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Objective: To describe the feasibility of retroperitoneal laparoscopic reimplantation of the left renal vein (LRV) for nutcracker syndrome (NCS). Patients and Methods: Two patients with NCS underwent the surgery. Both patients complained of gross hematuria and flank discomfort that could not be relieved by resting. They were placed in a supine position and 5 ports were placed in the right abdominal wall. The procedures were performed with a retroperitoneal approach. The LRV was transected and then reimplanted into the distal inferior vena cava. Results: The procedures were performed successfully without any major complications. The total operation time was 105 and 120 min, respectively. Hematuria and flank discomfort were resolved after the surgery. Ultrasonography revealed a patent lumen without compression. Conclusions: Retroperitoneal laparoscopic reimplantation of the LRV appears to be a feasible procedure with satisfactory short-term outcomes. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective: To report our initial experience in treating renal nutcracker syndrome by retroperitoneal laparoscopic extravascular stenting. Patients and Methods: Two male patients, aged 13 and 16 years, were diagnosed with nutcracker syndrome and received retroperitoneal laparoscopic extravascular stent placement. The perioperative data were collected and evaluated. The follow-up was 10 and 18 months. Results: Both procedures were successful without obvious complications. Total operative time was 65 and 50 min, estimated blood loss was 110 and 70 ml, and postoperative hospital stay was 4 and 6 days. The symptom of gross hematuria ceased 3 and 6 days after surgery. Both patients had normal findings during follow-up. Conclusions: Treatment of nutcracker syndrome by retroperitoneal laparoscopic extravascular stent placement is a safe and feasible procedure, especially for youngsters in the period of physical development. Longer follow-up and further experience are needed to evaluate the efficacy of this procedure. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Voltage-dependent anion channel (VDAC), a channel protein, exists in the outer mitochondrial membrane of somatic cells and is involved in multiple physiological and pathophysiological processes. Up until now, little has been known about VDAC in male germ cells. In the present study, the relationship between VDAC and human sperm motility was explored. Methods: Highly motile human spermatozoa were incubated in vitro with anti-VDAC antibody. Total sperm motility, straight line velocity (VSL), curvilinear velocity (VCL), and average path velocity (VAP) were recorded. Intracellular free calcium concentration ([Ca2+]i), pH value (pHi), and ATP content were determined. Results: Co-incubation with anti-VDAC antibody reduced VSL, VCL, and VAP of spermatozoa. Co-incubation further reduced [Ca2+]i. Anti-VDAC antibody did not significantly alter total sperm motility, pHi and intracellular ATP content. Conclusion: The data suggest that co-incubation with anti-VDAC antibody reduces sperm motility through inhibition of Ca2+ transmembrane flow. In this way, VDAC participates in the modulation of human sperm motility through mediating Ca2+ transmembrane transport and exchange. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Clusterin, a heterodimeric glycoprotein of approximately 80 kDa, exists extensively in human body fluids. The abnormal expression of clusterin is closely related to the occurrence, progression, and prognosis of tumors. Up to now, few studies have focused on clusterin in human testicular cancer. This study describes an extensive exploration of the presence and expression of clusterin in testicular seminoma. Methods: Tumor tissues and normal testis tissues were collected from 13 patients with testicular seminoma and 16 patients undergoing surgical castration for prostate cancer. Real-time polymerase chain reaction (PCR) was performed to detect the expression difference of clusterin mRNA between testicular seminoma and normal testis. Western blot and immunohistochemical analysis were performed to detect the presence and expression difference of clusterin protein between two groups. Results: Real-time PCR showed the expression of clusterin mRNA in testicular seminoma to be significantly lower than in normal testis (only 13% relative quantification). Western blot analysis indicated marked reductions in the expression of clusterin protein in testicular seminoma. Similar results were observed upon immunohistochemical analysis. Conclusion: In testicular seminoma and normal testis, clusterin exists in its heterodimeric secretory isoform. Clusterin expression is significantly lower in testicular seminoma than in normal testis. This is the first comprehensive study of the presence and expression of clusterin in human testicular cancer. © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective: Activated nuclear factor-κB is associated with the pathogenesis of numerous malignancies, including renal cell carcinoma (RCC). This study aimed to clarify the influence of a common insertion/deletion polymorphism (-94 ins/del ATTG, rs28362491) in the NFKB1 promoter on RCC susceptibility. Methods: We genotyped the NFKB1 -94 ins/del ATTG promoter polymorphism by the TaqMan method and assessed the association with RCC risk, clinicopathological parameters in a case-control study of 1,027 cases and 1,094 controls. Results: The genotype frequencies were significantly different between RCC cases and controls (p = 0.046). Compared with individuals carrying the ins/del + del/del genotypes, those with the ins/ins genotype had an increased RCC risk [p = 0.036, adjusted odds ratio (OR) = 1.23, 95% confidence interval (CI) = 1.02-1.48], particularly in the subgroup of younger age (p = 0.005, adjusted OR = 1.42, 95% CI = 1.11-1.83) and never smokers (p = 0.013, adjusted OR = 1.34, 95% CI = 1.07-1.69). Furthermore, the polymorphism was significantly associated with the risk of developing localized stage RCC (p = 0.020, OR = 1.26, 95% CI = 1.04-1.53). Conclusions: The functional NFKB1 promoter polymorphism is associated with an increased risk of RCC. © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Persistent müllerian duct syndrome (PMDS) is a rare form of male pseudohermaphroditism, characterized by the presence of a uterus and fallopian tubes owing to failure of müllerian duct regression in genotypically normal males. The association between a persistent müllerian duct and transverse testicular ectopia (TTE) is even more uncommon. PMDS with TTE is a very rare pathological association, often discovered during repair for inguinal hernia or cryptorchidism. We report 3 cases of Chinese patients with PMDS associated with TTE. Hysterectomy was performed, with resection of the underdeveloped fallopian tubes. Both gonads were placed into subdartos pouches in each scrotum by the transseptal approach. PMDS with TTE is a rarely encountered form of male pseudohermaphroditism usually unexpectedly found at surgery for cryptorchidism or inguinal hernia. Surgical treatment should avoid damage of fertile testes and vasa deferens. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Castleman's disease (CD) is an uncommon disorder of the lymphoid hyperplasia. It is especially rare in the retroperitoneum or perirenal area. We report the case of a 62-year-old woman who had an abdominal mass localized above the right kidney in the region of the right adrenal gland found by computed tomography scan. The patient subsequently underwent an exploratory laparotomy. Pathological examination revealed retroperitoneal localized CD (LCD) of the hyaline vascular type. Diversity of disease sites and nonspecificity of clinical manifestations lead to diagnostic difficulties. Therefore, diagnosis is mainly achieved via lymph node biopsy or pathological examination. Like in the reported case, LCD usually has a good prognosis after complete resection of the lesion. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective: Anastomosis of ureteropelvic junction with a laparoscope for the treatment of ureteropelvic junction obstruction (UPJO) is a time-consuming and technically challenging procedure. We present our experience of laparoscopic dismembered pyeloplasty and compare clinical outcomes of two different suture techniques. Methods: From September 2003 to June 2010, 105 laparoscopic dismembered pyeloplasties were performed in our department. All procedures were done using the retroperitoneal approach. According to the suture methods (interrupted or running), the patients were divided into two groups. An indwelling stent was placed intraoperatively in an antegrade manner. Data on operation time, blood loss and complications were collected. Results: All procedures were completed without open conversion. Mean operation time and anastomotic time were 96 (55-150) and 36 min (15-70), respectively. A significant decrease of operation and anastomosis time was seen when running sutures were applied. Mean blood loss was 54 ml (30-100). The total complication rate was 7.6%. No anastomotic stricture occurred. The average hospitalization stay was 7 days. During 5-85 months of follow-up, hydronephrosis was alleviated in all cases. Conclusions: Laparoscopic dismembered pyeloplasty for the treatment of UPJO can provide satisfactory clinical outcomes. Higher surgical efficiency and lower complication rates can be obtained by using the running suture method. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]