Fate of Neutrophils during the Recovery Phase of Ischemia/Reperfusion Induced Acute Kidney Injury

Effective clearance of inflammatory cells is required for resolution of inflammation. Here, we show in vivo evidence that apoptosis and reverse transendothelial migration (rTEM) are important mechanisms in eliminating neutrophils and facilitating recovery following ischemia/reperfusion injury (IRI) of the kidney. The clearance of neutrophils was delayed in the Bax knockout (KO)BM → wild-type (WT) chimera in which bone marrow derived cells are partially resistant to apoptosis, compared to WTBM → WT mice. These mice also showed delayed functional, histological recovery, increased tissue cytokines, and accelerated fibrosis. The circulating intercellular adhesion molecule-1 (ICAM-1)+ Gr-1+ neutrophils displaying rTEM phenotype increased during the recovery phase and blockade of junctional adhesion molecule-C (JAM-C), a negative regulator of rTEM, resulted in an increase in circulating ICAM-1+ neutrophils, faster resolution of inflammation and recovery. The presence of Tamm-Horsfall protein (THP) in circulating ICAM-1+ neutrophils could suggest that they are derived from injured kidneys. In conclusion, we suggest that apoptosis and rTEM are critically involved in the clearance mechanisms of neutrophils during the recovery phase of IRI.

The Normal Vasoseminal Vesiculography / 대한비뇨기과학회지

Vasoseminal vesiculography was performed on 40 asymptomatic men. Considerable variability in the appearance of the normal adult seminal tract was seen. The average lengths of the left and right ampullae were 4.23+/-0.77cm and 4.09+/-0.78cm respectively. Most ampullaes (75%) began at the vesicular fundus; the remainder projected either slightly more lateral (18%) or medial (7%) to the fundus. The average lengths of the left and right vesicle were 3.21+/-0.61cm and 3.24+/-0.49cm respectively ; the average widths were 1.36+/-0.30cm and 1.36+/-0.27cm. Eighty-seven per cent of subjects had symmetric-appearing vesicles. The average lengths or the left and right ejaculatory duct were 12.7+/-0.27mm and 13.0+/-0.59mm respectively; the average widths were 1.9+/-0.59mm and 1.8+/-0.58mm. Two normal configurations were noted; straight (70% ) and curved (30%). All ducts appeared symmetric. Criteria for normality are presented and the radiographic techniques were reviewed.

Efficacy of Ginseng Extract on Patients with Oligospermia / 대한비뇨기과학회지

Infertility is a world wide problem affecting up to 15% of married couples. Although it is well known that male factor is the important cause of the infertility in 40-50% of the cases, the appropriate drugs for treating this condition have not yet been established. With certain exceptions, the etiology of many cases of male infertility is unknown. For such cases, various drugs including both hormonal and non-hormonal agents are sometime prescribed, but there have been no entirely satisfactory results. The present investigation would assess the effectiveness of Korean Ginseng, herbal medicine in the treatment of male infertility during the period from September to December, 1988, at the Andrology Clinic of the Department of Urology, Seoul National University Hospital. This herbal medicine was selected because its ingredients accelerate the metabolism of lipids and synthesis of DNA, RNA and proteins. This medicine contains ingredients which build resistance against stress since many of male infertility are under stress and also is to control immunological disorders. Ginseng has steroid-like, anti-allergic and anti-inflammatory actions, and accommodates the blood-testis barrier, improve digestive functions and peripheral blood flow. Accordingly, Ginseng has been used as an agent restoring healthy conditions to maintain homeostasis or to keep physical and mental balance. Extensive chemical investigation on Ginseng has revealed that Ginseng contains characteristic dammarane-type triterpenoid saponins as the main principles. These saponins are called ginsenosides and represent the principal pharmacological actions of Ginseng. The ginsenosides react at the hypothalamus-pituitary-gonadal axis. The decreases of sexual drive and disorders of fecundity under challenge of stress are prevented by oral administration of ginsenosides. To assess the efficacy of treatment with Ginseng which is alleged to improve spermatogenesis in idiopathic infertile selected patients. Participants in this study are men with primary idiopathic oligospermia and asthenospermia. The inclusion criteria would be as follows : a) men aged 20-40 years, whose female partners are entirely normal. b) men having vaginal intercourse with one partner and without psycho-sexual problems. c) men willing to enter this clinical trial and relying only on the drug administered throughout the study. d) no history of serious chronic physical or psychological diseases. e) men whose female partners are not using any method of birth control. f) men with no history of drugs to treat sperm disorders within 3 months. A total of 12 patients with sperm counts of less than 20 x 10 6/ml (oligospermia group), and 5 patients with sperm motility of less than 20% (asthenospermia group) are selected as the study subjects. Parameters to be assessed are as follows : Before and after Ginseng administration, history taking, physical examination with testis size measurement, laboratory works including urinalysis, CBC, seminal fructose, semen analyses (pH, volume, density, motility, activity grade, morphology, fertility unit, and WBC), plasma hormonal assays (FSH, LH, testosterone, estradiol, and prolactin). Before starting the treatment, 2 semen samples are obtained preteded by 3 days of abstinence. For follow-up, patients will have a semen sample taken every month while in treatment. After the treatment, more than 2 semen analyses will be undertaken for the final evaluation. Treatment scheme is as follows : The composition of the Ginseng extract used in this clinical trial consisted of the standardized highly concentrated Ginseng extract G115, 100mg : concentrated standardized lectithin, 95mg , alpha tocopherol, 10mg ; and excipients q.s.ad. This Ginseng extract named Ginsana capsule produced by Pharmaton-Korea Co., Ltd. Four capsules of Ginsana are given twice a day by mouth before meal for more than 90 days to be justified on the basis of general assumption that spermatogenesis cycle lasts approximately 74 days. The results of the clinical investigation are considered to be effective, if more than double of improvemant being noted on the count or more than 30% ot improvement being noted on motility beyond the pre-treatment levles. Clinical characteristics of a total of 17 patients are listed in the table 1. The outcomes of this trial are presented as follows : (tables 2 and 3). Coital frequency increased from 2.6/week before Ginsana exposure to 3.1/week after the treatment. General health such as stamina, body weight and spirits improved in 10 patients of the 17 after Ginsang treatment. Regarding hormonal partmeters (table 2), Plasma FSH and LH were not changed much before and after Ginsana administration. Patients with low FSH and LH levels before the treatment and patients with high range of prolactin levels before the treatment have a tendency to improve more in semen parameters after the treatment. Hyperestrogenemia was decreased and plasma testosterone levels increased after Ginsana treatment. Subsequently, T/E2 ratio resulted in normal to help spermatogenesis. Regarding the semen parameters (table 3), sperm counts increased in 58% of the patients in oligosperrnia group after oligospermia group. Sperm motility improved in 33% of the patients rn oligospermia group after the treatment. Mean motility increased from 34% to 45% after the treatment in oligospermia group. Activity grade and fertility unit were also improved in oligospermia group after the treatment Other parameters such as volume, normal morphology, pH and seminal fructose were not changed significantly before and after Ginstna treatment. Only one case showed an improvement in sperm counts and motility of a total of 5 patients with asthenospermia. Pregnancy resulted in 2 patients of improved cases and 1 patient of not improved cases in oligopsermia group after Ginsana administration. So that, pregnancy rate was 25 % of the oligospermia group. The study results of some imvestigators are summarized in the table 4. From these results, Ginsana appears mainly act on testis directly, restore the steroidogenesis, resulting in the stimulation of spermatogenesis. in conclusion, the authors clinical experience confirmed that Ginsana, a traditional Chinese medicine, appears to be of value particularly in the trettment of idiopethic oligospermia without any noticeabel adverse side effects.

Scrotal Hypothermia in the Infertile Men / 대한비뇨기과학회지

Thirty four patients with subfertile semen, elevated intrascrotal temperature( > 34.0 degrees C) and >2 years of unsuccessful non-contraceptive coitus with spouse judged able to conceive were tested with a scrotal hypothermia device which was made by us. Varicocele, failed varicocelectomy and idiopathic infertility are conditions suitable for scrotal hypothermia treatment. Improvement in 1 or more semen parameters was seen in 16 patients(47%) and pregnancy occurred in 3 patients(9 %). Of 13 patients with pretreatment subfertile semen in 3 parameters, 5 patients(39%) showed improvement in 1 or more parameters, but none produced pregnancy. Of 9 patients with pretreatment subfertile semen in 2 parameters, 4 patients(44%) showed improvement in 1 or 2 parameters, but none produced pregnancy. Of 12 patients with pretreatment subfertile semen in one parameter, 7 patients(58 %) showed improvement in semen parameter and 3 patients(25%) produced pregnancy. Three patients with nonobstructive azoospermia showed no semen change with the scrotal hypothermia device. This result implies that the patient with minimal subfertile semen has the best chance to take effects.

Routine Endocrine Screening Test in Impotence / 대한비뇨기과학회지

Endocrine screening tests were routinely performed for 165 patients whose complaints were erectile impotence and 64 patients with hypogonadism during the period from January 1984 to December 1985 in Andrology Clinic of Department of Urology. Levels of plasma luteinizing hormone(LH), follicle stimulating hormone (FSH), testosterone and prolactin were measured by the radioimmunoassay technique. Results were summarized as follows; l. Impotence group: Mean values of plasma LH, FSH and testosterone were l0.42 IU/L (range: O.3 ~76.91 IU/L), l2.92 IU/L (range: 0.73~77.23 IU/L) and 5.71ng/ml (range: O.ll~15.19ng/ml), respectively. Normal testosterone levels with abnormal LH levels were found in 4.3% of the impotent patients, and normal testosterone levels with abnormal FSH levels were noted in 5.6% of the patients. Low testosterone levels, less than 3.Ong/ml, were found in 9.7% of the patients. Mean value of plasma prolactin was 13.83ng/ml (range: l.5~160 ng/ml). Elevated prolactin levels were noted in 2% of the impotent ratients. Of these, pituitary tumor was found in 1 patient. 2. Hypogonadism group: Sizes of testicles were less than 1Oml in all patients. Hypogonadism group was divided into hypergonadotropic hypogonadisms consisting of 4l patients and hypogonadotropic hypogonadisms containing 18 patients. In patients with hypergonadotropic hypogonadisms, mean LH, FSH and testosterone levels were 43.98 IU/L (range: 20.90~117.70 IU/L), 49.35IU/L (range: 20.00~95.35 IU/L) and 1.89ng/ml (range: 0.46~4.08 ng/ml), respectively. In patients with hypogonadotropic hypogonadisms, mean LH, FSH and testosterone levels were 2.24IU/L (range: 0.36 ~7.51 IU/L), 3.05 IU/L (range: 0.25 ~l5.04 IU/L) and 0.72 ng/ml (range: 0.ll~2.93 ng/m1). Plasma prolactin values were within normal ranges in all patients. In conclusion, plasma testosterone should be tested first as endocrine screening tests for patients with impotence and hypogonadism. Complete tests including plasma LH, FSH, testosterone and prolactin levels are considered then testosterone levels reveal abnormal. However, complete endocrine screening tests of LH, FSH and testosterone should be done for the hypogonadism patients with small testes of less than 1Oml in size.

Effects of Chemical Components and Enzyme Activities in Seminal Plasma on Sperm Motility / 대한비뇨기과학회지

A total of 189 male subjects with normal and abnormal semen quality were divided into seven groups according to WHO semen analysis criteria : Group I was composed of 62 subjects with normal semen parameters. They were subdivided into 4 sub-groups based on the sperm motility, such as subgroups I-1 with sperm motility between 41-50%, I -2 with motility between 51-60%, I -3 with motility 61-70%, and I-4 with motility over 71%. Group II was composed of 29 subjects with oligozoospermia of less than 20 X 106/ml of sperm density. Group III was composed of 9 subjects with asthenozoospermia of less than 40% of sperm motility. Group IV was composed of 13 subjects with teratozoospermia of more than 40% of abnormal morphology. Group V was composed of 31 subjects with testicular secretory azoospermia. Group VI was composed of 39 subjects with post-testicular obstructive azoospermia. Group VII was composed of 6 subjects with successful vasovasostomy and epididymovasostomy without pregnancy. Seminal plasma was separated from spermatozoa by centrifugation of fresh semen. The contents of protein and fructose and enzyme activities of hyaluronidase, a-amylase, b-glucuronidase, arylsulfatase, azocoll proteinase and acrosin were measured in each seminal plasma of the study groups. Enzyme activities and fructose content were compared based on their sperm motility and abnormalities of spermatozoa. The protein contents of seminal plasma of each group were nearly same. The fructose contents of both sub-group I-4 and group III were found to be very low compared with normal sperm group. Hyaluronidase originated from sperm acrosome and other accessory sex glands. It is related to increasing sperm motility by lowering seminal viscosity. The hyaluronidase activities of the sub-group I -4 and Group VII showed less than those of other groups. Alpha-amylase which cleaved long chain of carbohydrate was measured in each seminal plasma of the study groups. It did not affect lowering the viscosity of seminal plasma and sperm motility. Beta-glucuronidase originated from sperm acrosome and other accessory sex glands. It is related to increasing sperm motility by lowering seminal viscosity. The activity of b-glucuronidase was lowest in the sub-group I -4 and highest in the sub-group I-2 and Group III. Arylsulfatase activity was nearly same in all study groups. Azocoll proteinase activities, a non-specific neutral proteolytic enzyme, were negligible throughout the groups investigated in this study. This may indicate that lowering the viscosity of seminal plasma did not related to the proteolytic process. Acrosin was not contained in the seminal plasma. Disintegration of mucopolysaccharide is somewhat known to influence lowering. the viscosity in the seminal plasma. These findings suggest that sperm motility is affected by the enzyme activities and viscosity in the seminal plasma.

Sertoli Cell Only Syndrome / 대한비뇨기과학회지

A total of 178 patients with Sertoli cell only syndrome proved by histologic examination was investigated for the past 7 years at the infertility Clinic of Seoul National University Hospital. The size of testes ranged from 5 to 25ml with the mean of 13ml(An average normal size of Korean males: l9ml) However, testes size of greater than l5ml were found in 53.3% of the patients. Plasma FSH Levels ranged from 0.31 to 58.501U/L with a mean of 20.451U/L(Normal level of Korean males: l2.10IU/L). Plasma LH levels ranged from 1.56 to 59.75IU/L with a mean of l2.87 IU/L( Normal level of Korean males: 9.21U/L). Plasma testosterone levels ranged from 0.9 to 11.0ng/ml with a mean of 5.5ng/ml Accordingly, increased FSH levels were found in 49.4% and increased LH levels, in 25.4% of the patients. And decreased levels of testosterone levels were found in 8.9% of the patients. Stimulation tests of LH and FSH by an administration of 100ug bolus of LHRH were attempted on 3 patients. The basal FSH values were elevated over 24.l8IU/L in the 3 patients. The FSH values were increased l.8-fold 90 minutes after stimulation tests. The basal value of LH was elevated in a patient. The LH values were increased 9.l-fold 30 minutes following the stimulation tests. Leydig cell hyperplasia and peritubular fibrosis were found in 2 patients who had shown the exaggerated responses to LHRH stimulation tests. The patients with more abundant microfilament in cytoplasm and increased intercellular digitation of Sertoli cells proved by an electron microscopic examination, had the higher levels of basal FSH and LH. Therefore, the regulatory mechanism of secretion of both FSH and LH appears to be abnormal in the patients with Sertoli cell only syndrome. The karyotype evaluation revealed 46XY in 20 patients, 46XY 15S- in l patient and 46XYt(7, 14) in 1 patient of the 22 patients. Sertoli cell only syndrome seems to be heterogenous or a single process which may be in evolution at different developmental stages. Germ cell aplasia was found in 21 patients with cryptorchidism by histological examination. We could infer the more abnormal regulation of secretion of both gonadotropins (FSH and LH) in patients of cryptorchidism with germ cell aplasia than patients of Sertoli cell only syndrome without cryptorchidism.

Significance of Testicular Size and Plasma Hormone Levels in Infertile Males / 대한비뇨기과학회지

For the evaluation and management of male infertility, measurements of testicular size (volume) and plasma hormones (FSH, LH and testosterone) have been considered as very important procedures besides the routine examinations of history, physical examination, laboratory works including semen analyses and testicular biopsy and special studies. A total of 99 infertile males with small testes which were less than 1Oml in volume was subjected to the assessment of plasma FSH, LH and testosterone levels. They were divided into 6 study groups; such as Group I. Control: 28 men with normal semen parameters and plasma hormone values. Group II. Oligospermia: 12 patients with sperm density of less than 20 X 10 6/ml. Group III. Testicular azoospermia: 22 patients with testicular biopsy of better than germ cell arrest. Group IV Sertoli cell only syndrome: 25 patients proved by testicular histology. Group V. Klinefelter`s syndrome: 30 patients proved by karyotype studies. Group VI. Eunuchoidism: 10 patients proved by laboratory and physical examinations. The results obtained in this clinical study were as follows (Table 1): Testicular sizes were decreased in Groups IV. Sertoli cell only syndrome, V. klinefelter`s syndrome, and VI. Eunuchoidism. Plasma LH levels were increased in Groups IV. Sertoli cell only syndrome, and V Klinefelter`s syndrome. Plasma FHS levels were increased in Groups IV. Sertoli cell only syndrome, and V. Klinefelter`s syndrome. The long-term hormonal therapy with high doses of human chorionic gonadotropin and human menopausal gonadotropin combined with testosterone was applied to a total of 216 infertile patients with small tests (less than 10ml in volume) for 12 months (range: 3-24 months). Semen parameters were improved in 10 patients who were severe oligozoospermia before the treatment and spermatogenesis was induced in 14 patients who were azoospermic before the treatment following the hormonal therapy. In conclusion, an infertile male with small testis (less than 10ml, should be adequately evaluated before declaration of final diagnosis of sterility.

Clinical Investigation of Insam (Korean Ginseng) on Sexual Potency / 대한비뇨기과학회지

Ginsana G-115 (Insam, Korean Ginseng extract) was administered orally to 20 patients with erectile impotence (Insam group) for 2.8 months (l-10 months). Placebo was administered orally to 20 patients with erectile impotence (Control group) for 2.3 months (l-10 months). Sexual intercourse was possible in 55% of patients of Insam group and not changed significantly after the treatment on the 11 improved patients of Insam group.

Quantitative Analysis of the Seminiferous Epithelium in Human Testis / 대한비뇨기과학회지

Number of germ cells in the seminiferous epithelium was analyzed quantitatively in testicular biopsy specimens of 23 patients without ductal obstruction and of 4 patients with ductal obstruction. Roth number of mature spermatids within each cross-section of seminiferous tubule and number of atrophic tubule were counted in biopsy specimens. Results were expressed as cell number of mature spermatids per seminiferous tubule and percentage of atrophic tubules. A significant correlation was demonstrated between sperm density and mature spermatid counts. Patients with sperm counts of less than 40 x l0(6)/ml had mature spermatids counts of less than 25 per seminiferous tubule. Coefficients of correlation between mature spermatid count and percentage of atrophic tubules were higher than those of correlation between sperm counts and percentage of atrophic tubules. In asoospermrc patients with epididymal obstruction, sperm count after corrective surgery could be predicted correctly by this quantitative analysis technique of testicular biopsy specimens and partial obstruction of anastomotic site of seminal tract could be proved in oligozoospermic patients after corrective surgery.

Testicular Biopsy: Comparison of Open Surgical and Percutaneous Needle Biopsy Techniques / 대한비뇨기과학회지

Testicular biopsy has been known as very useful diagnostic procedure for the male infertility. For the past 9 months percutaneous testicular biopsy procedures were attempted on 64 patients with azoospermia or atrophic testis using a new Tru-Cut biopsy needle. In addition surgical testicular open biopsy procedure on one side and percutaneous testicular needle biopsy procedure on the other side were performed in comparison with two techniques. Biopsy specimens were fixed in Bouin solution. They were stained and histologically examined. Results were summarized as follows: Numbers of seminiferous tubules obtained by needle biopsy technique were found to be fewer than that of the tubules obtained by open biopsy technique. But diagnostic accuracy was not compromised by the needle biopsy technique. There was no bleeding either from the testis or scrotum, no extusion of testicular tissue from the puncuate site. In conclusion percutaneous testicular biopsy using Tru-Cut biopsy needle has been proved to be simple, time saving, less expensive and accurate method for testicular biopsy.

Twenty Years' Experience with Surgery for Obstructive Azoospermia / 대한비뇨기과학회지

No abstract available.

Evaluation of Mesterolone on Oligozoospermia / 대한비뇨기과학회지

Infertility is a world wide problem affecting up to 5% of all couples and in some communities up to 30% (WHO, l975). Although it is well known that the male factor is the main cause of the infertility in 40-50% of the cases, the appropriate drugs for treating this condition have not yet been found. Androgens have been tried at different doses, the higher ones to provoke suppression of spermatogenesis and ultimate rebound phenomenon. This has led to controversy due to the high percentage of permanent oligozoospermia reported by some authors (2-8%) and to the short-lived improvement obtained with this treatment. Mesterolone, an androgen without suppressive action upon the hypothalmic-pituitary axis. is presently used, although results are not yet conclusive. The present investigation would assess the effectiveness of mestero1one currently used in the treatment of idiopathic male infertility. To assess the effectiveness of treatment with mesterolone which is alleged to improve semen quality (sperm density, motility and morphology) in idiopathic infertile selected patients, this would be a double blind study to follow prospectively men suffering from primary idiopathic testicular failure being treated with mesterolone, Proviron, Schering, a drug which is presumed to improve this condition. Results would be assessed through several sperm parameters and pregnancy rate. Participants in the study will be men with primary idiopathic oligozoospermia and asthenozoospermia. The inclusion criteria would be as follows: a) men aged 20-40 years, whose female partners are entirely normal, b) informed volunteers with primary testicular failure, c) men having vaginal intercourse at least 2 times weekly with one partner and without known psycho-sexual problems, d) men willing to enter this study and relying only on the drug administered throughout the study, e) no history of renal, liver or any other chronic physical or psychological disease, t men who can be followed up regularly, and g) men whose female partner is not using any method of family planning. The exclusion criteria would be as follows: a) azoospermic patients, b) history of recent or severe liver or renal disease, and c) history recent severe infectious disease (less than 3 months ago), d) clinically detectable chronic diseases, e) concurrent use of drugs known or suspected to interact with the drug to be administered in the study or known to affect spermatogenesis. A total of 90 subjects are divided into the fol1owing three groups: a) placebo group: consisted of 30 Korean male with 15 oligozoospermia with sperm count of less than 20 x 1,000,000/ml and 15 asthenozoospermia with sperm motility of less than 309b, b) oligozoospermia group: consisted of 30 patients with sperm counts of less than 20 x1,000,000/ml, and c) asthenozoospermia group: consisted of 30 patients with sperm motility of less than 30%. Parameters for study are as follows: history taking, physical examination (testis size), laboratory works (CBC ESR, urinalysis, fructose in seminal fluid, testicular biopsy, semen analyses (pH of semen, volume, liquefaction. density, motility, agglutination, viability, normal form, WBC), hormonal assays (FSH, LH, testosterone, prolactin). Before starting treatment, 2 semen samples will be obtained with a time interval of not less than 1 week, each preceded by 3 days of sexual abstinence. For follow-up, patients will have a semen sample taken every month each preceded by 3 days of sexual abstinence while in treatment. After treatment, and for 3 months, a monthly semen analysis will be undertaken. Treatment scheme as follows: 75mg of mesterolone (proviron) was given by mouth daily for more than 90days to be justified on the basis of general assumption that spermatogenetic cycle lasts approximately 74days. An average duration of the treatment was 6.8 months in this study. In placebo group, digestive tablets are given as mesterolone administration. Clinical characteristics of a total of 90 patients were listed in the table l. The results were considered to be effective (+), if more than 30%, of improvement being noted on the count or more than 20% of improvement being noted on motility beyond the pre-treatment level. The results of this study are presented as follows: Changes of sperm density after treatment: Oligozoospermia group: sperm counts increased in 27%, of the 15 placebo treatment patients and 37% of the 30 mesterolone treatment patients. Asthenozoospermia group: sperm counts increased in 20%, of the 15 placebo treatment patients and in 27% of the 30 mesterolone treatment patients. Changes of sperm motility after treatment: Asthenozoospermia group: sperm motility improved in 13% of placebo treatment patients and 27% of mesterolone treatment patients. Oligozoospermia group: sperm motility improved in 20%, placebo treatment patients and 30% of mesterolone treatment patients. Changes of other parameters after treatment: Volume of seminal fluid and normal shape of spermatozoa were not changed significantly before and after the treatment between placebo and mesterolone groups and also between oligozoospermia and asthenozoospermia groups. Coital frequency and body weight were tend to increase after the mesterolone treatment. Pregnancy rates after treatment: Pregnancy resulted in l3%, of placebo treatment patients and 17% of mestero1one treatment patients in oligozoospermia group. Pregnancy occurred in 7%, of placebo treatment patients and l0% of mesterolone treatment patients in asthenozoospermia group. In conclusion, the author's clinical experience confirmed that mesterolone appears to be of value particularly in the treatment of idiopathic oligozoospermia and asthenozoospermia without any noticeable adverse effects.

Clinical Investigation of Smoking on Sexual Potency and Spermatogenesis of Men / 대한비뇨기과학회지

It has long been known that smoking can have a deleterious effect on sexual potency and fertility capacity of males but the subject of the possible adverse effects of cigarette smoking on steroidogenesis and spermatogenesis is controversial. The comparative study presented here was conducted on 30 cigarette-smokers and 30 non-cigarette-smokers of men. They were divided into 3 different groups such as control group (composed of 10 smokers and 10 non-smokers), impotence group (10 smokers and 10 non-smokers) and infertility group (10 smokers and 10 non-smokers). They were subjected to the investigation of medical history, body weight, height, testicular size, coital frequency per week, nocturnal penile tumescence frequency per week, routine laboratory works, plasma FSH, LH, testosterone and prolactin by radioimmunossay and semen analyses. The smokers were found to have a slightly smmaller frequency of coitus per week and also that of nocturnal penile tumescence per week than non-smokers but the differences were not significant. Plasma FSH, LH, testosterone and prolactin levels were also hot significantly different between smokers and non-smokers of each group. The levels of LH and testosterone of control group were greater than thoses of impotence and infertility groups. Semen samples from control and impotence groups showed no significant differences on volume, count, motility and morphology between smokers and non-smokers. Only in the infertility group, sperm motility was significantly greater in non-smokers than smokers and also morphology was slightly greater in non-smokers than smokers but the difference was not significant. The results of this study identify that the postulated deteriolated effect of cigarette smoking on steroidogenesis and spermatogenesis would have most significantly impinged. However, its clarification will require more careful and extensive investigations with large groups of subjects.

Sperm Granuloma and Success Rate of Vasovasostomy / 대한비뇨기과학회지

A discrepancy between patency and pregnancy rates persists even if a surgical success rate of vasovasostomy, improved. A sperm granuloma has been considered that it has relation to improvement of quality of sperm by decompression of intravasal pressure. During the period from 1981 to 1983, a total of 160 vasovasostomies were performed. An age of the patient ranged from 24 to 65 with the mean of 36.5. Duration of obstruction ranged from 5 months to 20 years with the mean of 4.2 years. Viable sperms more than 10 x 1,000,000/ml appeared in 145 out of the 160 patients (90.6%) , and pregnancy occurred in 98 out of the 160 patients (61.2%) following the vasovasostomy The sperm granuloma was found in 50% of 160 vasectomized patients. Forty-eight percent of patients whose patency were restored had sperm granuloma. Fifty percent of patients who impregnated their wives had sperm granuloma. There was statistically no significant difference in both patency and pregnancy rates between patients with and without sperm granuloma. But sperm months at 6 months post operatively was found to be higher in patients with sperm granuloma than without sperm granuloma (p<0.05).

Congenital Agenesis of the Vas Deferens / 대한비뇨기과학회지

Thirty three patients with congenital agenesis of the vas deferens were investigated in Seoul National University Hospital for the past 10 years. These patients correspond to 2.4% of 1,398 infertile males and 14.8% of 223 azoospermic patients due to epididymal obstruction. These anomalies were confirmed by surgical explorations, They were consisted of 24 patients with bilateral agenesis of the vas deferens and 9 patients with unilateral agenesis(5 in right side, 4 in left side). Type 2 anomaly, vas agenesis without defects of epididymis, was found in 25(44%) of a total of 57 anomalies of the vas deferens. Type 1 anomaly, vas agenesis with defects on body or tail of epididymis, was found in 21(37%), and type 3 in which the head of epididymis and distal vas are identified but body and tail of epididymis and proximal vas are absent, was found in 11(19%). The histological examination of the testis showed normal spermatogenesis in the most of the patients, The seminal volume was reduced in 24 patients, and normal in 9 patients. The seminal fructose was reduced in 13 patients. It is suggested that vas agenesis would be associated with the absence of seminal vesicle in patients with reduced seminal volume and reduced seminal fructose level. In seven patients with unilateral agenesis of the vas deferens, the obstructive lesions of epididymal tails of contralateral side were corrected by epididymovasostomy under surgical microscope. The results were successful in 2 patients. In three patients with bilateral agenesis of the vas deferens of type 3, epididymovasostomy could be performed. Successful results were obtained in 2 patients. In conclusion, the results of this clinical investigation emphasize the importance of careful scrotal examination in the diagnosis of an infertile males and in the preparative examination of vasectomy operation.

Detection of Antisperm Antibody in Vasectomized and Infertile Males / 대한비뇨기과학회지

We studied antisperm antibody by the use of the tray agglutination test in sera of 37 vasectomized males and 65 infertile males Antisperm antibody was found in 27 out of 37 vasectomized males (73%). Antibody titer was more than 1:32 in majority of the patients (25/27). The most common agglutination pattern was tail-to-tail agglutination (70.5 %). Antisperm antibody was found in 7 out of 17 obstructive azoospermia (41.2 %), and 3 out of 42 idiopathic infertility (7.1 %). But none was found in 6 patients with varicocele.

Clinical Investigation of Certain Plasma Hormones on Male Sexual and Reproductive Functions / 대한비뇨기과학회지

Certain hormone values were evaluated on 207 subjects during the period from January 1983 to December 1983. These subjects were divided into the following 5 groups: Group I composed of 28 healthy men; Group AI, 83 patients with impotence; Group III, 60 patients with infertility; Group AV, 31 patients with hypogonadism; and Group V, 5 patients with intersex. Levels of plasma LH, FSH, testosterone and prolactin were measured by radioimmunoassay technique. Results were analysed and compared with those of control group. Conclusions were summarized as follows: 1. Mean values of plasma LH, FSH, and testosterone of Group I(control group)were 7.91mIU/ml, 11.29 mIU/ml, and 595.7ng/100ml, respectively. 2. In Group II, mean values of FSH were significantly decreased, but those of testosterone and prolactin were within normal ranges. 3. In Group III, mean values of plasma LH and FSH were significantly elevated but those of plasma testosterone were inversely decreased. Levels of plasma prolactin were within normal ranges. 4. Testicular histology taken from azoospermias revealed that most common findings were germ cell aplasia. 5. In Group IV, hypergonadotropic to hypogonadotrophic hypogonadism ratio was 1.4:1. Mean values of plasma LH and FSH were significantly elevated in hypergonadotropic hypogonadism, but decreased in hypogonadotrophic hypogonadism, Mean values of testosterone decreased in both groups 7. A reciprocal proportion was found between age and plasma testosterone levels in the patients with varicocele.

Clinical Experience with Hormonal Treatment of Testicular Azoospermia / 대한비뇨기과학회지

No abstract available.

Male Infertility: XII. Pharmacological Treatment for Improving Semen Motility / 대한비뇨기과학회지

Some investigators suggest that the pancreatic proteinase kallikrein plays an important role in the regulation of spermatozoal motility. Particularly, oral kallikrein therapy exerted a favorable effect on Sperm motility in oligozoospermia and asthenozoospermia. We have carried out a similar clinical investigation of the efficacy of kallikrein, taken orally 60 kU per day for 3-9 months, on the quantitative and qualitative motility of spermatozoa in normogonadotropic infertile men. with 15 idiopathic oligozoospermia and 18 idiopathic asthenozoospermia. Number of spermatozoa increased more than double number of basic levels (over 40 x 10(6)/ml) in the 5 patients (33%) and pregnancy occurred in the 3 patients (20%) out of the 15 patients with idiopathic oligozoospermia (less than 20 x 10(6)/ml) after the kallikrein therapy. In these responded 5 patients, the sperm concentration changed from 13.6 x 10(6)/ml to 54.0 x 10(6)/ml, Motility and viability of spermatozoa improved more than 30% in the 5 patients (28%) and pregnancy occurred in the 2patients (11%) out of the 18 patients with idiopathic asthenozoospermia (less than 20% of sperm motility) after the therapy. In these. improved 5 patients, the sperm motility changed from 9.0% to 45.0%. No remarkable side effect was detected.