網路調查亞洲男性服用改善勃起功能障礙藥物行房時間計畫
Degree of Planning of Sexual Intercourse among Asian Men from China, Japan and Taiwan Taking Medication for Erectile Dysfunction: Findings of an Observational, Cross-Sectional Survey
Bang-Ping Jiann, MD1, Koichi Nakajima MD, PhD2, Sonali Dighe,DNB, MSc3, Chad D. Harshman Smith, MSE, MBA4, and
4Tarek A Hassan, MD, MSc3
Introduction: Management of erectile dysfunction (ED) is beset with assumptions around spontaneity of sexual intercourse, requiring candor between the physician and patient if appropriate treatment is to be implemented.
Aim: To evaluate the degree to which men who take ED medications plan for and have sex.
Methods: Men from China, Japan and Taiwan aged 40 to 70 years who had taken ED medications within the past 3 months were invited to participate anonymously in an online, self-administered survey that enquired about frequency and advance planning of sex, time between taking ED medication and intercourse, and treatment satisfaction. Data were analyzed using descriptive statistics.
Main Outcome Measures: Frequency of planning of sexual intercourse, planning and ED medication dosing interval, and frequency of ED medication use.
Results: Data from 604 respondents (mean age 50.8 years) from China (n = 254), Japan (n = 250) and Taiwan (n = 100) were collected. Men used ED medications a median of ≤ 4 times per month in all three territories. 76% who used ED medication during the past 3 months planned for sex on specific occasions, with 59% and 52% agreeing that they plan for sex on specific days of the week and times of the day, respectively. Most commonly, men planned for sex up to several hours to a day beforehand, with 94% taking ED medication within 4 hours of sex. Satisfaction with ED medication was generally high and related to erection rigidity, speed of onset and safety.
Conclusion: Knowledge of the degree to which individuals with ED plan for sex may have important implications for the appropriate prescription of ED medication. The high degree of planning around sexual activities exhibited by men taking ED medication suggests there is a need for appropriate counseling to ensure that treatment is aligned with patient behavior.
男性學論文獎臨床組第二名 財團法人鳳凰泌尿科學文教基金會
The Role of SLC9A3 in Taiwanese Patients with Congenital Bilateral Absence of Vas Deferens (CBAVD)
Han Sun Chiang1, Ya-Yun Wang2, Ying-Hung Lin2,
Yi-No Wu3 1Graduate Institute of Biomedical and Pharmaceutical Science,
Fu Jen Catholic University, New Taipei City, Taiwan; Department of Urology,
Fu Jen Catholic University Hospital, New Taipei City, Taiwan. 2Graduate Institute of Biomedical and Pharmaceutical Science,
Fu Jen Catholic University, New Taipei City, Taiwan. 3School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
Congenital bilateral absence of vas deferens (CBAVD) is a special entity in obstructive azoospermia. Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene are involved in Taiwanese CBAVD but most heterozygous 5T variant. The solute carrier family 9 isoform 3 (SLC9A3) is the Na+/H+ exchanger, which interacts with CFTR and regulates the Ca2+ homeostasis. Loss of SLC9A3 decreases CFTR protein and causes obstructive azoospermia in mice. It also causes mal-reabsorption by the efferent tubules, which leads to the obstructive phenomenon and eventually results in testicular atrophy. In 6-month old SLC9A3 deficiency mice, the atrophy of their vas deferens and seminal vesicles become more prominent. Decreases of CFTR expression in the reproductive organ in the SLC9A3 deficient (-/-) mice prove the interaction between CFTR and SLC9A3 in the reproductive tract. Most of Taiwanese CBAVD have at least one variant of SLC9A3 deletion and CFTR IVS8-5T, which co-contribute to Taiwanese CBAVD. The report indicates SLC9A3 deficiency can reverse the pathological changes in the gastrointestinal tract of CF mice. Further research can explore the definite mechanism of SLC9A3 and its role interacting with CFTR in different organ systems, which can contribute to novel treatment for the patients with cystic fibrosis and CBAVD.
男性學論文獎基礎組第一名
Dietary Modification is Associated with Normalization of Penile Hemodynamics in Rats Fed a High-fat Diet
Background: Diet is associated with self-reported indices of sexual health. The mechanisms responsible for these changes remain poorly understood.
Aim: To investigate the hemodynamic and histological impact of dietary change in a rat model of hyperlipidemia-associated erectile dysfunction.
Methods: Forty 2-month old male Sprague-Dawley rats were divided into 4 groups. 10 rats were fed a diet of standard chow and served as negative controls (N group). The remaining 30 age-matched rats were divided at random into 3 groups: (i) high-fat diet for 5 months starting at age 5 months (H group); (ii) high-fat diet for 5 months starting at age 4 months followed by 1 month of standard chow (H+N1M group); and (iii) high-fat diet for 5 months starting at age 2 months followed by 3 months of standard chow (H+N3M group). All rats underwent erectile function testing and sacrifice at age 10 months.
Outcomes: Intracavernous pressure (ICP) and mean arterial pressure (MAP) were measured to evaluate erectile function. Blood sample were collected to measure serum testosterone and lipid levels, and penile tissue specimens were obtained for histological examination.
Results: Total body weight, low-density lipoprotein, and serum glucose were significantly higher in the H group compare with the N and H+N3M groups. Serum high-density lipoprotein level was significantly lower in the H group compared with the N and H+N3M groups. The mean ICP/MAP ratio was significantly lower in the H group compared with the N and H+N3M groups (0.33±0.05 vs 0.79±0.07 vs 0.73±0.13; p<0.05 for both). Markers for intracorporal neuronal nitric oxide synthase and endothelial cells were more weakly expressed in the H group compared with the N and H+N3M groups. There was no significant difference in smooth muscle contents among the groups. Mean cavernosal oxidative stress and the apoptotic index were significantly higher in the H group compared with the N and H+N3M groups. No significant between-group differences were noted with respect to serum testosterone; the H group had significantly higher serum glucose and low density lipoprotein levels, effects that were partially mitigated in the H+N1M and H+N3M groups.
Clinical Translation: Administration of a healthy diet is associated with normalization of functional and histological penile defects associated with high-fat diet.
Strengths & Limitations: Metabolic changes were clearly linked to functional improvements in penile blood flow. Differences between rat and human lipoprotein metabolism are a limitation of this study.
Conclusion: Dietary changes may have positive effects on penile hemodynamics in a rat model of hyperlipidemia-associated erectile dysfunction.
男性學論文獎基礎組第二名
SEPT14 Mutations and Teratozoospermia: Genetic Effects on Sperm Head Morphology and DNA Integrity
Ya-Yun Wang 1,2, Tsung-Hsuan Lai 3,4, Mei-Feng Chen 5, Hui-Ling Lee 1,
Pao-Lin Kuo 6,7 and Ying-Hung Lin 2
Department of Chemistry, Fu Jen Catholic University, New Taipei City, Taiwan1
Graduate Institute of Biomedical and Pharmaceutical Science,
Fu Jen Catholic University, New Taipei City, Taiwan2
Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan3
School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan4
Bone and Joint Research Center, Chang Gung Memorial Hospital, Taoyuan County, Taiwan5
Department of Obstetrics & Gynecology, National Cheng Kung University, Tainan, Taiwan6
Department of Obstetrics and Gynecology, National Cheng-Kung University Hospital, Tainan, Taiwan7
The main objective of this study was to evaluate the potential genetic effects of SEPT14 on male infertility through sequencing the SEPT14 coding region. To address this research gap, 254 men with sperm abnormalities and 116 normozoospermic men were recruited, and the whole-coding regions of SEPT14 were sequenced. Two heterozygous mutations, p.Ala123Thr (3/254 vs. 0/116) and p.Ile333Thr (3/254 vs. 0/116), were identified in these cases. A high percentage of defective sperm heads was found in sperm with mutated SEPT14. Both mutations are highly evolutionarily conserved among vertebrates. The results of a fine morphological and chromatin structural analysis indicated severely malformed sperm heads with abnormal chromatin packaging through transmission electron microscopy and Toluidine blue staining. Compared with controls, high DNA fragmentation was demonstrated in sperm from cases carrying SEPT14 mutations using the comet assay. In addition, these two mutations in SEPT14 affected its polymerization ability in vitro. These data revels that the two SEPT14 missense mutations impaired sperm head morphology and induced DNA damage. Our study suggests that genetic variant of SEPT14 is one of the effects for human sperm formation and male fertility.
江萬煊教授傑出研究論文獎
Hepatocyte Nuclear Factor-4α P2 Promoter Variants are Associated with the Risk of Metabolic Syndrome and Testosterone Deficiency in Aging Taiwanese Men
Background: Hepatocyte nuclear factor-4α (HNF4A) can influence the risk of insulin resistance that is postulated to be an important link between metabolic syndrome (MetS) and testosterone deficiency (TD) in men.
Aim: To investigate the relationship between single-nucleotide polymorphisms (SNPs) of HNF4A and the risk of developing MetS and TD in a population of aging Taiwanese men.
Methods: A free health screening of men over 40 years of age was conducted in a medical center in Kaohsiung City, Taiwan. All participants underwent a physical examination, answered a questionnaire on demographics and medical history, completed the Androgen Deficiency in The Aging Male questionnaire to assess clinical symptoms of TD, and provided 20-mL whole blood samples for biochemical, hormonal, and genetic evaluation.
Main Outcome Measure: 3 common SNPs (rs11574736, rs1884613, and rs2144908) of HNF4A were selected and identified using a TaqMan 5’ allelic discrimination assay.
Results: 559 men were enrolled for this study (mean age, 55.8± 4.9 years). Prevalence of TD was significantly higher (P=.031) in subjects with MetS (16.8%) than those without MetS (10.1%). In SNP rs1884613 of HNF4A, subjects with the C allele carried a 1.31- and 1.50-times higher risk of developing MetS and TD, respectively, compared to those with the G allele, after adjusting for potential covariates. In addition, subjects with the CC genotype were exposed to a 1.91- and 2.20-times higher risk of developing MetS and TD, respectively, compared to those with the GG genotype.
Clinical Implications: Our findings may point to the importance of the role played by insulin resistance in the link between MetS and TD.
Strength & Limitations: Our current work is the first report with adequate sample size to evaluate the role of genetic variants of HNF4A on the risk of both MetS and TD in men. The limitations included subjects enrolled from a free health screening and single measurement of serum testosterone levels.
Conclusion: The rs1884613 SNP marker of HNF4A is significantly associated with an increased risk for developing both MetS and TD in aging Taiwanese men. Further population-based studies utilizing larger samples of different ethnicities may be needed to confirm these preliminary results.
男性學論文獎住院醫師組
The Relationship between Androgen Deprivation Therapy and Depression Symptoms in Patients with Prostate Cancer
Chen YZ1, Chiang PK1,2, Lin WR1,2, Chen M1,2,3, Chow YC1,3, Chiu AW1,4 and Tsai WK1,2. 1Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan. 2School of Medicine, MacKay Medical College, New Taipei City, Taiwan. 3Department of Cosmetic Applications and Management, MacKay Junior College of
Medicine Nursing and Management, Taipei, Taiwan. 4School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Aim: In this study, we administered a questionnaire to consecutive prostate cancer patients who received androgen deprivation therapy (ADT) for understanding the prevalence of depression symptoms.
Materials and Methods: We retrospectively identified patients with prostate adenocarcinoma who received ADT between January 2015 and February 2018 at Mackay Memorial Hospital. The patients were then asked to complete the Chinese version of the Patient Health Questionnaire-9 (PHQ-9) during an interview. The patients were divided into two groups according to PHQ-9 score: those with depression symptoms (PHQ-9 ≥ 6, depression group), and those without depression symptoms (PHQ-9 < 6, non-depression group). Two groups were compared using t-tests and correlation coefficients, as appropriate. Statistical significance was set at p < .05.
Results: There were no significant correlations between PHQ-9 scores and any of the parameters in the patients overall. In subgroup analysis, a positive correlation was found between the duration of ADT and PHQ-9 score in the patients with depression symptoms (p = .03). In addition, univariate analysis showed a positive association between the duration of ADT and PHQ-9 score, and a longer duration of ADT was further independently associated with increased PHQ-9 score in multivariate analysis in the patients with depression symptoms.
Conclusion: This study demonstrated that in patients with prostate cancer and depression symptoms, the severity of the depression symptoms was positively correlated with the duration of ADT. In contrast, this association was not found in patients without depression symptoms.