Male factors account for 20%-50% of cases of infertility and in 25% of cases, the etiology of male infertility is unknown. Effective treatments are well-established for hypogonadotropic hypogonadism, male accessory gland infection, retrograde ejaculation, and positive antisperm antibody. However, the appropriate treatment for idiopathic male infertility is unclear. Empirical medical treatment (EMT) has been used in men with idiopathic infertility and can be divided into two categories based on the mode of action: hormonal treatment and antioxidant supplementation. Hormonal medications consist of gonadotropins, androgens, estrogen receptor blockers, and aromatase inhibitors. Antioxidants such as vitamins, zinc, and carnitines have also been widely used to reduce oxidative stress-induced spermatozoa damage. Although scientifically acceptable evidence of EMT is limited because of the lack of large, randomized, controlled studies, recent systematic reviews with meta-analyses have shown that the administration of gonadotropins, anti-estrogens, and oral antioxidants results in a significant increase in the live birth rate compared with control treatments. Therefore, all physicians who treat infertility should bear in mind that EMT can improve semen parameters and subsequent fertility potential through natural intercourse.
Androgens ; Antioxidants ; Aromatase Inhibitors ; Drug Therapy ; Ejaculation ; Estrogens ; Female ; Fertility ; Gonadotropins ; Humans ; Hypogonadism ; Infertility ; Infertility, Male* ; Live Birth ; Male ; Pregnancy ; Pregnancy Outcome ; Semen ; Semen Analysis ; Spermatozoa ; Vitamins ; Zinc

No abstract available.
Humans ; Male ; Testosterone*

PURPOSE: Circumcision is widely practiced in Korea. Circumcision has been popularly performed with mechanical devices such as the Gomco clamp, the Plastibell device and other modified devices. We investigate the effect of using a new device (the circumcision clamp). MATERIALS AND METHODS: We conducted a retrospective study between December 2003 and February 2004 on 75 patients who wanted circumcision. 25 patients were operated on by performing conventional circumcision, and 50 patients were operated on by using the circumcision clamp. RESULTS: The mean operation time for the new device group was shorter than that for the conventional circumcision group (p<0.05). No significant difference of complications was noted between the conventional circumcision group and the circumcision clamp group. CONCLUSIONS: The new method with using the circumcision clamp has a benefit as it is designed to expose the glans and it saves operating time.
Circumcision, Male* ; Female ; Humans ; Korea ; Male ; Retrospective Studies

We found an error in this article. The author's affiliation.

BACKGROUND: Totally implantable access port (TIAP) provides reliable, long term vascular access with minimal risk of infection and allows patients normal physical activity. With wide use of ports, new complications have been encountered. We analyzed TIAP related complications and evaluated the outcomes of two different percutaneous routes of access to superior vena cava. METHODS: All 172 patients who underwent port insertion with internal jugular approach (Group 1, n = 92) and subclavian approach (Group 2, n = 79) between August 2011 and May 2013 in a single center were analyzed, retrospectively. Medical records were analyzed to compare the outcomes and the occurrence of port related complications between two different percutaneous routes of access to superior vena cava. RESULTS: Median follow-up for TIAP was 278 days (range, 1-1868). Twenty four complications were occurred (14.0%), including pneumothorax (n = 1, 0.6%), migration/malposition (n = 4, 2.3%), pinch-off syndrome (n = 4, 2.3%), malfunction (n = 2, 1.1%), infection (n = 8, 4.7%), and venous thrombosis (n = 5, 2.9%). The overall incidence was 8.7% and 20.3% in each group (p = 0.030). Mechanical complications except infectious and thrombotic complications were more often occurred in group 2 (p = 0.033). The mechanical complication free probability is significantly higher in group 1 (p = 0.040). CONCLUSIONS: We suggest that the jugular access should be chosen in patients who need long term catheterization because of high incidence of mechanical complication, such as pinch-off syndrome.
Catheterization ; Catheters ; Follow-Up Studies ; Humans ; Incidence ; Jugular Veins ; Medical Records ; Motor Activity ; Pneumothorax ; Retrospective Studies ; Subclavian Vein ; Vascular Access Devices ; Vena Cava, Superior ; Venous Thrombosis

The effects of NMDA-receptor antagonist (MK-801) were assessed for the oxygen free radical mediated brain (hippocampus) injury with eighty rats which were exposed to carbon monoxide (CO) followed by hyperbaric oxygen (HBO) treatment. Superoxide dismutase (SOD) and malondialdehyde (MDA) were used as parameters of the oxygen free radical reaction. Experimental groups consisted of (1) control group (=breathing with air), (2) CO group (=exposed to CO after air breath), (3) CO-air group(exposed to CO after air breath followed by air breath), and (4) CO-HBO group (=exposed to CO after air breath followed by 3 ATA HBO). Each group was divided two subgroup according to the pretreatment (normal saline or MK-801). CO, CO-air and HBO groups increased in SOD activity as compared with control group. And CO-air and HBO groups increased in MDA as compared with control and CO group. Pretreatment of MK-801 decreased SOD activities significantly (p-value<.05) , but MDA amount not significantly (p-value=.107). These results suggest a useful protective effect of NMDA-receptor antagonist (MK-801) in CO induced hippocampal injury mediated by oxygen free radicals.
Animals ; Brain Injuries* ; Brain* ; Carbon Monoxide ; Dizocilpine Maleate ; Free Radicals ; Malondialdehyde ; Oxygen* ; Rats* ; Superoxide Dismutase

PURPOSE: Metabolic syndrome (MS) plays a potential role in the etiology of benign prostatic hyperplasia (BPH). Recent studies have reported on an association between MS and BPH. However, there has been no consensus on recent results. This study was conducted to evaluate the associations among prostate-specific antigen (PSA), prostate volume (PV), and metabolic components in men who visited our health promotion center. MATERIALS AND METHODS: During the period from January 2005 to December 2010, 521 consecutive men (age range, 40 to 70 years) who underwent transrectal ultrasonography were enrolled in this retrospective study. The health screening program includes blood pressure, body measurements (height, weight, waist circumference, body mass index), biochemical analysis (serum glucose, total cholesterol, triglycerides, high-density and low-density lipoprotein cholesterol, fasting plasma glucose, tumor markers), stool and urine analysis, and a detailed clinical examination. RESULTS: The serum PSA level and PV were significantly higher in patients with MS than in patients without MS, retrospectively (p<0.001, p<0.001). Patients with more than one metabolic component were significantly more likely to have a larger PV and higher serum PSA level. The serum PSA level and PV were increased in a similar manner with the increasing sum of MS components (p<0.0001, p<0.0001). CONCLUSIONS: The MS components were associated with larger PV and higher serum PSA level. Therefore, each MS component could be an important factor in BPH development and management.
Blood Pressure ; Cholesterol ; Consensus ; Fasting ; Glucose ; Health Promotion ; Humans ; Lipoproteins ; Male ; Mass Screening ; Metabolic Syndrome X ; Plasma ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Retrospective Studies ; Triglycerides ; Waist Circumference

PURPOSE: Metabolic syndrome (MS) plays a potential role in the etiology of benign prostatic hyperplasia (BPH). Recent studies have reported on an association between MS and BPH. However, there has been no consensus on recent results. This study was conducted to evaluate the associations among prostate-specific antigen (PSA), prostate volume (PV), and metabolic components in men who visited our health promotion center. MATERIALS AND METHODS: During the period from January 2005 to December 2010, 521 consecutive men (age range, 40 to 70 years) who underwent transrectal ultrasonography were enrolled in this retrospective study. The health screening program includes blood pressure, body measurements (height, weight, waist circumference, body mass index), biochemical analysis (serum glucose, total cholesterol, triglycerides, high-density and low-density lipoprotein cholesterol, fasting plasma glucose, tumor markers), stool and urine analysis, and a detailed clinical examination. RESULTS: The serum PSA level and PV were significantly higher in patients with MS than in patients without MS, retrospectively (p<0.001, p<0.001). Patients with more than one metabolic component were significantly more likely to have a larger PV and higher serum PSA level. The serum PSA level and PV were increased in a similar manner with the increasing sum of MS components (p<0.0001, p<0.0001). CONCLUSIONS: The MS components were associated with larger PV and higher serum PSA level. Therefore, each MS component could be an important factor in BPH development and management.
Blood Pressure ; Cholesterol ; Consensus ; Fasting ; Glucose ; Health Promotion ; Humans ; Lipoproteins ; Male ; Mass Screening ; Metabolic Syndrome X ; Plasma ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Retrospective Studies ; Triglycerides ; Waist Circumference

PURPOSE: To assess changes in lower urinary tract symptoms (LUTS), prostate volume, and serum prostate-specific antigen (PSA) after discontinuation of 5-alpha reductase inhibitor (5ARI) combination therapy in patients with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: From December 2003 to December 2012, data were collected retrospectively from 81 men more than 40 years of age with moderate to severe BPH symptoms (International Prostate Symptom Score [IPSS]> or =8). The men were classified into group 1 (n=42) and group 2 (n=39) according to the use of 5ARI therapy. A combination of dutasteride 0.5 mg with tamsulosin 0.2 mg was given daily to all patients for 1 year. For the next 1 year, group 1 (n=42) received the combination therapy and group 2 (n=39) received tamsulosin 0.2 mg monotherapy only. The IPSS, prostate volume, and PSA level were measured at baseline and at 12 and 24 months according to the use of dutasteride. RESULTS: Discontinuation of dutasteride led to significant deterioration of LUTS, increased prostate volume, and increased PSA level. The repeated-measures analysis of variance showed that the changes in IPSS, prostate volume, and PSA level over time also differed significantly between groups 1 and 2 (p<0.001). CONCLUSIONS: Withdrawal of 5ARI during combination therapy resulted in prostate regrowth and deterioration of LUTS. The PSA level is also affected by the use of 5ARI. Therefore, regular check-up of the IPSS and PSA level may be helpful for all patients who either continue or discontinue the use of 5ARI.
5-alpha Reductase Inhibitors ; Humans ; Lower Urinary Tract Symptoms ; Male ; Oxidoreductases* ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia* ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Medial maxillectomy is commonly performed for benign and low-grade malignancies involving the lateral wall of the nose. The most frequent complications are cavity crusting, epicanthal scarring and epiphora. Silicone stent, tube fixation in lacrimal sac have been used for prophylaxis of epiphora. Authors studied for the incidence of epiphora and necessity for prophylatic procedure of epiphora in patients who underwent medial maxillectomy. MATERIALS AND METHOD: This study was performed on 26 patients treated with medial maxillectomy without additional procedure for management of epi-phora. The minimal duration of follow-up was 6 months. RESULTS: Twenty one patients were treated with medial maxillectomy only and five patients were treated with medial maxillectomy combined with irradiation. Incidence of epiphora was about 7% (2/26). All patients who complained of epiphora had inverted papilloma and underwent medial maxillectomy without irradiation. No patients treated with combination of medial maxillectomy and irradiation complained epiphora. CONCLUSION: It is not necessary to do routine prophylatic procedures for epiphora at the initial procedure.
Cicatrix ; Follow-Up Studies ; Humans ; Incidence ; Lacrimal Apparatus Diseases* ; Nose ; Papilloma, Inverted ; Silicones ; Stents