Medical Student Research Fellowship for Summer 2011

Mentor:                       Philippe E. Zimmern, MD
Department:               Urology
Room number:           J8.122
Mail Code:                 9110
Phone number:          214-648-9397
E-mail:                        Philippe.zimmern@utsouthwestern.edu
Project title:                The biomechanical properties of human vaginal wall in women with pelvic organ prolapse

Human subjects IRB approved project number (where applicable):       0402-222

Animal subjects IRB approved project number (where applicable):      

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects) 
PATIENT-BASED RESEARCH

Brief Description of Project:

Mio Yanagisawa will be our fourth summer student working on our long-term project regarding the biomechanical properties of human vaginal wall in women with pelvic organ prolapse. Prior students were Elisabeth Mosier, Rachel Jerome, and Adam Romman.

This summer project will be supervised by Dr Philippe Zimmern, Professor of Urology, Dr Fred Tibbals (BioCenter), and Dr Robert Eberhart (Bioengineering). This project is IRB-approved and will build on work done by the prior students listed above, namely comparing in vivo (BLSI 2000™) and ex-vivo (Instron) measurements of human vaginal wall properties.

Over the past 2 years, the inter- and intra-rater reliability of the BLSI 2000™ for vaginal wall measurements of prolapsed organs was assessed and confirmed to be sufficiently acceptable to warrant further clinical studies. However, one of the limitations of the current probe, designed for plastic surgery/wound healing measurements is its size, which precludes its usage in non-prolapsed parous women and in controls. SRLI, the company that currently manufactures the device in the US, is finishing up a novel prototype, per our request and design suggestions, with a reduced size, a thinner extremity, and a smaller aperture to allow deeper vaginal wall tissue evaluation, not just for patients with prolapse but for all female patients, regardless of their vaginal wall condition.

 

Therefore, the summer project of Mio Yanagisawa will focus on: 1) comparing the performance of this newly designed prototype with the existing BLSI 2000™; 2) obtaining measurements in age-matched controls, possibly comparing pre- and postoperative measurements after prolapse repair; 3) expanding the already large database of in vivo and ex-vivo data in women undergoing prolapse repair surgery.  Furthermore, Mio Yanagisawa will be asked to investigate the clinical correlation between vaginal wall prolapsed tissue properties, as measured by the BLSI 2000™ and outcome after prolapse repair, the tested hypothesis being that there is a higher risk of prolapse recurrence in weaker and more lax vaginal tissues. If this is confirmed, then patients with tissue properties obtained by this unique measurement, suggesting a higher risk of recurrence could be offered a biomaterial mesh to supplement the traditional repair with their native tissues.  Improved quantitative measures of progress following surgery could also be offered.

In addition, Mio will be involved with Dr Zimmern’s clinical practice at Aston, surgical procedures at Zale, and prolapse-related translational research projects, in consultation with Dr. Eberhart, including biomaterial design (Dr. Nandika D’Souza, UNT), finite element mechanics modeling of tissue and mesh-tissue interactions (Dr. CW Charles Chuong, UTA), SEM and nano-indentation (Dr. Stathis Meletis, UTA,) and tissue physics (Raman spectroscopy) with Dr. Fred Tibbals.  Weekly Friday meetings will be held throughout her summer project with the above investigators. 

 

Previous Research Activities or Publications with Medical Students:

Mio Yanagisawa will be our fourth summer student working on our long-term project regarding the biomechanical properties of human vaginal wall in women with pelvic organ prolapse. Prior students were Elisabeth Mosier, Rashel Jerome, and Adam Romman

  1. Mosier E, Lin VK, Zimmern P. Extracellular matrix expression of human prolapsed vaginal wall. Neurourol Urodyn. 29(4):582-586, 2010.
  2. Murray S, Schlomer BJ, Jerome R, Zimmern PE:  Secondary autologous fasica slings fare more poorly than primary slings.
  3. Mosier E, Jerome R, Xie X-J, Chuong C, Yan J, Eberhart R, Zimmern P:  In vivo (Cutometer©) measurement of anterior vaginal wall biomechanical properties in prolapse patients undergoing surgical repair.  Submitted to Neurourology and Urodynamics.
  4. Mosier E, Haverkorn RM, Zimmern PE. Abstract #1538: 3-D ultrasound assessment of collagen volume stability and durability over time in incontinent women.  AUA Annual Meeting, April 24 – 28, 2009, Chicago, Illinois
  5. Chuong C, Towns R, Eberhart R, Mosier E, Zimmern P. Development of a biomechanical finite element model to predict prolapsed anterior vaginal wall compartment properties.  Podium presentation ICS meeting 8/22-27/2010, Toronto.
  6. Adam N. Romman, Feras Alhalabi, and Philippe E. Zimmern.  Urethral dilation under anesthesia in women
  7. Jerome R, Murray S, Zimmern P;  The dark side of prophylactic suburethral tape placement.  Poster, SUFU Annual meeting, St. Petersburg, Florida. 2010.
  8. Schomer B, Jerome R, Murray S, Haverkorn R, Zimmern P.  Secondary autologous fascia slings fare more poorly than primary slings.  Poster. SUFU Annual meeting, St. Petersburg, Florida, 2010.
  9. Mosier E, Jerome R, Chuong C, Eberhart R, Zimmern P. In vivo measurement of the anterior vaginal wall biomechanical properties in prolapse patients undergoing surgical repair. Podium presentation, SUFU Annual meeting, St. Petersburg, Florida, 2010.