Urologists, Pediatric Specialist


Accepting new patients
University
UH Case Medical Center
11100 Euclid Ave
Cleveland, OH 44106
216-844-3009
Locations and availability (6)

Education ?

Medical School Score Rankings
University of Iowa
  • Currently 4 of 4 apples
Top 25%

Awards & Distinctions ?

Associations
American Board of Urology

Affiliations ?

Dr. Woo is affiliated with 6 hospitals.

Hospital Affilations

Score

Rankings

  • University Hospitals Geauga Medical Center
    13207 Ravenna Rd, Chardon, OH 44024
    • Currently 4 of 4 crosses
    Top 25%
  • UH Conneaut Medical Center
    158 W Main Rd, Conneaut, OH 44030
    • Currently 4 of 4 crosses
    Top 25%
  • Uh Richmond Medical Center
    27100 Chardon Rd, Cleveland, OH 44143
    • Currently 4 of 4 crosses
    Top 25%
  • UH Case Medical Center
  • LIJ Schneiders Childrens Hospital
  • University Hospitals Case Medical Center
    11100 Euclid Ave, Cleveland, OH 44106
  • Publications & Research

    Dr. Woo has contributed to 15 publications.
    Title Mesenchymal Stem Cell Recruitment and Improved Bladder Function After Bladder Outlet Obstruction: Preliminary Data.
    Date March 2011
    Journal The Journal of Urology
    Excerpt

    Mesenchymal stem cells have various therapeutic benefits in various organ injury models. Bladder outlet obstruction causes smooth muscle hypertrophy and fibrosis, leading to lowered compliance, increased storage pressures and renal injury. Decreased blood flow and hypoxia may contribute to obstruction related bladder decompensation. We used a mouse model to determine whether mesenchymal stem cell recruitment occurred after bladder outlet obstruction and whether this was associated with changes in bladder hypoxia, histology and function. We also identified potential chemokines involved in mesenchymal stem cell recruitment.

    Title Sumo Modification Regulates Blm and Rad51 Interaction at Damaged Replication Forks.
    Date March 2010
    Journal Plos Biology
    Excerpt

    The gene mutated in Bloom's syndrome, BLM, is important in the repair of damaged replication forks, and it has both pro- and anti-recombinogenic roles in homologous recombination (HR). At damaged forks, BLM interacts with RAD51 recombinase, the essential enzyme in HR that catalyzes homology-dependent strand invasion. We have previously shown that defects in BLM modification by the small ubiquitin-related modifier (SUMO) cause increased gamma-H2AX foci. Because the increased gamma-H2AX could result from defective repair of spontaneous DNA damage, we hypothesized that SUMO modification regulates BLM's function in HR repair at damaged forks. To test this hypothesis, we treated cells that stably expressed a normal BLM (BLM+) or a SUMO-mutant BLM (SM-BLM) with hydroxyurea (HU) and examined the effects of stalled replication forks on RAD51 and its DNA repair functions. HU treatment generated excess gamma-H2AX in SM-BLM compared to BLM+ cells, consistent with a defect in replication-fork repair. SM-BLM cells accumulated increased numbers of DNA breaks and were hypersensitive to DNA damage. Importantly, HU treatment failed to induce sister-chromatid exchanges in SM-BLM cells compared to BLM+ cells, indicating a specific defect in HR repair and suggesting that RAD51 function could be compromised. Consistent with this hypothesis, RAD51 localization to HU-induced repair foci was impaired in SM-BLM cells. These data suggested that RAD51 might interact noncovalently with SUMO. We found that in vitro RAD51 interacts noncovalently with SUMO and that it interacts more efficiently with SUMO-modified BLM compared to unmodified BLM. These data suggest that SUMOylation controls the switch between BLM's pro- and anti-recombinogenic roles in HR. In the absence of BLM SUMOylation, BLM perturbs RAD51 localization at damaged replication forks and inhibits fork repair by HR. Conversely, BLM SUMOylation relieves its inhibitory effects on HR, and it promotes RAD51 function.

    Title Simulated Childbirth Injuries in an Inbred Rat Strain.
    Date July 2009
    Journal Neurourology and Urodynamics
    Excerpt

    Vaginal distension (VD) in outbred rats has been shown to decrease urethral resistance, as well as increase the expression of the stem cell-homing chemokine, monocyte chemotactic factor 3 (MCP-3), but not stromal derived factor 1 (SDF-1). The aim of this study was to determine if similar responses are induced by VD in an inbred rat strain.

    Title Results of a Practical Protocol for Management of Prenatally Detected Hydronephrosis Due to Ureteropelvic Junction Obstruction.
    Date April 2009
    Journal Pediatric Surgery International
    Excerpt

    Several algorithms exist for the management of prenatally diagnosed hydronephrosis due to ureteropelvic junction obstruction (UPJO). We utilize a conservative and practical approach emphasizing observation, with less frequent use of renal flow scans (RFS). We reviewed the results of 143 pediatric patients with congenital UPJO managed at our institution, focusing on surveillance and selective utilization of RFS, according to a standardized protocol.

    Title Homologous Recombination and Maintenance of Genome Integrity: Cancer and Aging Through the Prism of Human Recq Helicases.
    Date September 2008
    Journal Mechanisms of Ageing and Development
    Excerpt

    Homologous recombination (HR) is a genetic mechanism in somatic cells that repairs DNA double-strand breaks and restores productive DNA synthesis following disruption of replication forks. Although HR is indispensable for maintaining genome integrity, it must be tightly regulated to avoid harmful outcomes. HR-associated genomic instabilities arise in three human genetic disorders, Bloom syndrome (BS), Werner syndrome (WS), and Rothmund-Thomson syndrome (RTS), which are caused by defects in three individual proteins of the RecQ family of helicases, BLM, WRN, and RECQL4, respectively. Cells derived from persons with these syndromes display varying types of genomic instability as evidenced by the presence of different kinds of chromosomal abnormalities and different sensitivities to DNA damaging agents. Persons with these syndromes exhibit a variety of developmental defects and are predisposed to a wide range of cancers. WS and RTS are further characterized by premature aging. Recent research has shown many connections between all three proteins and the regulation of excess HR. Here, we illustrate the elaborate networks of BLM, WRN, and RECQL4 in regulating HR, and the potential mechanistic linkages to cancer and aging.

    Title Prenatally Detected Ureteropelvic Junction Obstruction: Clinical Features and Associated Urologic Abnormalities.
    Date August 2008
    Journal Pediatric Surgery International
    Excerpt

    Urologic congenital anomalies associated with ureteropelvic obstruction (UPJO) have been previously characterized; however, less data are available regarding these associations in a prenatally diagnosed population. A retrospective study was conducted to evaluate significant clinical features and urological anomalies associated with prenatally diagnosed UPJO. The records of 143 children with prenatally diagnosed hydronephrosis secondary to UPJO were retrospectively reviewed. The gender, side of obstruction, degree of hydronephrosis, associated clinical features, and urological anomalies were noted. Hundred and forty-three children (M/F = 2.7) with a total of 198 affected renal units (RU) presenting with unilateral (61%) or bilateral (39%) UPJO were enrolled. In cases of unilateral obstruction, the left side was affected in 60 children (68%). The grade of hydronephrosis was Grade 1 in 56 RU (28%), Grade 2 in 51 RU (26%), Grade 3 in 50 RU (25%) and Grade 4 in 41 RU (21%). Associated clinical features included prematurity (n = 7, 4.9%), twinning (n = 5, 3.5%) and presentation with renal failure (RF) (n = 2). Excluding contralateral UPJO, other urologic anomalies were encountered in 29 patients (20.3%). Associated vesicoureteral reflux (VUR) was encountered in 11 patients (7.7%, M/F = 2.7). Pyeloplasty was required more often in children with associated VUR (54.5 vs. 18.2%) (P = 0.01). Contralateral multicystic dysplastic kidney (MCDK) was encountered in six patients (M/F = 2), one of whom presented with RF. One child carried the diagnosis of Schinzel-Giedion syndrome (SGS), demonstrating severe developmental and neurological disorders and bilateral hydronephrosis. The more frequent occurrence of UPJO in males with predominantly left-sided location, association with VUR and MCDK, and increased frequency of bilaterality in our prenatally diagnosed patients were similar to historical reports. In addition, prematurity and twinning were independently associated with UPJO. The higher rate of pyeloplasty in patients with associated reflux warrants further investigation.

    Title The Broken Genome: Genetic and Pharmacologic Approaches to Breaking Dna.
    Date July 2007
    Journal Annals of Medicine
    Excerpt

    The RecQ family of DNA helicases consists of specialized DNA unwinding enzymes that promote genomic stability through their participation in a number of cellular processes, including DNA replication, recombination, DNA damage signaling, and DNA repair pathways. Mutations resulting in the inactivation of some but not all members of the RecQ helicase family can lead to human syndromes which are characterized by marked chromosomal instability and an increased predisposition to cancer. An evolutionarily conserved interaction between RecQ helicases and topoisomerase 3s has been established, and this interaction is important in the regulation of recombination and genomic stability. Topoisomerases are critical in the cell because they relieve helical stress that arises when DNA is unwound. Topoisomerases function by breaking and rejoining DNA. By inhibition of the rejoining function, topoisomerase inhibitors are potent chemotherapeutic agents that have been used successfully in the treatment of hematologic malignancies and other cancers. This review discusses the roles of RecQ helicases in genomic stability, the interplay between RecQ helicases and topoisomerase 3s, and current and future prospects for targeting these interactions to develop novel anticancer therapies.

    Title Over Expression of Stem Cell Homing Cytokines in Urogenital Organs Following Vaginal Distention.
    Date April 2007
    Journal The Journal of Urology
    Excerpt

    PURPOSE: Vaginal delivery is a risk factor for stress urinary incontinence. Rat models of simulated childbirth demonstrated hypoxia of the urogenital organs as well as the development of stress urinary incontinence following vaginal distention. Stromal derived factor-1 and monocyte chemotactic protein-3 were identified as cytokines that are over expressed after myocardial ischemia and signal stem cell migration to ischemic sites in a rat cardiac model. Given the focal hypoxia observed with vaginal distention, we characterized stromal derived factor-1 and monocyte chemotactic protein-3 expression by pelvic organ tissues after vaginal distention. MATERIALS AND METHODS: A total of 16 female rats were randomized into 4 groups. Two groups underwent vaginal distention with harvest of pelvic tissues immediately or 24 hours after vaginal distention, a sham group underwent anesthesia only and a control group underwent no intervention. Reverse transcriptase-polymerase chain reaction was performed on RNA extracted from the urogenital organs. RESULTS: Monocyte chemotactic protein-3 expression in the urethra was increased 20 and 6-fold immediately and 24 hours after vaginal distention, respectively. Monocyte chemotactic protein-3 was 8 and 4-fold increased in the vagina after vaginal distention. There was no difference in monocyte chemotactic protein-3 expression in the rectum or bladder in any group. Stromal derived factor-1 was significantly under expressed immediately after vaginal distention in all tissues. CONCLUSIONS: Monocyte chemotactic protein-3 is significantly over expressed in rat urethral and vaginal tissues immediately following vaginal distention with above normal but decreasing expression 24 hours later. The association between monocyte chemotactic protein-3 over expression and targeted stem cell migration is under investigation. Successful characterization and control of such a repair mechanism in the lower urinary tract would introduce the potential for novel nonoperative treatments and/or preventive measures for stress urinary incontinence.

    Title In Vivo Efficacy of Stx213, a Second-generation Steroid Sulfatase Inhibitor, for Hormone-dependent Breast Cancer Therapy.
    Date December 2006
    Journal Clinical Cancer Research : an Official Journal of the American Association for Cancer Research
    Excerpt

    PURPOSE: Steroid sulfatase (STS) inhibitors that can decrease or prevent the biosynthesis of estrogenic steroids via the sulfatase route may play an important role in the treatment of breast cancer. We compare the in vivo efficacy of two potent STS inhibitors, STX64 and STX213, in a xenograft breast cancer model. EXPERIMENTAL DESIGN: MCF-7 cells stably expressing STS cDNA (MCF-7STS) were generated. Ovariectomized MF-1 female nude mice receiving s.c. injections of estradiol sulfate (E2S) and bearing both MCF-7STS and wild-type MCF-7 (MCF-7WT) tumors were orally treated with STX64 and STX213. Treatment was given for 49 days followed by a recovery period of 35 days in which animals received only E2S. Mice were weighed, and tumor measurements were taken weekly. RESULTS: STX64 and STX213 exhibited potent STS inhibition in vivo. However, STX213 showed a greater duration of activity. In vehicle-treated nude mice receiving E2S, tumor volumes increased 5.5-fold for MCF-7WT and 3.8-fold for MCF-7STS after 49 days compared with day 0. MCF-7WT tumor growth was reduced by 56% by STX213 over the dosing period, and subsequent growth was retarded during the recovery period. All treatments fully inhibited growth of MCF-7STS tumors, and recovery of these tumors was significantly retarded (P<0.01). All compounds completely inhibited liver and tumor STS activity. Additionally, STS mRNA expression in the MCF-7STS tumors directly correlated with the corresponding STS enzyme activity. CONCLUSIONS: This study indicates that STS inhibitors attenuate hormone-dependent human breast cancer growth and therefore offer a potentially novel treatment for this condition.

    Title The Rothmund-thomson Gene Product Recql4 Localizes to the Nucleolus in Response to Oxidative Stress.
    Date November 2006
    Journal Experimental Cell Research
    Excerpt

    Mutations in the RECQL4 helicase gene have been linked to Rothmund-Thomson syndrome (RTS), which is characterized by poikiloderma, growth deficiency, and a predisposition to cancer. Examination of RECQL4 subcellular localization in live cells demonstrated a nucleoplasmic pattern and, to a lesser degree, staining in nucleoli. Analysis of RECQL4-GFP deletion mutants revealed two nuclear localization regions in the N-terminal region of RECQL4 and a nucleolar localization signal at amino acids 376-386. RECQL4 localization did not change after treatment with the DNA-damaging agents bleomycin, etoposide, UV irradiation and gamma irradiation, in contrast to the Bloom and Werner syndrome helicases that relocate to distinct nuclear foci after damage. However, in a significant number of cells exposed to hydrogen peroxide or streptonigrin, RECQL4 accumulated in nucleoli. Using a T7 phage display screen, we determined that RECQL4 interacts with poly(ADP-ribose) polymerase-1 (PARP-1), a nuclear enzyme that promotes genomic integrity through its involvement in DNA repair and signaling pathways. The RECQL4 nucleolar localization was inhibited by pretreatment with a PARP-1 inhibitor. The C-terminal portion of RECQL4 was found to be an in vitro substrate for PARP-1. These results demonstrate changes in the intracellular localization of RECQL4 in response to oxidative stress and identify an interaction between RECQL4 and PARP-1.

    Title Giant Cell Fibroblastoma of the Penis.
    Date August 2006
    Journal Urology
    Excerpt

    Giant cell fibroblastoma (GCF) is an uncommon fibroblastic tumor of childhood. Appearing as superficial, poorly circumscribed masses, they are characterized histologically by a mixture of cellular and angiectoid areas with empty cleft-like spaces, lined by spindle-shaped and multinucleated giant cells. We present a case of an 11-month-old boy with penile GCF treated with local excision. The patient presented with a recurrent penile mass 1 year later and underwent repeat excision. Pathologic examination confirmed recurrent GCF. GCF is a benign, but locally recurrent tumor, as demonstrated by our case. To our knowledge, no cases of penile involvement have been previously reported.

    Title Docking Studies of Sulphamate Inhibitors of Estrone Sulphatase in Human Carbonic Anhydrase Ii.
    Date October 2003
    Journal Bioorganic & Medicinal Chemistry Letters
    Excerpt

    We describe the docking of selected steroidal and non-steroidal estrone sulphatase inhibitors, including the Phase I clinical trial candidate 667COUMATE (6), into the active site of human carbonic anhydrase II (hCA II). The docking scores are compared with the inhibition of hCA II and show good correlation with biological activity.

    Title Development of Seminoma Following Conservative Treatment of Testicular Epidermoid Cyst.
    Date May 2001
    Journal The Journal of Urology
    Title Potent Active Site-directed Inhibition of Steroid Sulphatase by Tricyclic Coumarin-based Sulphamates.
    Date January 2001
    Journal Chemistry & Biology
    Excerpt

    BACKGROUND: There is now abundant evidence that inhibition of steroid sulphatase alone or in conjunction with inhibition of aromatase may enhance the response of postmenopausal patients with hormone-dependent breast cancer to this type of endocrine therapy. Additionally, sulphatase inhibition has been proposed to be of potential therapeutic benefit in the immune system and for neuro-degenerative diseases. After the finding that our first highly potent active site-directed steroid sulphatase inhibitor, oestrone-3-O-sulphamate (EMATE), was highly oestrogenic, we proposed non-steroidal coumarin sulphamates such as 4-methylcoumarin-7-O-sulphamate (COUMATE) as alternative non-steroidal steroid sulphatase inhibitors. In this work, we describe how tricyclic coumarin-based sulphamates have been developed which are even more potent than COUMATE, are non-oestrogenic and orally active. We also discuss potential mechanisms of action. RESULTS: 4-Ethyl- (4), 4-(n-propyl)- (6), 3-ethyl-4-methyl- (8), 4-methyl-3-(n-propyl)coumarin-7-O-sulphamate (11); the tricyclic derivatives 665COUMATE (13), 666COUMATE (15), 667COUMATE (17), 668COUMATE (20) and the tricyclic oxepin sulphamate (22) were synthesised. In a placental microsome preparation, all of these analogues were found to be more active than COUMATE in the inhibition of oestrone sulphatase, with the most potent inhibitor being 667COUMATE which has an IC(50) of 8 nM, some 3-fold lower than that for EMATE (25 nM). In addition, 667COUMATE was also found to inhibit DHEA-sulphatase some 25-fold more potently than EMATE in a placental microsome preparation. Like EMATE, 667COUMATE acts in a time- and concentration-dependent manner, suggesting that it is an active site-directed inhibitor. However, in contrast to EMATE, 667COUMATE has the important advantage of not being oestrogenic. In addition, we propose several diverse mechanisms of action for this active site-directed steroid sulphatase inhibitor in the light of recent publications on the crystal structures of human arylsulphatases A and B and the catalytic site topology for the hydrolysis of a sulphate ester. CONCLUSIONS: A highly potent non-steroidal, non-oestrogenic and irreversible steroid sulphatase inhibitor has been developed. Several mechanisms of action for an active site-directed steroid sulphatase inhibitor are proposed. With 667COUMATE now in pre-clinical development for clinical trial, this should allow the biological and/or clinical significance of steroid sulphatase inhibitors in the treatment of postmenopausal women with hormone-dependent breast cancer and other therapeutic indications to be fully evaluated.

    Title Cloacal Exstrophy: A Comprehensive Review of an Uncommon Problem.
    Date
    Journal Journal of Pediatric Urology
    Excerpt

    OBJECTIVE: To provide a comprehensive overview of the clinical features, diagnosis, current management strategies, and outcomes of cloacal exstrophy. METHODS: A PUBMED/Medline search of the literature was performed on cloacal exstrophy focusing on associated anomalies, treatment, and quality of life issues. RESULTS: The incidence of cloacal exstrophy is between 1 in 200,000 and 400,000 live births. Survival rates now approach 100% secondary to improved understanding of underlying abnormalities and advances in neonatal care and surgical technique. Important principles of initial management include proper nutritional support, early closure of exstrophy, and preservation of intestinal length. The achievement of urinary and fecal continence remains a challenge. Data for long-term outcomes are now emerging which provide new insight into issues of gender identity, function, and psychosocial development of these patients. CONCLUSION: Cloacal exstrophy remains a rare and complex congenital anomaly, characterized by an array of anatomical defects affecting multiple organ systems. A multidisciplinary approach to management is advocated with a focus on optimization of patient function and quality of life.


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