 to <30 kg/m2 and the group with a BMI of 30 to 35 kg/m2. Conclusions: We found no association between obesity and LUTS. This could have been due to the less marked weight difference in our cohort. Whereas weight reduction may be an effective measure to improve LUTS, the implementation of a successful program remains a challenge.

Stiffness Modeling and Optimization of a 3-DOF Parallel Robot in a Serial-Parallel Polishing Machine

Peng Xu,Bing Li,Chi-Fai Cheung,Ju-Fan Zhang 한국정밀공학회 2017 International Journal of Precision Engineering and Vol.18 No.4

Polishing is a kind of finishing process that can effectively reduce the surface defects and improve the form accuracy. This paper presents a novel hybrid machine with 6 degrees of freedom (DOF) serial-parallel topological structure used as an ultra-precision polishing equipment which is composed of a 3-DOF parallel robot, a 2-DOF serial robot and a turntable providing a redundant DOF. Due to the complexity of structure, stiffness performance evaluation of the parallel robot becomes a challenge. As a result, a theoretical model of the parallel robot based on the virtual work principle and the deformation superposition principle is formulated for analyzing the stiffness performance. With the developed model, a multi-objective dimensional optimization method is developed to maximize both the workspace volume and the global stiffness performance of the parallel robot. Artificial intelligence approach based on genetic algorithms is implemented to obtain an optimal combination of structural parameters. The effectiveness of this method is validated by simulation and the parallel robot with optimized structural parameters has a workspace with higher stiffness performance, hence justifies its suitability for high precision polishing.

Novel Auto-regressive Measurement of Diamond Tool Wear in Ultra-precision Raster Milling

Shao-Jian Zhang,Suet To,Chi-Fai Cheung,Jian-Jun Du 한국정밀공학회 2012 International Journal of Precision Engineering and Vol. No.

In this paper, a new auto-regressive algorithm is proposed to reconstruct 3D topographic surface for diamond tool wear, using its in-process image. First, based on digital image processing technique, tool wear lands are separated from a tool wear image captured by a CCD camera under a 100X optical system; Second, a traverse search method of arc translation is put forward to eliminate feigned wear lands, and a least square polynomial method is adopted to fit inner- and outer-contours of the wear lands, self-adaptively filtering noises and connecting the discontinuous wear lands; Finally, the auto-regressive calibration method is developed to reconstruct its 3D topographic surface. The wear land is extracted self-adaptively, and the wear area, maximal wear width, average wear width and worn volume can be determined automatically by the algorithm. The reconstructed 3D topography of the tool wear land can be identified, based on the tool wear image captured by SEM. The result indicates that the method is capable of reconstructing 3D topography of the tool wear land and provides a possibility for in-process 3D-wear measurement in ultra-precision raster milling (UPRM) and the algorithm reliability is validated finally. And the influence of tool wear on surface roughness is discussed.

Report of the Second Asian Prostate Cancer (A-CaP) Study Meeting

Kim, Choung-Soo,Lee, Ji Youl,Chung, Byung Ha,Kim, Wun-Jae,Fai, Ng Chi,Hakim, Lukman,Umbas, Rainy,Ong, Teng Aik,Lim, Jasmine,Letran, Jason L.,Chiong, Edmund,Wu, Tong-lin,Lojanapiwat, Bannakij,Tü,rk Asian Pacific Prostate Society 2017 Prostate international Vol.5 No.3

<P>The Asian Prostate Cancer (A-CaP) Study is an Asia-wide initiative that has been developed over the course of 2 years. The study was launched in December 2015 in Tokyo, Japan, and the participating countries and regions engaged in preparations for the study during the course of 2016, including patient registration and creation of databases for the purpose of the study. The Second A-CaP Meeting was held on September 8, 2016 in Seoul, Korea, with the participation of members and collaborators from 12 countries and regions. Under the study, each participating country or region will begin registration of newly diagnosed prostate cancer patients and conduct prognostic investigations. From the data gathered, common research themes will be identified, such as comparisons among Asian countries of background factors in newly diagnosed prostate cancer patients. This is the first Asia-wide study of prostate cancer and has developed from single country research efforts in this field, including in Japan and Korea. At the Second Meeting, participating countries and regions discussed the status of preparations and discussed various issues that are being faced. These issues include technical challenges in creating databases, promoting participation in each country or region, clarifying issues relating to data input, addressing institutional issues such as institutional review board requirements, and the need for dedicated data managers. The meeting was positioned as an opportunity to share information and address outstanding issues prior to the initiation of the study. In addition to A-CaP-specific discussions, a series of special lectures was also delivered as a means of providing international perspectives on the latest developments in prostate cancer and the use of databases and registration studies around the world.</P>

Prospective randomized study of sexual function in men taking dutasteride for the treatment of androgenetic alopecia

Tsai, Tsen‐,Fang,Choi, Gwang Seong,Kim, Beom Joon,Kim, Moon‐,Bum,Ng, Chi Fai,Kochhar, Puja,Jasper, Stacy,Brotherton, Betsy,Orban, Barbara,Lulic, Zrinka John Wiley and Sons Inc. 2018 The Journal of dermatology Vol.45 No.7

<P><B>Abstract</B></P><P>Treatment with 5α‐reductase inhibitors has been associated with sexual adverse events such as impotence (erectile dysfunction) and decreased libido. The primary objective of this study was to evaluate adverse events related to sexual function, based on their frequency, duration, persistence and associated treatment discontinuations, in men treated with dutasteride for androgenetic alopecia. Participants were randomized to receive double‐blind dutasteride 0.5 mg or placebo once daily for 24 weeks, followed by open‐label dutasteride 0.5 mg for an additional 24 weeks. Sexual adverse events were followed up until resolution or for up to 24 weeks after the last dose. Overall, 117 men, 23–50 years of age, were randomized. The incidence of sexual adverse events was approximately twofold higher in the dutasteride group (16%) than the placebo group (8%) during the double‐blind period; the overall incidence of sexual adverse events was lower (5%) during the open‐label period. All adverse events were mild to moderate in severity and considered treatment‐related. The adverse events resolved while on study treatment or after the end of treatment and did not lead to treatment discontinuation. A limitation of this study was the small sample size. The sexual adverse events of impotence, decreased libido and ejaculation disorders reported in this study were expected and reversible.</P>

Types of Control in Acupuncture Clinical Trials Might Affect the Conclusion of the Trials: A Review of Acupuncture on Pain Management

Haiyong Chen,Zhipeng Ning,Wing Lok Lam,Wai-Yee Lam,Ying Ke Zhao,Jerry Wing Fai Yeung,Bacon Fung-Leung Ng,Eric Tat-Chi Ziea,Lixing Lao 사단법인약침학회 2016 Journal of Acupuncture & Meridian Studies Vol.9 No.5

Analgesic effects of acupuncture have been extensively studied in various clinical trials. However, the conclusion remains controversial, even among large scale randomized controlled trials. This study aimed to evaluate the association between the conclusion of the trials and the types of control used in those trials via systematic review. Published randomized controlled trials of acupuncture for pain were retrieved from electronic databases (Medline, AMED, Cochrane libraries, EMBASE, PsycINFO, Clinicaltrials.gov, and CAB Abstracts) using a prespecified search strategy. One hundred and thirty-nine studies leading to 166 pairs of acupuncture-control treatment effect comparisons (26 studies comprised of 53 intervention-control pairs) were analyzed based on the proportion of positive conclusions in different control designs. We found that treatment effects of acupuncture compared with nontreatment controls had the highest tendency to yield a positive conclusion (84.3%), compared with nonneedle-insertion controls (53.3%). Whereas with needle-insertion controls, the lowest tendency of positive conclusions was observed (37.8%). Consistently, in studies reporting successful blinding, a higher tendency of positive findings on the treatment effect of acupuncture was found in the noninsertion sham controls compared with that in the insertion sham controls. We conclude that the type of control is likely to affect the conclusion in acupuncture analgesic trials. Appropriate control should be chosen according to the aims of studies. Analgesic effects of acupuncture have been extensively studied in various clinical trials. However, the conclusion remains controversial, even among large scale randomized controlled trials. This study aimed to evaluate the association between the conclusion of the trials and the types of control used in those trials via systematic review. Published randomized controlled trials of acupuncture for pain were retrieved from electronic databases (Medline, AMED, Cochrane libraries, EMBASE, PsycINFO, Clinicaltrials.gov, and CAB Abstracts) using a prespecified search strategy. One hundred and thirty-nine studies leading to 166 pairs of acupuncture-control treatment effect comparisons (26 studies comprised of 53 intervention-control pairs) were analyzed based on the proportion of positive conclusions in different control designs. We found that treatment effects of acupuncture compared with nontreatment controls had the highest tendency to yield a positive conclusion (84.3%), compared with nonneedle-insertion controls (53.3%). Whereas with needle-insertion controls, the lowest tendency of positive conclusions was observed (37.8%). Consistently, in studies reporting successful blinding, a higher tendency of positive findings on the treatment effect of acupuncture was found in the noninsertion sham controls compared with that in the insertion sham controls. We conclude that the type of control is likely to affect the conclusion in acupuncture analgesic trials. Appropriate control should be chosen according to the aims of studies.