[show abstract][hide abstract] ABSTRACT: TO EVALUATE THE EFFICACY AND SAFETY OF THE HOLMIUM: yttrium-aluminium-garnet (YAG) laser for the treatment of urethral/bladder neck strictures after high-intensity focused ultrasound for prostate cancer.
Between February 2007 and July 2010, Holmium: YAG laser urethrotomies were performed in eleven patients for bladder neck strictures or prostatic urethral strictures. The laser was used with a 550-µm fiber at 2 J and frequency 30 to 50 Hz. The medical records were retrospectively reviewed for medical history, perioperative and postoperative data, uroflowmetry, International Prostate Symptoms Score/quality of life, and stricture recurrence.
At a median follow-up of 12.0 months (range, 4 to 35 months), the mean postoperative maximal flow rate and residual volume were improved significantly (P<0.05). The mean postoperative total, voiding and quality of life of international prostate symptom score were improved significantly (P<0.05). Of the 11 patients, 7 patients required one treatment, 4 patients two treatment, and 1 patients three treatment. 2 patients who had a documented urinary incontinence prior to the laser treatment subsequently required artificial urinary sphincter implantation and reported satisfaction without developing any recurrent strictures or artificial urinary sphincter erosion. All patients exhibited well-healed strictures and could void without difficulty.
HOLMIUM: YAG laser therapy represents a safe, effective and minimally invasive treatment for urethral/bladder neck strictures occurring secondary to high-intensity focused ultrasound for prostate cancer.
International neurourology journal 03/2013; 17(1):24-9.
[show abstract][hide abstract] ABSTRACT: Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for many nosocomial and community-acquired infections, resulting in significant morbidity and mortality. A practical way to limit the spread of MRSA is early detection and proper treatment. However, screening culture for MRSA typically requires 2-3 days. The Xpert MRSA assay (Cepheid, Sunnyvale, CA, USA) is a real-time polymerase chain reaction-based assay developed for screening an MRSA-specific DNA sequence within the staphylococcal cassette chromosome in 2 h. Lower respiratory tract specimens, such as transtracheal aspirates (TTAs) and bronchoalveolar lavage fluid (BALF), are commonly obtained from intubated patients. Therefore, using the lower respiratory tract specimens with the Xpert MRSA assay may be a practical tool for patient care. We performed the Xpert MRSA assay on 108 TTA and 21 BALF specimens from 92 patients and compared the results to those obtained by culture. The two assays showed concordant results in 120 (93.0%) cases and discordant results in 9 (7.0%) cases, which were culture‑negative and Xpert MRSA-positive. Among the discordant cases, 5 patients developed culture-positive samples 2-15 days after the Xpert MRSA detected MRSA. We conclude that the Xpert MRSA assay is a rapid, sensitive and clinically useful test, particularly for the early detection of MRSA.
Molecular Medicine Reports 10/2012; · 1.17 Impact Factor
[show abstract][hide abstract] ABSTRACT: INTRODUCTION AND HYPOTHESIS: Extracorporeal biofeedback was developed to reduce patient discomfort when performing strengthening exercises. The efficacy and safety of extracorporeal biofeedback combined with pelvic floor muscle training (PFMT) for the treatment of female stress urinary incontinence (SUI) were evaluated. METHODS: One hundred and six participants with SUI were enrolled in a 12-week PFMT program using extracorporeal biofeedback intervention. A standard pad test was performed, and pelvic floor muscle strength was assessed using the Oxford scale. Measurements were taken with a perineometer at baseline and at a 12-week follow-up visit. An objective cure was defined as less than 2 g of urine leakage by the standard pad test. The long-term effects of extracorporeal biofeedback and PFMT were investigated by interviewing the participants 12 months after treatment. RESULTS: Seventy-one participants completed the 12-week extracorporeal biofeedback intervention. The objective cure rate was 52.1 %, and there was a significant reduction in pad weight over the time period. The incontinence visual analogue scale, the Sandvik severity index, and the incontinence quality-of-life questionnaire domains were significantly improved after treatment (p < 0.001). The strength of the PFM was significantly increased after the 12-week treatment. After PFMT, 64.3 % of 56 participants reported good treatment compliance, and 24 participants (42.9 %) had continued PFMT at home 12 months after treatment. Age and baseline pad weight were negative predictive factors for an objective cure of SUI. CONCLUSIONS: Pelvic floor muscle training using extracorporeal biofeedback can be an effective and safe conservative treatment option for female SUI without the discomfort caused by vaginal sensors.
International Urogynecology Journal 09/2012; · 2.17 Impact Factor
[show abstract][hide abstract] ABSTRACT: We evaluated symptom specific goal achievement, and the correlations between goal achievement and traditional outcome measures after pharmacological therapy in patients with benign prostatic obstruction.
Men 50 years old or older with lower urinary tract symptoms secondary to benign prostatic obstruction and International Prostate Symptom Score 8 or greater were enrolled and treated with 10 mg alfuzosin XL for 12 months. Before treatment, face-to-face interviews were conducted to identify the single most bothersome symptoms and to set treatment goals for the symptoms in individual patients. After treatment, patients described perceptions of goal achievement using a 5-point Likert scale. Changes in International Prostate Symptom Score/quality of life score, International Continence Society male short form questionnaire, 3-day voiding diary and uroflowmetry parameters were analyzed to evaluate the correlations between goal achievement and traditional outcome measures.
Of 108 most bothersome symptoms slow stream (26.9%) was the most frequently reported followed by increased daytime frequency (21.3%) and nocturia (19.4%). After treatment the median score of goal achievement was 3 points with no significant difference among most bothersome symptoms. Changes in quality of life score (correlation coefficient -0.247, p=0.020) and maximal flow rate (correlation coefficient 0.254, p=0.021) were correlated with goal achievement. For men with most bothersome symptoms of storage, changes in the number of micturition and urgency episodes per 24 hours were correlated with goal achievement. For men with most bothersome symptoms of voiding the International Prostate Symptom Score voiding score was correlated with goal achievement.
Assessing goal achievement for most bothersome symptoms can be a useful outcome measure in patients with benign prostatic obstruction with heterogeneous symptoms or goals reflecting change in quality of life.
The Journal of urology 03/2011; 185(3):1003-9. · 4.02 Impact Factor
[show abstract][hide abstract] ABSTRACT: We investigated the relationship between ultrasound estimated bladder weight/corrected ultrasound estimated bladder weight and the bladder outlet obstruction index derived from pressure flow study to evaluate its diagnostic efficacy to predict bladder outlet obstruction.
A total 193 men older than 50 years with lower urinary tract symptoms were enrolled in this study. Ultrasound estimated bladder weight measurements were made with a 3-dimensional ultrasound system. Corrected bladder weight was defined as ultrasound estimated bladder weight divided by body surface area on data analysis. The study population was classified into obstructed and unobstructed groups (bladder outlet obstruction index 40 or greater and less than 40, respectively). We evaluated the correlation between bladder outlet obstruction and clinical parameters, including bladder weight/corrected bladder weight and the diagnostic accuracy of bladder weight/corrected bladder weight for bladder outlet obstruction.
A total of 50 (26%) and 143 patients (74%) were categorized as obstructed and nonobstructed, respectively. Corrected bladder weight, maximum urine flow and the bladder contraction index showed statistically significant differences between the groups. Bladder weight/corrected bladder weight positively correlated with the bladder outlet obstruction index and corrected bladder weight showed a stronger correlation. Corrected bladder weight was significantly increased depending on obstruction severity. When corrected bladder weight was used to diagnose obstruction, sensitivity, specificity, and positive and negative predictive values were 61.9%, 59.8%, 33.8% and 82.6%, respectively, at a 28 gm/m(2) cutoff.
Ultrasound estimated bladder weight/corrected ultrasound estimated bladder weight is a statistically significant parameter correlating with bladder outlet obstruction. However, bladder weight/corrected bladder weight alone was insufficient to predict bladder outlet obstruction due to its weak correlation with and low accuracy for diagnosing obstruction.
The Journal of urology 03/2011; 185(3):964-9. · 4.02 Impact Factor
[show abstract][hide abstract] ABSTRACT: Endothelin (ET)-1 and its receptors (ETA and ETB receptor) are present in the central nervous system. ET exerts biological effects on gliogenesis and glial cell functions. In order to define a possible mechanism of ETA receptor signaling, the distribution of the ETA receptor in developing oligodendrocytes and the effects of ET-1 on the myelination of oligodendrocytes were examined. ETA receptor immunoreactivity was confined to the perivascular elements of the blood vessels during early postnatal development. However later in development, ETA receptor immunoreactivity was no longer observed in the vessels but became localized to the myelinating oligodendrocytes of the primitive corpus callosum of the white matter, apart from the vessels. ET-1 induced myelin basic protein (MBP) in primary oligodendrocyte precursor cell culture though the ETA receptor and was blocked by an ETA receptor antagonist. In addition, ET-1 evoked the release of Ca(2+) which is a central regulator of oligodendrocyte differentiation. Our results provide a link between ET-1 and its ETA receptor and myelination during oligodendrocyte differentiation.
Journal of Korean medical science 01/2011; 26(1):92-9. · 0.84 Impact Factor
[show abstract][hide abstract] ABSTRACT: We evaluated the efficacy of transurethral injection (TUI) for the treatment of recurrent or persistent stress urinary incontinence after mid-urethral sling (MUS) procedures.
A retrospective study was conducted among 23 women who had undergone TUI for failed MUS using bulking agents, Macroplastique® and Durasphere®. The Sandvik questionnaire, Subjective Symptom Visual Analogue Scale (VAS), Incontinence Quality of Life (I-QOL) assessment, and Benefit, Satisfaction, and Willingness to Continue questionnaire were used to evaluate the efficacy of TUI.
The cure rate was 34.8% for a median follow-up of 10 months. Subjective symptom VAS, total, and all domains of I-QOL scores were significantly improved after TUI. Ninety-two percent of the patients reported a benefit and 77% of the patients were satisfied with the treatment.
TUI for failed MUS demonstrated a low cure rate but high patient satisfaction, and the procedure was minimally invasive with no significant complications.
International Urogynecology Journal 12/2010; 21(12):1479-83. · 2.17 Impact Factor
[show abstract][hide abstract] ABSTRACT: This prospective multicenter study was conducted to evaluate the efficacy and safety of an adjustable mid-urethral sling (MUS) using transobturator adjustable tape (TOA) in women with severe stress urinary incontinence or combined stress urinary incontinence (SUI) and voiding dysfunction (VD).
One day after placement of TOA, the tension was adjusted. Six months after surgery, changes in several questionnaires and uroflowmetry (UFM) parameters were evaluated.
Among the 65 women enrolled in the study, 27 (41.5%) required postoperative tension readjustments. At 6 months, the complete cure rate of SUI was 84.4%, and patient satisfaction with the operation was 86.2%. There was improvement in the total scores on several questionnaires. There were no significant changes in postoperative UFM parameters.
Our results support the use of TOA as an effective modality for the treatment of SUI in women at risk for persistent postoperative SUI or obstructive symptoms.
International Urogynecology Journal 10/2010; 22(3):341-6. · 2.17 Impact Factor
[show abstract][hide abstract] ABSTRACT: Based on the integral theory, tension-free placement of a mid-urethral sling (MUS) for female stress urinary incontinence (SUI) has gained substantial popularity owing to the ease of the procedure and its effectiveness. Published series with long-term follow-up show continence rates after the MUS procedure ranging from 70% to 80%. Complication rates after MUS procedures are usually low. This review aimed to describe the historical change and the current use of the MUS. We discuss the efficacy and complications of various MUS procedures and the current strategies for managing failed slings.
[show abstract][hide abstract] ABSTRACT: The adenomatous polyposis coli gene (APC) was initially identified through its link to colon cancer. It is associated with the regulation of cell cycle progression, survival, and differentiation of normal tissues. Recent studies have demonstrated that APC is also expressed in the adult brain at high levels. However, its role in glial cells under pathological progression remains unclear. In this study, we evaluated the expression of APC and its association with beta-catenin signaling pathway, following the induction of an excitotoxic lesion by kainic acid (KA) injection, which cause pyramidal cell degeneration. APC was predominantly present in oligodendrocytes in the normal brain, but was specifically associated with activated astrocytes in the KA-treated brain. Our quantitative analysis revealed that APC significantly increased from 1 day post lesion (PI), reached peak values at 3 days PI, and decreased thereafter. The phospho-GSK3beta levels also showed similar spatiotemporal patterns while beta-catenin expression was reduced at 1 and then increasingly returned to normal levels at 3, 7 days PI. For the first time, our data demonstrate the injury-induced astrocytic changes in the levels of APC, GSK3beta, and beta-catenin in vivo, which may actively be participate in cell adhesion and in the signaling pathway regulating cell survivals during brain insults.
Neurochemical Research 09/2009; 35(1):114-21. · 2.13 Impact Factor
[show abstract][hide abstract] ABSTRACT: Transferrin binding protein (TfBP) is a cytoplasmic glycoprotein that was originally isolated from the chick oviduct. As we previously demonstrated the constitutive expression of TfBP in the avian nervous system, in this study we examined whether TfBP is expressed in the reptilian nervous system. In accordance with previous findings in the chicken, oligodendrocytes were most prominently labeled by antiserum to TfBP. Great variability was observed between different regions of the central nervous system (CNS) in terms of TfBP-labeled oligodendrocyte numbers. In the retina, TfBP was localized specifically in the cells that are morphologically oligodendrocytes and present in the optic nerve and the ganglion cell layer. TfBP staining was also seen in the Schwann cells of peripheral nerves. Furthermore, choroid plexus cells and capillary endothelial cells similarly exhibited strong reactions. These results may reflect the fact that the homology of nervous system genes is conserved between close phylogenetic lines, and proove the potential of TfBP as a marker for oligodendrocytes in avian as well as reptile.
Archives of Histology and Cytology 03/2009; 72(1):65-76. · 0.60 Impact Factor
[show abstract][hide abstract] ABSTRACT: Ionizing radiation including I(131) might produce chromosomal translocation, causing hematologic malignancy. The incidence of leukemia following radioactive iodine treatment for thyroid cancer has been reported to be approximately 0.1 to 2.0% in Western countries, whereas fewer cases have been reported in Korea. We hereby report four cases of secondary hematologic malignancy, who received iodine therapy for thyroid cancer after thyroidectomy: two cases of acute lymphoblastic leukemia with t(9;22)(q34;q11.2), a case of MDS with 5q deletion, and a case of MDS with normal karyotype. Three cases of hematologic malignancy have developed after cumulative dosage of less than 800 mCi. The treatment intervals in two cases were less than 12 months, and the other two cases had I(131) therapy only once. Assessment of causality using the Naranjo probability scale for adverse drug reactions showed that a 'possible' relationship existed between the use of I(131) and secondary hematologic malignancy in all of the four cases in this report.
The Korean Journal of Laboratory Medicine 01/2009; 28(6):425-9. · 0.72 Impact Factor
[show abstract][hide abstract] ABSTRACT: The first examples of boronic acid-linked fluorescent and colorimetric chemosensors for copper ions are reported; the monoboronic acid-conjugated rhodamine probe displays a highly selective fluorescent enhancement with Cu2+ among the various metal ions whereas the fluorescence of the bisboronic acid-conjugated fluorescein probe is selectively quenched by Cu2+, probably by way of a PET mechanism.
Chemical Communications 01/2009; · 6.38 Impact Factor
[show abstract][hide abstract] ABSTRACT: The nonessential amino acid L-serine functions as a glia-derived trophic factor and strongly promotes the survival and differentiation of cultured neurons. The L-serine biosynthetic enzyme 3-phosphoglycerate dehydrogenase (Phgdh) and the small neutral amino acid transporter ASCT1 are preferentially expressed in specific glial cells in the brain. However, their roles in pathological progression remain unclear. We examined the expression of Phgdh and ASCT1 in kainic acid (KA)-induced neurodegeneration of the mouse hippocampus using immunohistochemistry and Western blots. Our quantitative analysis revealed that Phgdh and ASCT1 were constitutively expressed in the normal brain and transiently upregulated by KA-treatment. At the cellular level, Phgdh was expressed in astrocytes in control and in KA-treated mice while ASCT1 that was expressed primarily in the neurons of the normal brain appeared also in activated astrocytes in KA treated mouse brain. The preferential glial expression of ASCT1 was consistent with that of Phgdh. These results demonstrate injury-induced changes in Phgdh and ASCT1 expression. It is hypothesized that the secretion of L-serine is regulated by astrocytes in response to toxic molecules such as glutamate and free radicals that promote neurodegeneration, and may correspond to the level of L-serine needed for neuronal survival and glial activation during brain insults.
Neurochemical Research 09/2008; 34(5):827-34. · 2.13 Impact Factor
[show abstract][hide abstract] ABSTRACT: Astrocytes have been considered to be transformed from radial glial cells that appear at early stage of development and play a scaffold-role for neuronal cell migration. Recent studies indicate that neuroepithelial cells in the spinal cord also give rise to astrocytes. However, the mode of astroglial generation and migration in the ventricular neuroepithelium remains poorly understood. In this study, we have utilized immunohistochemical and retroviral lineage tracing methods to characterize the developmental profiles of astrocytes in the chick optic tectum, which develops from both the neural tube and invasion of optic tract. Chick vimentin and glial fibrillary acidic protein (GFAP) were found as single bands at molecular weights consistent with those reported for mammalian species. Differential developmental trends were observed for both proteins with relative vimentin levels decreasing and GFAP levels increasing with embryonic age. We observed two streams of tectal GFAP-labeled astrocytes originated from the tectal ventricle (intrinsic origin) and the optic tract (extrinsic origin). The extrinsic astrocytes arose from the ventral neuroepithelium of the third ventricle, dispersed bilaterally to the optic tract, and subsequently to the outer layer of optic tectum, indicating migration of astrocytes along retinal ganglion cell axons. On the other hand, the intrinsic astrocytes from the tectal ventricular neuroepithelium appeared first in the ventral part of the optic tectum, and then in the lateral and dorsal tectum. The intrinsic tectal astrocytes closely associated with fascicles of vimentin-labeled radial glial cells, indicating a presumptive radial migration of astrocytes. These results demonstrated that the optic tectum contains heterogeneous populations of astrocytes developed from the different origins and routes of migration.
Neurochemical Research 08/2008; 33(7):1346-55. · 2.13 Impact Factor
[show abstract][hide abstract] ABSTRACT: Transferrin-binding protein (TfBP) has been shown to be a novel protein, structurally related to the chicken heat shock protein 108. The physiological function of this protein, however, has not yet been established. Antiserum to TfBP selectively stains transferrin- and iron-rich oligodendrocytes and choroidal epithelium in the adult and embryonic chick brain, suggesting a role for this protein in transferrin and iron storage in these cells. In this study, we further demonstrate TfBP-immunoreactivity (IR) in the blood vessels of the embryonic chick central nervous system. A strong TfBP-IR was present in blood vessels from E6, declined from E10 and was absent by E18. Thus, the expression of the TfBP in the blood vessels precedes its expression in the oligodendrocytes. At the subcellular level, TfBP-IR was confined to the cytoplasm of capillary pericytes while the Tf-receptor IR was associated with the capillary endothelium of the brain. The up-regulated expression of TfBP, together with the Tf-receptor of the brain capillaries, suggests that pericytes may be associated with the high iron uptake required for the metabolic demands of the developing brain.
Neurochemical Research 06/2008; 33(11):2288-93. · 2.13 Impact Factor