• Title/Summary/Keyword: Age of initiation

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Misuse of testosterone replacement therapy in men in infertile couples and its influence on infertility treatment

  • Song, Seung-Hun;Sung, Suye;Her, Young Sun;Oh, Mihee;Shin, Dong Hyuk;Lee, Jinil;Baek, Jeongwon;Lee, Woo Sik;Kim, Dong Suk
    • Clinical and Experimental Reproductive Medicine
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    • v.46 no.4
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    • pp.173-177
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    • 2019
  • Objective: We investigated the clinical characteristics of men with testosterone replacement therapy (TRT)-induced hypogonadism and its effect on assisted reproductive technology (ART) in infertile couples. Methods: This study examined the records of 20 consecutive male patients diagnosed with azoospermia or severe oligozoospermia (< 5 × 106/mL) who visited a single infertility center from January 2008 to July 2018. All patients were treated at a primary clinic for erectile dysfunction or androgen deficiency symptoms combined with low serum testosterone. All men received a phosphodiesterase 5 inhibitor and TRT with testosterone undecanoate (Nebido®) or testosterone enanthate (Jenasteron®). Patients older than 50 years or with a chronic medical disease such as diabetes were excluded. Results: The mean age of patients was 37 years and the mean duration of infertility was 16.3 ± 11.6 months. At the initial presentation, eight patients had azoospermia, nine had cryptozoospermia, and three had severe oligozoospermia. Serum follicle-stimulating hormone levels were below 1.0 mIU/mL in most patients. Three ongoing ART programs with female factor infertility were cancelled due to male spermatogenic dysfunction; two of these men had normal semen parameters in the previous cycle. After withholding TRT, serum hormone levels and sperm concentrations returned to normal range after a median duration of 8 months. Conclusion: TRT with high-dose testosterone can cause spermatogenic dysfunction due to suppression of the hypothalamic-pituitary-testicular axis, with adverse effects on infertility treatment programs. TRT is therefore contraindicated for infertile couples attempting to conceive, and the patient's desire for fertility must be considered before initiation of TRT in a hypogonadal man.

Clinical Features and Outcomes of Pelvic Insufficiency Fractures (골반 부전 골절의 임상 양상과 치료 결과)

  • Seo, Yong Min;Kim, Young Chang;Kim, Ji Wan
    • Journal of the Korean Fracture Society
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    • v.30 no.4
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    • pp.186-191
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    • 2017
  • Purpose: The purpose of this study was to investigate the radiological and epidemiological characteristics, as well as the clinical course of pelvic insufficiency fractures in the elderly population. Materials and Methods: At a Haeundae Paik Hospital, we retrospectively reviewed patients with pelvic insufficiency fractures between March 2010 and May 2017. The demographic data of patients were analyzed, and bone mineral density and bone turnover markers were evaluated to estimate the metabolic status of the bone. The radiological characteristics were evaluated by comparing the simple x-ray images with the computed tomography images, and the types of fractures were classified via computed tomography images. For clinical course evaluation, we investigated comorbid complications, and compared the walking ability scale before and 6 months after the fracture. Results: A total of 42 patients were included, with an average age of 76.5 years. All were female except one case. In 5 cases where the initial medical examination was from another institution, the fracture was not found in 3 cases. All cases received conservative treatment. After the diagnosis of pelvic bone fracture using a simple x-ray imaging, additional fractures were found in 81.0% of the study population using a computed tomography. Initiation of gait occurred at an average of 2.8 weeks, and every case except 1 (97.6%) fully recovered their gait ability. Conclusion: We concluded that there was a limitation with diagnosing pelvic insufficiency fracture using only a simple x-ray imaging technique. In general, cases in this study showed conservative treatment yielded favorable clinical outcome with relatively less critical complications.

Effects of feeding different levels of dietary corn silage on growth performance, rumen fermentation and bacterial community of post-weaning dairy calves

  • Lingyan Li;Jiachen Qu;Huan Zhu;Yuqin Liu;Jianhao Wu;Guang Shao;Xianchao Guan;Yongli Qu
    • Animal Bioscience
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    • v.37 no.2
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    • pp.261-273
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    • 2024
  • Objective: The objective of this study was to evaluate the growth performance, rumen fermentation parameters and bacterial community of post-weaning dairy calves in response to five diets varying in corn silage (CS) inclusion. Methods: A total of forty Holstein weaned bull calves (80±3 days of age;128.2±5.03 kg at study initiation) were randomized into five groups (8 calves/group) with each receiving one of five dietary treatments offered as total mixed ration in a 123-d feeding study. Dietary treatments were control diet (CON; 0% CS dry matter [DM]); Treatment 1 (T1; 27.2% CS DM); Treatment 2 (T2; 46.5% CS DM); Treatment 3 (T3; 54.8% CS DM); and Treatment 4 (T4; 67.2% CS DM) with all diets balanced for similar protein and energy concentration. Results: Results showed that calves offered CS had greater average daily gain, body length and chest depth growth, meanwhile altered rumen fermentation indicated by decreased rumen acetate concentrations. Principal coordinate analysis showed the rumen bacterial community structure was affected by varying CS inclusion diets. Bacteroidetes and Firmicutes were the predominant bacterial phyla in the calf rumens across all treatments. At the genus level, the abundance of Bacteroidales_RF16_group was increased, whereas Unclassified_Lachnospiraceae was decreased for calves fed CS. Furthermore, Spearman's correlation test between the rumen bacteria and rumen fermentation parameters indicated that Bacteroidales_RF16_group and Unclassified Lachnospiraceae were positively correlated with propionate and acetate, respectively. Conclusion: The results of the current study suggested that diet CS inclusion was beneficial for post-weaning dairy calf growth, with 27.2% to 46.5% CS of diet DM recommended to achieve improved growth performance. Bacteroidales_RF16_group and Unclassified Lachnospiraceae play an important role in the rumen fermentation pattern for post-weaning calves fed CS.

Acetycholinesterase Inhibiting Effect and Free Radical Scavenging Effect of Soybean(Glycine max) and Yak-Kong(Rhynchosia nolubilis) (대두와 약콩의 Acetylcholinesterase 활성 억제효과와 항산화 효과)

  • 강순아;한진아
    • Journal of the East Asian Society of Dietary Life
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    • v.14 no.1
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    • pp.64-69
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    • 2004
  • The deficiency of the neurotransmitter acetylcholine(ACh) is responsible for the initiation of Alzheimer's disease. In addition, there is a simple evidence that oxidative stress significantly increases in persons with Parkinson's disease compared to age-matched healthy persons. Therefore, the objective of the study was to investigate the neurodegeneration inhibitory effect of soybean(Glycine Max) and Yak-Kong(Rhynchosia Nolubilis) by measuring the degree of inhibiting Acetylcholinesterase (AChE) catabolizing the ACh and the free radical scavenger effect in vitro. AChE was measured by the minor modified Ellman assay. Free radical scavenging activity was measured using l-diphenyl-2-picrylhydrazyl (DPPH). First, the MeOH extracts of Soybean and Yak-Kong showed the AChE inhibiting activity of 62.0$\pm$2.43% and 65.0$\pm$3.29% at the 5 mg/$m\ell$ concentration. The 50% inhibitory concentration ($IC_{50}$/) of AChE was 1.96 and 1.31 mg/$m\ell$ in the MeOH extracts of soybean and Yak-Kong. Second, the MeOH extracts of soybean and Yak-Kong showed the free radical scavenger activity of 23.1$\pm$4.26% and 80.7$\pm$4.61% at the 5 mg/$m\ell$. IC50 of free radical scavenger activity in Soybean and Yak-Kong was 13.00 and 1.41 mg/$m\ell$ in MeOH extracts and was 5.95 and 2.74 mg/$m\ell$ in hot-water extracts, respectively. In this study, the extracts of Soybean and Yak-Kong showed powerful effects in the AChE inhibition and free radical scavenging. The extracts of Soybean and Yak-Kong were expected to prevent the many neurodegenerative diseases.

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Studies on the Hemodilution Perfusion with Rygg-Kyvsgaard Oxygenator (혈액희석 체외순환법에 관한 임상적 관찰 -상온하 Rygg-Kyvsgaard 산화기 및 Sigmamotor pump 사용예를 중심으로-)

  • 손광현
    • Journal of Chest Surgery
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    • v.3 no.2
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    • pp.73-90
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    • 1970
  • Clinical perfusion data on 16 cases of cardiopulmonary bypass using Sigmamotor pump and RyggKyvsgaard Oxygenator which performed at Seoul National University Hospital during the period of Aug. 1968 to Aug. 1970 was analized. AIl cases were hemodiluted and the perfusion was carried out under the normothermic condition. The age of the patients ranged between 6 and 43 years. The b:dy weight varied between 18.3 and 54.0 kg and the body surface area between 0.78 and 1. 59$M^2$. The priming solution was consiste:I with fresh ACD blood. Hartmann solution and Mannitol. The average amount of priming was approximately 2242 ml. The average hemodilution rate was 17%. The flow rate ranged from 1.7L to 3.5L/Min/$M^2$ and averaged 2.4L/Min/$M^2$ or 78mI/Min/kg. The duration of perfusion varied from 22 to 110 min with average of 56.9 minutes. Some hemodynamic responses were observed. The arterial pressure dropped immediately after the initiation of partial perfusion and was more marked after the total perfusion foIlowed by gradual increase to the safety level. The central venous pressure reflected the reduced blood volume especially in the cases of prolonged perfusion which lasted over 60 min. In most of the cases, red blood cell count decreased and white blood ceIl count increased after the perfusion. Hemoglobin level was decreased, averaging of 12.5mg%, Hct 3.3% and platelets count of 18% postoperatively. Plasma hemoglobin increased mildly, from pre-perfusion average value of 4. 06mg% to postperfusion value of 22.5mg%. Serum potassium was 4.4mEq/L pre-operatively and was decreased to 3.7mEq/L postoperatively. Five cases showed definite hypopotassemia immediately after the operation. Sodium and chloride decreased mildly. These electrolyte changes are thought to be related with hemodilution. diuretics and reduced blood volume during and after the perfusion. Arterial blood pH value revealed minimal to moderate elevation from preperfusion average value of 7.376 to 7.461 during perfusion and then 7.365 after perfusion. The pC02 and hicarbonate showed minimal to moderately lowered values. The total CO2 was decreased. Buffer base decreased during perfusion (Av. 42.6mEq/L) and further decreased after the perfusion (Av. 40.8mEq/L). These arterial blood acid base changes suggested that the metabolic acidosis was accompanied by respiratory alkalosis during and immediately after the perfusion. Authors belived that the acidosis could more effectively be corrected with the more additional dose of bicarbonate than we used by this study. The chest tune drainage during the first 24 hours following operation was 1158 ml in average. One case (Case No. 15) showd definite bleeding tendency and it was believed that the cause might be due to the defect of heparin and protamine titration. The average urinary out put during 24 hours post-perfusion was 1291ml. One case (Case No. ]) showed definite post perfusion oliguria. As conclusion hemodilution using fresh ACD blood. Hartmann and Mannitol solution added with Bivon and high flow rate unler normothermia. was thought to amelioratc the severity of mctabolic acidosis during and after perfusion with relatively satisfactory effect on the diuresis and bleeding tendency.

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The Effect of Cardiopulmonary Bypass on Serum Magnesium (체외순환에 의한 혈청 Magnesium의 변화)

  • Chae, Hurn;Rho, Joon Ryang;Suh, Kyung Phill;Lee, Yung-Kyoon
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.239-244
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    • 1976
  • Alterations in the serum magnesium level were studied in twenty patients who had open-heart surgery during the period from August 1974 to May 1975. The patients were chosen at random. The operative procedures included repair for congenital heart diseases in fifteen patients and cardiac valve replacement for acquired valvular heart diseases in five patients. The age ranged from 8 to 46 years, with an average of 19 years. None of the patients had a history of gross neuromuscular abnormalities. Cardiopulmonary bypass was carried out using a roller pump and a disposable oxygenator. The prime solution consisted of 2 units of ACD banked blood and approximately an equal volume of non-blood additives in adults, while a relatively smaller volume was added in children. The average flow rate was 2,733 ml per minute. Blood samples for magnesium and arterial blood pH were obtained the day after admission 25 minutes after initiation of the bypass and on the morning the day after operation. Preoperative data were then compared with those obtained during the bypass and postoperatively by a paired test. During the bypass, the serum magnesium level decreased significantly from $1.425{\pm}0.029$ to $1.210{\pm}0.063mEq.$ liter (p<0.001). Also, there was a significant decrease in serum magnesium from $1.425{\pm}0.029$ preoperatively to $1.255{\pm}0.083mEq$. per liter (p<0.001). Also, there was a significant decrease in serum magnesium from $1.425{\pm}0.029$ preoperatively to $1.255{\pm}0.083mEq$. per liter postoperatively (p<0.01). The duration of bypass was less than 90 minutes in 10 patients (group A) and exceeded 90 minutes in the remaining 10 (group B). There was no statistical correlation between the groups A and B ($p{\gg}0.20$). Statistical analyses of the serum magnesium level and arterial blood pH showed no significant correlation with correlation coefficient; being -0.3485(pre-op), -0.2971(during bypass), and -0.1008(post-op), respectively. In all the patients, no gross neuromuscular abnormalities were found postoperatively. At present, the clinical significance of the serum magnesium level during and after bypass is controversial. In the near future, however, it is expected that improvements in prime solution and heart-lung machine will solve this problem.

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Estimating the Payment of Farmland Reverse Mortgage and Its Policy Considerations (농지 역모기지의 월지급금 추정 및 정책적 시사점)

  • Park, Won-Seok;Cho, Deok-Ho;Kim, Byung-Kyu
    • Journal of the Economic Geographical Society of Korea
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    • v.13 no.4
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    • pp.548-560
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    • 2010
  • This study aims to estimate the payment of farmland reverse mortgage(FRM) and to explore policy considerations about the restructuring of rural area after the initiation of farmland reverse mortgage. Farmland reverse mortgage provides stable monthly income basement for the welfare of rural elderly by liquidating fixed asset such as farmlands which the elderly in rural area owns. The main results of this study can be summarized as follows. First, FRM model based on Housing Equity Conversion Model, which is suggested by Rodda et al (2003), was built. Then, critical factors like farmland value rising rates and interest rates were elaborated, and affordable and proper monthly payment were estimated. 246,982 won, 419,374 won and 757,379 won is given to the borrower at age 65, 75 and 85 respectively with 100,000,000 won value farmland. Second, policy considerations which are necessary for the successful launch of FRM, and restructuring of rural area after launching FRM were discussed. Three policy considerations were proposed. First is about the integrated asset management system for rural elderly people. Second is about the reasonable settlement of corporate farmers system. And third is about the preparations for rural land use planning.

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The Association Between Apolipoprotein E Genotype and Lipid Profiles in Healthy Woman Workers (건강한 여성 근로자에서 Apolipoprotein E와 혈중 지질 농도와의 관련성)

  • Moon, Gi-Eun;Sung, Sook-Hee;Chang, Youn-Koun;Park, Il-Keun;Paek, Yun-Mi;Kim, Soo-Geun;Choi, Tae-In;Jin, Young-Woo
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.3
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    • pp.213-221
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    • 2010
  • Objectives: Plasma lipid profiles and Apolipoprotein E (ApoE) are established risk factors for cardiovascular disease (CVD). The knowledge of lipid profile may estimate the potential victims of cardiovascular disease before its initiation and progression and offers the opportunity for primary prevention. The most common ApoE polymorphism has been found to influence plasma lipid concentrations and its correlation with CVD has been extensively investigated in the last decade. Methods: The ApoE polymorphism and its influence on plasma lipid were investigated in healthy woman workers. The information on confounding factors was obtained through a self-administered questionnaire and ApoE polymorphism was investigated using PCR. Results: The relative frequencies of alleles E2, E3 and E4 for the study population (n = 305) were 0.127, 0.750 and 0.121, respectively. ApoE polymorphism was associated with variations in plasma HDL-cholesterol lipid profile. In order to estimate the independent effects of alleles E2 and E4, as compared with E3, on lipid profile, multiple regression was performed after adjustment for confounding variables such as age, BMI, blood pressure, education status, insulin, fasting glucose, HOMA-IR, menopause. ApoE2 had a negative association with HDL cholesterol and ApoE4 had a positive association with LDL cholesterol. Conclusions: This study identified that the ApoE and CVD risk factors contribute to the lipid profiles, similar to other studies. The analysis including dietary intake and other gene in further studies may help to identify clear effects on lipid profiles as risk factor for CVD.

Effect of Elevated CO2 Concentration and Temperature on the Growth and Ecophysiological Responses of Ginseng (Panax ginseng C. A. Meyer) (CO2농도와 온도증가에 따른 인삼의 생육 및 생리.생태학적 반응 연구)

  • Lee, Kyoung-Mi;Kim, Hae-Ran;Lim, Hoon;You, Young-Han
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.57 no.2
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    • pp.106-112
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    • 2012
  • In order to understand the growth and ecophy -siological response of ginseng to global warming condition, we cultivated one and two year ginseng seedlings in control (ambient $CO_2$ + ambient temperature) and global warming treatment (elevated $CO_2$ + elevated temperature) from March 2010 to July 2011. Shoot appearance and initiation of flowering were advanced by 3-4 days in global warming treatment than in control. However, timing of fruit setting and seed ripeness was similar in both control and global warming treatment. Shoot length was longer in global warming treatment than in control, and also the number of leaves was much in global warming treatment. Fresh root weight was not different between control and global warming treatment. Photosynthetic rate was higher in global warming treatment than at control. Photosynthetic rate and transpiration rate were higher in two year seedlings than in one year seedlings at control, but was not different between seedling age of ginseng in global warming treatment. Water use efficiency was higher in one year seedlings than two year seedlings at control and global warming treatment. These results demonstrated that Korean ginseng more or less positively responds to global warming situation.

A Study on the Grounded Theory on Conflict Experiences of Elderly Participants in a senior Employment Promotion Program : Focused on Creating an Aged-friendly Village (노인일자리 참여 노인의 갈등 경험에 관한 근거이론 연구 : 고령친화마을 만들기를 중심으로)

  • Lim, Byung-Woo
    • Journal of Industrial Convergence
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    • v.18 no.6
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    • pp.61-73
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    • 2020
  • The purpose of this study was to categorize conflict resolution by exploring the conflict experiences of the elderly who participate in jobs for the elderly to create an elderly-friendly village. This study applied grounded theory, a qualitative research method, For data collection, a FGI was conducted by sampling 5 elderly job participants in ◯◯-dong, ◯◯-gu, Seoul. The data were analyzed according to the paradigm model of Strauss & Corbin(1998). As a result of the analysis, causal conditions were social, economic, psychological and physical motivations for participation and contextual conditions were economic difficulties, social disconnection, and differences in life experiences influenced the initiation of conflict. The core phenomena were conflict initiated by 'the difference between experience and role' and 'the difference in psychosocial relationship skills', and the intervention condition were the activation of interpersonal relationships through communication to resolve the conflict, social integration through the use of capabilities, It appeared as a regular social activities. The interaction strategy emerged as a strategy for resolving conflict for senior citizen jobs through education, mutual support for building trust, and successful senior-friendly village program operation. The consequences, it was found that job conflicts for the elderly were alleviated by finding one's life, activating community exchanges, increasing a sense of achievement, and growing a sense of community. In conclusion, the conflict resolution types for senior citizens were classified into educational solution type, mutual support solution type, and success experience solution type.