Hueih-Shing Hsu

Decreased blood flow and defective energy metabolism in the varicocele-bearing testicles of rats.

This study was designed to elucidate the hemodynamic and energetic changes of testicles in experimental varicocele. Partial ligation of the left renal vein was performed in 10 Sprague-Dawley rats to induce dilatation of the internal spermatic vein, and sham operation was performed in the other 10 age-matched Sprague-Dawley rats used as controls. Blood pressure and rectal temperature were maintained at a constant level. Testicular blood flow was detected by laser Doppler flowmeter on the day before surgery and 4 weeks after surgery, respectively. Concentrations of various adenine nucleotides were determined by high-performance liquid chromatography (HPLC). We found a significant decrease from 10.2 +/- 1.5 to 7.4 +/- 1.8 mlLD/min/100 g (p < 0.005) in testicular blood flow after inducing varicocele in the rats. The energy charge of adenine nucleotides of the varicocele-bearing rats was 0.62 +/- 0.07 which was significantly lower than the 0.73 +/- 0.02 of the control group (p < 0.005). These observations have, thus, led us to propose the hypothesis that impaired spermatogenesis may result from defective energy metabolism in the varicocele-bearing testicles of rats.

Defective mitochondrial oxidative phosphorylation in varicocele-bearinc testicles

OBJECTIVES Our previous study revealed a decreased blood flow in varicocele-bearing testicles. For further understanding of the possible mechanism of varicocele-induced infertility, we investigated the changes in energy metabolism in varicocele-bearing testicles. METHODS Partial ligation of the left renal vein was performed in 40 Wistar rats to induce dilation of the internal spermatic vein, and sham operations were performed in 20 other age-matched Wistar rats serving as controls. Orchiectomy was done at 1, 2, 4, and 6 months after induction of varicocele (or sham operation) in both groups. The histologic changes in the testicles were evaluated under the light microscope. The concentration of adenine nucleotides was determined by high-performance liquid chromatography, and various enzyme activities of mitochondria were determined by a spectrophotometer. RESULTS Histologic studies of varicocele-bearing testicles showed a lower Johnsen score (8.5 +/- 0.7 versus 9.3 +/- 0.5) and a decreased mean testicular tubular diameter (280.0 +/- 3.2 versus 295.0 +/- 1.4 microns) compared with the testicles in the sham-operated group. The energy charge decreased from 0.71 +/- 0.04, 0.70 +/- 0.03, 0.69 +/- 0.06, and 0.64 +/- 0.03 to 0.62 +/- 0.08, 0.59 +/- 0.05, 0.58 +/- 0.05, and 0.56 +/- 0.02 at 1, 2, 4, and 6 months, respectively. The reduced nicotinamide-adenine dinucleotide-cytochrome c reductase activities were decreased from 136.6 +/- 4.9, 127.3 +/- 10.7, 121.6 +/- 7.8, and 118.9 +/- 8.5 to 96.3 +/- 13.9, 95.6 +/- 27.8, 88.3 +/- 13.8, and 80.4 +/- 8.7 nmol/min/mg of protein, respectively; the succinate-cytochrome c reductase activities were decreased from 50.4 +/- 2.7, 49.0 +/- 4.7, 49.6 +/- 7.1, and 42.6 +/- 1.6 to 40.3 +/- 7.3, 41.0 +/- 11.5, 40.2 +/- 5.7, and 32.0 +/- 1.3 nmol/min/mg of protein, respectively; and the cytochrome c oxidase activities were decreased from 361.2 +/- 23.4, 350.3 +/- 25.5, 223.5 +/- 12.9, and 194.1 +/- 18.3 to 253.7 +/- 32.9, 256.4 +/- 38.8, 178.2 +/- 15.7, and 147.1 +/- 17.2 nmol/min/mg of protein at 1, 2, 4, and 6 months, respectively. CONCLUSIONS We thus suggest that defective energy metabolism plays an important role in the impairment of spermatogenesis of varicocele-bearing testicles.

The effect of nocturia on sleep quality and daytime function in patients with lower urinary tract symptoms: a cross-sectional study

Background Nocturia has been proven to have a negative impact on the quality of life and sleep quality in general elderly population. However, there are limited studies on the quantitative effect of nocturia on sleep quality and daytime dysfunction, specifically in patients with lower urinary tract symptoms. Patients and methods During March 1, 2015 to December 31, 2015, a total of 728 patients who visited our urology department due to voiding dysfunction and experienced nocturia at least once per night were enrolled. Three questionnaires were administered to them after obtaining their written consents. Pittsburgh Sleep Quality Index (PSQI) questionnaire, Epworth Sleepiness Scale (ESS) questionnaire, and International Prostate Symptom Score (IPSS) questionnaire were applied to evaluate their sleep quality, daytime dysfunction, and voiding problems, respectively. Statistical analysis of the impact of nocturia on sleep quality and daytime dysfunction was performed. Results The mean age of patients was 61 years, with a male-to-female ratio of 2.7. The mean nocturia number was 3.03. The IPSS, PSQI, and ESS scores were 17.56, 8.35, and 8.22, respectively. The nocturia number increased with age and was significantly correlated to ESS score (daytime dysfunction) and PSQI total score (sleep quality) in overall group. Among subgroups divided by age and sex, there was a significant correlation between nocturia number and daytime dysfunction in male patients or patients younger than 65 years. Conclusion In patients with lower urinary tract symptoms, nocturia number increased with age and was significantly correlated with poor sleep quality. Nocturia plays an important role in patients younger than 65 years in daytime dysfunction.