No abstract available.
Pregnancy* ; Pyelonephritis*

PURPOSE: While performing clean intermittent catheterization(CIC), atraumatic and non-infecting techniques are important in preventing long-term complications secondary to CIC. The aim of this study is to characterize several essential technical aspects of CIC in patients with neurologically stable spinal cord injury or diseases(SCI/D). MATERIALS AND METHODS: Between July 2002 and March 2003, a prospective questionnaire survey was undertaken in 106 neurologically stable SCI/D patients who were performing CIC as primary bladder emptying methods. Structured questionnaire was administered with the interview. Questionnaire items included key technical CIC steps and related questions. RESULTS: Mean age of the patients(74 males and 32 females) were 35.9(+/-1.3, SE) years and the duration of CIC was 17.3(+/-2.3) months. Levels of SCI/D were: cervical in 45 patients(42.4%), followed by thoracic in 43(40.6%), lumbar in 16(15.1%), and sacral in 2(1.9%). Omitting hand washing before CIC was found in 16 patients(15.1%), meatal cleansing before CIC in 13(12.3%), using lubricants in 12(11.3%), and performing CIC as a timed basis in 36(34.0%). The most preferred posture to perform CIC were: sitting(63.0%), followed by lying(19.1%) and standing(14.6%) in men, while sitting(45.6%), followed by the squatting(33.3%) and lying(15.8%) in women. Majority of the patients performed CIC five times a day with spending about ten minutes for each CIC. Omitting key elements were not significantly associated with the sex, age, level of SCI/D, duration of CIC, level of education, socioeconomic status. However, omitting meatal cleaning before CIC were significantly associated with the patients with shorter duration of performing CIC, lower educational level, and lower socioeconomic status(p<0.05). 57.6% of the patients were satisfied with the current CIC methods. CONCLUSION: Our results showed that some patients do omit key elements of the CIC steps. These elements should be emphasized during the initial CIC education and also must be screened during long-term followup in the SCI/D patients performing CIC.
Catheterization ; Education ; Female ; Follow-Up Studies ; Hand Disinfection ; Humans ; Intermittent Urethral Catheterization* ; Lubricants ; Male ; Posture ; Prospective Studies ; Surveys and Questionnaires ; Social Class ; Spinal Cord Diseases* ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder ; Urinary Bladder, Neurogenic

Purpose: Adjuvant chemotherapy (AC) is recommended for muscle-invasive or lymph node-positive upper urinary tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). However, disease recurrences are frequently observed in pT1 disease, and AC may increase the risk of overtreatment in pT2 UTUC patients. This study aimed to validate a risk-adapted scoring model for selecting UTUC patients with ≤pT2 disease who would benefit from AC. Materials and Methods: We retrospectively analyzed 443 ≤pT2 UTUC patients who underwent RNU. A risk-adapted scoring model was applied, categorizing patients into low- or high-risk groups. Recurrence-free survival (RFS) and cancer-specific survival (CSS) were analyzed according to risk group. Results: Overall, 355 patients (80.1%) and 88 patients (19.9%) were categorized into the low- and high-risk groups, respectively, with the latter having higher pathological stages, concurrent carcinoma in situ, and synchronous bladder tumors. Disease recurrence occurred in 45 patients (10.2%), among whom 19 (5.4%) and 26 (29.5%) belonged to the low- and high-risk groups, respectively (p<0.001). High-risk patients had significantly shorter RFS (64.3% vs. 93.6% at 60 months; hazard ratio [HR] 13.66; p<0.001) and worse CSS (80.7% vs. 91.5% at 60 months; HR 4.25; p=0.002). Multivariate analysis confirmed that pT2 stage and the high-risk group were independent predictors of recurrence and cancer-specific death (p<0.001). Decision curve analysis for RFS showed larger net benefits with our model than with the T stage model. Conclusions The risk-adapted scoring model effectively predicts recurrence and identifies optimal candidates for AC post RNU in non-metastatic UTUC.

AIMTo investigate whether the biological process of superparamagnetic iron oxide (SPIO)-labeled human mesenchymal stem cells (hMSCs) may be monitored non-invasively by using in vivo magnetic resonance (MR) imaging with conventional 1.5-T system examinations in corpus cavernosa of rats and rabbits.

METHODSThe labeling efficiency and viability of SPIO-labeled hMSCs were examined with Prussian blue and Tripan blue, respectively. After SPIO-labeled hMSCs were transplanted to the corpus cavernosa of rats and rabbits, serial T2-weighted MR images were taken and histological examinations were carried out over a 4-week period.

RESULTShMSCs loaded with SPIO compared to unlabeled cells had a similar viability. For SPIO-labeled hMSCs more than 1 X 10 (5) concentration in vitro, MR images showed a decrease in signal intensity. MR signal intensity at the areas of SPIO-labeled hMSCs in the rat and rabbit corpus cavernosa decreased and was confined locally. After injection of SPIO-labeled hMSCs into the corpus cavernosum, MR imaging demonstrated that hMSCs could be seen for at least 12 weeks after injection. The presence of iron was confirmed with Prussian blue staining in histological sections.

CONCLUSIONSPIO-labeled hMSCs in corpus cavernosa of rats and rabbits can be evaluated non-invasively by molecular MR imaging. Our findings suggest that MR imaging has the ability to test the long-term therapeutic potential of hMSCs in animals in the setting of erectile dysfunction.

Animals ; Cell Survival ; Contrast Media ; administration & dosage ; Dextrans ; Ferrosoferric Oxide ; Humans ; Iron ; Magnetic Resonance Imaging ; methods ; Magnetite Nanoparticles ; Male ; Mesenchymal Stem Cell Transplantation ; methods ; Oxides ; Penis ; pathology ; Rabbits ; Rats ; Staining and Labeling ; methods