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PurposeTo maximize the chance of maintaining peritoneal dialysis (PD) after retroperitoneoscopic nephroureterectomy without interruption in PD-dependent patients who were suspected as having upper tract urothelial carcinoma (UTUC).MethodsDuring 2005–2018 at our hospital, 10 PD-dependent patients who were suspected as having UTUC underwent hand-assisted retroperitoneoscopic nephroureterectomy (HARN) and bladder cuff resection by a single surgeon. The medical record and post-operative outcomes were retrospectively analyzed. Our surgical tips aiming at staying on PD including keeping adequate but relatively lower insufflation pressure during the operation, reducing the negative pressure of the drain tube post-operatively and initiating PD at a low volume with gradual titration, were also presented in the article.ResultsA total of ten patients were enrolled in our study. The first five patients failed to resume PD and need interim hemodialysis due to various reasons. After some technique modifications, all the following five patients have PD reinstitution immediately after the operation without increasing the incidence of post-operative complications.ConclusionStaying on PD wound be beneficial for those ESRD patients who underwent retroperitoneoscopic nephroureterectomy due to UTUC, mainly to avoid hemodynamic interference and possible complications related to hemodialysis during the peri-operative period. However, it remains challenging for surgeons. We concluded the key points to minimize peritoneal violation. By adherence to our tips, retroperitoneoscopic nephroureterectomy should be strongly considered in PD patients with suspicious UTUC if feasible.

Tumor multifocality and location are prognostic factors for upper tract urothelial carcinoma (UTUC). However, confounding effects can appear when these two factors are analyzed together. Therefore, we aimed to investigate the impact of tumor distribution on the outcomes of multifocal UTUC after radical nephroureterectomy. From the 2780 UTUC patients in the Taiwan UTUC Collaboration Group, 685 UTUC cases with multifocal tumors (defined as more than one tumor lesion in unilateral upper urinary tract) were retrospectively included and divided into three groups: multiple renal pelvic tumors, multiple ureteral tumors, and synchronous renal pelvic and ureteral tumors included 164, 152, and 369 patients, respectively. We found the prevalence of carcinoma in situ was the highest in the synchronous group. In multivariate survival analyses, tumor distribution showed no difference in cancer-specific and disease-free survival, but there was a significant difference in bladder recurrence-free survival. The synchronous group had the highest bladder recurrence rate. In summary, tumor distribution did not influence the cancer-specific outcomes of multifocal UTUC, but synchronous lesions led to a higher rate of bladder recurrence than multiple renal pelvic tumors. We believe that the distribution of tumors reflects the degree of malignant involvement within the urinary tract, but has little significance for survival or disease progression.

We sought to examine the effect of tumor location on the prognosis of patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU). This retrospective study came from the Taiwan UTUC Collaboration Group, which consisted of 2658 patients at 15 institutions in Taiwan from 1988 to 2019. Patients with kidney-sparing management, both renal pelvic and ureteral tumors, as well as patients lacking complete data were excluded; the remaining 1436 patients were divided into two groups: renal pelvic tumor (RPT) and ureteral tumor (UT), with 842 and 594 patients, respectively. RPT was associated with more aggressive pathological features, including higher pathological T stage (p < 0.001) and the presence of lymphovascular invasion (p = 0.002), whereas patients with UT often had synchronous bladder tumor (p < 0.001), and were more likely to bear multiple lesions (p = 0.001). Our multivariate analysis revealed that UT was a worse prognostic factor compared with RPT (overall survival: HR 1.408, 95% CI 1.121–1.767, p = 0.003; cancer-specific survival: HR 1.562, 95% CI 1.169–2.085, p = 0.003; disease-free survival: HR 1.363, 95% CI 1.095–1.697, p = 0.006; bladder-recurrence-free survival: HR 1.411, 95% CI 1.141–1.747, p = 0.002, respectively). Based on our findings, UT appeared to be more malignant and had a worse prognosis than RPT.

The clinical efficacy of adjuvant chemotherapy in upper tract urothelial carcinoma (UTUC) is unclear. We aimed to assess the therapeutic outcomes of adjuvant chemotherapy in patients with advanced UTUC (pT3-T4) after radical nephroureterectomy (RNU). We retrospectively reviewed the data of 2108 patients from the Taiwan UTUC Collaboration Group between 1988 and 2018. Comprehensive clinical features, pathological characteristics, and survival outcomes were recorded. Univariate and multivariate Cox proportional hazards models were used to evaluate overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS). Of the 533 patients with advanced UTUC included, 161 (30.2%) received adjuvant chemotherapy. In the multivariate analysis, adjuvant chemotherapy was significantly associated with a reduced risk of overall death (hazard ratio (HR), 0.599; 95% confidence interval (CI), 0.419–0.857; p = 0.005), cancer-specific mortality (HR, 0.598; 95% CI, 0.391–0.914; p = 0.018), and cancer recurrence (HR, 0.456; 95% CI, 0.310–0.673; p < 0.001). The Kaplan–Meier survival analysis revealed that patients receiving adjuvant chemotherapy had significantly better five-year OS (64% vs. 50%, p = 0.002), CSS (70% vs. 62%, p = 0.043), and DFS (60% vs. 48%, p = 0.002) rates compared to those who did not receive adjuvant chemotherapy. In conclusion, adjuvant chemotherapy after RNU had significant therapeutic benefits on OS, CSS, and DFS in advanced UTUC.

Purpose To explore the association between chronic prostatitis (CP) and the subsequent development of benign prostatic hyperplasia (BPH). Methods Data analyzed were medical claims of Taiwan’s National Health Insurance program. From 2010 to 2017, 3571 patients ≧20 years with CP diagnosed by certified urologists were enrolled. Patients with past BPH diagnosis and diagnosis of prostate cancer, inguinal hernia, interstitial cystitis, and urethritis in the past and within one year after the first CP diagnosis were excluded. Age-matched controls were randomly selected from all non-CP individuals of the same exclusion criteria in the study period with a CP/non-CP ratio of 1:4. The follow-up was made from the first CP diagnosis to death or the end of 2018. The endpoint was the newly diagnosed BPH. Cox proportional hazard regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of BPH in association with CP. Results Over a maximum of 8 years of follow-up, 287 (8.03%) and 258 (0.43%) BPH events were noted for the CP and non-CP group, respectively, representing a covariate adjusted HR (aHR) of 4.30 (95% CI, 3.61–5.13). Younger patients tended to suffer from higher aHRs, especially those aged 20–39 years (aHR: 11.45, 95% CI, 5.12–25.64). Conclusion The Taiwan national health database indicated that CP patients had a significantly higher risk of developing BPH later than non-CP patients. Interestingly, the younger the CP is diagnosed (under 40), the greater the risk.

Urothelial carcinomas of the upper urinary tract (UTUC) are rare tumors with a high malignancy degree. Radical nephroureterectomy (RNU) with bladder cuff excision remains one of the standard treatments in clinically localized or locally advanced UTUCs. However, the role of cytoreductive RNU in treating clinically lymph node-positive (N+) UTUCs remains unclear. A nationwide retrospective study was conducted by the Taiwan UTUC Collaboration Group from July 1988 to June 2022. Patients with clinical N + UTUC before initiation of cancer therapy were included in this study. Initial clinically node-positive disease was noted in 288 (5.4%) of the 5,301 patients. Of the patients, 239 (83%) patients underwent RNU. UTUC-related mortality was markedly higher among patients not receiving RNU than among those who underwent surgery (69.4% vs. 36%). After adjusting for the effects of stepwise enrolled parameters, multivariate analysis showed that undergoing RNU (or not) and smoking (or not) were the only independent predictors of overall survival (OS). After adjusting for the effects of significant stepwise enrolled variables, multivariate analysis showed that RNU and smoking (or not) were the only independent predictors of cancer-specific survival (CSS). Our findings showed that RNU is associated with better OS and CSS in Taiwanese patients with N + UTUC. Common patient characteristics and most cancer characteristics were not related to the outcome. Our results provide new evidence on the efficacy of RNU for patients with N + UTUC, which could alter and guide the direction of future treatment guidelines.

Background Nephroureterectomy with bladder cuff excision is the standard treatment for high-risk upper urinary tract urothelial carcinoma (UTUC). The role of minimally invasive surgery in treating locally advanced UTUC remains controversial. This study aimed to compare the outcomes of open , laparoscopic , and robotic surgeries for managing locally advanced UTUC. Methods We retrospectively reviewed 705 patients with locally advanced UTUC from multiple institutions throughout Taiwan. Perioperative outcomes and oncological outcomes, such as cancer-specific survival , overall survival , disease-free survival and bladder-free survival , were compared between the open, laparoscopic and robotic groups. Results The minimally invasive group had better overall and cancer-specific survival (CSS) rates. The 2-year CSS rates of the open, laparoscopic and robotic groups were 71%, 83%, and 77% respectively ( p  < 0.001). The robotic group had similar outcomes to the laparoscopic group. ( p  = 0.061, 0.825, 0.341 for OS, CSS, DFS respectively.) More lymph node dissections were performed and more lymph nodes were harvested in the robotic group ( p  = 0.009). Conclusions Our results demonstrated that minimally invasive surgery, including laparoscopic and robotic surgery, for locally advanced UTUC resulted in oncological outcomes that are non-inferior to those of open surgery.

Background In mammals, Eag K + channels (K V 10) are exclusively expressed in the brain and comprise two isoforms: Eag1 (K V 10.1) and Eag2 (K V 10.2). Despite their wide presence in various regions of the brain, the functional role of Eag K + channels remains obscure. Here we address this question by characterizing the subcellular localization of rat Eag1 (rEag1) and rat Eag2 (rEag2) in hippocampal neurons, as well as determining the structural basis underlying their different localization patterns. Results Immunofluorescence analysis of young and mature hippocampal neurons in culture revealed that endogenous rEag1 and rEag2 K + channels were present in both the dendrosomatic and the axonal compartments. Only rEag1 channels displayed a punctate immunostaining pattern and showed significant co-localization with PSD-95. Subcellular fractionation analysis further demonstrated a distinct enrichment of rEag1 in the synaptosomal fraction. Over-expression of recombinant GFP-tagged Eag constructs in hippocampal neurons also showed a significant punctate localization of rEag1 channels. To identify the protein region dictating the Eag channel subcellular localization pattern, we generated a variety of different chimeric constructs between rEag1 and rEag2. Quantitative studies of neurons over-expressing these GFP-tagged chimeras indicated that punctate localization was conferred by a segment (A723-R807) within the proximal post-cyclic nucleotide-binding homology domain (post-CNBHD) region in the rEag1 carboxyl terminus. Conclusions Our findings suggest that Eag1 and Eag2 K + channels may modulate membrane excitability in both the dendrosomatic and the axonal compartments and that Eag1 may additionally regulate neurotransmitter release and postsynaptic signaling. Furthermore, we present the first evidence showing that the proximal post-CNBHD region seems to govern the Eag K + channel subcellular localization pattern.

This study applies the Theory of Planned Behavior (TPB) to examine how environmental education affects consumers’ willingness to purchase organic agricultural products. A questionnaire survey of 266 participants in Tainan City, Taiwan, provided the data for analysis using structural equation modeling (SEM). The results show that attitude, subjective norms, and perceived behavioral control each have a significant and positive influence on behavioral intention. Among these, attitude has the strongest impact, suggesting that favorable evaluations of organic products and greater environmental awareness are key factors shaping consumers’ willingness to buy them. Based on these findings, several practical implications are proposed. Public agencies and schools may strengthen environmental education programs to cultivate sustainable consumption habits. Businesses should emphasize transparent information and credible green marketing to increase consumer trust. In addition, policy support, such as financial incentives or better market access, could reduce barriers to purchasing organic products and promote more sustainable consumer behavior.

This study developed an integrated model linking experiential value, experience quality, customer satisfaction, and customer loyalty to examine the psychological process and behavioral responses of food truck consumers. Using Structural Equation Modeling (SEM) with 363 valid samples, the results indicated good model fit. Experiential value positively influenced experience quality, and both experience quality and satisfaction significantly influenced loyalty. The direct effect of experience quality on loyalty was insignificant, confirming the full mediating role of satisfaction. These findings highlight that satisfaction is the key mechanism transforming perceived quality into loyalty behavior. The study validates the “experience–satisfaction–loyalty” framework and offers practical insights for food truck operators, emphasizing experience design and experience quality management as effective strategies to enhance customer satisfaction and long-term brand loyalty.