OBJECTIVE: The effects on spermatogenesis by expression of vascular endothelial growth factor (VEGF) and endothelin-1 (ET-1) were investigated. MATERIALS AND METHODS: Testicular specimens were obtained from 40 infertile males due to primary testicular failure and from 10 fertile males with other urologic problems. The specimens of infertile males were devided into 4 groups according to histologic findings; Sertoli cell only syndrome (A), maturation arrest (B), hypospermatogenesis (C) and sloughing and disorganization (D). VEGF and ET-1 expression were detected with immunohistochemical stain. RESULTS: VEGF expression on Leydig cell was detected in all cases. But, VEGF expression rates on germ cell were significantly higher in infertile group B, C, D compared to that of the control group (p<0.05). ET-1 expression rates on Leydig cell was significantly lower in all infertile group compared to that of the control group (p<0.05). But, ET-1 expression rates on Sertoli cell was significantly higher in all infertile group compared to that of the control group (p>0.05). In germ cell of infertile group, LH, FSH and prolactin were significantly decreased, and estradiol is increased in positive stain group on ET-1 immunohistochemical stain (p<0.05). VEGF and ET-1 expression were not correlated mean seminiferous tubule diameter (p>0.05). CONCLUSIONS: Abnormal spermatogenesis would be reflected in VEGF expression in germ cell.
Endothelin-1* ; Estradiol ; Germ Cells ; Humans ; Male ; Oligospermia ; Prolactin ; Seminiferous Tubules ; Sertoli Cell-Only Syndrome ; Spermatogenesis ; Testis* ; Vascular Endothelial Growth Factor A

OBJECTIVE: Rebamipide is a propionic acid derivative that has an action of the inhibition of superoxide production and removal of hydroxyl radical with the sperm incubation and cryopreservation. In the present study, to investigate whether rebamipide is useful to treat male infertility and sterility, the author observed the antioxidative effects in patient with male infertility and also examined its absorption and distribution in rat genital organ. METHODS: To measure the distribution of rebamipide in reproductive organ in the rat, carbon indicated rebamipide, 14C-OPC-12759, was orally administered to 10 Spraque-Dawley rats and its organ concentration in serum, liver, kidney, stomach, duodenum, colon, urinary bladder, seminal vesicle, epididymis and testicle were measured each time after 0.5, 1, 2, 4, 8 and 24 hours by using HPLC fluorescent method. The concentrations in semen were measured by HPLC fluorescent method in a sample of 50 infertile males who took 900 mg of rebamipide daily for 3 months. To measure the antioxidative effect and fertility rate for 3 months, each month before and after the treatment, sperm motility, vitality, the oxygen free radical formation, level of peroxidation, fetilizing capacity of semen sample which were obtained from infertile male patients by masturbation after at least 48 hours abstinence were analyzed by computer assisted semen analyzer, eosin-nigrosin stain, chemiluminescence, thiobarbituric acid method and hypo-osmotic swelling test. Simultaneously in a sample that wanted baby, both pregnancy and delivery were researched. RESULTS: The 14C-OPC-12759 concentration in the body of white rats was highest in gastrointestinal organ like stomach, smal intestine and duodenum and followed by genital organ like seminal vesicle, testis and epididymis. The rebamipide concentration in semen of infertile males was 220.77+/-327.84 ng/mL (SD) which showed a large deviation but it was higher than serum which was 126+/-76 ng/mL (SD). In the infertile males, after the treatment with rebamipide, the level of seminal reactive oxygen species (ROS) and lipid peroxidation have significantly decreased in duration of the treatment (p<0.05) and sperm vitality and fertilizing capacity except sperm motility significantly improved on post treatment of 2~3 months (p<0.05). Out of the 41 cases who hoped for pregnancy, 15 cases (36.6%) became pregnant and 12 cases had childbrith, 2 cases had miscarriage and one case is ongoing. The side effect was observed in 1 case (2%) which experienced diarrhea but it was lost spontaneously. CONCLUSIONS: We conclude from this study that rebamipide showed relatively high tendancy of absorption and excretion in the genital organ. In infertile males who had elevated ROS in semen, by specifically inhibiting the cell damage from the antioxidation, a way to preserve sperm motility, vitality and fertilizing capacity was confirmed.
Abortion, Spontaneous ; Absorption* ; Animals ; Birth Rate ; Carbon ; Chromatography, High Pressure Liquid ; Colon ; Cryopreservation ; Diarrhea ; Diethylpropion ; Duodenum ; Epididymis ; Female ; Genitalia ; Hope ; Humans ; Hydroxyl Radical ; Infertility ; Infertility, Male ; Intestines ; Kidney ; Lipid Peroxidation ; Liver ; Luminescence ; Male ; Masturbation ; Oxygen ; Pregnancy ; Rats ; Reactive Oxygen Species ; Semen ; Seminal Vesicles ; Sperm Motility ; Spermatozoa ; Stomach ; Superoxides ; Testis ; Urinary Bladder

No abstract available.
Emergencies* ; Emergency Service, Hospital*

No abstract available.

PURPOSE: The clinical efficacy and safety of apomorphine hydrochloride SL, a new centrally acting oral agent for the management of the male erectile dysfunction (ED), were evaluated. MATERIALS AND METHODS: Sixty consecutive patients with ED, who visited the Male Sexual Dysfunction Clinic at Pusan National University Hospital, between April and December 2002, were evaluated by open labelled and uncontrolled randomized methods. Apomorphine hydrochloride SL (Uprima(r)), 4-8 3mg tablets, was prescribed on each visit, which was administered sublingually according to the standard patient guidelines. An overall evaluation of erectile function was performed using the international index of erectile function (IIEF) and global efficacy assessment questions (GAQ). RESULTS: The age distribution of the 51 cases was 22 to 76 years, with a mean of 47.6+/-10.6 years. During the mean follow-up period of 26.2+/-18.6 days, ranging from 7 to 156 days, the sum of the IIEF symptom scores changed significantly, from 11.2+/-6.7, at the baseline, to 17.0+/-8.2, on the 3rd visit (p>0.05). The IIEF scores were significantly improved in the Q3 and Q4, at 45.7% and 59.8%, respectively(p<0.05), while those in the Q6, Q10, Q12 and Q13 were not improved after treatment (p>0.05). The improvements in the IIEF scores revealed in psychogenic and mild grade ED were statistically significance (p<0.05). Selectivity as a treatment regimen was shown in only 5 cases (8.3%). Adverse reactions were noted in 7 cases (13.7%), but were self-limited, and resulted in only 1 (1.9%) drop-out due to dizziness. CONCLUSIONS: Apomorphine hydrochloride SL is suggested would be a proper oral agent in patients with psychogenic or mild degree organic ED.
Age Distribution ; Apomorphine* ; Busan ; Dizziness ; Erectile Dysfunction* ; Follow-Up Studies ; Humans ; Male ; Tablets

Adenomatoid tumor is an uncommon neoplasm found mainly near or in the epididymis in the male and the fallopian tubes and ovary in the female. We observed a case of adenomatoid tumor of the epididymis, which was found incidentally 20 years ago by patient self examination. A rubbery, non-tender, 2 X 1-cm mass was found in the tail portion of the right epididymis. Scrotal ultrasonography showed a 2.1 X 1.1 X 1.2-cm hypoechoic solitary mass. Mass excisional biopsy with partial epididymectomy was done under local anesthesia. Pathologic examination showed an adenomatoid tumor.
Adenomatoid Tumor* ; Anesthesia, Local ; Biopsy ; Epididymis* ; Fallopian Tubes ; Female ; Humans ; Male ; Ovary ; Self-Examination ; Ultrasonography

PURPOSE: Information has been limited on the genetic control of germ cell apoptosis and its role in the pathogenesis of male infertility. The object of this study was to investigate the effects of c-kit gene expression and apoptosis on human spermatogenesis. MATERIALS AND METHODS: Testicular specimens were obtained from 90 infertile males with nonobstructive azoospermia(NOA) due to primary testicular failure and from 9 healthy volunteers. The specimens of infertile men were divided into 4 groups according to hitopathologic findings: Sertoli cell only(SCO) syndrome(A), maturation arrest(B), hypospermatogenesis(C) and disorganization with sloughing(D). C-kit gene expression and apoptosis were detected with immunohistochemical stain. RESULTS: The frequency of c-kit expression was lower(p<0.05) and that of apoptosis was higher(p<0.01) in infertility groups B, C, and D compared to that of the control group. A significant inverse correlation was observed in the c-kit gene expression and apoptosis in groups B, C and D(p<0.05). A similar relationship was also observed in the Sertoli cells in group D and the control group. CONCLUSIONS: With the result, we suggest that variation in c-kit gene expression and apoptosis are associated with abnormal spermatogenesis and play a role in the pathophysiology of male infertility.
Apoptosis* ; Gene Expression ; Germ Cells ; Healthy Volunteers ; Humans ; Infertility ; Infertility, Male ; Male ; Sertoli Cells ; Spermatogenesis* ; Testis

PURPOSE: We investigated the prevalence of premature ejaculation and knowledge of the disease in young and middle-aged men in Busan. MATERIALS AND METHODS: The subjects were 500 men aged from 21 to 49 years(average 37.7 years) who had no history of erectile dysfunction and had a stable sexual partner. The numbers of responders in their third, fourth, and fifth decades were 36, 299, and 165, respectively. All interviews were performed by the same urologic resident. The questionnaire consisted of 10 questions in three domains covering the prevalence and severity of premature ejaculation, its influence on sexual life, and therapy. RESULTS: The overall prevalence of premature ejaculation was 41.0% (205/500), being highest in younger men (50.0% in the third decade [18/36], 45.8% in the fourth decade [137/299], and 30.3% in the fifth decade [50/165]). Men saying they "always or almost always" or "usually" had the condition accounted for 2.0% (10 men) of the total study population, being 0 in the third decade, 2.0% (6 men) in fourth decade and 2.4% (4 men) in fifth decade. The man himself and his sexual partner complained of more than moderate discomfort in 29 cases (14.1%) and 22 cases (10.7%), respectively. Only three men (1.4%) had received treatment for premature ejaculation, but the numbers of men who wished to try medical or surgical treatment were 32 (66.7%) and 16 (33.3%), respectively. CONCLUSIONS: Although the prevalence of premature ejaculation is high in young and middle aged men in Busan, it has not been regarded as sexual dysfunction for the most part, and the treatment rate is low. We suggest that public education about the pathophysiology and management of premature ejaculation is required.
Busan* ; Education ; Erectile Dysfunction ; Humans ; Male ; Middle Aged ; Premature Ejaculation* ; Prevalence* ; Surveys and Questionnaires ; Sexual Partners

PURPOSE: Erectile dysfunction(ED) is commonly experienced in men with diabetes mellitus. Hypoxia in the penile tissue by vascular complications is regarded as a pathophysiologic factor in diabetic ED. The aim of this study is to investigate whether HIF-1alpha is altered in diabetic penile tissues and whether its alteration may modulate penile expression of VEGF and NOS, which are believed to play a role in diabeteic ED. MATERIALS AND METHODS: OLETF rats, an animal model for type II diabetes mellitus, and LETO rats, a non-diabetic control group, were used. We analyzed the distribution of HIF-1alpha, VEGF, and NOS(eNOS and iNOS) in the isolated corupus cavernosum of both LETO and OLETF rats by immunohistochemicalstaining. The mRNA expression levels of HIF-1alpha, VEGF, eNOS, and iNOS were also analyzed by reverse transcriptase-polymerase chain reaction(RT-PCR). RESULTS: There was no difference in the concentration of nitrite/nitrate in cavernosal homogenate between LETO rats and OLETF rats. By immunohistochemical staining. HIF-1alpha, VEGF, and iNOS were expressed more abundantly in stain in OLETF rats. By RT-PCR analysis, HIF-1alpha mRNA, VEGF mRNA and iNOS mRNA expression levels were higher in the OLETF rats compared to LETO rats. CONCLUSIONS: We suggest that increased HIF-1alpha, VEGF and iNOS expressions in OLETF rat may be associated with microvascular injury in corpus cavernosum. Such microvascular injury is proposed to be associated with vasculogenic erectile dysfunction.
Animals ; Anoxia ; Diabetes Mellitus ; Erectile Dysfunction ; Humans ; Hypoxia-Inducible Factor 1 ; Male ; Models, Animal ; Nitric Oxide Synthase* ; Nitric Oxide* ; Penis ; Rats* ; Rats, Inbred OLETF ; RNA, Messenger ; Vascular Endothelial Growth Factor A* ; Vascular Endothelial Growth Factors

No abstract available.
Gonadotropins* ; Humans*