Cerebral Proerectile Effect of Apomorphine and Vasoactive Agents in Anesthetized Rats / 대한비뇨기과학회지

PURPOSE: To establish central control of a penile erection, the centrally elicited erectile effects of apomorphine hydrochloride and various vasoactive agents were investigated after intracerebroventricular administration. MATERIALS AND METHODS: Anesthetized male Sprague-Dawley rats were used for the study. After intracerebroventricular administration of normal saline(NS), apomorphine hydrochloride(AH), prostaglandin E1(PGE1), sodium nitroprusside(SNP), phenylephrine hydrochloride(PE) and phentolamine(PT) under a stereotaxic setting, the intracavernosal pressure(ICP), systolic femoral artery pressure(FAP), heart rate(HR), time to first response, duration and number of erectile response and adverse reactions were evaluated for 60 minutes. To show if the centrally elicited erection by agents in native setting were effective, the above criteria were re-evaluated after a bilateral pelvic neurotomy and bilateral orchiectomy. RESULTS:Cerebral proerectile effects were elicited by AH with no significant changes in the FAP and HR, but with PGE1, SNP, PE and PT significant changes in both the FAP and HR were observed. The ICP/FAP ratio was highest with SNP at 0.75+/-0.08. The mean time to first response was shortest with AH at 18.1+/-5.1min. The mean duration was longest with AH at 39.4+/-10.9min. The number of responses was highest with AH at 2.7+/-1.1. Adverse reactions, such as stretching, yawning and ejaculation, were simultaneously observed during increases in the ICP. In the case of a bilateral pelvic neurotomy or bilateral orchiectomy, these elicited erectile responses disappeared. CONCLUSIONS: Vasoactive agents, such as SNP, PGE1 and PE, had a cerebral proerectile effect, but AH showed more an evidently potent proerectile effect in the aspects of ICP, time to first response and duration of erectile response. Testosterone and the pelvic nerve are suggested to be essential for a central proerectile response.

Surgical Outcome of 153 Vasovasostomies on 10 Years or More after Vasectomy / 대한비뇨기과학회지

PURPOSE: In the 1970s, male sterilization (vasectomy) has been performed on a large scale as an accepted method of family planning in Korea. Since then, especially during last decade, there has been an increase in the number of patients requesting vasovasostomy after a long term interval following a vasectomy. MATERIALS AND METHODS: We evaluated 153 cases of vasovasostomy performed, 10 years or more after a vasectomy, at the Pusan National University Hospital between March 1983 and March 2002. Clinical data were collected through telephone interviews and a survey of medical records. RESULTS: The ages at the time of reversal ranged from 30 to 57, with an average of 41.6 years. The obstructive intervals ranged from 10 to 24, with an average of 17.0 years. To the cases were divided into 3 the obstructive intervals; 10 to 14, 15 to 19 and 20 to 24 years, with 130 (85.0%), 15 (9.8%) and 8 cases (5.2%), respectively. The overall patency and pregnancy rates were 81.6 and 36.0%, respectively. There were no significant differences according to the methods of vasovasostomy, suture materials, ooze from the proximal vasal end, the presence of sperm granuloma, the levels of anastomosis or the age of patients, with the exception of the ages of the partners in the patency and pregnancy rates for the patients with vasovasostomy 10 years or more after vasectomy. CONCLUSIONS: Our results suggest that the pregnancy rates after vasovasostomies, following at least a 10 years long term obstruction, are very low, despite the desirable patency rates. Therefore, it is important that we should apply the assisted reproductive technology, as well as advanced surgical skills, to improve the pregnancy rates.

The Antioxidant Effect of Rebamipide in Human Semen Specimens / 대한비뇨기과학회지

PURPOSE: Rebamipide is a propionic acid derivative that inhibits superoxide production and removes hydroxyl radicals. This study was performed to investigate the effects of adding rebamipide to semen, in an effort to determine if reactive oxygen species (ROS) production and lipid peroxidation of the sperm cell membrane as well as an improvement in seminal parameter and fertilizing capacity under oxidative stress was inhibited. MATERIALS AND MTHODS: Semen was collected from 30 normal healthy volunteers by masturbation after at least 48 hours abstinence. After liquefaction of the semen at room temperature, the prepared sperm was diluted with a sperm wash media to a uniform density of 20x106/ml. The semen was treated with 0.25ml of 0.2mM FeSO4 and 1mM sodium ascorbate for 60 min in the presence of various rebamipide concentrations (0, 10, 30, 100, and 300microM). ROS production, sperm motility, vitality, fertilizing capacity and the level of lipid peroxidation were analyzed by chemiluminescence, computer assisted semen analysis, eosin-nigrosin staining, a hypo-osmotic swelling test and the thiobarbituric acid method, respectively. RESULTS: Rebamipide at 100 and 300microM increased the sperm motility (p<0.05) but did not affect the sperm vitality. The ROS production and lipid peroxidation in the sperms treated with FeSO4/sodium ascorbate were inhibited by rebamipide in a dose-dependent fashion (p<0.05 in each). The total swelling rate of the hypo-osmotic swelling test was also increased by high rebamipide concentrations (100 and 300microM), respectively 49.2 17.9 and 50.8 21.7% (p<0.05). CONCLUSIONS: These results suggest rebamipide is an effective free radical scavenger and may be useful as an oral antioxidant in patients with male infertility due to increased ROS generation. However, further study to be possible the clinical use of rebamipide for improve the fertilizing capacity in male infertility is required.

The Antioxidant Effect of Rebamipide in Human Semen Specimens / 대한비뇨기과학회지

PURPOSE: Rebamipide is a propionic acid derivative that inhibits superoxide production and removes hydroxyl radicals. This study was performed to investigate the effects of adding rebamipide to semen, in an effort to determine if reactive oxygen species (ROS) production and lipid peroxidation of the sperm cell membrane as well as an improvement in seminal parameter and fertilizing capacity under oxidative stress was inhibited. MATERIALS AND MTHODS: Semen was collected from 30 normal healthy volunteers by masturbation after at least 48 hours abstinence. After liquefaction of the semen at room temperature, the prepared sperm was diluted with a sperm wash media to a uniform density of 20x106/ml. The semen was treated with 0.25ml of 0.2mM FeSO4 and 1mM sodium ascorbate for 60 min in the presence of various rebamipide concentrations (0, 10, 30, 100, and 300microM). ROS production, sperm motility, vitality, fertilizing capacity and the level of lipid peroxidation were analyzed by chemiluminescence, computer assisted semen analysis, eosin-nigrosin staining, a hypo-osmotic swelling test and the thiobarbituric acid method, respectively. RESULTS: Rebamipide at 100 and 300microM increased the sperm motility (p<0.05) but did not affect the sperm vitality. The ROS production and lipid peroxidation in the sperms treated with FeSO4/sodium ascorbate were inhibited by rebamipide in a dose-dependent fashion (p<0.05 in each). The total swelling rate of the hypo-osmotic swelling test was also increased by high rebamipide concentrations (100 and 300microM), respectively 49.2 17.9 and 50.8 21.7% (p<0.05). CONCLUSIONS: These results suggest rebamipide is an effective free radical scavenger and may be useful as an oral antioxidant in patients with male infertility due to increased ROS generation. However, further study to be possible the clinical use of rebamipide for improve the fertilizing capacity in male infertility is required.

Oral Testosterone Decanoate (Andriol(R)) Supplement Therapy Improve the Quality of Life in the Men with Testosterone Deficiency / 대한남성과학회지

PURPOSE: We evaluated the changes in quality of life after administering an oral testosterone supplement to men with testosterone deficiencies. MATERIALS and METHODS: The changes of subjective symptoms were estimated in 39 cases (33 cases in the experimental group and 6 cases in the placebo group) of testosterone definiency,in men who were treated with oral testosterone undecanoate (Andriol(R)) or a placebo by the single blind method from March 2001 to January 2002. The 80mg dose of oral testosterone was administered twice daily in a period of three months. Digital rectal examinations and laboratory tests including serum testosterone, PSA, cholesterol, AST and ALT were conducted on pretreatment and during the 1st and 3rd months after treatment. The changes in quality of life were evaluated on pretreatment and monthly after treatment by the PNUH QOL Scoring System, which consisted of 21 question sinquiring about the following 7 functions: metabolic, cardiopulmonary, musculoskeletal, gastroinestinal, neurologic and psychiatric and sexual. The Saint Louis University Questionnaire was used simultaneously to evaluate the changes in quality of life. RESULTS: The 39 cases showed a 19~64 years old age distribution (mean 45.9 years old). Underlying causes of testosterone deficiency were primary hypogonadism and andropause in 10 and 29 cases, respectively. During the follow-up period, the drop-out after treatment in the experimental group was 4 cases due to low compliance or personal reasons. Serum testosterone was significantly increased in the each month of posttreatment compared to pretreatment levels only in the experimental group (p<0.05). No abnormal finding was detected on digital rectal examination or in serum PSA, cholesterol, AST and ALT levels in either guoup. Sexual dysfunction was the most common problem prior to treatment, followed by metabolic, psychatric, musculoskeletal, neurologic, gastrointestinal and cardiopulmonary dysfunction, in order. After treatment, sexual dysfunction showed the most improvement in symptom score followed by cardiopulmonary, metabolic, cardiopulmonary, musculoskeletal, and gastrointestinal functions showed significantly more improved symptom scores in the experimental group than in the control group. The positive rate of Saint Louis University Questionnaire significantly decreased in the posttreatment compared to pretreatment levels only in the experimental group (p<0.05). The complications were nonspecific symptoms such as gastrointestinal problems and fatigue in 3 cases, and acne, urticatria and joint pain in 1 case of the experimental group. But, they were self-limited and did not cause drop-out. CONCLUSIONS: Androgen supplement therapy with oral testosterone undecanoate (Andriol(R)) enhanced the quality of life through the improvement of general body functions including physical functions and mental functions in men with testosterone deficiencies.