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13. Clinical Practice Manual for Late-onset Hypogonadism Syndrome

Author

Namiki, Mikio, Akaza, Hideyuki, Shimazui, Toru, Ito, Naoki, Iwamoto, Teruaki, Baba, Katsuyuki, Kumano, Hiroaki, Koh, Eitetsu, Tsujimura, Akira, Matsumiya, Kiyomi, Horie, Shigeo, Maruyama, Osamu, Marumo, Ken, Yanase, Toshihiko, and Kumamoto, Yoshiaki

Published
2008

19. AB25. What would YES (Morning Erection/Sleep-related Erection) be without NO (Nitric Oxide) induced by Teststerone?

Author

Kumamoto, Yoshiaki

Subjects
Podium Lecture, Morning Erection, sleep-related Erection, NO (Nitric Oxide)
Abstract

As you know, for penile erection, a sufficient amount of testosterone-induced nitric oxide is needed in the smooth muscle of the penile arterial wall. With aging, LOH syndrome and so on, the serum testosterone level decreases, resulting in a decline of penile erectile function. Furthermore, it is known that the enzyme PDE5 in the penile artery wall also inhibits that function. Even so, it may be safe to say that decreasing testosterone is the major factor for erectile dysfunction, excepting severe diabetic arterial sclerosis. Currently, however, almost all doctors treat ED cases with a PDE5-Inhibitor only. From my understanding of the above-mentioned mechanism of erection, I think this medical treatment is not scientific and only a half measure. Cases in which PDE5-inhibitors alone are effective are limited to those in which sufficient NO is maintained to barely induce erection unless inhibited by PDE5. Aging males, especially, have lower NO levels caused by low testosterone. These cases cannot be cured satisfactorily by PDE5 inhibitors alone, even if the men can somehow achieve sexual intercourse. Therefore, I cannot understand or agree with the treatment method using a PDE5-Inhibitoralone without checking the testosterone level. Furthermore, simple temporal recovery of sexual activity does not revitalize the male fundamental physiology, that is, sleep-related erection and morning erection. And a more important problem is that latent psychological disorders should be thoroughly investigated for patients consulting about so-called ED. It is even said that it is lucky for a patient to have a chance to consult about ED, since it means that the doctor will check for other disorders; for example, metabolic syndrome so on. More aged men are beginning to feel loss of motivation and poor physiological condition after the climacteric stage, with loss of morning erection, even if they do not express complaints. These problems are mostly caused by a decline in testosterone, which latently accelerates arterial sclerosis and vascular disorders, shortening the male life span. Such patients with low levels of free testosterone complaining of ED should be treated with testosterone substitution and a PDE9-inhibitor (especially long-acting Cialis) for a period of at least 2-3 months. This treatment will restore the male physiological functions of sleep-related erection and morning erection and as well as treating many symptoms of LOH syndrome at the same time. However, the most important effect of revitalization of male physiology is surely the restoration of the self-actualization and dignity of maleness to patients. That should be considered the most clinically significant outcome.

Published
2014

21. 回腸を利用した膀胱形成術後に回腸部分より発生した腺癌の1例

Author

Takahashi, Atsushi, Tsukamoto, Taiji, Kumamoto, Yoshiaki, Sato, Yoshikazu, Shibuya, Akihiko, and Sato, Masaaki

Subjects
Ileocytoplasty, 494.9, Adenocarcinoma
Abstract

回腸を利用した膀胱形成術後に回腸部分より発生した腺癌の1例札幌医科大学泌尿器科学教室(主任:熊本悦明教授)高橋敦, 塚本泰司, 熊本悦明, 佐藤嘉一, 渋谷明彦札幌医科大学中央検査部病理部門(主任=森道夫教授)佐藤昌明22年間尿路として機能していなかった回腸膀胱の回腸部分より発生した腺癌の1例を報告した.この例では, 回腸を用いた膀胱形成術の3ヵ月後に回腸導管が行われたことから, 尿の暴露に加え膀胱の炎症あるいは以前の放射線照射が癌発生に関係しているのではないかと推測された., We report a case of adenocarcinoma arising in the ileal segment of an ileocystoplasty which had remained defunctionalized for 22 years, after conversion to the ileal conduit. In our case, inflammation or previous radiation as well as urine exposure are suggested to have participated in the development of the carcinoma in the augmented bladder.

Published
1993

22. Correlation between the Japanese Aging Male Questionnaire (JAMQ) and Aging Male's Symptom (AMS) scale in Japanese male.

Author

Horie, Shigeo, Hisasue, Shin-ichi, Nakao, Mutsuhiro, Ide, Hisamitsu, China, Toshiyuki, Nagae, Mika, Saito, Keisuke, Isotani, Shuji, Yamaguchi, Raizo, Muto, Satoru, and Kumamoto, Yoshiaki

Subjects
PHYSIOLOGICAL effects of testosterone, HYPOGONADISM, MALE reproductive organs, DISEASES in men, STATISTICAL correlation, SEXUAL dysfunction, JAPANESE people
Abstract

Objectives: To clarify the correlation between the Japanese Aging Male Questionnaire (JAMQ) and the Aging Males' Symptoms (AMS) scale through the factor analysis in Japanese male. Materials and methods: In 61 male patients who visited the LOH outpatient clinic of Teikyo University Hospital, subjective symptoms featuring LOH were evaluated using the JAMQ and AMS. Factor analysis was performed on each questionnaire to clarify the LOH-related factors. Correlational analysis between the subscale scores representing such factors and the serum hormone profiles was also performed. Results: Factor analysis of the JAMQ revealed an internal structure consisting of three subgroups: somatic, psychological and sexual factors with good categorization of the indicators to the appropriate subgroup. In contrast, the indicators of the AMS showed incomplete conformity to the subgroups of the JAMQ. Correlational analysis showed that each score on the JAMQ subgroups had the highest coefficient of correlation with the corresponding AMS subgroup ( p < 0.001). There was no significant association between total and free serum testosterone levels and the total and subscale scores on either AMS or JAMQ. Conclusions: The results of factor analysis suggest that the sexual perceptions of Japanese populations might differ from those of Caucasian populations. JAMQ would be useful to separately assess individual aspects of somatic, psychological and sexual symptoms related to LOH among Japanese males. [ABSTRACT FROM AUTHOR]

Published
2014
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23. Hematospermia: An investigation of the bleeding site and underlying lesions.

Author

Furuya, Seiji, Ogura, Hiroshi, Saitoh, Nobuhito, Tsukamoto, Taiji, Kumamoto, Yoshiaki, and Tanaka, Yoshinori

Subjects
HEMORRHAGE, PRECANCEROUS conditions
Abstract

Evaluates the site of hemorrhage and causative lesions in patients with hematospermia in Japan. Use of puncture technique for seminal vesicles; Confirmation of mullerian duct cyst as the bleeding site; Observation of ectopic prostatic tissue in the prostatic urethra.

Published
1999
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40. ヒト前立腺のアルファ受容体

Author

Furuya, Seiji, Yokoyama, Eiji, Kumamoto, Yoshiaki, and Tsukamoto, Taiji

Subjects
494.9
Abstract

ヒト前立腺の組織条片はアルファ交感神経刺戟薬によって収縮した.ベータ-交感神経薬, 副交感神経薬, プロスタグランディン, PGEおよびPGF2α, アンジオテンシン2では収縮も弛緩反応も示さなかった.このノルアドレナリン誘発性収縮は, アルファ交感神経遮断薬によって抑制された.通電法による電気刺戟は, この前立腺組織条片を収縮させた.この電気刺戟により誘発された収縮は, フェノキシベンザミンで抑制拮抗されたが, ヨヒンビンでは抑制拮抗されなかった.ヒト前立腺組織では, アルファ-1受容体の存在が優位である, Strips of human prostate showed a contractile response to alpha-adrenergic agonists There was no response to beta-adrenergic and cholinergic agents, prostaglandins, PGE 1 and PGF 2 α or angiotensin II. The noradrenaline-induced contraction was inhibited by an alpha-adrenolytic agent. Electrial field stimulation elicited contraction of the prostatic specimens. This stimulation-induced contraction was antagonized by phenoxybenzamine, but not by yohimbine. These results indicate that alpha-I-adrenergic receptors are Preferentially present in the human prostatic tissue.

Published
1983

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