Testicular seminoma with human chorionic gonadotropin production

Testicular seminoma with elevated serum human chorionic gonadotropin level (hCG-positive seminoma) is regarded as more malignant than marker-negative seminoma, although Its prognosis is still unclear. To clarify the malignant potential of seminoma with hCG production, the serum levels of the beta subunit of hCG (β-hCG) and lactic acid dehydrogenase (LDH) were examined in 35 and 40 patients, respectively, and the Immunohistochemical expression of β-hCG examined in 45 tumors. The elevation of the LDH serum level correlated to the Invasive status, metestatic status and poor outcome, while that of the serum β-hCG level correlated only to the metastatic status. Immunohistochemical expression of β-hCG was observed in syncytiotrophoblastic giant cells in 11 tumors and a few mononuclear seminoma cells In 36 tumors. Expression was not associated with the malignancy potential, except where the expression In mononuclear cells Inversely correlated to the invasive status. These results suggest that most seminomas produce a slight amount of hCG; that an elevated hCG serum level Indicates the pressnce of metastatic tumors and mainly reflects an increase in tumor volume but not in cellular malignancy potential; and that the LDH serum level, rather than hCG, is more useful as a prognostic indicator for patients with seminoma.     

Analysis of Implantation in Assisted Reproduction Through the Use of Serial Human Chorionic Gonadotropin Measurements

Purpose: Our purpose was to examine implantation of singleton pregnancies achieved following various assisted reproductive technologies (ARTs) through the appearance and rising titers of serum human chorionic gonadotropin (hCG) levels. Methods: A total of 114 singleton pregnancies resulting from in vitro fertilization and intrauterine insemination was analyzed. Patients were divided into five groups according to the type of ovarian stimulation protocol [gonadotropin stimulation with/without the use of gonadotropin-releasing hormone agonist (GnRHa), long protocol, or flare-up technique] and to the day of embryo transfer (day 2 or day 3 after oocyte retrieval). Serial serum hCG levels were measured between 10 and 25 days after fertilization and log-transformed. Linear regression analyses were performed and extrapolated to hCG = 10 mIU/ml (hCG ₁₀ ), which was used as an estimate of detectable implantation. The slopes of the regression lines were used to estimate the rising speed of hCG. Results: There were no significant differences in the days of hCG in maternal serum to reach 10 mIU/ml (implantation) or in the slopes of the regression lines for all five studied groups. Conclusions: The appearance of hCG in maternal serum was used to assess the time of clinically detectable implantation. Furthermore, because hCG production is a marker of trophoblastic activity, its serum doubling time was used as an indicator of embryo quality. Results showed that in various ART protocols with and without GnRHa, there were no significant differences in implantation time or embryo quality. Embryo development in early pregnancy follows a preprogrammed-timing schedule and depends mainly on the embryonic age of the health, successfully implanted conceptus.     

Testosterone Enhances GABA and Taurine but not N-Methyl-D,L-Aspartate Stimulation of Gonadotropin Secretion in the Goldfish: Possible Sex Steroid Feedback Mechanisms

The effects of gonadal steroids on GABA-, taurine (TAU)- and N-methyl-D, L-aspartate (NMA)-induced gonadotropin-II (GTH-II) release were investigated in male and female goldfish in vivo. In sexually regressed goldfish (both sexes mixed), intraperitoneal implantation for 5 to 10 days with solid Silastic pellets containing testosterone (100 μg/g), oestradiol (100 μg/g) or progesterone (100 μg/g) was previously shown to elevate serum sex steroid levels to values comparable to those in sexually mature animals, and to potentiate gonadotropin-releasing hormone-stimulated GTH-II release. In the present study, testosterone but not oestradiol or progesterone enhanced the stimulatory effects of exogenous GABA (100 μg/g) on GTH-II release in vivo. TAU (1 mg/g) stimulated GTH-II release in sexually regressed mixed sex and sexually recrudescent male goldfish, and both testosterone and oestradiol implantation enhanced GTH-II release induced by TAU. The glutamate agonist NMA (25 to 50 μg/g) was also found to stimulate GTH-II release; however it was relatively less effective in elevating serum GTH-II levels than GABA and TAU, and its effects were not modulated by sex steroid treatments. Pretreatment of goldfish with α-methyl-p-tyrosine to deplete brain and pituitary catecholam-ines did not affect NMA action on GTH-II release. Our results indicate that GABA, TAU and NMA are involved in the neuroendocrine regulation of GTH-II release in goldfish, and support the idea that testosterone participates in the positive feedback regulation of pituitary gonadotropin release in a non-mammalian vertebrate by enhancing GABA- and TAU-stimulated GTH release in vivo.     

大鼠卵巢、睾丸人绒毛膜促性腺激素受体的比较研究

以分离的细胞膜为受体制剂，对大鼠卵巢及睾丸人绒毛膜促性腺激素（ＨＣＧ）受体进行比较研究，发现二者的受体结合特性有一定差异；同时将大鼠寒丸膜及睾丸匀浆作对比，友现睾丸膜制剂较睾丸匀浆更能准确地体现睾丸ＨＣＧ受体的真正特性。     

人绒毛膜促性腺激素在脑实质生殖细胞肿瘤诊治中的意义

目的研究脑实质生殖细胞肿瘤(GCT)患者脑脊液和血清中人绒毛膜促性腺激素(HCG)水平变化,评价其在肿瘤诊断、疗效监测中的意义。方法对5例脑实质内GCT患者的脑脊液和血清HCG水平在治疗前后进行系列测定。以10例性别年龄匹配的因其他疾病接受腰穿检查的患者作为对照组,测定其脑脊液HCG水平。观察脑脊液和血清HCG水平在治疗前后的变化情况。结果10例对照组患者的脑脊液中均测不到HCG。从5例GCT患者共采集17对脑脊液和血清配对样本。所有5例患者都出现脑脊液和血清HCG水平升高。治疗后脑脊液和血清HCG水平迅速下降。血清和脑脊液HCG水平呈显著相关。每一对样本中,脑脊液HCG水平均高于血清。血清、脑脊液HCG水平比为0.245±0.190。结论脑脊液HCG升高对诊断脑实质内GCT具有高度特异性和较高灵敏度。对分泌HCG的GCT,脑脊液和血清HCG是评价治疗效果和监测肿瘤复发的重要指标。     

Role of Estrogens on Human Male Reproductive System

This review focuses on estrogen role on human male physiology. Biological estrogen actions on male reproductive system are summarized with particular regard to the effects of congenital estrogen deprivation in men. The effects of estrogen on spermatogenesis, hormonal secretion and gonadotropin feedback and on sexual behavior are discussed. It is remarked that the role of estrogens in male reproduction is a very recent acquisition in reproductive endocrinology, but it promises new future fields of research to be investigated as well as the possible disclosure of new strategies in clinical practice.     

Human chorionic gonadotropin and growth factors at the embryonic-endometrial interface control leukemia inhibitory factor (LIF) and interleukin 6 (IL-6) secretion by human endometrial epithelium

BACKGROUND: The elucidation of the molecular mechanisms by which the embryo contributes to its implantation is an area of extensive research. The main objective of this study was to investigate the pattern of leukemia inhibitory factor (LIF) and interleukin-6 (IL-6) secretion by human endometrial epithelium, and their regulation by human chorionic gonadotropin (hCG) and other growth factors present at the embryonic-endometrial interface. METHODS: Endometrial epithelial cells (EEC) were isolated from biopsies collected at both proliferative and secretory phases of fertile women. RESULTS: HCG (1-50 IU/ml) increased LIF secretion by EEC cultures derived from follicular phase (up to 285+/-75%) or from secretory phase (up to 212+/-16%). In contrast, hCG reduced IL-6 secretion by EEC in both phases. The hCG/LH receptor gene was transcribed by EEC as evidenced by RT-PCR. Insulin-like growth factors 1 and 2 increased LIF secretion by EEC. Transforming growth factor beta1 stimulated LIF and reduced IL-6 secretion. CONCLUSIONS: Through hCG, the blastocyst may be involved in the control of its implantation (via an increase of proimplantatory LIF) and tolerance (via an inhibition of proinflammatory IL-6). Other growth factors present at the embryonic-endometrial interface are also involved in the control of LIF and IL-6 endometrial secretion.     

杭州地区8516例孕中期妇女产前筛查回顾性分析

目的分析杭州地区孕中期妇女运用甲胎蛋白(AFP)和游离绒毛膜促性腺激素β亚基(Free-βhCG)进行胎儿先天缺陷产前筛查的结果;并据此修正两筛查指标的孕周中位数值。方法对杭州地区孕14~20w的妇女进行产前AFP和Free-βhCG的检测。胎儿先天畸形由染色体核型分析、B超检查确诊,或经引产证实。应用非线性加权回归求得本地区两筛查指标的中位数,并计算中位倍数值进行分布拟合。比较标化前后检测效果。结果8516例受检孕妇,共筛查出唐氏综合征3例、爱德华综合征2例,神经管畸形7例,其他胎儿异常17例;杭州地区孕中期妇女AFP及Free-β-hcG中位数比欧洲妇女分别高18%和14%;用修正后的中位数重新分析,孕中期假阳性率降低。结论血清AFP、Free-βhcG联合检测,可作为杭州地区孕中期妇女产前筛查优选项目。而根据地域人群的差异,对Mu ltiCalc软件内嵌中位数进行修正后更适于杭州地区孕中期妇女的产前筛查。     

Hypothalamic laterality in regulating gonadotropic function: unilateral hypothalamic lesion and ovarian compensatory hypertrophy

Regardless of the side of hemiovariectomy, unilateral lesion placed in the right-side medial anterior hypothalamus suppressed ovarian compensatory hypertrophy, but the lesion made in the left side failed to suppress it. This suggests the presence of a hypothalamic laterality in regulating gonadotropin secretion.     

Placental site trophoblastic tumor of the mediastinum

Choriocarcinoma has been described as the most frequent subtype of mediastinal germ cell tumors showing trophoblastic differentiation. We report a unique case of a placental site trophoblastic tumor, which developed in the mediastinum of a 14-year-old boy 2 years after the resection of a mature teratoma. The recurrent tumor was composed of a grossly hemorrhagic and necrotic mass. Histologically, diffusely infiltrating large polygonal cells with focal nodular growth and a teratomatous part containing mature intestinal, respiratory, and squamous epithelium with adjacent cutaneous adnexal structures were found. The typical morphologic features included vessel wall infiltration by the neoplastic cells with fibrinoid deposits and geographic necroses within the tumor masses. Characteristic diffuse positivity for melanoma cell adhesion molecule and human leucocyte antigen G was found on immunohistochemical investigation, confirming the diagnosis of placental site trophoblastic tumor. The patient died 1 year later after polychemotherapy. The outcome of this rare tumor is similar to the reported poor clinical outcome in patients with mediastinal choriocarcinomas.