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    ABSTRACT: Despite the crucial role of the brain in the control of the human lower urinary tract, little is known about the supraspinal mechanisms regulating micturition. To investigate the central regulatory mechanisms activated during micturition initiation and actual micturition, we used an alternating sequence of micturition imitation/imagination, micturition initiation, and actual micturition in 22 healthy males undergoing functional magnetic resonance imaging. Subjects able to micturate (voiders) showed the most prominent supraspinal activity during the final phase of micturition initiation whereas actual micturition was associated with significantly less such activity. Initiation of micturition in voiders induced significant activity in the brainstem (periaqueductal gray, pons), insula, thalamus, prefrontal cortex, parietal operculum and cingulate cortex with significant functional connectivity between the forebrain and parietal operculum. Subjects unable to micturate (nonvoiders) showed less robust activation during initiation of micturition, with activity in the forebrain and brainstem particularly lacking. Our findings suggest that micturition is controlled by a specific supraspinal network which is essential for the voluntary initiation of micturition. Once this network triggers the bulbospinal micturition reflex via brainstem centers, micturition continues automatically without further supraspinal input. Unsuccessful micturition is characterized by a failure to activate the periaqueductal gray and pons during initiation.
    European Urology Supplements 03/2013; 12(1):e70–e71. DOI:10.1016/S1569-9056(13)60563-1 · 3.37 Impact Factor
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    ABSTRACT: We investigated effects of ring size choosing strategy for Shang Ring male circumcision. 74 cases were recruited and assigned into the larger or smaller ring group. Compared to the larger ring group, there was shorter operation time (7.5±1.9 vs.6.7±1.4 min, P =0.035), and less blood loss (1.6±0.7 vs. 1.1±0.8 ml, P =0.014) in the smaller ring group. The smaller ring group also exhibited shorter healing duration than the larger ring group (22.3±4.1 days vs. 24.4±4.5 days, P =0.041). When the measured size does not fit into commercially available size, it is better to choose the smaller one.
    JAIDS Journal of Acquired Immune Deficiency Syndromes 09/2012; DOI:10.1097/QAI.0b013e318273aec9 · 4.39 Impact Factor
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    ABSTRACT: Our understanding of the pathogenesis of bladder cancer has improved considerably over the past decade. Translating these novel pathobiological discoveries into therapies, prevention, or strategies to manage patients who are suspected to have or who have been diagnosed with bladder cancer is the ultimate goal. In particular, the chemoprevention of bladder cancer development is important, since urothelial cancer frequently recurs, even if the primary cancer is completely removed. The numerous alterations of both oncogenes and tumor suppressor genes that have been implicated in bladder carcinogenesis represent novel targets for therapy and prevention. In addition, knowledge about these genetic alterations will help provide a better understanding of the biological significance of preneoplastic lesions of bladder cancer. Animal models for investigating bladder cancer development and prevention can also be developed based on these alterations. This paper summarizes the results of recent preclinical and clinical chemoprevention studies and discusses screening for bladder cancer.
    Journal of Oncology 09/2011; 2011:528353. DOI:10.1155/2011/528353