The aim of this study is to analyze the level of target molecule expression in metastatic renal cell carcinoma (RCC) to determine whether there is a correlation between molecular marker expression and clinical response. Ten patients with metastatic RCC, who received receptor tyrosine kinase (RTK) targeted therapy after cytoreductive or radical nephrectomy, were included. The expression of target molecules relating to the RTK, mammalian target of rapamycin, hypoxia inducible factor, mitogen activated protein kinase, and adenosine monophosphate-activated protein kinase pathways were analyzed using real-time polymerase chain reaction and immunohistochemistry. We correlated the level of target molecule expression with clinical response, including efficacy and adverse events experience during RTK targeted therapy. All patients showed similar histological subtype and grade on pathological examination; however, the expression of RCC target molecules was very different among the patients. The expression of molecules related to the RTK pathway in RCC tissue as well as relative expression of molecules in RCC tissue compared to normal kidney tissue, were higher in patients who showed a good response to RTK targeted therapy compared to those that showed a poor response. Target molecule expression in normal kidney tissue was higher in patients who experienced high-grade adverse events than in patients who experienced low-grade events. Target molecule expression in metastatic RCC correlates with targeted therapy clinical response including efficacy and adverse events. Personalized target molecule expression profiles could be used to predict clinical response to different targeted therapies, thus helping optimization of targeted therapies for patients with metastatic RCC.
Adenosine ; Anoxia ; Biomarkers ; Carcinoma, Renal Cell* ; Genetic Variation ; Humans ; Immunohistochemistry ; Kidney ; Nephrectomy ; Protein Kinases ; Protein-Tyrosine Kinases ; Real-Time Polymerase Chain Reaction ; Sirolimus

We conducted this study to evaluate the combined effect of acellular bladder submucosa matrix (BSM) and autologous urethral tissue for the treatment of long segment urethral stricture in a rabbit model. To prepare the BSM, porcine bladder submucosa was processed, decellularized, configured into a sheet-like shape, and sterilized. Twenty rabbits were randomized to normal control, urethral stricture, urethroplasty using BSM only or BSM/autologous urethral tissue (n=5 per group). Retrograde urethrography was performed at 4, 8, and 12 weeks postoperatively, and the grafted specimens were harvested at week 12 to evaluate urethral reconstruction through histopathologic and immunohistochemical analysis. The mean urethral width of the control, stricture, BSM, and BSM/autologous urethral tissue groups at week 12 was 10.3+/-0.80, 3.8+/-1.35, 8.8+/-0.84, and 9.1+/-1.14 mm, respectively. The histopathologic study revealed that the BSM/autologous urethral tissue graft had a normal area of urethral lumen, compact muscular layers, complete epithelialization, and progressive infiltration by vessels in the regenerated urethra. In contrast, the BSM grafts revealed keratinized epithelium, abundant collagenized fibrous connective tissue, and were devoid of bundles of circular smooth muscle. Nontransected ventral onlay-augmented urethroplasty using an acellular BSM scaffold combined with an autologous urethral tissue graft represents a feasible procedure for urethral reconstruction.
Animals ; Epithelium/surgery ; Mucous Membrane/cytology/*transplantation ; Muscle, Smooth/surgery ; Rabbits ; Reconstructive Surgical Procedures/methods ; Swine ; Tissue Engineering ; Urethra/*surgery ; Urethral Stricture/*surgery ; Urinary Bladder/*cytology

We conducted this study to evaluate the combined effect of acellular bladder submucosa matrix (BSM) and autologous urethral tissue for the treatment of long segment urethral stricture in a rabbit model. To prepare the BSM, porcine bladder submucosa was processed, decellularized, configured into a sheet-like shape, and sterilized. Twenty rabbits were randomized to normal control, urethral stricture, urethroplasty using BSM only or BSM/autologous urethral tissue (n=5 per group). Retrograde urethrography was performed at 4, 8, and 12 weeks postoperatively, and the grafted specimens were harvested at week 12 to evaluate urethral reconstruction through histopathologic and immunohistochemical analysis. The mean urethral width of the control, stricture, BSM, and BSM/autologous urethral tissue groups at week 12 was 10.3+/-0.80, 3.8+/-1.35, 8.8+/-0.84, and 9.1+/-1.14 mm, respectively. The histopathologic study revealed that the BSM/autologous urethral tissue graft had a normal area of urethral lumen, compact muscular layers, complete epithelialization, and progressive infiltration by vessels in the regenerated urethra. In contrast, the BSM grafts revealed keratinized epithelium, abundant collagenized fibrous connective tissue, and were devoid of bundles of circular smooth muscle. Nontransected ventral onlay-augmented urethroplasty using an acellular BSM scaffold combined with an autologous urethral tissue graft represents a feasible procedure for urethral reconstruction.
Animals ; Epithelium/surgery ; Mucous Membrane/cytology/*transplantation ; Muscle, Smooth/surgery ; Rabbits ; Reconstructive Surgical Procedures/methods ; Swine ; Tissue Engineering ; Urethra/*surgery ; Urethral Stricture/*surgery ; Urinary Bladder/*cytology

Stromal sarcoma of the prostate is very rare and shows rapid growth, which consequently is related to poor prognosis. Recently, we treated two cases of prostatic stromal sarcoma: one with robot-assisted laparoscopic radical prostatectomy and the other with open radical cysto-prostatectomy with an ileal conduit. To the best of our knowledge, this is the first case report of a prostatic stromal sarcoma managed by use of a robotic procedure. Here, we report of our experiences in the treatment of prostatic stromal sarcoma by use of two different methods.
Adult ; Humans ; Laparoscopy/*methods ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Prostate/surgery ; Prostatectomy/*methods ; Prostatic Neoplasms/diagnosis/*surgery ; Rectum/surgery ; *Robotics ; Sarcoma/diagnosis/*surgery ; Seminal Vesicles/surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Urinary Bladder/surgery ; Urinary Diversion/*methods

Stromal sarcoma of the prostate is very rare and shows rapid growth, which consequently is related to poor prognosis. Recently, we treated two cases of prostatic stromal sarcoma: one with robot-assisted laparoscopic radical prostatectomy and the other with open radical cysto-prostatectomy with an ileal conduit. To the best of our knowledge, this is the first case report of a prostatic stromal sarcoma managed by use of a robotic procedure. Here, we report of our experiences in the treatment of prostatic stromal sarcoma by use of two different methods.
Adult ; Humans ; Laparoscopy/*methods ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Prostate/surgery ; Prostatectomy/*methods ; Prostatic Neoplasms/diagnosis/*surgery ; Rectum/surgery ; *Robotics ; Sarcoma/diagnosis/*surgery ; Seminal Vesicles/surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Urinary Bladder/surgery ; Urinary Diversion/*methods

The most promising treatment for stress urinary incontinence can be a cell therapy. We suggest human amniotic fluid stem cells (hAFSCs) as an alternative cell source. We established the optimum in vitro protocol for the differentiation from hAFSCs into muscle progenitors. These progenitors were transplanted into the injured urethral sphincter and their therapeutic effect was analyzed. For the development of an efficient differentiation system in vitro, we examined a commercial medium, co-culture and conditioned medium (CM) systems. After being treated with CM, hAFSCs were effectively developed into a muscle lineage. The progenitors were integrated into the host urethral sphincter and the host cell differentiation was stimulated in vivo. Urodynamic analysis showed significant increase of leak point pressure and closing pressure. Immunohistochemistry revealed the regeneration of circular muscle mass with normal appearance. Molecular analysis observed the expression of a larger number of target markers. In the immunogenicity analysis, the progenitor group had a scant CD8 lymphocyte. In tumorigenicity, the progenitors showed no teratoma formation. These results suggest that hAFSCs can effectively be differentiated into muscle progenitors in CM and that the hAFSC-derived muscle progenitors are an accessible cell source for the regeneration of injured urethral sphincter.
Amniotic Fluid/*cytology ; Animals ; Biological Markers/metabolism ; Cell Differentiation ; Cell Lineage ; Cell Transformation, Neoplastic ; Cells, Cultured ; Coculture Techniques ; Female ; Gene Expression Regulation ; Humans ; Immunohistochemistry ; Mice ; Mice, Inbred ICR ; Regeneration ; *Stem Cell Transplantation ; Stem Cells/*cytology/metabolism ; Urethra/physiology ; Urinary Incontinence, Stress/pathology/*therapy ; Urodynamics

We report here on a case of mucinous adenocarcinoma that probably originated in the renal pelvis of a horseshoe kidney. A 61-year-old woman presented with a palpable mass in the left upper quadrant of the abdomen, and this mass had been present for several months. Computed tomography (CT) revealed a left renal pelvic tumor in the horseshoe kidney. Grossly, a 10x9x8 cm unilocular cystic mass filled with chocolate colored mucinous fluid was seen. A connection between the cystic mass and the renal pelvis was demonstrated on retrograde pyelography. Microscopically, the cyst contained anaplastic columnar mucosecretory epithelial cells. Some atypical cell clusters were freely floating in the mucinous lakes. The histopathological findings were consistent with mucinous adenocarcinoma. In addition, glandular metaplasia was noted in the cystic wall. Immunohistochemical assessment of the pelvic adenocarcinoma revealed the positive expressions of carcinoembryonic antigen (CEA) and cytokeratin 20 (CK20) and a weak positive expression of cytokeratin 7 (CK7).
Female ; Humans ; Cysts ; Adenocarcinoma

Primary neuroendocrine carcinomas are uncommon highly malignant tumors of the genitourinary tract, and they have a poor prognosis. We report here on a case of a primary neuroendocrine carcinoma of the urethra that developed after radical cystectomy and ileal conduit diversion for treating transitional cell carcinoma of the urinary bladder.

PURPOSE: We wanted to investigate the efficacy and safety of the immunotherapeutic Uro-Vaxom for treating uncomplicated recurrent cystitis in female patients only. MATERIALS AND METHODS: Adult female patients were enrolled in this multicenter, open-label study if they had acute cystitis at the enrollment visit and positive results on urine culture (> or =10(3)CFU/ml). The patients were treated for 3 months with one capsule daily of Uro-Vaxom after antibiotic therapy, and they were observed for another 3 months. The primary efficacy criteria were the cystitis recurrence rates over 6 months, the distribution of cystitis and the proportion of patients with cystitis. RESULTS: A total of 50 patients were evaluated. During the 6-month trial, the number of cystitis recurrences was significantly reduced in comparison with the 6-month pretrial period (on the average 0.64 as compared to 3.0 recurrences, respectively p<0.001). The incidences of frequency, urgency and dysuria remained low until the end of the trial. Uro-Vaxom was well tolerated: side-effects were mentioned by 8% of the 50 patients, and there was no case leading to treatment withdrawal. CONCLUSIONS: Uro-Vaxom significantly reduced the incidence of cystitis during the 6 months of this study, including the 3 months of treatment. These results demonstrate that Uro-Vaxom is a valuable agent for prophylaxis of recurrent cystitis.
Adult ; Cystitis* ; Dysuria ; Escherichia coli ; Female ; Humans ; Incidence ; Recurrence

PURPOSE: This study was designed to assess the prognosis of pT3 transitional cell carcinoma of the renal pelvis(renal pelvic tumor) according to the parenchymal invasion pattern and adjuvant chemotherapy. MATERIALS AND METHODS: A total of 48(34 males and 14 females) patients were surgically treated for a renal pelvic tumor. Of these 48 patients, the 27 pT3 renal pelvic tumor patients who had over one year follow-up period were enrolled. The patients were divided into two groups according to the invasion pattern(Group 1: renal parenchymal invasion, Group 2: peripelvic fat invasion). Among these 27 patients, 15 patients received adjuvant chemotherapy following surgery, whereas the other 12 patients did not. The prognostic factors, including age, gender, laterality, tumor grade, size, lympho-vascular invasion, lymph node involvement, the invasion pattern and adjuvant chemotherapy, were analyzed with respect to disease-free survival. RESULTS: There were seventeen patients in Group 1 and 10 patients in Group 2. The mean duration of follow up was 39.4 months. Age, gender, laterality, tumor grade, size, lympho-vascular invasion, invasion pattern and adjuvant chemotherapy had no significant impact on disease-free survival on both the univariate and multivariate analyses. Only lymph node involvement(p=0.028, hazard ratio=20.98) was a prognostic predictor in this study. However, the incidence of renal parenchymal invasion was higher for the high grade tumors than for the low grade tumors. CONCLUSIONS: The renal parenchymal invasion pattern and adjuvant chemotherapy had no significant impact on disease-free survival on both univariate and multivariate analyses for the patients with pT3 renal pelvic tumor. Further studies are necessary to clarify this result.
Carcinoma, Transitional Cell* ; Chemotherapy, Adjuvant* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Kidney Pelvis* ; Lymph Nodes ; Male ; Multivariate Analysis ; Prognosis