Jae Yup Hong

Relationship Among Total Kidney Volume, Renal Function and Age

PURPOSE We measured kidney volume using software and investigated the relationship between kidney volume and renal function. MATERIALS AND METHODS Age, gender, height, body weight, body mass index, body surface area and serum creatinine were recorded for 539 normal individuals. A tissue segmentation tool program was used to measure kidney volume from computerized tomography images. The glomerular filtration rate was calculated using the Cockcroft-Gault equation and an abbreviated modification of diet in renal disease equation. We looked for correlations of renal parenchymal volume with age and anthropometric measurements. We also tested for a correlation between kidney volume and renal function using the glomerular filtration rate according to the Cockcroft-Gault and modification of diet in renal disease equations. RESULTS Mean kidney volume in all participants was 261.3 ± 58.1 ml. Mean volume in men was approximately 14 ml greater than in women (266.1 vs 251.8 ml, p = 0.004). Kidney volume correlated significantly with height (r = 0.344, p <0.001), body weight (r = 0.343, p <0.001), body mass index (r = 0.177, p <0.001), body surface area (r = 0.371, p <0.001) and age (r = -0.418, p <0.001). Kidney volume also correlated with the glomerular filtration rate according to the Cockcroft-Gault and modification of diet in renal disease equations (p <0.001, r = 0.615 and p <0.001, r = 0.432, respectively). Kidney volume and the glomerular filtration rate decreased in parallel with increasing age. CONCLUSIONS Kidney volume correlates well with renal function and anthropometric measurements. Knowledge of these relationships will be valuable in clinical urology and nephrology.

Chronic kidney disease among men with lower urinary tract symptoms due to benign prostatic hyperplasia

Study Type – Diagnosis (case series)
Level of Evidence 4

Detection of Y Chromosome Microdeletion is Valuable in the Treatment of Patients With Nonobstructive Azoospermia and Oligoasthenoteratozoospermia: Sperm Retrieval Rate and Birth Rate

Purpose We evaluated clinical characteristics, sperm retrieval rates, and birth rates in a relatively large number of infertile patients with Y chromosome microdeletions. Materials and Methods We retrospectively reviewed clinical data from 213 patients with nonobstructive azoospermia (NOA) and 76 patients with oligoasthenoteratozoospermia (OATS) who were tested for Y chromosome microdeletion from March 2004 to June 2011. Results Of the 289 patients, 110 patients presented with Y chromosome microdeletion and 179 patients presented with no microdeletion. Among the patients with Y chromosome microdeletions, 83/110 (75.4%) were NOA patients and 27/110 (24.5%) were OATS patients. After subdividing the patients with Y chromosome microdeletion, 29 had azoospermia factor (AZF)b-c microdeletion and 81 had AZFc microdeletion. The sperm retrieval rate was similar between patients with Y chromosome microdeletion and those with no microdeletion (26.6% vs. 25.6%, p=0.298) after multiple testicular sperm extraction (TESE). Excluding 53 patients who did not undergo TESE, 30 patients were analyzed. All of the 9 men with AZFb-c microdeletion had a complete absence of sperm despite multiple TESE. However, multiple TESE was successful for 9 of 21 patients with only AZFc microdeletion (p=0.041). Twenty patients with Y chromosome microdeletion gave birth. Conclusions In NOA and OATS patients, no significant difference in the sperm retrieval rate was shown between patients with Y chromosome microdeletion and those with no microdeletion. Patients with short Y chromosome microdeletion such as AZFc microdeletion have better prognoses for sperm retrieval and an increased chance of conception than do patients with larger microdeletions such as AZFb-c microdeletion.

In Vitro Culture-Induced Pluripotency of Human Spermatogonial Stem Cells

Unipotent spermatogonial stem cells (SSCs) can be transformed into ESC-like cells that exhibit pluripotency in vitro. However, except for mouse models, their characterization and their origins have remained controversies in other models including humans. This controversy has arisen primarily from the lack of the direct induction of ESC-like cells from well-characterized SSCs. Thus, the aim of the present study was to find and characterize pluripotent human SSCs in in vitro cultures of characterized SSCs. Human testicular tissues were dissociated and plated onto gelatin/laminin-coated dishes to isolate SSCs. In the presence of growth factors SSCs formed multicellular clumps after 2–4 weeks of culture. At passages 1 and 5, the clumps were dissociated and were then analyzed using markers of pluripotent cells. The number of SSEA-4-positive cells was extremely low but increased gradually up to ~ 10% in the SSC clumps during culture. Most of the SSEA-4-negative cells expressed markers for SSCs, and some cells coexpressed markers of both pluripotent and germ cells. The pluripotent cells formed embryoid bodies and teratomas that contained derivatives of the three germ layers in SCID mice. These results suggest that the pluripotent cells present within the clumps were derived directly from SSCs during in vitro culture.

Sexual function and stress level of male partners of infertile couples during the fertile period.

To evaluate the sexual function and stress level during timed intercourse (TI) of male partners of infertile couples.

PTEN loss-mediated Akt activation increases the properties of cancer stem-like cell populations in prostate cancer.

Objective: To demonstrate that the PTEN/PI3K/Akt/NF-κB pathway plays an important role in regulating the prostate cancer stem-like cell population by upregulating ABCG2. Methods: Targeted PTEN knockdown in human prostate DU145 and 22Rv1 cells using a small interfering RNA were confirmed by immunoblot analysis using antibodies of PTEN, phospho-Akt, Akt, and a-tubulin. Knockdown PTEN DU145 and 22Rv1 cells were augmented, and the stem cell-like properties were examined by cell viability and tumor sphere formation and treated by Akt IV inhibitor to provide the signal transduction pathway. Luciferase activity assays were performed. Results: The knockdown of PTEN in prostate cancer cell lines increased the stem-like properties of the cells, including their sphere-forming ability, stem cell population number, epithelial-mesenchymal transition-related gene expression, and ABCG2 expression. Additionally, PTEN expression was highly associated with elevated expression of phospho-Akt. Treatment with an Akt inhibitor suppressed the PTEN-mediated effects on the properties of these stem-like cells as well as drug resistance, ABCG2 expression, and the NF-κB pathway. Conclusion: The loss of PTEN in prostate cancer cells resulted in an increased PI3K/Akt pathway. Due to the Akt activation, PTEN loss may play an important role in prostate cancer by promoting cancer stemness through a mechanism that involves enhanced NF-κB signaling.

Reversible infertility associated with testosterone therapy for symptomatic hypogonadism in infertile couple.

Purpose Androgen replacement therapy has been shown to be safe and effective for most patients with testosterone deficiency. Male partners of infertile couples often report significantly poorer sexual activity and complain androgen deficiency symptoms. We report herein an adverse effect on fertility caused by misusage of androgen replacement therapy in infertile men with hypogonadal symptoms. Materials and Methods The study population consisted of 8 male patients referred from a local clinic for azoospermia or severe oligozoospermia between January 2008 and July 2011. After detailed evaluation at our andrology clinic, all patients were diagnosed with iatrogenic hypogonadism associated with external androgen replacement. We evaluated changes in semen parameters and serum hormone level, and fertility status. Results All patients had received multiple testosterone undecanoate (NebidoR) injections at local clinic due to androgen deficiency symptoms combined with lower serum testosterone level. The median duration of androgen replacement therapy prior to the development of azoospermia was 8 months (range: 4-12 months). After withdrawal of androgen therapy, sperm concentration and serum follicle-stimulating hormone level returned to normal range at a median 8.5 months (range: 7-10 months). Conclusion Misusage of external androgen replacement therapy in infertile men with poor sexual function can cause temporary spermatogenic dysfunction, thus aggravating infertility.

Correlation Between Serum Prostate Specific Antigen Level and Prostate Volume in a Community-based Cohort: Large-scale Screening of 35,223 Korean Men

OBJECTIVE To investigate the relationship between prostate specific antigen (PSA) level and prostate volume (PV) according to age in a community-based population of Korean men enrolled in a large-scale screening program. METHODS A total of 35,223 men who enrolled in the Korean Prostate Health Council Screening Program from January 2001 to December 2011 were included in this study. Patients with a serum PSA level of >10 ng/mL or younger than 40 years were excluded. We analyzed PSA level and PV as measured through transrectal ultrasonography according to stratified age cohorts. We used Pearson correlation and linear regression analysis according to age to describe the correlation between PSA level and PV. RESULTS Mean PSA level and mean PV increased significantly with age (all P values <.001). Based on data from 5 age cohorts, mean PSA level increased about 0.3 ng/mL every 10 years and mean PV increased about 3 mL every 10 years. The slope of the linear regression between PSA level and PV was 4.582, and the slope of the linear regression increased with age. We derived equations relating PSA level and PV for the various age cohorts. CONCLUSION Based on a large-scale health screening program, we derived equations relating PSA level to PV according to age group. These data provide a baseline for the normal population by avoiding the interventional bias of urinary symptoms, in contrast to previous data derived from patients who visited hospitals because of prostate-related health concerns.

Laparoscopic Treatment of Appendicovesical Fistula

A 23-year-old man had a history of intermittent episodes of urinary tract infection with associated low abdominal pain for 15 years. Persistent bacteriuria even with prolonged antibiotics was the reason why he was referred to our hospital. Laboratory tests were normal except pyuria and growth of Escherichia coli in the urinary samples. Cystoscopy revealed a small slit-like opening on the right lateral wall of bladder dome. We found some air within the bladder and a suspicious communicating tract between the appendix and bladder on a CT scan. With a strong impression of appendicovesical fistula, a laparoscopy was performed to confirm a diagnosis and to remove the appendicovesical fistula resulting in a satisfactory result without any complication.

MP81-08 THE COMPARISON OF THERAPEUTIC EFFICACY OF CHA1 MSC AND ADMSC AND EVALUATE THE THERAPEUTIC MECHANISM IN A CHRONIC INTERSTITIAL CYSTITIS RAT MODEL

the therapeutic outcomes were examined by conscious cystometry, histological analyses, and gene expression analyses. Next, we compared the efficacy of M-MSCs at a low dosage (1 x 10 cells) with adult bone-marrow (BM)-derived MSCs. RESULTS: Rats in the KC group exhibited irregular voiding frequencies and decreased micturition interval (MI) compared with the sham group rats. A transplantation of M-MSCs (0.25, 0.5, and 1 x 10 cells; KC þ M-MSC group) significantly increased the MI as a dose dependent manner. Bladder capacity and micturition volume of rats in the KC group decreased significantly compared with those in the sham group. However, these parameters were reversed after transplantation of M-MSCs with every cell dosage. The bladders in the KC group exhibited markedly increased infiltration of Toluidine blue stained mast cells and a higher number of TUNEL stained apoptotic cells, compared to the sham group. The administration of M-MSCs significantly reversed the infiltration of mast cell and apoptosis detected in the KC bladders. Furthermore, M-MSC therapy helped to prevent the bladder tissue fibrosis. The gene expression analyses indicated that several genes related to tissue fibrosis, including TGF-b1 and TGF-b2, were markedly upregulated in the KC bladder. However their expression was significantly suppressed by the administration of M-MSCs. Importantly, MMSCs ameliorated the bladder function of KC rats at a low dose (1 x 10) of cells for which BM-derived MSCs did not substantially improve aberrant bladder function. CONCLUSIONS: This study demonstrates for the first time the therapeutic efficacy of hESC-derived M-MSCs on KC in rats. The injection of M-MSCs restores bladder function with superior efficacy compared to BM-derived MSCs by protecting against the abnormal alteration in mast cell infiltration, apoptosis and fibrotic damage.