Chih-Shou Chen

Identification of genetic alterations in upper urinary tract urothelial carcinoma in end-stage renal disease patients.

Clinical presentations of end‐stage renal disease (ESRD) patients on dialysis with upper urinary tract urothelial carcinoma (UUT‐UC) are different from those with normal renal function. The pathogenesis remains unknown. We investigated the pathogenetic influence of chromosomal aberrations in patient on dialysis with UUT‐UC. The chromosomal aberrations of UUT‐UC specimens from seven dialysis patients were assessed by conventional comparative genomic hybridization (cCGH). Subsequently, we further investigated 20 cases by whole genome and fine‐tiling oligonucleotide array‐based CGH to demonstrate gains and losses, and compared with the clinicopathologic background. The chromosomal aberrations in UUT‐UC specimens from dialysis patients were more complex than in bladder urothelial carcinoma (B‐UC). Our data showed that gains at 5p, 7, 19q, and losses at 4q, 9p, and 15q are common in UUT‐UC of ESRD patients. Gains in regions associated with DNA repair genes were noted in this study. High‐stage and high‐grade tumors displayed more copy number variants. In addition, female ESRD patients with UUT‐UC had more frequent chromosomal aberrations than their male counterparts. In conclusion, unique chromosomal aberrations were indentified in UUT‐UC in ESRD patients.

Evidences of the inflammasome pathway in chronic prostatitis and chronic pelvic pain syndrome in an animal model

The mechanism of non‐bacterial chronic prostatitis (CP/CPPS) has long been investigated but remains unclear. Under the hypothesis that abnormal response of innate immunity may be a cause of CP/CPPS, this study evaluated inflammasome, as part of innate immunity, and its effects on persist inflammation and CP/CPPS.

Effect of hyaluronic acid on urine nerve growth factor in cyclophosphamide-induced cystitis

Objectives:  To investigate how hyaluronic acid (HA) affects nerve growth factor (NGF) production and bladder overactivity in a cyclophosphamide (CYP)‐induced cystitis rat model.

Clinical observations of the effect of antidiuretic hormone on nocturia in elderly men

To evaluate the effect of desmopressin on nocturia, based on patients’ subjective scoring of nocturia, as desmopressin is widely used to treat nocturnal enuresis and nocturnal polyuria.

The Effects of Adipose-Derived Stem Cells in a Rat Model of Tobacco-Associated Erectile Dysfunction

Tobacco use is associated with erectile dysfunction (ED) via a number of mechanisms including vascular injury and oxidative stress in corporal tissue. Adipose derived stem cells (ADSC) have been shown to ameliorate vascular/corporal injury and oxidative stress by releasing cytokines, growth factors and antioxidants. We assessed the therapeutic effects of intracavernous injection of ADSC in a rat model of tobacco-associated ED. Thirty male rats were used in this study. Ten rats exposed to room air only served as negative controls. The remaining 20 rats were passively exposed to cigarette smoke (CS) for 12 weeks. At the 12-week time point, ADSC were isolated from paragonadal fat in all rats. Amongst the 20 CS exposed rats, 10 each were assigned to one of the two following conditions: (i) injection of phosphate buffered saline (PBS) into the corpora cavernosa (CS+PBS); or (ii) injection of autologous ADSC in PBS into the corpora cavernosa (CS+ADSC). Negative control animals received PBS injection into the corpora cavernosa (normal rats [NR] + PBS). After injections all rats were returned to their previous air versus CS exposure state. Twenty-eight days after injection, all rats were placed in a metabolic cage for 24-hour urine collection to be testing for markers of oxidative stress. After 24-hour urine collection all 30 rats also underwent erectile function testing via intracavernous pressure (ICP) testing and were then sacrificed. Corporal tissues were obtained for histological assessment and Western blotting. Mean body weight was significantly lower in CS-exposed rats than in control animals. Mean ICP, ICP /mean arterial pressure ratio, serum nitric oxide level were significantly lower in the CS+PBS group compared to the NR+PBS and CS+ADSC groups. Urine markers for oxidative stress were significantly higher in the CS+PBS group compared to the NR+PBS and CS+ADSC groups. Mean expression of corporal nNOS and histological markers for endothelial and smooth muscle cells was significantly lower, and tissue apoptotic index significantly higher, in the CS+PBS group compared to the NR+PBS and CS+ADSC groups. Our findings confirm that chronic tobacco exposure causes ultrastructural damage to the corporal tissue and increases systemic oxidative stress states. Treatment with ADSC ameliorates these adverse effects and holds promise as a potential therapy for tobacco-related ED.

Pilot Study on the Effect of Composite UmayC in Catheter-Associated Lower Urinary Tract Infection

Purpose: Previous studies showed that cranberries and related products may play a role in the prevention of urinary tract infection. The objective of this study is to investigate composite UmayC, a cranberry composite with the herbal extract Acrobio TS® and Acrobio GL®, in its effectiveness for catheter-associated lower urinary tract infection in an animal model. Materials and Methods: A catheter was inserted into the bladder of rats with or without bacterial suspension. The rats were randomly assigned to the treated or the control group, which, respectively, received or did not receive UmayC in chowder diet. The voiding pattern was recorded using a metabolic cage. Spleen lysate cytokines were measured in both groups with Western blot analysis. Results: The voiding pattern remained nearly the same in UmayC-treated rats, even when they had a bacterial suspension-filled catheter inserted. The most significant cytokine changes in these rats were decreased spleen interleukin-10 and interleukin-6, which may indicate a diminished host response to infection under UmayC herbal composite treatment. Conclusions: UmayC herbal composite can reduce bladder irritation caused by catheter-related infection. The host immune response to infection may also be altered and improved by the preventive effectiveness of Acrobio TS- and Acrobio GL-composited cranberry.

Performing laparoscopic radical cystectomy is feasible for the elderly with marginal cardiopulmonary function

Purpose: The purpose of this study was to report the feasibility, safety, and benefits of laparoscopic radical cystectomy (LRC) for patients with bladder cancer (BC) who are older than 75 years and with marginal cardiopulmonary function in a regional teaching hospital. Materials and Methods: The charts of thirty patients who underwent LRC between 2013 and 2016 in a community teaching hospital were reviewed. The patients were subgrouped into the age groups ≥75 years and <75 years. Data extracted from the charts included patient demographics, American Society of Anesthesiologists (ASA) Score, Charlson Comorbidity Index (CCI) Score, cardiopulmonary function test result, pathological results, conversion rate, operative time, Intensive Care Unit days, and postoperative recovery time. Results: A significant difference was observed in the data of the group ≥75 years group compared with the <75 years group, with a higher ASA score (P = 0.0007) and higher rate of marginal cardiopulmonary function (80% vs. 26.7%, P = 0.0092). No significant difference was observed in sex, CCI score (3.93 vs. 3.27), body mass index (24.8 vs. 24.4), ejection fraction (69% vs. 70.97%), operation time (473 vs. 465 min), blood loss (503 vs. 380 mL), urinary diversion type, Intensive Care Unit care (1.13 vs. 0.6 days), interval to ambulation (2 vs. 1.8 days), interval to oral food intake (3.2 vs. 2.6 days), interval to normal bowel function (4.6 vs. 3.6 days), postoperative hospitalization (15.67 vs. 11.67 days), and blood transfusion rate (33.3% vs. 26.7%) between the two groups. No conversion to open surgery or mortality was observed. Surgical complications occurred in 15 patients, with a complication rate of 50%. No surgical mortality was noted in 30 or 90 days. Most pathological cases revealed urothelial carcinoma. Conclusions: LRC is a safe option with favorable outcomes in BC patients older than 75 years with marginal cardiopulmonary function in a regional teaching hospital.

Partial Bladder Outlet Obstruction: Bladder Dysfunction and Related Issues in Animal Studies

Bladder dysfunction following partial bladder outlet obstruction (PBOO) is a frequent consequence of benign prostate enlargement in aging males. Bladder dysfunction also occurs in both postmenopausal women and women with PBOO, and results from various etiologies such as anti-incontinence surgery or pelvic organ prolapse. These problems can be attributed to bladder outlet obstruction induced by secondary detrusor functional changes. In addition, PBOO often occurs in children with congenital abnormalities in the lower urinary tract, and leads to voiding dysfunction. Animal models of PBOO are useful for understanding many aspects of the pathophysiologic process. In this review, we describe the studies of bladder dysfunction and related issues based on animal models of PBOO.

Application of Transrectal Power Doppler Ultrasound in the Prediction of Corrected Maximal Uroflow Rate

Background A reliable interpretation of uroflowmetry depends on adequate voiding volume. Unfortunately, many patients may not be in a position to void enough volume to allow an effective interpretation. The main objective of this study was to determine how a valuable uroflow rate can be obtained with an inadequate or even no voiding volume. We have tried to develop a new method to predict the actual uroflow rate by adding power Doppler information during transrectal ultrasound (TRUS) in patients who do not have an interpretable voiding volume. Patients and Methods Fifty-five patients with complete uroflowmetry and TRUS with power Doppler study were enrolled. Analyses of the uroflowmetry and power Doppler parameters were performed. Correlation coefficients were calculated to reveal the relationships among these parameters. Results The correlation coefficient between the prostate intracapsular pulsatility index (PI) and corrected peak flow rate (cQ max ) was —0.79. Correlation between the PI of vessels outside the prostate and cQ max was not significant, as the intracapsular PI was. We generated a linear regression equation, cQ max = 0.8911 × PI + 14.569, to predict cQ max by intracapsular PI. This equation can be applied when adequate spontaneous voiding is not available. Conclusion TRUS is informative when power Doppler parameters are applied. Corrected peak uroflow rate can be predicted even in patients who have an inadequate or no voiding volume.