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PurposeOptimal strategies to treat idiopathic male infertility have remained unclear. The aim of this study was to evaluate the effectiveness of combination antioxidant therapy with several vitamins and supplements on semen parameters.MethodsThirty‐one men with oligozoospermia and/or asthenozoospermia evaluated by a Makler counting chamber were randomly assigned to two treatment groups: a combination of antioxidant supplements (L‐carnitine, zinc, astaxanthin, coenzyme Q10, vitamin C, vitamin B12, and vitamin E) and a Chinese herbal medicine, hochu‐ekki‐to (HE). Serum endocrinological profiles and semen parameters, especially total motile sperm count, were compared between before and after 12 weeks of treatment in both groups.ResultsIn the supplement group, endocrinological findings were not significantly improved. The semen parameters of semen volume, sperm concentration, and sperm motility were not statistically significantly improved, whereas total motile sperm count was significantly improved. In contrast, none of the endocrinological factors or semen findings were significantly improved by the Chinese herbal medicine although semen concentration, semen motility, and total motile sperm count showed a tendency to increase.ConclusionBecause combination antioxidant therapy could improve sperm motility significantly for patients with idiopathic oligoasthenozoospermia, our supplement could be one treatment option for idiopathic male infertility.

10 young patients from 7 to 16 years of age with moyamoya disease were treated by temporal muscle graft (encephalo-myo-synangiosis: EMS) for the purpose of increasing extracranial and intracranial collateral circulation. Ischemic cerebrovascular symptoms and signs were encountered in all of them without intracranial hemorrhage. The patients were observed for 6–26 months after the first operation. Transient ischemic attacks disappeared in 4 out of 7 patients, and improved in frequency and duration in the remaining 3. Paresis of the limbs disappeared in 1 patient and improved in 2. In 2 patients, facial palsy disappeared and dysarthria improved as well. Ataxia disappeared in 2 patients, and involuntary movement of the extremities disappeared in 2. There were no ineffective cases clinically. In postoperative carotid angiography, the middle cerebral arteries were visualized clearly to the peripheral portion mainly via the thickened deep temporal arteries, and the abnormal vascular networks in the region of the basal ganglia reduced in size in most of patients. Improvements in intelligence quotient, electroencephalogram and cerebral blood flow were also obtained in several patients, respectively. EMS seemed to be an effective surgical treatment in young patients with moyamoya disease who suffered from cerebral ischemic symptoms.

Finasteride is not necessarily effective on all of the male pattern baldness (MPB) patients. To know any factor which correlates with the effectiveness of finasteride, the polymorphism of androgen receptor (AR) gene was analyzed. Symptoms of the 488 MPB patients (18-62 y) before and after treatment with total dose of 10 mg or more of finasteride was typed by photographic method. The number of CAG and GGC repeats in AR gene of MPB patients was determined by DNA sequencing. When the number of the triplet repeats (CAG + GGC) was plotted against the degree of symptom improvement after treatment with this drug, a broad correlation between these variables was observed. The smaller the repeat number, the higher the improvement with finasteride. The group of patients with shorter repeat region in AR gene responded better to this drug than that with longer repeat region, although the former patients tended to reveal severe initial symptoms. Determination of such polymorphism is thought to be useful in the drug choice for MPB patients.

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