• Animal cells and systems
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• v.14 no.4
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• pp.237-244
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• 2010

Stress urinary incontinence (SUI) is a common condition that primarily affects women. Here, we investigate the effects of human adipose-derived stem cells (ADSCs) in a rodent model of SUI. Female Sprague-Dawley rats at 7 weeks of age were randomly divided into three groups (n=8 per group): sham-operation, SUI-induction by transabdominal urethrolysis, and SUI-induction followed by transplantation of human ADSCs into the urethra. The abdominal leak point pressure at 8 weeks after the operation was markedly decreased by transabdominal urethrolysis, confirming successful induction of SUI. Interestingly, transplantation of human ADSCs into the urethra significantly blunted the decrease of abdominal leak point pressure in SUI-induced rats. Accordingly, we observed expression of ${\alpha}$-smooth muscle actin in a significant proportion of transplanted ADSCs, indicating differentiation of ADSCs into smooth muscle cells in the urethra. Moreover, the SUI-induced elevations of c-Fos immunoreactivities in the pontine micturition center (PMC) and in the ventrolateral periaqueductal gray (vlPAG) were clearly suppressed by transplantation of human ADSCs. These results imply that human ADSCs can be an effective therapeutic modality to ameliorate the symptoms of SUI.

• Journal of Biomedical Engineering Research
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• v.44 no.1
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• pp.85-91
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• 2023

Stress urinary incontinence (SUI) occurs when abdominal pressure increases, such as sneezing, exercising, and laughing. Surgical and non-surgical treatments are the common methods of SUI treatment; however, the conventional treatments still require continuous and invasive treatment. Laser have been used to treat SUI, but excessive temperature increase often causes thermal burn on urethra tissue. Therefore, the optimal conditions must be considered to minimize the thermal damage for the laser treatment. The current study investigated the feasibility of the laser irradiation condition for SUI treatment using non-ablative 980 nm laser from a safety perspective through numerical simulations. COMSOL Multiphysics was used to analyze the numerical simulation model. The Pennes bioheat equation with the Beer's law was used to confirm spatio-temporal temperature distributions, and Arrhenius equation defined the thermal damage caused by the laser-induced heat. Ex vivo porcine urethral tissue was tested to validate the extent of both temperature distribution and thermal damage. The temperature distribution was symmetrical and uniformly observed in the urethra tissue. A muscle layer had a higher temperature (28.3 ℃) than mucosal (23.4 ℃) and submucosal layers (25.5 ℃). MT staining revealed no heat-induced collagen and muscle damage. Both control and treated groups showed the equivalent thickness and area of the urethral mucosal layer. Therefore, the proposed numerical simulation can predict the appropriate irradiation condition (20 W for 15 s) for the SUI treatment with minimal temperature-induced tissue.

• Journal of Veterinary Clinics
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• v.21 no.3
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• pp.264-269
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• 2004

A retrospective analysis was performed with 270 cases of canine urolithiasis examined at Laboratory of Clinical Pathology, College of Veterinary Medicine, Seoul Nat'l University in the period between January 2001 and December 2003. The Shih-Tzu (64 cases), Yorkshire terrier (60 cases), miniature schnauzer (41 cases) and maltese terrier (36 cases) had higher incidences than other breeds. Canine urolithiasis occurred from 4 months to 15 years of age, but the most prevalent age was 3 years. Mean age was $5.68\pm3.14$ years. The major mineral component. of calculi was struvite (54.1%) and calcium oxalate (30.4%). There was no sex prevalences: male 131 cases, female 132 cases. The most prevalent anatomic locations of calculi were urinary bladder (53 of 131 cases), urethra (24 of 131 cases) and bladder/urethra (45 of 131 cases) in males and urinary bladder (103 of 132 Cases) in females. The major mineral component of calculi in urinary bladder was struvite (102 of 160 cases), and that in urethra (13 of 25 cases) and multiple locations (29 of 62 cases) was calcium oxalate: The major components of calculi were not always consistent with the components which could be expected from urine pH and crystals. So it is suggested that the components of the calculi must be analyzed after surgical removal to prevent the recurrence when the calculi could not be dissolved by diets or urine pH modifiers.

• Archives of Reconstructive Microsurgery
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• v.25 no.1
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• pp.19-24
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• 2016

Urethral reconstruction is a problematic issue, thus its management can be challenging. Different methods using various materials were introduced for urethral reconstruction. The authors have made some changes in the groin flap surgery, affording more successful urethral reconstruction for defects of long urethra and penile soft tissue. A 45-year-old male requested both functional and cosmetic reconstruction of his defected penis, caused by an iatrogenic urethral injury and chronic infection following removal of paraffin self-injected on the penile shaft. The defect affected the full length of the penile urethra, corpus spongiosum, and prepuce. A groin flap was designed, measuring $28{\times}10cm$. The most distal flap was utilized for the construction of the luminal surface of the neourethra; relaxed length measuring 8 cm, and the lumen wide enough. Competent external meatus and neourethra was confirmed by retrograde cystogram and the patient voided with sufficient urine caliber up to 2 years follow-up. This operative technique has advantages. Donor sites have non-hair bearing skin for the neourethra and minimal or almost notrecognizable donor site morbidity. After surgery, the patient was relieved from voiding difficulties combined with psychological stress. The author would like to introduce a unique approach for the urethral and ventral phalloplasty using the groin flap.

• Archives of Plastic Surgery
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• v.49 no.3
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• pp.448-452
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• 2022

Total reconstruction of the penis (TPR) represents a challenge for urologists and plastic surgeons, especially when urethral length is severely reduced. We here describe, for the first time in an oncologic scenario, a double flap phalloplasty using a pedicled anterolateral thigh (ALT) flap for penile reconstruction and a radial forearm free flap (RFFF) for complete neourethra and glans reconstruction following penile amputation. A 48-year-old patient came to our department following a total penectomy with inferior urethral derivation. The indication for a double flap phalloplasty was posed as only way to fully reconstruct the urethra on its length avoiding possible complications of single flap reconstruction using tube-into-tube technique. Both flaps healed uneventfully with no neourethral strictures or fistulas described. At 18 months follow-up, the patient was extremely satisfied with the aesthetic result and was able to void in standing position. We think that a double free tissue transfer for TPR should be considered, particularly when a urethral length > 14 cm needs to be reconstructed. While the pedicled ALT can be used to reconstruct a proper penile shaft with an easily concealed scar, the RFFF can provide adequate neourethra length with satisfactory sensory recovery at the neoglans.

• Journal of Veterinary Clinics
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• v.8 no.1
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• pp.93-101
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• 1991

Experimental obstruction of urethra was induced for 66 hours on 5 male dogs to determine the diagnostic value of ECG and blood chemical values. The results obtained in the examination were summarized as follows ; 1. Changes of ECG, blood chemical values and clinical sings were observed from 30 hours after urethral obstruction. 2. In ECG, the peaked and amplitude of T wave were increased remarkably. p wave were decreased, and intervals of PR(Q) and QRS complex were prolonged after urethral obstruction. 3. The levels of BUN, potassium, creatinine in serum after urethral obstruction were increased remarkably and correlation between these levels and the increase of amplitude in T wave were recognized to be significant.

• Journal of Korean Medical classics
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• v.28 no.4
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• pp.79-97
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• 2015

Objectives : To research origin of the shape of vital gate(命門) in Yixuerunmen makes us understand more exactly what the author, Li Chan(李梴) thought vital gate shaped. Methods : It's shape described in his book was compared with pictures portraying it in Hua Tuo Xuan Men Nei Zhao Tu(華陀玄門內照圖), one of references of his book. Results : He reasonably modified its passing track, while explaining it according to the paintings in Hua Tuo Xuan Men Nei Zhao Tu. Vital gate, as he thought, was not an real organ like the other five viscera, but a cord or a tube similar to blood vessels. He believed its cord had long connections from pericardium to terminal of urethra, which went through pericardium upward, right kidney downward, right around terminal rectum down-frontward, and urethra in parallel outward. Conclusions : He had consistent understandings for vital gate to penetrate several different viewpoints, as based on pictures in Hua Tuo Xuan Men Nei Zhao Tu.

• Journal of Veterinary Clinics
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• v.24 no.2
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• pp.288-291
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• 2007

Hypospadias is a malformation in which the urethra open on the ventral side of the penis and its frequency is about from 0.3% to 0.5% male birth in human. It is considered a disorder both genetic and environmental factors involves in pathogenesis. A KNC(Korean native calf) showing symptoms of fusion defect of the male ventral urethra, penile defect, bifid scrotum and low body weigh was born. To prevent an ascending urinary tract infection, dermatitis and loss of hair, surgical operation was performed to make a genitals like a female. After the operation, the KNC got a regenerative hair and normal urination. However the KNC became anorexia, loss in weight and weak. Seventy days after birth, the KNC died. The view of autopsy was a yellowish hepatomegaly, hydronephrosis, closed ureter and complex disorder in interanl organ. The symptoms of hepatomegaly and hydronephrosis could be due to a fluid therapy as a consequence of ureter obstruction. The normal urination of the KNC before it got sick, suggested that ureter obstruction in the case of this KNC was formed at its postnatal growth stage.

• Journal of Veterinary Clinics
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• v.39 no.1
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• pp.16-22
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• 2022

A 12-year-old spayed female beagle dog was presented with pollakiuria and stranguria. Abdominal ultrasonography identified irregular a marginated, hyperechoic mass in the urethra and trigon area of the bladder. Computed tomography (CT) revealed a heterogeneous mass in the trigone area leading to a urethra. There was no evidence of regional or distant metastasis. Cytologic analysis suspected transitional cell carcinoma (TCC). The patient was treated with piroxicam, mitoxantrone, and once weekly fractionated radiation therapy (RT) with volumetric modulated arc therapy (VMAT). A follow-up CT scan at 6 months after RT revealed a reduction in tumor size. At 17 months after the start of RT, the patient became severely anorectic and lethargic. Ultrasound examination revealed a hyperechoic mass in the apex area of bladder while the trigone area of the bladder and urethra appeared normal. Multiple hypoechoic nodules of various sizes were found in the liver and spleen. The patient was humanely euthanized at the request of the owner. A combination of piroxicam, mitoxantrone, and hypofractionated RT with VMAT protocol was well tolerated. This case described tumor response and survival time of a canine TCC treated with piroxicam, mitoxantrone, and once weekly palliative RT using computer-assisted planning and VMAT.

• Archives of Plastic Surgery
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• v.50 no.6
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• pp.578-585
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• 2023

An artificial sphincter implanted in the bulbous urethra to treat severe postprostatectomy urinary incontinence is effective, but embedding-associated complications can occur. We assessed the feasibility, efficacy, and safety of urethral graciloplasty cross-innervated by the pudendal nerve. A simulation surgery on three male fresh cadavers was performed. Both ends of the gracilis muscle were isolated only on its vascular pedicle with proximal end of the obturator nerve severed and transferred to the perineum. We examined whether the gracilis muscle could be wrapped around the bulbous urethra and whether the obturator nerve was long enough to suture with the pudendal nerve. In addition, surgery was performed on a 71-year-old male patient with severe urinary incontinence. The postoperative 12-month outcomes were assessed using a 24-hour pad test and urodynamic study. In all cadaveric simulations, the gracilis muscles could be wrapped around the bulbous urethra in a γ-loop configuration. The length of the obturator nerve was sufficient for neurorrhaphy with the pudendal nerve. In the clinical case, the postoperative course was uneventful. The mean maximum urethral closure pressure and functional profile length increased from 40.7 to 70 cm H₂O and from 40.1 to 45.3 mm, respectively. Although urinary incontinence was not completely cured, the patient was able to maintain urinary continence at night. Urethral graciloplasty cross-innervated by the pudendal nerve is effective in raising the urethral pressure and reducing urinary incontinence.