Appropriate Testosterone-to-Estradiol Ratios for Aromatase Inhibitor Usage in Oligoasthenospermic Men / 대한남성과학회지

PURPOSE: We investigated whether oligospermic or asthenospermic men have decreased testosterone-to-estradiol (TE) ratios and whether this condition can be corrected with an oral aromatase inhibitor. We also determined the predictive value of pretreatment TE ratios for aromatase inhibitor efficacy in infertile men. MATERIALS AND METHODS: From June 2002 to December 2003, a total of 68 subfertile men with abnormal TE ratios were treated with 1 mg of anastrozole daily for 3 months. Changes in serum testosterone, serum estradiol, TE ratios, and semen parameters were evaluated 3 months after this therapy. RESULTS: Men treated with anastrozole had an increase in TE ratios (mean 0.2+/-0.7 [SE] versus 0.38+/-0.15; p<0.001). Semen analysis before and during anastrozole treatment showed an increase in sperm concentration (48.96 versus 70.42 million/mL; p<0.001) and motility (26.3 versus 33.2%; p<0.005). CONCLUSIONS: Men who are subfertile with lower TE ratios can be treated with an aromatase inhibitor with an increase in TE ratios that correlates with improved semen characteristics. We advise that an aromatase inhibitor be used in oligospermic or asthenospermic men if the TE ratio is below 0.2.

Histo-pathologic Characteristics of Cystic Renal Cell Carcinoma / 대한비뇨기과학회지

PURPOSE: No consistent histo-pathological characteristics of cystic renal cell carcinomas have previously been determined. In this study, attempts were made at our hospital to evaluate the histopathological characteristics of this cancer. MATERIALS AND METHODS: The medical records of 451 patients with renal cell carcinomas, having undergone a radical nephrectomy, between January 1995 and April 2002, were retrospectively reviewed. The renal cell carcinomas were classified, according to the criteria of the World Health Organization, as a cystic renal cell carcinoma in 31 of these patients (6.8%). The tumor size, nuclear grade and pathological stage were investigated. RESULTS: The mean age of the patients was 52 years, ranging from 35 to 75. Cancer stages were T1, T2 and T3 in 26 (84%), 3 (10%) and 2 (6%) patients, respectively. The nuclear grade and pathological stage were lower in patients with a cystic renal cell carcinoma. CONCLUSIONS: 81% of the cystic renal cell carcinoma cases were diagnosed incidentally. The cystic renal cell carcinomas were usually detected at lower stages and grades, and therefore were associated with a better prognosis than the renal cell carcinomas.