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Candyland [Shared]

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Ali Alatas

on 2 April 2015

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Transcript of Candyland [Shared]

From

Bellbottoms
to
Bluetooth
:
40 Years of Clinical Andrology
Paul Turek MD, FACS, FRSM
The Turek Clinic
Beverly Hills & San Francisco
Vietnam war ends
Mood rings, hip huggers
8-track tapes
All in the Family (top TV show)
Wozniack & Jobs: Apple 1 Prototype
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Began formal evaluation of male infertility patients as a resident at Univ. of Pennsylvania
Reported long term fertility outcomes of men with undescended testicles
Larry Lipshultz MD
Greenberg, SH, Lipshultz LI and Wein AJ. Experience with 425 subfertile male patients. J Urol. 1978 119:507-10.

Lipshultz LI, Caminos-Torres, I, Greenspan CS, Snyder PS. Testicular function after orchiopexy for unilaterally undescended testis. NEJM. 1976 295:15-18.
Low fertilization with IVF
Not usable for IUI
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First IVF performed
Louise Brown b. 1978
Nobel Prize (Edwards) 2010
Steptoe and Edwards
Apple II computer sells for $1300 to $2600
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Evaluated karyotypes in 1170 infertile men
Absence of the long arm of the Y chromosome
Localized genetic male infertility to Y chromosome
Tiepolo and Zuffardi
Teipolo F and Zuffardi O. Localization of factors controlling spermatogenesis in the nonfluorescent portion of the human Y chromosome long arm. Genetics. 1978 119:507-10.
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Isolates Prostatic Specific Antigen (PSA)
FDA approves PSA as diagnostic test
Revolutionized early detection
and monitoring of prostate cancer
AACR: “Landmark discovery
of the 20th century”
T. Ming Chu (Roswell Park)
Risk similar to family history of heart disease
Risk similar to smoking history
Relationship elucidated: erectile dysfunction and heart disease.
Thompson IM, Tangen CM, Goodman PJ, Probstfield JL, Moinpour CM, Coltman CA.Erectile dysfunction and subsequent cardiovascular disease. JAMA. 2005 294; 2996-3002.
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High success regardless of vasectomy age.
Reliable and robust procedures
Landmark paper on vasectomy
reversal
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First WHO Manual for Semen Analysis
Now on 5th Edition
Epididymal Sperm Retrieval
Described
Temple-Smith PD, Southwick GJ, Yates CA, Trounson AO, de Kretser DM. Human pregnancy by in vitro fertilization (IVF) using sperm aspirated from the epididymis. J In Vitro Fert Embryo Transf. 1985 2:119–22.
Belker AM, Thomas AJ Jr, Fuch EF, Konnak JW , Sharlip ID.Results of 1,469 microsurgical vasectomy reversals by the Vasovasostomy Study Group. J Urol. 1991 145:505-11.
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Routine clinical practice now
Has led to FNA Mapping and Microdissection TESE
Sperm found in bone marrow transplant survivors
“Every sperm is sacred”
TESE reported (Testicular sperm extraction)
Craft I, Bennett V, Nicholson N. Fertilising ability of testicular spermatozoa. Lancet. 1993;342:864.
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ICSI (Intracytoplasmic Sperm Injection)
Palermo G, Joris H, Devroey P, Van Steirteghem AC Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet. 1992.
Endeavor
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Routine clinical practice
Rescues most PDE5i failures
Mainstay of post-prostatectomy ED treatment
FDA approves intracavernosal injections for erectile dysfunction
Reijo R, Lee T Y, Salo P, et al. Nat Genet. 1995;10:383-93
Explains 6-15% of men with low to no sperm counts
DAZ gene discovered on Y chromosome
Galileo
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Massive, instant success
Blockbuster billion dollar drug
Rescues 2/3 of men with ED.
FDA approves Sildenafil (Viagra) for erectile dysfunction
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80% of prostate cancer surgeries now
Faster recovery; shorter hospital stay
First report: robotic radical prostatectomy
Abbou CC, Hoznek A, Salomon L, Olsson LE, Lobontiu A, Saint F, et al. Laparoscopic radical prostatectomy with a remote controlled robot. J Urol. 2001, 165:1964.
Full transcript