Combination of Korean Red Ginseng Extract and Hydrogen-Rich Water Improves Spermatogenesis and Sperm Motility in Male Mice / 中国结合医学杂志

OBJECTIVE@#To investigate the effect of hydrogen-rich Korean Red Ginseng (KRG) water (HRGW) mixture on the spermatogenesis and sperm motility of mice of different ages.@*METHODS@#Eighty young (3 month-old) and aged (12 month-old) male mice were randomly assigned to 4 groups (n =10 per group) including control group, hydrogen-rich water (HRW) group (10 mL/kg daily), KRG group (50 mg/kg daily) and HRGW group (10 mL/kg and 50 mg/kg daily) by an oral zoned needle for 4 weeks. Sperm count and motility were measured using sperm suspension released from cauda epididymis. Serum follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone, and reactive oxygen species (ROS) in serum have also been estimated. Tubular changes were examined through histological hematoxylin and eosin staining. Expression of antioxidation (PPx3, PPx4, GSTm5 and GPx4), spermatogenesis (inhibin-a, neptin-2 and CREM), antiaging (SIRT1 and SIRT2), and angiogenesis [visfatin and vascular endothelial growth factor (VEGF)] related genes were examined through real-time polymerase chain reaction.@*RESULTS@#HRW and KRG treatment stimulated spermatogenesis followed by increasing sperm production and sperm motility (P <0.05). These effects were strengthened synergistically by a HRGW mixture (P <0.05 or P <0.01). HRGW greatly increased the expressions of antioxidation, antiaging, spermatogenesis related genes and VEGF especially in aged mice (P <0.05). Serum testosterone and FSH levels also increased, while serum ROS level decreased (all P <0.05).@*CONCLUSION@#HRGW increases sperm production and motility by enhancing antioxidation and stimulating spermatogenesis and sex hormone production, particularly in aged mice.

Efficacy and Safety of a Mixed Extract of Trigonella foenum-graecum Seed and Lespedeza cuneata in the Treatment of Testosterone Deficiency Syndrome: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

PURPOSE: The aim of this study was to investigate the efficacy and safety of a mixed extract of Trigonella foenum-graecum seed and Lespedeza cuneata (TFGL) for the treatment of testosterone deficiency syndrome (TDS). MATERIALS AND METHODS: Patients were instructed to take a placebo or 200 mg TFGL capsule twice per day for 8 weeks. The primary efficacy variable was the change from baseline in the Aging Males' Symptoms scale (AMS), as well as levels of serum total and free testosterone. Secondary efficacy measurements included changes from baseline in the number of ‘yes’ answers on the Androgen Deficiency in the Aging Male (ADAM) questionnaire, levels of serum total cholesterol, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride, all domain scores of the International Index of Erectile Function (IIEF), perceived stress scale-10 (PSS-10), as well as changes in body composition. RESULTS: The TFGL group exhibited a significant improvement in the AMS scores at 8 weeks, total testosterone at 8 weeks, and free testosterone at 4 and 8 weeks. At 4 weeks, 25% of the TFGL group changed to negative in terms of ADAM scores and 34.1% of the TFGL group had negative scores at the end of the study. The TFGL group exhibited a significant improvement in total cholesterol, HDL-C, LDL-C, triglyceride, IIEF scores, and PSS-10 scores at 8 weeks. CONCLUSIONS: The mixed extract of TFGL resulted in significant improvements in symptoms of TDS, as measured by the AMS, ADAM, PSS-10 and testosterone levels.

Restoration of Spermatogenesis Using a New Combined Herbal Formula of Epimedium koreanum Nakai and Angelica gigas Nakai in an Luteinizing Hormone-Releasing Hormone Agonist-Induced Rat Model of Male Infertility

PURPOSE: We investigated the protective effect of a mixture of 2 herbal extracts, KH-465, which consisted of Epimedium koreanum Nakai and Angelica gigas Nakai, on spermatogenesis in a luteinizing hormone-releasing hormone (LHRH) agonist-induced rat model of male infertility. MATERIALS AND METHODS: Seventy-five 12-week-old male Sprague-Dawley rats were randomly divided into 5 groups, containing 15 rats each: a normal control group that received no treatment and 4 experimental groups (I, II, III, and IV) in which an LHRH agonist was administered for 4 weeks to induce spermatogenic failure. Group I received distilled water, and groups II, III, and IV received 200 mg/kg/day of KH-465, 400 mg/kg/day KH-465, and depo-testosterone for 4 weeks, respectively. Weight changes of the testis and epididymis, sperm count motility, and levels of testosterone (T), free T, follicle-stimulating hormone (FSH), luteinizing hormone (LH), superoxide dismutase (SOD), and 8-hydroxy-2′-deoxyguanosine (8-OHdG) were estimated. RESULTS: Body, testis, and epididymis weight showed no significant differences among the control and experimental groups. Treatment with KH-465 increased the sperm count and motility. Serum hormone levels of T, free T, and FSH were not significantly different in the experimental groups, while the LH level was higher than in the LHRH agonist-induced control group, but not to a significant extent. Levels of SOD were higher and 8-OHdG were lower in the groups that received KH-465 than in the LHRH agonist-induced control group. CONCLUSIONS: Our results suggest that KH-465 increased sperm production via reducing oxidative stress and had a positive effect in a male infertility model.

Effects of Korean red ginseng on semen parameters in male infertility patients: A randomized, placebo-controlled, double-blind clinical study / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the effects of Korean red ginseng (KRG) on semen parameters in male infertility patients in a randomized, double-blind, placebo-controlled study.</p><p><b>METHODS</b>A total of 80 male infertility patients with varicocele were recruited from April 2011 to February 2012. The subjects were then divided into the following four groups: non-varicocelectomy (V)+placebo (P) group, V+P group, non-V+KRG group (1.5-g KRG daily), and V+KGR group (1.5-g KRG daily). Semen analysis was performed and hormonal levels were measured in each treatment arm after 12 weeks.</p><p><b>RESULTS</b>All groups but not the non-V+P group, showed significant improvements in sperm concentrations, motility, morphology, and viability at the end of the study. However, there were no significant differences in serum follicle-stimulating hormone, luteinizing hormone, and testosterone among groups. The incidence of adverse events was low, and all events were assumed to be unrelated to the treatments administered.</p><p><b>CONCLUSIONS</b>Although the exact mechanism by which KRG improves spermatogenesis remains unclear, KRG may be a useful agent for the treatment of male infertility. Nevertheless, additional studies to evaluate the optimal dose and duration of treatment are needed.</p>

The Effect of 5-alpha Reductase Inhibitors on the Efficacy of Photoselective Vaporization of the Prostate with 120 W GreenLight HPS Laser / 대한남성과학회지

PURPOSE: To evaluate the effect of preoperative 5-alpha reductase inhibitor (ARI) administration on the operative results of photoselective vaporization of prostate with 120W GreenLight HPS laser. MATERIALS AND METHODS: Data were collected from 98 benign prostatic hyperplasia (BPH) patients who underwent transurethral electrovaporization of prostate by 120W Greenlight HPS laser between Jan. 2010 and Dec. 2010. We compared the time of operation, the energy required in lasering, postoperative maximum uroflow velocity, change in residual urine volume and complications between 5-ARI administrating group and control group. RESULTS: 56 patients administrated 5-ARI at least 3 months before surgery. 30 and 26 patients administrated finasteride and dutasteride, respectively. Mean follow up period was 4.1+/-1.8 months. Mean age of the subjects and mean prostate volume were not different. Mean change of postoperative hemoglobin, lasing time and energy required in lasering were greater in 5-ARI administrating group. There were 3 and 1 cases of acute urinary retension in 5-ARI administrating group and control group, respectively. CONCLUSIONS: The mean change of hemoglobin and mean energy required in lasering were greater and mean lasing time was longer in the patients who administrated 5-ARI before photoselective vaporization of prostate by 120W Greenlight HPS laser. Further investigation and extensive study will be needed to confirm these results.

The Use of Phytotherapy in Male Patients with a Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: Single Center Study / 대한남성과학회지

PURPOSE: Recently, the use of complementary and alternative medicine (CAM) is increasing among patients with low urinary tract symtoms (LUTS) caused by benign prostate hyperplasia (BPH). We assessed current usage and awareness of phytotherapy, the most ubiquitous CAM, in BPH/LUTS patients. MATERIALS AND METHODS: A total of 204 patients with BPH who completed a questionnaire between January 2009 and December 2010 were enrolled. The questionnaire was composed of questions about age, education level, accompanying disease, type of phytotherapy, route of purchase, reason of taking medicine and whether the patient is using phytotherapy in combination with conventional medicine. RESULTS: The mean age was 55.5+/-8.7 years. 56 of the total patients (27.5%) were using phytotherapy. The patients who were accompanied with erectile dysfunction used phytotherapy the most. The most commonly used phytotherapy for prescription and health functional food was Saw palmetto. The most common route of purchase was by clinician's prescription (46.4%). Most patients answered the dissatisfaction of present treatment's effect as the main reason for using phytotherapy. The number of patients who were taking combination therapy of BPH medication and phytotherapy was much more than using phytotherapy alone. CONCLUSIONS: 27.5% of patients who had BPH/LUTS were using phytotherapy. This is the point of time for many urologists to acquire the knowledge of studies and latest research of phytotherapy and use it in treating patients with BPH/LUTS.

Evaluation of Complementary and Alternative Medicine for Treating Patients with Erectile Dysfunction / 대한비뇨기과학회지

Purpose: The aim of this study was to evaluate complementary and alternative medicines (CAM) employed for treating patients with erectile dysfunction. Materials and Methods: A total of 204 patients with erectile dysfunction who completed a questionnaire between January and June 2005 were evaluated. The questionnaire was composed of 13 questions. This survey employed a broad definition for CAM, including acupuncture, biofeedback, folk remedies, chiropractic, homeopathy, hypnosis, massage, psychotherapy, relaxation, energy healing, imagery, special diet, spiritual healing and herbal medicine. The CAMs used by the patients with erectile dysfunction were divided into processed health foods, natural health foods and other therapies, and these were all analyzed. Results: The mean age was 57.9+/-10.1 years. 78 of the total patients with erectile dysfunction had employed at least one CAM. CAM users were more likely to be high school educated, nonsmokers and exercisers. The CAMs used were processed health foods 62% (48/78), natural health foods 15% (12/78), and other therapies 66% (52/78). The processed health foods were soy 25%, ginseng 23% and mushroom 19%. Of the natural health foods, tomato was 42%, soy was 25% and ginseng was 17%. Of the other therapies, herbal medicine was 45%, acupuncture was 25%, moxibustion and cupping a boil were 17%. 35% (27/78) of the patients with erectile dysfunction had employed more than one of the processed health foods, natural health foods and other therapies. Conclusions: Patients with erectile dysfunction had mainly employed processed health foods more than the natural health foods, herbal medicine and acupuncture. We think that more research is required about the effects and benefits of CAM in association with ED.

Age-related Changes of Nitric Oxide Synthase Isoforms and Endothelin-1 in Rat Corpus Cavernosum / 대한비뇨기과학회지

PURPOSE: Relaxation of the penile cavernous smooth muscle, which is the main process in penile erection, is controlled by endothelial-derived substances. This study was designed to determine whether aging resulted in altered endothelial autocrine/paracrine function. MATERIALS AND METHODS: We analyzed the distribution of endothelin-1 (ET-1) and nitric oxide synthase (NOS) in the isolated corpus cavernosum from both young (12 weeks old) and aged (50 and 80 weeks old) rats by immunohistochemical (IHC) staining. Vascular mRNA expressions of NOS isoforms and ET-1 were also analyzed by reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: The concentration of nitrite/nitrate in the corpus cavernosum was significantly decreased in aged rats but plasma nitrite/nitrate concentration was not changed by aging. IHC staining revealed that the aged vessels showed a marked IHC staining for inducible NOS (iNOS) although the vessels from 12-week-old rats were negative for iNOS. In contrast, there was a reduction of immunoreactivity for endothelial NOS (eNOS) with aging. With aging, expression of eNOS mRNA was slightly decreased in the corpus cavernosum. However, expression of iNOS mRNA was markedly increased with increasing age. IHC staining for vascular ET-1 peptide in young rats showed a scanty distribution in the endothelial cell layer. However, the staining for ET-1 increased both the endothelial cells and vascular smooth muscle layers in the aged rats. mRNA expression of ET-1 gene was upregulated in the aged rats. CONCLUSIONS: It is suggested that the activation of vascular endothelin cascade and alterations in the expression of NOS isoforms may play an important role in the age-dependent, vasculogenic, erectile dysfunction.

Adenomatoid Tumor of the Epididymis / 대한남성과학회지

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.

Hormone Supplement Therapy in Andropause / 대한비뇨기과학회지

Though the causes of aging are genetically determinated, beginning and progression of aging may be mediated by a change of endocrine factors. The change of endocrine factors in aging males widely differ for every man and is less clear than in women resulting in an underestimation of the problem unless he presents with sexual dysfunction and reduced fecundity. Only recently, it has been accepted that the andropause, manifested by decline levels of serum androgen and other key hormones after the 30th year, results in various physical and mental disabilities similar to those experienced by women. With the various type and route, testosterone for androgen supplement therapy has been used properly to treat andropause with a desirable clinical outcome under the standard recommended guideline as well as obviously close monitoring on the long term trial. Additionally, benefit and risk of miscellaneous hormones including dehydroepiandrosterone, growth hormone, melatonin and others is still investigating on andropause patients under the various clinical setting. Nevertheless, it is strongly suggested that hormone supplement therapy restores the quality of life through the improvement of general body functions in senescence with andropause.

The Clinical Efficacy of Topical Agents for Premature Ejaculation / 대한남성과학회지

PURPOSE: The penile hypersensitivity is one of the complicated causes of premature ejaculation so that it has been applied to the local anesthesia or the penile dorsal neurectomy in the cases of treatment. The authors had compared the clinical efficacy of various kinds of OTC topical agents which were designed for premature ejaculation and were approved of selling in Korean market. MATERIALS AND METHODS: 10 normal adult male with ages from 29 to 24 years (ave. 33.4) were enrolled in this study. 8 topical agents of cream-type such as SS-cream(R), gel-type such as Power gel(R), B.M. gel(R), BIGTO gel(R) and Control gel(R), solution-type such as E.L.T soln(R), and spray type such as Sanova(R), Tstone(R) were applicated. With exception of SS-cream(R) which was natural medicine, the rest of them were made from lidocane 9.6%. We evaluated characteristics, efficacy, satisfaction and adverse reactions in treatment of premature ejaculation with 8 topical agents. RESULTS: In concerning of their odor, SS-sream(R) was the strongest (p<0.05). The viscosity was the highest in cream-type agent as SS-cream(R). However washing after sexual intercourse is relatively easy in every cases with the lowest necessity of washing in solution-type E.L.T soln(R) (p<0.05). The main causes of feeling the usage of drugs by partners were delay of ejaculation time, feeling of foreign bodies in genital organ, and the odor of drugs itself. Except SS-cream(R) with 60 minutes, the interval time of drug effect was about 15 to 20 minutes in every cases without any significant difference as well as adequate duration of drug efficacy. The times of usage per one pack was more in both E.L.T(R). soln which was make-up compact-type, and Sanova(R), Tstone(R) which was spray-type than the rest of drugs which were contained in disposal pack or tube. Also E.L.T soln(R), Sanova(R) and Tstone(R) had showed the convenience of usage (p<0.05). With overall satisfaction, there was excellent convenience of usage in E.L.T. soln which was packed in make-up compact (p<0.05). CONCLUSIONS: Topical anesthetic agents designed for premature ejaculation are safe and effective medical treatment with no significant difference in their characteristics, efficacy, and occurrence of adverse reaction among the various topical agents. Therefore, we suggest that the most important factors which influence the satisfaction and selectivity to topical anesthetic agents for premature ejaculations are the preserving container and method of application.

The Clinical and Component Analyses of Submandibular Sialolithes / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Sialolithiasis occurs in the submandibular gland rather than in the parotid or sublingual gland. It was manifested by several biochemical and anatomical factors inducing saliva retension. There have been various clinical reports about sialolith, but only a few analytical reports. MATERIALS AND METHODS: A retrospective review was carried out for the period of July, 1998 to July, 2000 of 25 cases of the submandibular sialolithes, which was diagnosed and removed . We performed clinical and component analysis of sialolithes with a new method that uses the absorption band of an infrared spectrometer analysis. RESULTS: Calcium phosphate (16 cases) showed a strong band at 1000cm-1 and calcium phosphate and albumin (9 cases) showed a strong double band at 1700cm-1 and 1000cm-1. The incidence of submandibular sialolithiasis was predominant in females, accounting for the male to female ratio of 8:17. The age distribution of sialolithes was 15 to 62 years. Sialolithes were removed by the transoral approach under local anesthesia and external approach (submandibular gland resection) under general anesthesia. For most patients, sialolithes were brown in color (12 cases), 2~14mm in size, 2.1~1636.8ng in weight and located on the Wharton's duct orifice (17 cases). CONCLUSION: The most common types of sialolithes were calcium phosphate (16 cases, 64%). The rest of sialolithes (9 cases, 36%) were mixed calcium phosphate and albumin. Compared to all the other methods used in the sialolithes analysis, the infrared analysis furnished the permanent record in the shortest time. It was also ideal for qualitative identification and semiquantitative estimation of small fractions of calcium.

Effects of Anti-oxidants in Freezing and Thawing of Sperm / 대한비뇨기과학회지

PURPOSE: It is known that reactive oxygen species which increase during the cryopreservation of sperm are harmful to sperm. This study analyzed the concentration, motility, morphology and lipid peroxidation of cell membrane before and after the cryopreservation of sperm for an evaluation of the influences of reactive oxygen species in sperm function. MATERIALS AND METHODS: Semen samples from 50 normal healthy volunteers were collected by masturbation. After liquefaction at room temperature, the semen was divided and stored in cryogenic tubes supplemented with Ham`s F-10 medium and a cryoprotective agent. To the experimental group was added superoxide dismutase(SOD, Sigma, USA) 100microliter, catalase (Sigma, USA) 100microliter, SOD and catalase 50microliter and 200microliter, glutathione peroxidase 10microliter, SOD and glutathione peroxidase 50microliterand 20microliter. It was then divided into groups I, II, III, IV and V. Antioxidant was not added to the control group. All specimens were cryopreservated at -196degrees C liquid nitrogen, then thawed at room temperature. We analyzed sperm motility and morphology, and the level of lipid peroxidation was measured by thiobarbituric acid(TBA). RESULTS: The sperm concentration and morphology did not show any significant differences statistically between the experimental and the control groups. After cryopreservation, the sperm motility was significantly decreased in the experimental and the control groups(p<0.05). In groups II, III, IV and V, the sperm motility decreased more than in group I and the control group(p<0.05). In groups II, III, IV and V, lipid peroxidation of cell membrane was significantly lower than in group I and the control group(p<0.05). In both the experimental and the control groups, the ratio of motile sperm decreased significantly, according to increasing lipid peroxidation(p<0.05, r=0.566). CONCLUSIONS: We conclude from this study that the reactive oxygen species occuring in sperm cryopreservation may significantly influence the function of sperm. A cryoprotective agent supplemented with proper anti-oxidant may reduce the harmful effect associated with sperm cryopreservation.

Significance of Zn and Se Levels in Seminal Plasma and Blood Plasma in Male Infertile Patients / 대한비뇨기과학회지

Zinc (Zn) and Selenium (Se) were analysed in seminal and blood plasmas from 60 male infertility group and 10 normal control group. The concentrations of Zn and Se were estimated by atomic absorbance spectrophotometry (AAS, Smith-hieftje-4000, Thermo-Jarrel-Ash, USA). Seminal plasma Zn and Se in control group and infertility group were 146.3 +/- 41.5 microgram/ml, 152.4+/-61.4 microgram/ml and 0.074+/-0.03 microgram/ml, 0.068+/-0.03 microgram/ml, respectively. Blood plasma Zn and Se in control group and infertility group were 1.65 +/-0.62 microgram/ml, 1.56+/-0.54 microgram/ml and 0.084+/-0.02 microgram/ml, 0.082+/-0.04 microgram/ml, respectively. In control group, the concentration of Zn in seminal plasma was significantly higher than in blood plasma (p0.05). In infertility group, the concentration of Zn in seminal plasma was significantly higher than in blood plasma (p0.05). The Zn and Se in seminal and blood plasmas repealed no statistically significant differences according to sperm density and plasma FSH, LH, testosterone and prolactin level (p>0.5). As a result, we suggest that the .ole of Zn and Se in male infertility may have directly effects on sperm function and spermatogenes.

Postoperative long-term follow-up of benign prostatic hyperplasia on viewpoint of quality of life / 대한비뇨기과학회지

As a part of ongoing effort to evaluate alternative treatments for benign prostatic hyperplasia (BPH}. we compared the outcomes of transurethral resection of prostate(TURP) with those of open prostatectomy(OP). To identify effect of TURP on high mortality due to cardiac death. We compared long-term mortality and the causes of death after each surgical procedures. From Jan 1981 to Dec. 1990, surgical management was underwent on 338 patients with BPH in Pusan National University Hospital. Of 338 patients. survival was identified in 70 of OP group and 166 of TURP group. Direct interview was possible in 50 of OP group and 135 of TURP group. Mean age and follow-up were 69.8 years old and 89.5 months in OP group and 68.7 years old and 45.4 months in TURP group. Both OP and TURP were effective in improving subjective voiding symptoms including comprehensive symptom and Boyarsky symptom score, but, no significant difference was observed between them. Postoperative convalescence period was significantly shorter in TURP group compared to OP group. The incidence of sexual dysfunction including loss of libido and poor erection was similar between two surgical groups, but the incidence of retrograde ejaculation was higher in TURP group than OP group. Postoperative mortality and leading causes of death were no difference between two groups. Conclusively, we could not find the significant differences between OP group and TURP group as to symptom improvement, long-term mortality and morbidity, and effectiveness on patient`s consent. Although we confess that further evaluation is needed for precise and objective results, such results show postoperative improvement of voiding symptoms, quality of life and long-term outcomes that may not depend on surgical options.