Introduction Erectile dysfunction (ED) and hypertension are frequent comorbid conditions. The vasodilating properties of type 5 phosphodiesterase inhibitor (PDE5I) are the major concerns for the treatment of ED patients on antihypertensive medications. Aim To evaluate the efficacy and safety of Udenafil [Zydena] (Dong-A, Seoul, Korea), a newly developed PDE5I, for the treatment of ED patients on antihypertensive medication. Methods It was a multicentered, randomized, double-blind, placebo-controlled, fix-dosed clinical trial among 165 ED patients receiving antihypertensive medications. The subjects treated with placebo, 100 mg or 200 mg of Udenafil for 12 weeks were asked to complete the Sexual Encounter Profile (SEP) diary, the International Index of Erectile Function (IIEF), and the Global Assessment Question (GAQ) during the study period. Main Outcome Measures Primary parameter: the change from baseline for IIEF erectile function domain (EFD) score; Secondary parameters: the IIEF Question 3 and 4, SEP Question 2 and 3, the rate of achieving normal erectile function (EFD ≥ 26) and the response to GAQ. Results Compared to placebo, patients receiving both doses of Udenafil showed significantly improved the IIEF-EFD score. The least squares means for the change from baseline in IIEF-EFD scores were 8.4 and 9.8 for 100 mg and 200 mg Udenafil groups, respectively; those values were significantly higher than that of placebo (2.4, P < 0.0001). Similar results were observed in the comparison of Q3 and Q4 of IIEF, SEP diary and GAQ. Headache and flushing were the most common treatment-emergent adverse events, which were transient and mild-to-moderate in nature. No parameters of efficacy and safety were affected among the subsets stratified according to either the number of antihypertensive medication received or the previous experience of PDE5Is treatment. Conclusion Udenafil significantly improved erectile function among ED patients with hypertensive symptom treated with concomitant antihypertensive medication. The treatment did not increase the frequency or severity of adverse events.

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Abstract:The aim of t his study was to recover spermatozoa easily from fresh or frozen-thawed testicular sperm extraction (TESE) samples. We simply minced and washed the TESE samples in medium. Spermatozoa were recovered and washed in the bottom of a PVP droplet with an injection pipette and injected into oocytes. In all cycles 100% of spermatozoa (motile and/or immotile) could be recovered. Injected oocytes were fertilized (100% per cycle and in 41.9% of oocytes) and fertilized oocytes were cleaved (100% per cycle; 38.5% of injected oocytes; 91.8% of fertilized oocytes) a f t e r I C S I w i t h f r e s h o r f r o z e n -t h a w e d T E S E spermatozoa. The rates of progression to the embryo stage (2-8 cell) and blastocyst formation and their quality were similar in both the fresh sample group and the frozen-thawed sample group. Both of embryo transfer (73.5%) and embryo-blastocyst transfer (26.5%) were performed successfully. Thirty-four cycles of ICSI with testicular spermatozoa resulted in 23.5% pregnancy rates (fresh sample group, 22.2%; frozen-thawed sample group, 24%) with both embryo transfer (8%) and embryoblastocyst transfer (66.7%). This new sperm preparation method is very simple, easy, effective and rapid for recovering spermatozoa from TESE samples for ICSI. Key words: Fresh or frozen-thawed TESE sample, Spermatozoa recovery, ICSI, Embryo and blastocyst, PregnancyThe introduction of intracytoplasmic sperm injection (ICSI) [1] was originally considered for male factor infertility when spermatozoa could be found in the ejaculate. The possibility of achieving pregnancy with even one available spermatozoon has precipitated the search for a method to obtain spermatozoa from testicular tissue or epididymal sites, when seminal azoospermia is a constant finding. In patients with o b s t r u c t i v e a n d n o n o b st r u c t i v e a z o o s p e r m i a , fertilization and pregnancy can be accomplished by means of a combination of intracytoplasmic sperm injection with epididymal spermatozoa retrieved by microsurgical epididymal sperm aspiration or testicular sperm extraction [2][3][4][5][6][7]. Although ICSI is an effective clinical treatment strategy for male infertility patients, new types of technical difficulties have arisen, because of the extremely small number of spermatozoa handled in this procedure. The recovery of spermatozoa from extremely low quality sperm samples or TESE tissues for use in the ICSI procedure is very difficult [6][7][8].The aim of this study was to recover the spermatozoa easily from fresh or frozen-thawed TESE samples in a 3% polyvinylpyrrolidone (PVP) droplet. Materials and Methods Female patientsWomen under the age of 35 (mean: 28.7; range: 25-35 years) and having many oocytes retrieved (>10) were recruited for this study at