Ja Hyeon Ku

Potential differentiation of human mesenchymal stem cell transplanted in rat corpus cavernosum toward endothelial or smooth muscle cells

One of the causes of erectile dysfunction (ED) is the damaged penile cavernous smooth muscle cells (SMCs) and sinus endothelial cells (ECs). To investigate the feasibility of applying immortalized human mesenchymal stem cells (MSCs) to penile cavernous ECs or SMCs repair in the treatment of ED, the in vivo potential differentiation of the immortalized human MSCs toward penile cavernous endothelial or smooth muscle was investigated. One clone of immortalized human bone marrow mesenchymal stem cell line B10 cells via retroviral vector encoding v-myc were transplanted into the cavernosum of the Sprague–Dawley rats and harvested 2 weeks later. The expression of CD31, von Willebrand factor (vWF), smooth muscle cell actin (SMA), calponin and desmin was determined immunohistochemically in rat penile cavernosum. Multipotency of B10 to adipogenic, osteogenic or chondrogenic differentiation was found. Expression of EC specific markers (CD31 or vWF protein) and expression of SMC specific markers (calponin, SMA or desmin protein) were demonstrated in grafted B10 cells. When human MSCs were transplanted into the penile cavernosum, they have the potential to differentiate toward ECs or SMCs. Human MSCs may be a good candidate in the treatment of penile cavernosum injury.

Health-related quality of life and sexual function in women with stress urinary incontinence and overactive bladder

Background:  We evaluated the impact of stress urinary incontinence (SUI) and overactive bladder (OAB) on health‐related quality of life (HRQOL) and sexual function.

Effect of subclinical prostatic inflammation on serum psa levels in men with clinically undetectable prostate cancer

OBJECTIVES To examine whether subclinical prostatic inflammation might influence serum prostate-specific antigen (PSA) levels in men with clinically undetectable prostate cancer. METHODS A total of 461 patients who underwent prostate biopsy at our hospital were studied between January 1996 and December 1999. Of these patients, a total of 125 patients without detectable prostate cancer or a history or symptoms of prostatitis, with serum PSA levels of less than 20.0 ng/mL and other specified exclusion criteria, were included in the study. Inflammation observed at biopsy was scored for inflammation extent and inflammatory aggressiveness, and the effects of these morphologic aspects of inflammation on serum PSA levels were examined. RESULTS The extent of inflammation tended to increase as the prostate volume increased (P = 0.006). Patients with a PSA greater than 2.5 ng/mL had a greater extent and aggressiveness of inflammation than those with PSA levels of 2.5 ng/mL or less (P = 0.004 and P = 0.050, respectively). However, no statistically significant differences were found in terms of the extent of inflammation or inflammatory aggressiveness between patients with PSA levels greater than 4.0 ng/mL and those with PSA levels of 4.0 ng/mL or less. Furthermore, the extent of inflammation did not account for PSA levels greater than 2.5 or 4.0 ng/mL by multivariate analysis. CONCLUSIONS Our results indicate that subclinical prostatic inflammation is not the etiology of a serum PSA greater than 4.0 ng/mL in men without clinically detectable prostate cancer.

TMPRSS2-ERG Gene Fusion and Clinicopathologic Characteristics of Korean Prostate Cancer Patients

OBJECTIVES To survey the status of TMPRSS2-ERG fusion in Korean prostate cancer patients, we assessed the differences in clinicopathologic characteristics and biochemical recurrence according to TMPRSS2-ERG fusion status. METHODS The incidence of the TMPRSS2-ERG fusion gene was evaluated via fluorescence in situ hybridization (FISH) using ERG break-apart probes in 254 prostate cancer tissues resected by radical prostatectomy, and analyses of clinicopathologic parameters and biochemical recurrence were conducted. RESULTS The fusion rate of the TMPRSS2-ERG gene was 20.9% (53/254). TMPRSS2-ERG gene fusion was identified more frequently in patients with low Gleason grade (primary Gleason pattern ≤ 3 or sum of Gleason score ≤ 7, P = .015 and .027). Patients with large cribriform glands in Gleason pattern 4 harbored a rare TMPRSS2-ERG fusion gene compared with patients without large cribriform glands (P = .027). The incidence of biochemical recurrence did not differ according to TMPRSS2-ERG fusion gene status (P = .598). CONCLUSIONS ERG gene aberration did not correlate with biochemical recurrence of prostate cancers in Korean patients. Lower Gleason grade demonstrated higher rates of TMPRSS2-ERG fusion compared with high-grade tumors, including those demonstrating a large cribriform glands pattern. Prostate cancer with large cribriform glands revealed rare TMPRSS2-ERG gene fusion.

Correlation between prostatic urethral angle and bladder outlet obstruction index in patients with lower urinary tract symptoms.

OBJECTIVES To evaluate the association of prostatic urethral angle (PUA) with bladder outlet obstruction (BOO) index in men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). METHODS A retrospective analysis was made of 260 men with LUTS and/or BPH aged>50 years (median: 65.9, range: 50-87). Patients underwent an evaluation including the International Prostatic Symptom Score, serum prostate-specific antigen levels, transrectal ultrasonography, frequency-volume chart, uroflowmetry, and measurement of postvoid residual, and multichannel video urodynamic study with a pressure-flow study. RESULTS Patients with higher PUA (PUA>or=35 degrees) had higher prostate-specific antigen levels (P=.043), larger prostate volume (P<.001), higher maximal urethral closure pressure (P=.004), higher detrusor pressure at maximum flow rate (P=.008), and higher BOO index (P=.032), in comparison with those who had lower PUA (PUA<35 degrees). There was no significant difference of PUA values according to the degree of intravesical prostatic protrusion. When we compared BOO index according to PUA, patients with higher PUA had higher BOO index than those with lower PUA (30.6+/-1.8 vs 23.6+/-1.8, P=.006). The area under the curve of PUA was significant for BOO (area, 63.0%; 95% confidence interval, 55.1%-70.9%; P=.002). CONCLUSIONS PUA may be one method to asses the presence of BOO in men with LUTS and/or BPH. Our findings suggest that PUA may help in the treatment of individuals by better predicting their likely classification from a pressure-flow study.

Metastasectomy without Systemic Therapy in Metastatic Renal Cell Carcinoma: Comparison with Conservative Treatment

Aim: The objective of this study was to evaluate the efficacy of metastasectomy after nephrectomy in patients with metastatic renal cell carcinoma who had not received systemic therapy. Patients and Methods: A total of 62 patients were included in the study. The patients were categorized according to their surgical treatment: the metastasectomy group (n = 21) and the nonmetastasectomy group (n = 41). Results: In the metastasectomy group, the median overall survival was 36.5 (range 4.0–182.7) months, whereas the patients of the nonmetastasectomy group reached a median overall survival of 8.4 (range 0.9–63.7) months (p < 0.001). The 1-, 3-, and 5-year overall survival rates were calculated at 71.4 and 34.1%, 47.6 and 9.8%, and 9.8 and 2.4%, respectively (p < 0.001). When the patients were stratified according to their characteristics, the overall survival was lower in the nonmetastasectomy group than in the metastasectomy group in the younger patients (p = 0.002), in both male (p = 0.001) and female (p = 0.030) patients, in patients with a poor performance status (p = 0.027), in patients with a shorter time between diagnosis of the primary tumor and development of metastases (p < 0.001), and in patients with a solitary metastasis (p = 0.005). Multivariate analysis using the Cox proportional hazards model showed that only the metastasectomy status was an independent predictor of the overall survival (Hazard ratio 2.57, 95% confidence interval 1.21–5.44; p = 0.014). Conclusion: Our findings suggest that for the management of metastatic renal cell carcinoma, complete surgical resection of the metastatic lesions may prolong survival even in patients with some poor prognostic factors who cannot or are not willing to receive systemic therapy.

Human neural crest stem cells transplanted in rat penile corpus cavernosum to repair erectile dysfunction

To investigate the feasibility of applying neural crest stem cells (NCSCs), with multipotent capacity, to repair injury in the penile cavernosum, the HNC10.K10 (K10) immortalized NCSC line was transplanted into the penile cavernosum of adult rats, as one of the causes of erectile dysfunction is damaged penile cavernous smooth muscle cells and sinus endothelial cells.

Bladder cancer after nephroureterectomy in patients with urothelial carcinoma of the upper urinary tract

OBJECTIVES To determine the independent risk factors of bladder recurrence in patients with upper urinary tract (UUT) urothelial carcinoma (UC). MATERIALS AND METHODS A total of 181 patients with UUT-UC were enrolled in this study. Their median age was 63 years (range 36-90), and median follow-up after total nephroureterectomy was 37.5 months (range 1.0-174.0). The end-point of this study was defined as the initial intravesical recurrence of UC. RESULTS Of the 181 patients, 64 (35.4%) developed subsequent bladder tumors at a median interval of 6.3 months (range 1.7-50.1) after initial treatment. By univariate analysis, a previous bladder tumor history (P = 0.046) and tumor necrosis (P < 0.001) were found to have a significant prognostic impact on bladder tumor-free survival in patients with superficial UUT-UC, whereas surgical margin status (P = 0.045) and the use of adjuvant chemotherapy (P = 0.003) were found to be prognostic factors for bladder tumor-free survival in those with invasive UUT-UC. However, by multivariate analysis, only tumor necrosis (P = 0.012, relative risk = 6.512) was found to have a significant impact on intravesical recurrence in patients with superficial UUT-UC. However, surgical margin status (P = 0.007, relative risk = 5.846) and the use of adjuvant chemotherapy (P = 0.001, relative risk = 0.223) were retained as independent predictors of bladder tumor survival in those with invasive UUT-UC. CONCLUSIONS Our findings may be useful in patients with UUT-UC who may require more stringent follow-up by cystoscopy to detect bladder tumors.

The role of apoptosis in the pathogenesis of varicocele

blebbing, nuclear condensation, and fragmentation in the form of vesicles called ‘apoptotic bodies’ [3]. Many pathways result in apoptosis, and these processes appear to be regulated on three levels [4]. In the cell membrane, specific membrane receptors mediate the death signals of the TNF receptor family, which consists of Fas and the Fas ligand. At the cytoplasmic level, signal transduction pathways involving cysteine proteases called caspases are also involved. Finally, at the nuclear level, specific apoptotic regulatory genes, including p53 and Bcl-2 , also exert regulatory effects on apoptosis.

Late recurrence of renal cell carcinoma >5 years after surgery: clinicopathological characteristics and prognosis

Study Type – Therapy (case series)