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권태균,최재영,김태환,양정덕,서장수 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.5
Purpose: We report our initial experience with transurethral injection of autologous adipose-derived regenerative cells (ADRCs) for the treatment of urinary incontinence after radical prostatectomy. Materials and Methods: After providing written informed consent, six men with persistent urinary incontinence after radical prostatectomy were enrolled in the study. Under general anesthesia, about 50 mL of adipose tissue was obtained from the patients by liposuction. ADRCs were obtained by separation with centrifugation using the Celution cell-processing device. A mixture of ADRCs and adipose tissue were transurethrally injected into the submucosal space of the membranous urethra. Functional and anatomical improvement was assessed using a 24-h pad test, validated patient questionnaire, urethral pressure profile, and magneticresonance imaging (MRI) during 12-week follow-up. Results: Urine leakage volume was improved with time in all patients in the 24-h pad test, with the exemption of temporal deteriorationat the first 2 weeks post-injection in 2 patients. Subjective symptoms and quality of life assessed on the basis of questionnaireresults showed similar improvement. The mean maximum urethral closing pressure increased from 44.0 to 63.5 cm H2O at 12 weeks after injection. MRI showed an increase in functional urethral length (from 6.1 to 8.3 mm) between the lower rim of the pubicbone and the bladder neck. Adverse events, such as pelvic pain, inflammation, or de novo urgency, were not observed in any case during follow-up. Conclusion: This study demonstrated that transurethral injection of autologous ADRCs can be a safe and effective treatment modalityfor postprostatectomy incontinence.
방광이행세포암종에서 종양억제유전자 부위의 Microsatellite Instability와 p53 유전자의 돌연변이 분석
권태균,정성광,김법완,김진아,김정완 경북대학교 병원 2001 경북대학교병원의학연구소논문집 Vol.5 No.1
Purprose: The objectives of this study is to eveluate the role of microsatellite instability(MI) and p53 gene inactivation in transitional cell carcinoma(TCC) of the bladder. Meterials and Methods: TOtal 31 cases of TCC patients, not treated with radiation or anticancer chemotherapy, were included in this study.Fifteen out of 31 patients were superficial and 16 were invasive TCC according to pathologic stage, while 16 were low grade and 15 were high grade TCC according to Ash grading system.The presence of MI was investigated in 3 loci of 9p site(D9S162, IFNA,D9S1747), and 6 loci of 17p site(D17S261, D17S513, D17S654, D17S695,D17S796, TP53) using a method based on the polymerase chain reaction(PCR).And the p53 point mutations were detected using polymerase chain reaction-single stranded conformation polymorphism(PCR-SSCP)analysis.The p53 protein overexpression was determined by immunohistochemical stain using DO-7 parimary antibody on formalin fixed, paraffin embedded tissue sections. Results: On MI anaylsis, altered band pattern were detected in 16 of 31 case (51.6%) in 9p region and 15 of 31 cases(48.4%) in 17p region.MI of the 9p region showed no association with tumor grade or stage.MI of the 17p site also showed no difference between superficial and invasive tumor group,but were higher in high grade(73.3%) than low grade tumor group(25.0%).On PCR-sscp analysis, total 8 mutations were found in 6 cases(19.4%) and 4 of 8 mutations (50%) were at exon 8.On immunohchemical staining, p53 nuclear overexpressions were found in 18 cases(58.1%)and more common in high grade and invasive tumor group(p<0.05). Fifteen out of 18 cases(83.3%) showed MI of the 9p or 17p regions. Conclusions: These results suggest that the p16 alterations may associated with high grade/invasive tumor.And DNA mismatch repair system may play an important role in tumorigenesis of bladder tumor.MI analysis can be a useful method to detect early genetic alterations in transitional cell carainoma of the bladder.(Korean J Urol 1999;40:1449~58)