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Güzel A, Özorak A, Oksay T, Öztürk SA, Bozkurt KK, Yunusoğlu S, Uz E, Uğuz AC, Koşar PA. The efficiency of oxerutin on apoptosis and kidney function in rats with renal ischemia reperfusion injury. ULUS TRAVMA ACIL CER 2022; 28:344-351. [PMID: 35485553 PMCID: PMC10493537 DOI: 10.14744/tjtes.2021.15740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 07/13/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Background: Renal ischemia-reperfusion injury (RIRI) is the most frequent cause of acute renal failure in clinical conditions such as trauma and shock as well as renal surgeries. Oxerutin is a member of the flavonoid family and possesses antioxidant properties. The aim of this study was to investigate whether oxerutin has protective effects on RIRI. METHODS Twenty-eight male Wistar albino rats were randomly divided into three groups: sham control group (n=8), RIRI group (n=10), and RIRI + oxerutin group (n=10). RIRI was achieved by clamping the left renal artery for 30 min, followed 1-h reperfusion period. Thereafter, blood samples and left kidney tissue samples were taken for histopathological and biochemical examination. Blood urea nitrogen (BUN), urea, creatinine, and cystatin C levels, which are indicators of kidney function, as well as tumor necrosis factor-alpha, which is an indicator of inflammation were analyzed in blood samples. Total antioxidant status and total oxidant status (TOS), which are indicators of oxidative stress were analyzed on renal tissues. The apoptotic index, an indicator of kidney damage, as well as histopathological changes were evaluated on renal tissues. RESULTS The apoptotic index, TOS, tumor necrosis factor-alpha, BUN, and urea levels were lower in the RIRI + oxerutin group than in the RIRI group (p<0.05). The results demonstrated that the histopathological and biochemical properties of oxerutin protected rats from RIRI. CONCLUSION The findings obtained in this study show that prophylactic administration of oxerutin has protective effects on apoptosis and renal failure caused by RIRI. Therefore, oxerutin can be used as an effective prophylactic agent in the treatment of RIRI.
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Affiliation(s)
- Ahmet Güzel
- Department of Urology, Aydin State Hospital, Aydın-Turkey
| | - Alper Özorak
- Department of Urology, Suleyman Demirel University Faculty of Medicine, Isparta-Turkey
| | - Taylan Oksay
- Department of Urology, Suleyman Demirel University Faculty of Medicine, Isparta-Turkey
| | - Sefa Alperen Öztürk
- Department of Urology, Suleyman Demirel University Faculty of Medicine, Isparta-Turkey
| | - Kemal Kürşat Bozkurt
- Department of Pathology, Suleyman Demirel University Faculty of Medicine, Isparta-Turkey
| | - Sedat Yunusoğlu
- Department of Urology, Afyonkarahisar State Hospital, Afyonkarahisar-Turkey
| | - Efkan Uz
- Department of Biochemistry, Suleyman Demirel University Faculty of Medicine, Isparta-Turkey
| | | | - Pınar Aslan Koşar
- Department of Medical Biology, Suleyman Demirel University Faculty of Medicine, Isparta-Turkey
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Thapa K, Singh TG, Kaur A. Cyclic nucleotide phosphodiesterase inhibition as a potential therapeutic target in renal ischemia reperfusion injury. Life Sci 2021; 282:119843. [PMID: 34298037 DOI: 10.1016/j.lfs.2021.119843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/10/2021] [Accepted: 07/13/2021] [Indexed: 12/19/2022]
Abstract
AIMS Ischemia/reperfusion (I/R) occurs in renal artery stenosis, partial nephrectomy and most commonly during kidney transplantation. It brings serious consequences such as DGF (Delayed Graft Function) or organ dysfunction leading to renal failure and ultimate death. There is no effective therapy to handle the consequences of Renal Ischemia/Reperfusion (I/R) injury. Cyclic nucleotides, cAMP and cGMP are the important second messengers that stimulate intracellular signal transduction for cell survival in response to growth factors and peptide hormones in normal tissues and in kidneys plays significant role that involves vascular tone regulation, inflammation and proliferation of parenchymal cells. Renal ischemia and subsequent reperfusion injury stimulate signal transduction pathways involved in oxidative stress, inflammation, alteration in renal blood flow leading to necrosis and apoptosis of renal cell. MATERIALS AND METHODS An extensive literature review of various search engines like PubMed, Medline, Bentham, Scopus, and EMBASE (Elsevier) databases was carried out. To understand the functioning of Phosphodiesterases (PDEs) and its pharmacological modulation in Renal Ischemia-Reperfusion Injury. KEY FINDINGS Current therapeutic options may not be enough to treat renal I/R injury in group of patients and therefore, the current review has discussed the general characteristics and physiology of PDEs and preclinical-studies defining the relationship between PDEs expression in renal injury due to I/R and its outcome on renal function. SIGNIFICANCE The role of PDE inhibitors in renal I/R injury and the clinical status of drugs for various renal diseases have been summarized in this review.
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Affiliation(s)
- Komal Thapa
- Chitkara College of Pharmacy, Chitkara University, 140401 Punjab, India; School of Pharmacy, Himachal Pradesh, India
| | | | - Amarjot Kaur
- Chitkara College of Pharmacy, Chitkara University, 140401 Punjab, India
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Coskuner ER, Ozkan B. Reno-protective effects of Phosphodiesterase 5 inhibitors. Clin Exp Nephrol 2021; 25:585-597. [PMID: 33754203 DOI: 10.1007/s10157-021-02051-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/09/2021] [Indexed: 12/20/2022]
Abstract
The kidneys are vital organs that play an important role in removing waste materials from the blood, electrolyte balance, blood pressure regulation, and red blood cell genesis. Kidney disease can be caused by various factors, including diabetes, ischemia/reperfusion injury, and nephrotoxic agents. Inflammation and oxidative stress play a key role in the progression and pathogenesis of kidney diseases. Acute kidney injury (AKI) and chronic kidney disease (CKD) are important health problems worldwide, as they are associated with a long-term hospital stay, and increased morbidity and mortality in high-risk patients. Current standard therapeutic options are not sufficient to delay or stop the loss of kidney function. Therefore, it is necessary to develop new therapeutic options. Phosphodiesterase 5 inhibitors (PDE5Is) are a currently available class of drugs that are used to treat erectile dysfunction and pulmonary hypertension in humans. However, recent evidence suggests that PDE5Is have beneficial renoprotective effects via a variety of mechanisms. In this review, the benefits of PDE5 inhibitors in clinical conditions associated with kidney disease, such as diabetic nephropathy, ischemia-reperfusion injury, and acute and chronic kidney injury, are summarized.
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Affiliation(s)
- Enis Rauf Coskuner
- Department of Urology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Acibadem Bakirkoy Hospital, Halit Ziya Usakligil Cad No:1, Bakirkoy, 34140, Istanbul, Turkey.
| | - Burak Ozkan
- Department of Urology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Acibadem Bakirkoy Hospital, Halit Ziya Usakligil Cad No:1, Bakirkoy, 34140, Istanbul, Turkey
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Sertkaya Z, Koca O, Ozturk M, Akyuz M, Gumrukcu G, Kutluhan MA, Karaman MI. Protective Effect of Udenafil Against Ischemia Reperfusion Injury Due to Testicular Torsion/Detorsion in Rat Model. Eurasian J Med 2020; 52:115-119. [PMID: 32612416 DOI: 10.5152/eurasianjmed.2020.19229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 09/29/2019] [Indexed: 11/22/2022] Open
Abstract
Objective Testicular torsion causes migration of neutrophils to the ischemic region and formation of free oxygen radicals that have a critical effect on ischemic reperfusion (I/R) injury. Udenafil is a selective, strong, and reversible inhibitor of phosphodiesterase type enzyme. In our study, we evaluate the protective effect of udenafil against reperfusion injury due to I/R. Materials and Methods Twenty-one male, adult, Wistar-Albino rats aged 8 months were randomly divided into three groups; sham, I/R, and I/R+udenafil. One hour before the detorsion operation, the sham and I/R groupssaline, and I/R+udenafil groups were administered 2 mg/kg udenafil intraperitoneally. Blood samples were collected to evaluate the inflammatory mediators. Spermatogenic factors were evaluated according to Johnsen criteria. Results Histopathological and molecular parameters from all groups were compared. Mean values of TNF-α and IL-1β in venous blood samples were calculated. We observed that TNF-a values were statistically significantly increased in the I/R group than those in sham groups, and these values were decreased with udenafil treatment Furthermore, the glutathione peroxidase (GPx) level was statistically significantly decreased in the I/R group, and treatment with udenafil prevented this decrease. Evaluation of spermatogenesis using the Johnsen scoring system showed no statistically significant difference in mean scores between the groups. Conclusion We concluded that deterioration of biochemical and histopathological parameters are reversed, and injury due to I/R in testicle tissue may be decreased with udenafil treatment. Results of this experimental study show that efficacy of the udenafil treatment in testis torsion should be investigated.
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Affiliation(s)
- Zulfu Sertkaya
- Department of Urology, Memorial Hospital, Diyarbakir, Turkey
| | - Orhan Koca
- Department of Urology, Medistate Hospital, Istanbul, Turkey
| | - Metin Ozturk
- Department of Urology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Akyuz
- Department of Urology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Gulistan Gumrukcu
- Department of Pathology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Musab Ali Kutluhan
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
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Kim DK, Shin SJ, Lee J, Park SY, Kim YT, Choi HY, Yoon YE, Moon HS. Carbon monoxide-releasing molecule-3: Amelioration of renal ischemia reperfusion injury in a rat model. Investig Clin Urol 2020; 61:441-451. [PMID: 32666002 PMCID: PMC7329640 DOI: 10.4111/icu.2020.61.4.441] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 02/05/2020] [Indexed: 12/22/2022] Open
Abstract
Purpose Despite the role of carbon monoxide in ameliorating ischemia-reperfusion injury (IRI), its use in the clinical setting is restricted owing to its toxicity. Herein, we investigated the in vivo effects of carbon monoxide–releasing molecule-3 (CORM-3) on IRI. Materials and Methods Fifteen rats were equally and randomly divided into three groups: sham (right nephrectomy), control (right nephrectomy and left renal ischemia), and CORM-3 (right nephrectomy and CORM-3 injection before left renal ischemia). Kidney tissues and blood samples collected from sacrificed rats were evaluated to determine the renoprotective effect and mechanism of CORM-3. Results Concentrations of serum creatinine and kidney injury molecule-1 in the CORM-3 group were significantly lower than in the control group after 75 minutes of IRI (1.2 vs. 2.4 mg/dL, p=0.01, and 292 vs. 550 pg/mL, p<0.001, respectively). Furthermore, the CORM-3 group exhibited a higher portion of normal tubules and glomeruli. TUNEL staining revealed fewer apoptotic renal tubular cells in the CORM-3 group than in the control group. The expression of 960 genes in the CORM-3 group was also altered. Pretreatment with CORM-3 before renal IRI produced a significant renoprotective effect. Fifteen of the altered genes were found to be involved in the peroxisome proliferator-activated receptors signaling pathway, and the difference in the expression of these genes between the CORM-3 and control groups was statistically significant (p<0.001). Conclusions CORM-3 ameliorates IRI by decreasing apoptosis and may be a novel strategy for protection against renal warm IRI.
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Affiliation(s)
- Dae Keun Kim
- Department of Urology, CHA Fertility Center Seoul Station, CHA University School of Medicine, Seoul, Korea
| | - Su-Jin Shin
- Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jiyoung Lee
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
| | - Sung Yul Park
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
| | - Yong Tae Kim
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
| | - Hong Yong Choi
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
| | - Young Eun Yoon
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
| | - Hong Sang Moon
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
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Georgiadis G, Zisis IE, Docea AO, Tsarouhas K, Fragkiadoulaki I, Mavridis C, Karavitakis M, Stratakis S, Stylianou K, Tsitsimpikou C, Calina D, Sofikitis N, Tsatsakis A, Mamoulakis C. Current Concepts on the Reno-Protective Effects of Phosphodiesterase 5 Inhibitors in Acute Kidney Injury: Systematic Search and Review. J Clin Med 2020; 9:jcm9051284. [PMID: 32365529 PMCID: PMC7287956 DOI: 10.3390/jcm9051284] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/16/2020] [Accepted: 04/24/2020] [Indexed: 12/11/2022] Open
Abstract
Acute kidney injury (AKI) is associated with increased morbidity, prolonged hospitalization, and mortality, especially in high risk patients. Phosphodiesterase 5 inhibitors (PDE5Is), currently available as first-line therapy of erectile dysfunction in humans, have shown a beneficial potential of reno-protection through various reno-protective mechanisms. The aim of this work is to provide a comprehensive overview of the available literature on the reno-protective properties of PDE5Is in the various forms of AKI. Medline was systematically searched from 1946 to November 2019 to detect all relevant animal and human studies in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. In total, 83 studies were included for qualitative synthesis. Sildenafil is the most widely investigated compound (42 studies), followed by tadalafil (20 studies), icariin (10 studies), vardenafil (7 studies), zaprinast (4 studies), and udenafil (2 studies). Even though data are limited, especially in humans with inconclusive or negative results of only two clinically relevant studies available at present, the results of animal studies are promising. The reno-protective action of PDE5Is was evident in the vast majority of studies, independently of the AKI type and the agent applied. PDE5Is appear to improve the renal functional/histopathological alternations of AKI through various mechanisms, mainly by affecting regional hemodynamics, cell expression, and mitochondrial response to oxidative stress and inflammation.
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Affiliation(s)
- Georgios Georgiadis
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece; (G.G.); (I.-E.Z.); (I.F.); (C.M.); (M.K.)
| | - Ioannis-Erineos Zisis
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece; (G.G.); (I.-E.Z.); (I.F.); (C.M.); (M.K.)
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, Heraklion, Crete 71003, Greece;
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | | | - Irene Fragkiadoulaki
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece; (G.G.); (I.-E.Z.); (I.F.); (C.M.); (M.K.)
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, Heraklion, Crete 71003, Greece;
| | - Charalampos Mavridis
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece; (G.G.); (I.-E.Z.); (I.F.); (C.M.); (M.K.)
| | - Markos Karavitakis
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece; (G.G.); (I.-E.Z.); (I.F.); (C.M.); (M.K.)
| | - Stavros Stratakis
- Department of Nephrology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece; (S.S.); (K.S.)
| | - Kostas Stylianou
- Department of Nephrology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece; (S.S.); (K.S.)
| | - Christina Tsitsimpikou
- Department of Hazardous Substances, Mixtures and Articles, General Chemical State Laboratory of Greece, Ampelokipi, Athens, Greece;
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Nikolaos Sofikitis
- Department of Urology, School of Medicine, Ioannina University, Ioannina, Greece;
| | - Aristidis Tsatsakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, Heraklion, Crete 71003, Greece;
| | - Charalampos Mamoulakis
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece; (G.G.); (I.-E.Z.); (I.F.); (C.M.); (M.K.)
- Correspondence:
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Nair SM, Power NE, Coleman JA. Examining Mannitol Use in Kidney Cancer Surgery: A Cautionary Tale of Extrapolated Surgical Data. Eur Urol Focus 2019; 5:930-934. [PMID: 31628080 PMCID: PMC8560078 DOI: 10.1016/j.euf.2019.09.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 09/30/2019] [Indexed: 11/30/2022]
Abstract
Mannitol for renal protection during partial nephrectomy is common but unsupported by evidence from clinical trials. The impact of mannitol on renal physiology includes both beneficial and harmful effects. Current understanding of renal ischemia reperfusion injury suggests potentially targetable processes that have a lower potential risk.
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Affiliation(s)
- Shiva M Nair
- Urology Division, Department of Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London Health Sciences Centre, London, Ontario, Canada.
| | - Nicholas E Power
- Urology Division, Department of Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London Health Sciences Centre, London, Ontario, Canada
| | - Jonathan A Coleman
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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Use of Mannitol for Ischemia Reperfusion Injury in Kidney Transplant and Partial Nephrectomies—Review of Literature. Curr Urol Rep 2019; 20:6. [DOI: 10.1007/s11934-019-0868-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Yoon YE, Lee HH, Na JC, Han WK. Prospective assessment of urinary neutrophil gelatinase-associated lipoprotein in living kidney donors: toward understanding differences between chronic kidney diseases of surgical and medical origin. BJU Int 2018; 123:869-876. [PMID: 30347133 DOI: 10.1111/bju.14592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate the clinical implications of postoperative urinary neutrophil gelatinase-associated lipoprotein (NGAL) changes and the association between urinary NGAL (uNGAL) and renal function in living kidney donors. SUBJECTS, PATIENTS AND METHODS We included 76 healthy adults who underwent donor nephrectomy between December 2013 and November 2014. Perioperative serum creatinine (sCr), uNGAL, serum NGAL (sNGAL), and urinary microalbumin were prospectively measured until 6 months postoperatively. Patients with chronic kidney disease (CKD) due to medical disorders who visited our outpatient clinic during the same period were included for comparison. RESULTS The mean (SD) preoperative uNGAL of donors was 5 (5.17) ng/mL. uNGAL (corrected for urinary creatinine) was maximal at 1-2 days postoperatively, decreased on postoperative day 3, and stabilised by 7 days after surgery. Postoperative uNGAL was not associated with sex, age, or preoperative renal function. When corrected for sNGAL to compensate for the systemic increase in NGAL with major surgery, uNGAL on days 1-3 postoperatively was negatively correlated with sCr. Postoperatively, donor uNGAL remained higher than preoperatively for up to 6 months but was significantly lower than in patients with medical CKD with similar glomerular filtration rates. CONCLUSION Acute kidney injury due to hyperfiltration of remnant kidney after donor nephrectomy was maximal within 1-2 days postoperatively. The rise in uNGAL during this period in donors was negatively correlated with postoperative sCr levels. Decreased renal function after nephrectomy differs from that of medical CKD.
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Affiliation(s)
- Young Eun Yoon
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
| | - Hyung Ho Lee
- Department of Urology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Joon Chae Na
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Woong Kyu Han
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
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