2.Alum Irrigation for the Treatment of Intractable Haematuria
Christopher Chee Kong Ho ; Zulkifli Md Zainuddin
Malaysian Journal of Medical Sciences 2009;16(4):66-68
Managing intractable haematuria is a daunting task. One cause of this condition is radiationinduced
haemorrhagic cystitis. Several treatments for the condition have been proposed and one
non-invasive option is alum irrigation. Here, we report on a 65-year-old woman with intractable
haematuria secondary to radiation cystitis who was successfully treated with alum irrigation. Alum
irrigation is safe, well tolerated and relatively cheap. A review of the literature and a comprehensive
discussion on alum irrigation as treatment for haematuria is discussed here to create an awareness
regarding this treatment option.
4.Ketamine-Associated Ulcerative Cystitis: A Case Report and Literature Review
Christopher Chee Kong Ho ; Hafez Pezhman ; Singam Praveen ; Eng Hong Goh ; Boon Cheok Lee ; Md Zainuddin Zulkifli ; Mohamed Rose Isa
Malaysian Journal of Medical Sciences 2010;17(2):61-65
Ketamine can be abused as a recreational drug, and there has been a recent surge in its
usage. The effects of ketamine on the urinary system were unknown until the recent publication
of a few case reports. Many doctors are still unaware of this new clinical entity, termed ketamineassociated
ulcerative cystitis. We report a case that we encountered and discuss the diagnosis and
disease management in addition to a review of the literature.
5.Men's Health Index: A Pragmatic Approach to Stratifying and Optimizing Men's Health.
Hui Meng TAN ; Wei Phin TAN ; Jun Hoe WONG ; Christopher Chee Kong HO ; Chin Hai TEO ; Chirk Jenn NG
Korean Journal of Urology 2014;55(11):710-717
PURPOSE: The proposed Men's Health Index (MHI) aims to provide a practical and systematic framework for comprehensively assessing and stratifying older men with the intention of optimising their health and functional status. MATERIALS AND METHODS: A literature search was conducted using PubMed from 1980 to 2012. We specifically looked for instruments which: assess men's health, frailty and fitness; predict life expectancy, mortality and morbidities. The instruments were assessed by the researchers who then agreed on the tools to be included in the MHI. When there was disagreements, the researchers discussed and reached a consensus guided by the principle that the MHI could be used in the primary care setting targetting men aged 55-65 years. RESULTS: The instruments chosen include the Charlson's Combined Comorbidity-Age Index; the International Index of Erectile Function-5; the International Prostate Symptom Score; the Androgen Deficiency in Aging Male; the Survey of Health, Ageing and Retirement in Europe Frailty Instrument; the Sitting-Rising Test; the Senior Fitness Test; the Fitness Assessment Score; and the Depression Anxiety Stress Scale-21. A pilot test on eight men was carried out and showed that the men's health index is viable. CONCLUSIONS: The concept of assessing, stratifying, and optimizing men's health should be incorporated into routine health care, and this can be implemented by using the MHI. This index is particularly useful to primary care physicians who are in a strategic position to engage men at the peri-retirement age in a conversation about their life goals based on their current and predicted health status.
Aging/*physiology
;
*Health Status
;
Humans
;
Life Expectancy/*trends
;
Male
;
Men's Health/*standards/*trends
6.Aging Male Symptoms Scale (Ams) For Health-Related Quality Of Life In Aging Men: Translation And Adaptation In Malay
Hui Meng Tan ; Wah Yun Low ; Seng Fah Tong ; Jamaiyah Haniff ; Geeta Appannah ; Verna K.M. Lee ; Ee Ming Khoo ; Chirk Jenn Ng ; Christopher Chee Kong Ho
Malaysian Journal of Public Health Medicine 2015;15(2):17-23
The Aging Male Symptoms Scale (AMS) measures health-related quality of life in aging men. The objective of this paper is to describe the translation and validation of the AMS into Bahasa Melayu (BM). The original English version of the AMS was translated into BM by 2 translators to produce BM1 and BM2, and subsequently harmonized to produce BM3. Two other independent translators, blinded to the English version, back-translated BM3 to yield E2 and E3. All versions (BM1, BM2, BM3, E2, E3) were compared with the English version. The BM pre-final version was produced, and pre-tested in 8 participants. Proportion Agreement, Weighted Kappa, Spearman Rank Correlation Coefficient, and verbatim responses were used. The English and the BM versions showed excellent equivalence (weighted Kappa and Spearman Rank Coefficients, ranged from 0.72 to 1.00, and Proportion Agreement values ranged from 75.0% to 100%). In conclusion, the BM version of the AMS was successfully translated and adapted.
7.Human Adipose Tissue Derived Stem Cells as a Source of Smooth Muscle Cells in the Regeneration of Muscular Layer of Urinary Bladder Wall
Salah Abood Salem ; Angela Ng Min Hwei ; Aminuddin Saim ; Christopher Ho Chee Kong ; Ismail Sagap ; Rajesh Singh ; Mohd Reusmaazran Yusof ; Zulkifili Md Zainuddin ; Ruszymah Hj Idrus
Malaysian Journal of Medical Sciences 2013;20(4):80-87
Background: Adipose tissue provides an abundant source of multipotent cells, which represent a source of cell-based regeneration strategies for urinary bladder smooth muscle repair. Our objective was to confirm that adipose-derived stem cells (ADSCs) can be differentiated into smooth muscle cells.
Methods: In this study, adipose tissue samples were digested with 0.075% collagenase, and the resulting ADSCs were cultured and expanded in vitro. ADSCs at passage two were differentiated by incubation in smooth muscle inductive media (SMIM) consisting of MCDB I31 medium, 1% FBS, and 100 U/mL heparin for three and six weeks. ADSCs in non-inductive media were used as controls. Characterisation was performed by cell morphology and gene and protein expression.
Result: The differentiated cells became elongated and spindle shaped, and towards the end of six weeks, sporadic cell aggregation appeared that is typical of smooth muscle cell culture. Smooth muscle markers (i.e. alpha smooth muscle actin (ASMA), calponin, and myosin heavy chain (MHC)) were used to study gene expression. Expression of these genes was detected by PCR after three and six weeks of differentiation. At the protein expression level, ASMA, MHC, and smoothelin were expressed after six weeks of differentiation. However, only ASMA and smoothelin were expressed after three weeks of differentiation.
Conclusion: Adipose tissue provides a possible source of smooth muscle precursor cells that possess the potential capability of smooth muscle differentiation. This represents a promising alternative for urinary bladder smooth muscle repair.
Adipose Tissue
;
Stem Cells
;
Muscle Cells
;
Regeneration
;
Urinary Bladder
8.Ureteral stricture formation after ureteroscope treatment of impacted calculi: A prospective study.
Xeng Inn FAM ; Praveen SINGAM ; Christopher Chee Kong HO ; Radhika SRIDHARAN ; Rozita HOD ; Badrulhisham BAHADZOR ; Eng Hong GOH ; Guan Hee TAN ; Zulkifli ZAINUDDIN
Korean Journal of Urology 2015;56(1):63-67
PURPOSE: Urinary calculi is a familiar disease. A well-known complication of endourological treatment for impacted ureteral stones is the formation of ureteral strictures, which has been reported to occur in 14.2% to 24% of cases. MATERIALS AND METHODS: This was a prospective study. Ureterotripsy treatment was used on patients with impacted ureteral stones. Then, after 3 months and 6 months, the condition of these patients was assessed by means of a kidney-ureter-bladder (KUB) ultrasound. If the KUB ultrasound indicated moderate to serious hydronephrosis, the patient was further assessed by means of a computed tomography intravenous urogram or retrograde pyelogram to confirm the occurrence of ureteral strictures. RESULTS: Of the 77 patients who participated in the study, 5 developed ureteral strictures. Thus, the stricture rate was 7.8%. An analysis of the intraoperative risk factors including perforation of the ureter, damage to the mucous membrane, and residual stone impacted within the ureter mucosa revealed that none of these factors contributed significantly to the formation of the ureteric strictures. The stone-related risk factors that were taken into consideration were stone size, stone impaction site, and duration of impaction. These stone factors also did not contribute significantly to the formation of the ureteral strictures. CONCLUSIONS: This prospective study failed to identify any predictable factors for ureteral stricture formation. It is proposed that all patients undergo a simple postoperative KUB ultrasound screening 3 months after undergoing endoscopic treatment for impacted ureteral stones.
Constriction, Pathologic/*diagnosis
;
Humans
;
Hydronephrosis/diagnosis
;
Kidney/ultrasonography
;
Prospective Studies
;
Risk Factors
;
Ureter/*pathology/ultrasonography
;
Ureteral Calculi/*therapy
;
Ureterolithiasis/*surgery
;
Ureteroscopy/*adverse effects
;
Urinary Bladder/ultrasonography
9.Incorporation of Smooth Muscle Cells Derived from HumanAdipose Stem Cells on Poly(Lactic-co-Glycolic Acid) Scaffoldfor the Reconstruction of Subtotally Resected Urinary Bladderin Athymic Rats
Salah Abood SALEM ; Zahra RASHIDBENAM ; Mohd Hafidzul JASMAN ; Christopher Chee Kong HO ; Ismail SAGAP ; Rajesh SINGH ; Mohd Reusmaazran YUSOF ; Zulkifli Md. ZAINUDDIN ; Ruszymah Bt Haji IDRUS ; Min Hwei NG
Tissue Engineering and Regenerative Medicine 2020;17(4):553-563
BACKGROUND:
The urinary tract can be affected by both congenital abnormalities as well as acquired disorders, such ascancer, trauma, infection, inflammation, and iatrogenic injuries, all of which may lead to organ damage requiring eventualreconstruction. As a gold standard, gastrointestinal segment is used for urinary bladder reconstruction. However, one majorproblem is that while bladder tissue prevents reabsorption of specific solutes, gastrointestinal tissue actually absorbs them.Therefore, tissue engineering approach had been attempted to provide an alternative tissue graft for urinary bladderreconstruction.
METHODS:
Human adipose-derived stem cells isolated from fat tissues were differentiated into smooth muscle cells andthen seeded onto a triple-layered PLGA sheet to form a bladder construct. Adult athymic rats underwent subtotal urinarybladder resection and were divided into three treatment groups (n = 3): Group 1 (‘‘sham’’) underwent anastomosis of theremaining basal region, Group 2 underwent reconstruction with the cell-free scaffold, and Group 3 underwent reconstructionwith the tissue-engineered bladder construct. Animals were monitored on a daily basis and euthanisation wasperformed whenever a decline in animal health was detected.
RESULTS:
All animals in Groups 1, 2 and 3 survived for at least 7 days and were followed up to a maximum of 12 weekspost-operation. It was found that by Day 14, substantial ingrowth of smooth muscle and urothelial cells had occurred inGroup 2 and 3. In the long-term follow up of group 3 (tissue-engineered bladder construct group), it was found that theurinary bladder wall was completely regenerated and bladder function was fully restored. Urodynamic and radiologicalevaluations of the reconstructed bladder showed a return to normal bladder volume and function.Histological analysisrevealed the presence of three muscular layers and a urothelium similar to that of a normal bladder. Immunohistochemicalstaining using human-specific myocyte markers (myosin heavy chain and smoothelin) confirmed the incorporation of theseeded cells in the newly regenerated muscular layers.
CONCLUSION
Implantation of PLGA construct seeded with smooth muscle cells derived from human adipose stemcells can lead to regeneration of the muscular layers and urothelial ingrowth, leading to formation of a completelyfunctional urinary bladder.
10.Incorporation of Smooth Muscle Cells Derived from HumanAdipose Stem Cells on Poly(Lactic-co-Glycolic Acid) Scaffoldfor the Reconstruction of Subtotally Resected Urinary Bladderin Athymic Rats
Salah Abood SALEM ; Zahra RASHIDBENAM ; Mohd Hafidzul JASMAN ; Christopher Chee Kong HO ; Ismail SAGAP ; Rajesh SINGH ; Mohd Reusmaazran YUSOF ; Zulkifli Md. ZAINUDDIN ; Ruszymah Bt Haji IDRUS ; Min Hwei NG
Tissue Engineering and Regenerative Medicine 2020;17(4):553-563
BACKGROUND:
The urinary tract can be affected by both congenital abnormalities as well as acquired disorders, such ascancer, trauma, infection, inflammation, and iatrogenic injuries, all of which may lead to organ damage requiring eventualreconstruction. As a gold standard, gastrointestinal segment is used for urinary bladder reconstruction. However, one majorproblem is that while bladder tissue prevents reabsorption of specific solutes, gastrointestinal tissue actually absorbs them.Therefore, tissue engineering approach had been attempted to provide an alternative tissue graft for urinary bladderreconstruction.
METHODS:
Human adipose-derived stem cells isolated from fat tissues were differentiated into smooth muscle cells andthen seeded onto a triple-layered PLGA sheet to form a bladder construct. Adult athymic rats underwent subtotal urinarybladder resection and were divided into three treatment groups (n = 3): Group 1 (‘‘sham’’) underwent anastomosis of theremaining basal region, Group 2 underwent reconstruction with the cell-free scaffold, and Group 3 underwent reconstructionwith the tissue-engineered bladder construct. Animals were monitored on a daily basis and euthanisation wasperformed whenever a decline in animal health was detected.
RESULTS:
All animals in Groups 1, 2 and 3 survived for at least 7 days and were followed up to a maximum of 12 weekspost-operation. It was found that by Day 14, substantial ingrowth of smooth muscle and urothelial cells had occurred inGroup 2 and 3. In the long-term follow up of group 3 (tissue-engineered bladder construct group), it was found that theurinary bladder wall was completely regenerated and bladder function was fully restored. Urodynamic and radiologicalevaluations of the reconstructed bladder showed a return to normal bladder volume and function.Histological analysisrevealed the presence of three muscular layers and a urothelium similar to that of a normal bladder. Immunohistochemicalstaining using human-specific myocyte markers (myosin heavy chain and smoothelin) confirmed the incorporation of theseeded cells in the newly regenerated muscular layers.
CONCLUSION
Implantation of PLGA construct seeded with smooth muscle cells derived from human adipose stemcells can lead to regeneration of the muscular layers and urothelial ingrowth, leading to formation of a completelyfunctional urinary bladder.