[Show abstract][Hide abstract] ABSTRACT: Stem cell-based therapies represent new promises for the treatment of urinary incontinence. This study was performed to assess optimized cell passage number, cell dose, therapeutic efficacy, feasibility, toxicity, and cell trafficking for the first step of the pre-clinical evaluation of human amniotic fluid stem cell (hAFSC) therapy in a urinary incontinence animal model.
The proper cell passage number was analyzed with hAFSCs at passages 4, 6, and 8 at week 2. The cell dose optimization included 1×10⁴, 1×10⁵, and 1×10⁶ cells at week 2. The in vivo cell toxicity was performed with 0.25×10⁶, 0.5×10⁶, and 1×10⁶ cells at weeks 2 and 4. Cell tracking was performed with 1×10⁶ cells at weeks 2 and 4.
The selected optimal cell passage number was smaller than 6, and the optimal cell dose was 1×10⁶ for the mouse model. In our pre-clinical study, hAFSC-injected animals showed normal values for several parameters. Moreover, the injected cells were found to be non-toxic and non-tumorigenic. Furthermore, the injected hAFSCs were rarely identified by in vivo cell trafficking in the target organs at week 2.
This study demonstrates for the first time the pre-clinical efficacy and safety of hAFSC injection in the urinary incontinence animal model and provides a basis for future clinical applications.
Yonsei medical journal 05/2015; 56(3):648-57. DOI:10.3349/ymj.2015.56.3.648 · 1.29 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We conducted this study to evaluate the combined effect of acellular bladder submucosa matrix (BSM) and autologous urethral tissue for the treatment of long segment urethral stricture in a rabbit model. To prepare the BSM, porcine bladder submucosa was processed, decellularized, configured into a sheet-like shape, and sterilized. Twenty rabbits were randomized to normal control, urethral stricture, urethroplasty using BSM only or BSM/autologous urethral tissue (n=5 per group). Retrograde urethrography was performed at 4, 8, and 12 weeks postoperatively, and the grafted specimens were harvested at week 12 to evaluate urethral reconstruction through histopathologic and immunohistochemical analysis. The mean urethral width of the control, stricture, BSM, and BSM/autologous urethral tissue groups at week 12 was 10.3±0.80, 3.8±1.35, 8.8±0.84, and 9.1±1.14 mm, respectively. The histopathologic study revealed that the BSM/autologous urethral tissue graft had a normal area of urethral lumen, compact muscular layers, complete epithelialization, and progressive infiltration by vessels in the regenerated urethra. In contrast, the BSM grafts revealed keratinized epithelium, abundant collagenized fibrous connective tissue, and were devoid of bundles of circular smooth muscle. Nontransected ventral onlay-augmented urethroplasty using an acellular BSM scaffold combined with an autologous urethral tissue graft represents a feasible procedure for urethral reconstruction.
Journal of Korean Medical Science 03/2015; 30(3):301-7. DOI:10.3346/jkms.2015.30.3.301 · 1.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Trichomonas vaginalis, a causative agent of trichomoniasis, may trigger symptomatic or asymptomatic nongonococcal urethritis and chronic prostatitis in men. Despite the availability of highly sensitive diagnostic tests, such as nucleic acid amplification tests, including PCR, few prospective studies present data on male T. vaginalis infection in South Korea. In the present study, the prevalence of T. vaginalis and associated clinical conditions were evaluated in 201 male patients from a primary care urology clinic in South Korea. The prevalence of T. vaginalis infection in our cohort was 4% (8/201) by PCR. T. vaginalis infection was common in men older than 40 years (median age, 52 years). Among the 8 Trichomonas-positive patients, 87.5% (7/8) had prostatic diseases, such as prostatitis and benign prostatic hyperplasia, and 25.0% (2/8) and 12.5% (1/8) were coinfected with Chlamydia trachomatis and Mycoplasma genitalium, respectively. Our results suggest that T. vaginalis infection is not rare in men attending primary care urology clinics in South Korea, especially in those older than 40 years, in whom it may explain the presence of prostatic disease. The possibility of T. vaginalis infection should be routinely considered in older male patients with prostatic diseases in South Korea.
The Korean Journal of Parasitology 10/2014; 52(5):551-5. DOI:10.3347/kjp.2014.52.5.551 · 1.15 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Aim:
We present the oncologic outcomes of laparoscopic nephroureterectomy management of pT3 upper urinary tract urothelial carcinoma.
Between October 2003 and January 2011, 50 patients with pT3 upper urinary tract urothelial carcinoma which had pathologically confirmed underwent laparoscopic nephroureterectomy at our institution. Demographic data, perioperative results, pathological findings and oncologic outcomes were reviewed and analyzed retrospectively.
There were 36 patients (72%) of high grade lesion and 14 patients (28%) of low grade lesion. Lymphovascular invasion was observed in 16 patients (32%) and the surgical margin was positive in one patient. N stage was pN0 in 16 (32%), pN1 in 3 (6%), pN2 in 1 (2%) and pN3 in 1 (2%). The 5-year overall survival rate was 52.6% and the 5-year cancer-specific survival rate was 65.3%. Overall recurrence developed in 23 patients. There were 10 patients (20%) of urothelial recurrence which were all occurred in the bladder at the mean period of 13.6 months, and 7 patients of them were invasive bladder cancer. There were 16 patients (32%) of non-urothelial recurrence developed at the mean period of 9.69 months. On multivariate analyses lymphadenopathy and lymph node involvement of cancer (N+) were identified as independent predictive factors for the cancer-specific survival, and concomitant bladder tumor, grade and lymphovascular invasion were identified as independent predictive factors for the overall recurrence free survival.
Laparoscopic nephroureterectomy in patients with high stage upper urinary tract urothelial carcinoma appear comparable to those of open surgery in the regard of oncologic outcomes.
Minerva urologica e nefrologica = The Italian journal of urology and nephrology 09/2014; 66(3):159-66. · 0.97 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective
To investigate whether a triple combination of early-differentiated cells derived from human amniotic fluid stem cells (hAFSCs) would show synergistic effects in urethral sphincter regeneration. Materials and Methods
We early-differentiated hAFSCs into muscle, neuron and endothelial progenitor cells and then injected them into the urethral sphincter region of pudendal neurectomized ICR mice, as single-cell, double-cell or triple-cell combinations. Urodynamic studies and histological, immunohistochemical and molecular analyses were performed. ResultsUrodynamic study showed significantly improved leak point pressure in the triple-cell-combination group compared with the single-cell- or double-cell-combination groups. These functional results were confirmed by histological and immunohistochemical analyses, as evidenced by the formation of new striated muscle fibres and neuromuscular junctions at the cell injection site. Molecular analysis showed higher target marker expression in the retrieved urethral tissue of the triple-cell-combination group. The injection of early-differentiated hAFSCs suppressed in vivo host CD8 lymphocyte aggregations and did not form teratoma. The nanoparticle-labelled early-differentiated hAFSCs could be tracked in vivo with optical imaging for up to 14 days after injection. Conclusion
Our novel concept of triple-combined early-differentiated cell therapy for the damaged sphincter may provide a viable option for incontinence treatment.
BJU International 05/2014; 114(5). DOI:10.1111/bju.12815 · 3.53 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The bladder is an organ susceptible to a variety of congenital anomalies, injuries, and disorders. To address the clinical limitations of existing scaffolds, we fabricated a novel scaffold that can be applied to morphological and functional bladder reconstruction. As a first step to prove the benefit of the scaffold, intensive in vitro and in vivo analyses were conducted. The novel composite scaffold was fabricated using polycaprolactone/Pluronic F127 (PCL/F127) and variable proportions (1, 3, 5 and 10 wt%) of porcine acellular bladder submucosa matrix (BSM). Physicochemical properties and biocompatibilities of the scaffolds were characterized. For cell-mediated analysis, upper urinary tract-derived stem cells (uUSCs) were used. Observations of tensile strength, modulus, porosity, cell adhesion, viability, and proliferation characteristics of scaffolds indicated that the optimum proportion of BSM in the composite scaffolds was 3 or 5 wt%. Based on comparison of 3 and 5 wt% BSM/PCL/F127 scaffolds with respect to degradability, hydrophilicity, surface properties, and functional group presence, the 3 wt% BSM was chosen for in vivo studies. Eight weeks after kidney-subcapsular implantation of the 3 wt% BSM/PCL/F127 scaffold, cells remained attached to the surface and there was no evidence of teratomas. A BSM content of 3 wt% was the optimum proportion for fabrication of the neo scaffold. We expected that the 3 wt% BSM/PCL/F127 composite scaffold would act as an ideal matrix after cystectomy based on its favorable physicochemical properties and biocompatibilities.
[Show abstract][Hide abstract] ABSTRACT: To report our early experience with thermo-expandable urethral stents (Memokath) for the management of recurrent urethral stricture and to assess the efficacy of urethral stents.
Between March 2012 and February 2013, 13 patients with recurrent urethral stricture after several attempts with direct visual internal urethrotomy (DVIU) or failed urethroplasty underwent DVIU with thermally expandable, nickel-titanium alloy urethral stent (Memokath) insertion. Follow-up study time points were at 1, 3, 6, 9, and 12 months after stent insertion. Follow-up evaluation included uroflowmetry, retrograde urethrogram, plain radiography, and urinalysis.
The mean patient age was 47.7 years (range, 18 to 74 years). The mean urethral stricture length was 5.54 cm (range, 1 to 12 cm). There were six patients with bulbar, four patients with proximal penile, one patient with distal penile, and two patients with whole penile urethral strictures, respectively. The overall success rate was 69% (9/13) and the mean postoperative peak flow rate was 17.7 mL/s (range, 6 to 28 mL/s). Major complications occurred in four patients including one patient (7.7%) with urethrocutaneous fistula induced by the stent and three patients with urethral hyperplasia. The mean follow-up duration was 8.4 months.
Our initial clinical experience indicates that thermo-expandable stents can be another temporary management option for recurrent urethral stricture patients who are unfit for or refuse urethroplasty. Distal or whole penile urethral stricture can be factors predicting poor results.
Korean journal of urology 12/2013; 54(12):851-7. DOI:10.4111/kju.2013.54.12.851
[Show abstract][Hide abstract] ABSTRACT: Objective:
Preoperative percutaneous nephrostomy (PCN) has been commonly performed for patients with urinary stones complicated with pyelonephritis or obstructive uropathy; in fact, a considerable number of patients undergo ureteroscopic removal of stone (URS) in the presence of a PCN. We assessed the effectiveness of PCN during URS in the management of upper ureteral stones.
Patients and methods:
We retrospectively analyzed 140 patients who underwent URS for upper ureteral stones between January 2008 and December 2011. All URS were performed by a single experienced surgeon. The subjects were divided into two groups depending on the presence of a PCN at the time of the surgery (PCN group: 42 and non-PCN group: 98). The PCN group was subdivided into two groups depending on the performance of external fluid irrigation through PCN during the surgery (irrigation group: 21 and non-irrigation group: 21). To evaluate operative outcomes, we compared operative times, auxiliary procedures required, and success and complication rates.
The PCN group showed significantly better outcomes in terms of the operative time (57.4 minute vs. 68.1 minute) and success rate (92.9% vs. 78.6%) without increasing the complication rate. In the PCN group, the irrigation group showed a shorter operative time compared to the non-irrigation group, although statistical significance was not observed. Other perioperative outcomes, such as the success rate, auxiliary procedures, and complication rates, were not significantly different between the two groups.
URS for upper ureteral stones in patients with PCN produced superior surgical outcomes in terms of the success rate, operative time, and auxiliary procedure rate without increasing the complication rate. The presence of PCN with/without external irrigation during URS can be a beneficial factor to produce better outcomes of URS for the management of upper ureteral stones.
Journal of endourology / Endourological Society 07/2013; 27(10). DOI:10.1089/end.2013.0347 · 1.71 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A key challenge to the industrial application of nanotechnology is the development of fabrication processes for functional devices based on nanomaterials which can be scaled up for mass production. In this report, we disclose the results of non-thermal radio-frequency (rf) atmospheric pressure plasma (APP) based deposition of TiO2 nanoparticles on a flexible substrate for the fabrication of dye-sensitized solar cells (DSSCs). Operating at 190 °C without a vacuum enclosure, the APP method can avoid thermal damage and vacuum compatibility restrictions and utilize roll-to-roll processing over a large area. The various analyses of the TiO2 films demonstrate that superior film properties can be obtained by the non-thermal APP method when compared with the thermal sintering process operating at 450 °C. The crystallinity of the anatase TiO2 nanoparticles is significantly improved without thermal agglomeration, while the surface defects such as Ti(3+) ions are eliminated, thus providing efficient charge collecting properties for solar cells. Finally, we successfully fabricated a flexible DSSC with an energy conversion efficiency of 4.2% using a transparent plastic substrate. This work demonstrates the potential of non-thermal APP technology in the area of device-level, nano-enabled material manufacturing.
[Show abstract][Hide abstract] ABSTRACT: To evaluate the outcomes of sling transection in treating obstructive voiding symptoms after transobturator sling surgery and the recurrence rates of stress urinary incontinence after 5-year follow-up.
Between January 2004 and March 2006, we retrospectively reviewed 461 patients who underwent the transobturator sling procedure. Of 461 patients, 28 patients (6.1%) underwent transection of suburethral sling tape under local anesthesia and followed up for at least 5 years after sling transection. We analyzed the overall success rates and recurrence rates of stress urinary incontinence using uroflowmetry with post-void residual measurement, 5 cm visual analogue scale for assessment of postoperative goal achievement, obstructive domain of International Prostate Symptom Score (IPSS) and quality of life (QoL).
Mean maximal urinary flow and post-void residual were 21.8 ± 4.1 mL/s and 38.8 ± 3.4 mL at 5-year follow-up after sling transection. The mean 5 cm visual analogue scale, O-IPSS and IPSS QoL scores were 4.3 ± 1.4, 2.8 ± 2.9, and 2.3 ± 1.9, respectively, at 5-year follow-up. The objective and subjective success rates were 100% and 68%. Six patients (24%) redeveloped stress urinary incontinence.
According to our long-term (≥ 5 years) follow-up results, the transection of suburethral sling tape is a simple and effective method to treat obstructive symptoms after the transobturator sling procedure.
[Show abstract][Hide abstract] ABSTRACT: Several studies have demonstrated the superiority of endorectal coil magnetic resonance imaging (MRI) over pelvic phased-array coil MRI at 1.5 Tesla for local staging of prostate cancer. However, few have studied which evaluation is more accurate at 3 Tesla MRI. In this study, we compared the accuracy of local staging of prostate cancer using pelvic phased-array coil or endorectal coil MRI at 3 Tesla.
Between January 2005 and May 2010, 151 patients underwent radical prostatectomy. All patients were evaluated with either pelvic phased-array coil or endorectal coil prostate MRI prior to surgery (63 endorectal coils and 88 pelvic phased-array coils). Tumor stage based on MRI was compared with pathologic stage. We calculated the specificity, sensitivity and accuracy of each group in the evaluation of extracapsular extension and seminal vesicle invasion.
Both endorectal coil and pelvic phased-array coil MRI achieved high specificity, low sensitivity and moderate accuracy for the detection of extracapsular extension and seminal vesicle invasion. There were statistically no differences in specificity, sensitivity and accuracy between the two groups.
Overall staging accuracy, sensitivity and specificity were not significantly different between endorectal coil and pelvic phased-array coil MRI.
Yonsei medical journal 05/2012; 53(3):550-6. DOI:10.3349/ymj.2012.53.3.550 · 1.29 Impact Factor