Joong Shik Lee

Gene Amplification and Mutation Analysis of Epidermal Growth Factor Receptor in Hormone Refractory Prostate Cancer

Amplification and mutation of the epidermal growth factor receptor (EGFR) and Her‐2 genes were analyzed in both hormone sensitive and hormone refractory prostate cancer (HRPC).

Urologic complications following obstetric and gynecologic surgery.

Purpose Urologic injuries occur frequently during surgery in the pelvic cavity. Inadequate diagnosis and treatment may lead to severe complications and side effects. This investigation examined the clinical features of urologic complications following obstetric and gynecologic surgery. Materials and Methods We accumulated 47,318 obstetric and gynecologic surgery cases from 2007 to 2011. Ninety-seven patients with urological complications were enrolled. This study assessed the causative disease and surgical approach, type, and treatment method of the urologic injury. Results Of these 97 patients, 69 had bladder injury, 23 had ureteral injury, 2 had vesicovaginal fistula, 2 had ureterovaginal fistula, and 1 had renal injury. With respect to injury rate by specific surgery, laparoscopic-assisted radical vaginal hysterectomy was the highest with 3 of 98 cases, followed by radical abdominal hysterectomy with 15 of 539 cases. All 69 cases of bladder injury underwent primary suturing during surgery without complications. Of 14 cases with an early diagnosis of ureteral injury, 7 had a ureteral catheter inserted, 5 underwent ureteroureterostomy, and 2 underwent ureteroneocystostomy. Of nine cases with a delayed diagnosis of ureteral injury, ureteral catheter insertion was carried out in three cases, four cases underwent ureteroureterostomy, and two cases underwent ureteroneocystostomy. Conclusions Bladder injury was the most common urological injury during obstetric and gynecologic surgery, followed by ureteral injury. The variety of injured states, difficulty of diagnosis, and time to complete cure were much greater among patients with ureteral injuries. Early diagnosis and urologic intervention is important for better outcomes.

Success Rate of Microsurgical Multiple Testicular Sperm Extraction and Sperm Presence in the Ejaculate in Korean Men With Y Chromosome Microdeletions

Purpose We assessed the frequency of azoospermia factor a (AZFa), AZFb, and AZFc deletions and examined correlations between the deletion sites and the success rates of sperm presence within the ejaculate and surgical sperm retrieval in Korean men. Materials and Methods A total of 1,919 azoospermic and severely oligozoospermic men were assessed for Y chromosome microdeletions. Among them, 168 men with AZF deletions were identified and their medical records were reviewed. Results Of the total 168 men with AZF deletions, there were 13 with AZFa, 10 with AZFb, 95 with AZFc, 37 with AZFbc, and 13 with AZFabc deletions. Of the 95 men with isolated AZFc deletion, 51 had the presence of sperm in the ejaculate. Of the infertile men with any other deletion, however, only two patients (one man with AZFb deletion and another with AZFbc deletion) showed the presence of sperm in the ejaculate. The success rates for surgical sperm retrieval were 7.1% (1/14) in men with AZFbc deletion and 54.8% (17/31) in the isolated AZFc deletion group. No sperm was obtained from the patients with AZFa or AZFb deletions who underwent microsurgical sperm retrieval. In the isolated AZFc deletion group, there were significant differences between azoospermic and severely oligozoospermic patients in terms of testicular volume and serum levels of follicle-stimulating hormone and luteinizing hormone, whereas no significant differences were found when the group was divided by surgical sperm retrieval outcomes. Conclusions Deletions of the AZFa and AZFb regions are associated with severe spermatogenetic impairment. However, more than half of men with an AZFc deletion had sperm within the ejaculate or testis for in vitro fertilization with intracytoplasmic sperm injection.

Do cigarette smoking and obesity affect semen abnormality in idiopathic infertile males

Purpose This study was conducted to find the relative risk of semen abnormality with respect to smoking history and obesity. Materials and Methods Subfertile or infertile men were enrolled in this study from July 2010 to June 2011. All participants provided their cigarette use information, self-reported weight, height, semen analysis, physical examination, and sexually transmitted disease status. None of the enrolled patients had any specific pathological reason for infertility. Semen abnormality was defined as a condition in which one or more parameters did not satisfy the World Health Organizations criteria. Results A total of 1,073 male patients were considered for this study. After the application of the inclusion criteria, 193 patients were finally analyzed. These patients were divided into two groups according to semen abnormality: the normal semen group (n=72) and the abnormal semen group (n=121). Baseline characteristics, except age and smoking history, were not significantly different between the two groups. Smoking history and age were risk factors for the semen abnormality of idiopathic infertile male patients. Conclusions Smoking and old age were risk factors for semen abnormality. However, obesity did not affect the semen abnormality. Smoking affected semen quality and is therefore expected to play a negative role in conception.

MP73-20 NOVEL CULTURE METHOD FOR RENAL CELL CARCINOMA: MODIFIED ORGANOID CULTURE

included non-white race (p<0.01), preoperative diabetes (p<0.01) and hypertension (HTN) (p<0.01), higher ASA (p<0.01), higher BMI (p<0.01), and higher Charlson score (p<0.01). The incidence of AKI was higher in patients with preoperative proteinuria (10.3% vs. 4.6%, p1⁄40.01). The median eGFR preservation measured within one month after surgery was lower (83.6% vs. 91%, p1⁄40.04) in those with proteinuria; however, there were no significant differences by 3 months after surgery or last follow-up visit. Independent predictors of AKI were high BMI (p<0.01), longer ischemia time (p<0.01), and preoperative proteinuria (p1⁄40.02). CONCLUSIONS: Preoperative proteinuria by urine dipstick is an independent predictor of postoperative AKI after RPN. This test may be used to identify patients, especially those without overt CKD, who are at increased risk for developing AKI after RPN.

MP06-15 EFFECT OF CORM-3 IN ISCHEMIA REPERFUSION INJURY AND CISPLATIN-INDUCED TOXICITY: DIFFERENCES IN NORMAL KIDNEY CELL AND RENAL CANCER CELL

group showed disappointment of IRI change. In selective group, the serum TNF-a and HMGB-1 level was lower than systemic group (TNF-a: 30.6 vs 85.4 pg/ml, p<0.05, HMGB-1: 2.6 vs 11.4 ng/ml, p<0.05). The mRNA expression of IL-1b was also suppressed in selective group specimen. CONCLUSIONS: H2S administration performed safety and appeared to have potential cytoprotective and anti-inflammatory effects following renal IRI. This effect was most profound with selective renal artery administration. Further work investigating the benefits of H2S for organ procurement and preservation is warranted as this may allow for improved outcomes following renal transplantation.

MP06-14 IMPACT OF VISCERAL AND SUBCUTANEOUS ADIPOSE TISSUE ON POST DONATION RENAL FUNCTION IN LIVING KIDNEY DONORS

group showed disappointment of IRI change. In selective group, the serum TNF-a and HMGB-1 level was lower than systemic group (TNF-a: 30.6 vs 85.4 pg/ml, p<0.05, HMGB-1: 2.6 vs 11.4 ng/ml, p<0.05). The mRNA expression of IL-1b was also suppressed in selective group specimen. CONCLUSIONS: H2S administration performed safety and appeared to have potential cytoprotective and anti-inflammatory effects following renal IRI. This effect was most profound with selective renal artery administration. Further work investigating the benefits of H2S for organ procurement and preservation is warranted as this may allow for improved outcomes following renal transplantation.

MP06-12 USEFULNESS OF MULTI-DETECTOR COMPUTED TOMOGRAPHY SCANNING FOR REPLACEMENT OF DIETHYLENETRIAMINE PENTAACETIC ACID (DTPA)

RESULTS: Renal function tests were statistically significant lower in ischemic groups (LC and LS) in comparison to sham through the study period, where LS group showed statistically significant lower serum creatinine and higher GFR at all end point times than LC group. (Figure 1) Sildenafil-treated group showed statistically significant lower renal cortical and medullary necrosis and interstitial fibrosis than control group. Regarding RI, LS group showed statistically significant higher expression of all RI than other groups (p value <0.05). Also, LS group showed statistically significant higher expression of Ki-67 than both groups at 1, 3, 7 and 14 days post renal IR injury (p Values < 0.05). (Figure 2) CONCLUSIONS: Local sildenafil administration; beside its role in renal protection against IR, enhances renal regenerative capacity after release of ischemic insult.

MP39-18 MITOCHONDRIA FUNCTION CHANGE AND ACTIVATION OF AMPK-PGC1? PATHWAY THROUGH INDUCTION OF CLEAR CYTOPLASM IN RENAL CELL CARCINOMA

INTRODUCTION AND OBJECTIVES: Peripheral blood mitochondrial DNA (mtDNA) is suggested as a risk factor for several types of cancer. Previous studies have assessed the association between mtDNA and renal cell carcinoma (RCC), however, contradictory results were obtained. The aim of the present study was to assess the role of peripheral blood mtDNA in prediction and early detection of renal cell carcinoma in a cohort of Egyptian patients. METHODS: The study enrolled 57 patients with early localized RCC (TNM stage I and II), confirmed by histopathological examination. They were consecutively recruited between August 2012 and March 2015 after excluding patients with advanced RCC (TNM stage III and IV) (to omit the effect of disease progression on mtDNA content), patients with other malignancies, family history of kidney cancer, recurrent RCC, and patients who received neoadjuvant therapy. Sixty healthy individuals with matching age and sex were included as control. The Ethics Committee approved this study and all subjects gave informed consent.Relative mtDNA copy number was measured using quantitative real-time PCR assay. Mitochondrial DNA (mtDNA) copy number was determined relative to the nuclear gene (HBB gene) using the formula. RESULTS: Fifty seven patients (36 males, 21 females) diagnosed with early localized RCC were included: 50 clear RCC,5 papillary RCC and 2 chromophobe RCC cases. The mean age was 60.14 6.83 years. Median mtDNA copy number was significantly higher in RCC cases than controls (166 vs 91, P<0.001). The role of mtDNA copy number as a risk factor for RCC was evaluated using unconditional logistic regression analysis. The median mtDNA content of the control group (91) was used as a cutoff value to analyze mtDNA copy number. It was found that patients with mtDNA content higher than 91 had a significant increase in RCC risk of 18 fold than those with lower levels with OR (odds ratio) of 18.0 (95% CI 1⁄4 5.065-63.9) in univariate analysis and an adjusted OR of 18.9 (95% CI 1⁄4 5.11-70.11) in multivariate analysis (after adjusting for age, gender, smoking status, hypertension and body mass index). The diagnostic value of mtDNA content in early detection of RCC was further assessed. Using receiver operating curve (ROC curve) analysis, it was found that mtDNA can detect RCC at a cutoff value of 108.5 with 86% sensitivity, 80% specificity, 80.3 % positive predictive value and 85.7% negative predictive value. CONCLUSIONS: Increased mtDNA copy number could be used as a potential independent predictor of RCC risk. In addition, it may serve as a promising non-invasive biomarker for early detection of RCC.