Appropriate cut-off value for follicle-stimulating hormone in azoospermia to predict spermatogenesis

<p>Abstract</p> <p>Background</p> <p>This study was undertaken to determine the optimal cut-off value for FSH to predict the presence of spermatogenesis in patients with non-obstructive azoospermia.</p> <p>Methods</p> <p>A total of 206 non-obstructive azoospermic men were enrolled in this prospective study. By using receiver operating characteristic (ROC) curves, we determined the optimal cut-off value for FSH and evaluated whether the test could adequately predict successful sperm retrieval.</p> <p>Results</p> <p>There were 108 non-obstructive azoospermic patients who had evidence of spermatogenesis (group A) and achieved success in sperm retrieval. Another 98 non-obstructive azoospermic patients (group B) failed in sperm retrieval. The mean value of serum FSH in group B was significantly higher than in group A (28.03 +/- 14.56 mIU/mL vs 7.94 +/- 4.95 mIU/mL, p < 0.01; respectively). The area under the receiver operating characteristic curves were 0.939 +/- 0.02 and a cut-off value of 19.4 mIU/mL discriminated between group A and B with a sensitivity of 70%. The positive predictive value for failed sperm retrieval (group B) can reach 100%.</p> <p>Conclusions</p> <p>Elevated plasma levels of FSH of more than 19.4 mIU/mL could be used as a reliable criterion for a trial of sperm retrieval from testes in artificial reproductive techniques.</p

Down-Regulation of Glucose-Regulated Protein (GRP) 78 Potentiates Cytotoxic Effect of Celecoxib in Human Urothelial Carcinoma Cells

Celecoxib is a selective cyclooxygenase-2 (COX-2) inhibitor that has been reported to elicit anti-proliferative response in various tumors. In this study, we aim to investigate the antitumor effect of celecoxib on urothelial carcinoma (UC) cells and the role endoplasmic reticulum (ER) stress plays in celecoxib-induced cytotoxicity. The cytotoxic effects were measured by MTT assay and flow cytometry. The cell cycle progression and ER stress-associated molecules were examined by Western blot and flow cytometry. Moreover, the cytotoxic effects of celecoxib combined with glucose-regulated protein (GRP) 78 knockdown (siRNA), (−)-epigallocatechin gallate (EGCG) or MG132 were assessed. We demonstrated that celecoxib markedly reduces the cell viability and causes apoptosis in human UC cells through cell cycle G1 arrest. Celecoxib possessed the ability to activate ER stress-related chaperones (IRE-1α and GRP78), caspase-4, and CCAAT/enhancer binding protein homologous protein (CHOP), which were involved in UC cell apoptosis. Down-regulation of GRP78 by siRNA, co-treatment with EGCG (a GRP78 inhibitor) or with MG132 (a proteasome inhibitor) could enhance celecoxib-induced apoptosis. We concluded that celecoxib induces cell cycle G1 arrest, ER stress, and eventually apoptosis in human UC cells. The down-regulation of ER chaperone GRP78 by siRNA, EGCG, or proteosome inhibitor potentiated the cytotoxicity of celecoxib in UC cells. These findings provide a new treatment strategy against UC

One-Stage Correction of Proximal Hypospadias and Penoscrotal Transposition

Background and Purpose: Total correction of proximal hypospadias and penoscrotal transposition (PST) is a challenge to surgeons. Staged operation is Usually recommended because the blood supply to the neourethra or the skin covering the penile shaft may be severed during scrotoplasty. This paper describes results obtained using a new technique for total correction, which preserves the blood supply to the neourethra in a one-stage operation, Patients and Methods: Between July 1998 and March 2000, five boys (mean age 4 yr) with proximal hypospadias and PST Underwent total correction in a one-stage operation, The urethral meatus of these patients was located at mid shaft in one, at the penoscrotal junction in two, and at the scrotum in two. Hypospadias was repaired using the Snodgrass procedure and PST was corrected using the Ehrlich and Scardino technique. Radical bulbar urethra dissection and tunica albugineal plication were used to correct penile curvature in all five cases. The urethral stern was removed on the seventh or eighth postoperative day. The meatus was then dilated using the cone tip of an ophthalmic ointment tube two or three times per day for 2 to 4 Postoperative urinary flow was observed in the outpatient clinic. Results: The mean follow-up period was 11.2 months. There was no postoperative fistula. One patient had postoperative meatal stenosis that was successfully treated by dilation. Postoperatively, the penile base was well above the scrotal rhugae and the meatus was at the tip of the glans in each patient. The postoperative urinary, flow was straight in all patients. Conclusion: Combining Snodgrass hypospadias repair and Ehrlich and Scardino PST repair in a one-stage operation preserved the blood supply to the neourethra and achieved excellent functional and cosmetic results

The Effect of Biological Dyes and Contrast Media on the Vas Deferens in Long Evans Rats

The conventional diagnostic procedure of vasography utilizes a contrast medium to evaluate the patency of the vas deferens. With the development of microsurgical reconstruction for obstructive azoospermia in the past two decades, intraoperative vasography with saline or biological dye injection has replaced the use of radiographic contrast media. However, there are few reports on the effect uf biological dyes on the healthy vas deferens. Therefore, we used experimental vasography to evaluate histological changes and functional patency of the vas deferens after infusion with a contrast medium and biological dye. Four groups of 10 Long Evans male rats were injected by vasopuncture with 1% methylene blue, 1% gentian violet arid 38% Urografin or saline into the vas deferens. The animals were killed 30 days later, and the vasa deferentia were excised and examined for histological changes and for functional patency. Vasopuncture with saline injection induced minimal change both at the puncture site and in the distal vas deferens. In both the Urografin- and methylene blue-injected groups, inflammation at the puncture site was found ill 20-22% of cases, and 10-11% of cases revealed functional obstruction of the vasal lumen. in the gentian violet-injected group, severe histological and obliterated changes were found in all cases. Leakage of the dye and contrast medium or the sperm reaction may be responsible for the inflammation; otherwise, methylene blue and urografin did trot seem to be harmful to the vas deferens. Although gentian violet is a blue dye, as is methylene blue, it has marked destructive effects oil the vas deferens. It is concluded that some biological dyes used for vasal injection can cause occlusion of the vasal lumen, while inflammatory responses can occur from placing a needle transmurally