精浆内脂质运载蛋白型前列腺素D合成酶与α-葡萄糖苷酶的相关性研究

目的分析脂质运载蛋白型前列腺素D合成酶(L-PGDS)与精浆其他参数之间的关系,探讨L-PGDS在男性生殖系统中的作用。方法分析92份精液中的精子密度、精子活力、L-PGDS浓度、酸性磷酸酶活力以及α-葡萄糖苷酶活力。依据精子密度,将标本分为3组:正常组(精子密度>20×106/ml)、寡精子组(精子密度<20×106/ml)及无精子组(精子密度为0)。彩色精子质量分析系统测定精子密度及活力,双抗体夹心酶联免疫吸附试验(ELISA)检测精浆内的L-PGDS浓度,分光光度计测定α-葡萄糖苷酶活力。结果正常组、寡精子组以及无精子组患者精浆L-PGDS浓度依次降低,差异显著(P<0.001)。L-PGDS的浓度与α-葡萄糖苷酶、精子密度及精子活力呈正相关,相关系数(r)分别为0.426、0.813和0.380。结论精浆L-PGDS浓度可作为少精子症的辅助诊断指标。     

Urinary excretions of lipocalin-type prostaglandin D2 synthase predict the development of proteinuria and renal injury in OLETF rats.

BACKGROUND: Otsuka Long-Evans Tokushima Fatty (OLETF) rats genetically develop diabetes which is associated with hypertension. In preliminary studies, urinary excretions of L-PGDS (lipocaline-type prostaglandin D synthase) increase before diabetic nephropathy obviously develops, and this may predict progression of renal injury following diabetes. In the present study, we attempted to define whether urinary excretions of L-PGDS behave as the predictor of development of diabetic nephropathy in OLETF rats. METHODS: We investigated alterations of urinary L-PGDS excretions during the establishment of diabetes and assessed the relationship between the L-PGDS excretions and renal function in OLETF rats. Furthermore, we treated OLETF rats with troglitazone and analysed the effects on L-PGDS metabolisms. Urinary L-PGDS was measured by immunoenzyme assay and the occurrence of L-PGDS and its mRNA in the kidney was assessed by immunohistochemistry and a PCR method. RESULTS: Urinary excretions of L-PGDS were significantly higher in OLETF rats than non-diabetic Long-Evans Tokushima Otsuka (LETO) rats. The excretions age-dependently increased in OLETF and this increase appeared to be due to increased glomerular permeability to L-PGDS. Messenger RNA and antigenicity of L-PGDS were demonstrated in renal tissue; however, the de novo synthesis of L-PGDS mRNA seemingly contributed to urinary L-PGDS excretions much less than glomerular filtration. Multiple regression analysis revealed that urinary L-PGDS was determined by urinary protein excretions, and not by high blood pressure per se. Conversely, urinary proteinuria in the established diabetic nephropathy was predicted by urinary L-PGDS excretions in the early stage of diabetes. CONCLUSIONS: Urinary excretions of L-PGDS are likely to reflect the underlying increase in glomerular permeability. This property may be useful to predict forthcoming glomerular damage following diabetes in OLETF rats.     

Localization of immunoreactive testibumin in the testis and epididymis of adult rats

Testibumin is a glycoprotein previously isolated from the spent media of primary Sertoli cell-enriched cultures prepared from 20-day-old rats. Immunoassayable testibumin is found in the highest concentrations in testis, epididymis and fluids of the male reproductive tract in adult rats. In the present study, light microscopy was used to show that immunostainable testibumin in paraffin sections of rat testis was localized along the base of the seminiferous epithelium and in finger-like projections from the base of the epithelium, corresponding to the position of the Sertoli cells. The immunostaining of Sertoli cells was shown to be specific since either purified testibumin or crude Sertoli cell-enriched culture medium could compete with antibody for binding sites in tissue sections. The observations using light microscopy were confirmed when Sertoli cells were examined by electron microscopy using a pre-embedding immunostaining technique. The epithelium of the epididymis also contained immunoreactive testibumin which was localized in the caput, corpus and cauda. Immunostainable testibumin was also localized in the corpora lutea of the rat ovary and in the epithelium of the uterine endometrium. These observations are consistent with previous reports that immunoreactive testibumin is present in these organs as demonstrated by radio-immunoassays. We conclude that (i) the immunolocalization of testibumin in Sertoli cells adds to a growing list of observations suggesting that it is made in this cell type; (ii) the other sites of testibumin synthesis in the male are uncertain but the ovary and uterus are possible sites in the female; (iii) electron microscopy following pre-embedding immunostaining and epitope selection can be used as an adjunct to conventional immunocytochemistry to localize proteins in Sertoli cells.     

Expression and localization of N- and E-cadherin in the human testis and epididymis

Cellular interactions in the testis and epididymis are an important prerequisite for spermatogenesis and sperm maturation, and involve a well-developed complex of intercellular junctions. Cadherins are cell surface proteins which mediate intercellular Ca2+ -dependent adhesion and are believed to be fundamentally important for maintaining multicellular structures. In the present study we report the expression of a 135 kDa N-cadherin polypeptide in the human seminiferous epithelium by immunoblotting. The presence of N-cadherin was demonstrated by immunohistochemistry on the surface of spermatogonia and primary spermatocytes, and possibly also around some early spermatids, whereas late spermatids were always negative. Endothelial cells also stained for N-cadherin, whereas peritubular cells and Leydig cells did not. No expression of E-cadherin could be demonstrated in the human testis. In the human epididymis E-cadherin, but not N-cadherin, was expressed and localized to the surface of the principal epithelial cells as shown by immunohistochemistry. These observations indicate that cadherins play an important role in the organization of the seminiferous and epididymal epithelium.     

Cathepsin D in human reproductive tissues: cellular localization in testis and epididymis and surface distribution in different sperm conditions

Mammalian sperm surface antigens are acquired either during spermatogenesis or sperm maturation in the epididymis. These antigens, many of which are hydrolytic enzymes, are actively synthesized and secreted by the resident epithelial cells and adsorbed to the sperm membrane as part of posttesticular sperm modification. In this study, we aimed to investigate the expression of cathepsin-D (CAT-D) in human reproductive tissues and its distribution on the sperm surface in different sperm conditions. Immunohistochemical results revealed the expression of CAT-D in the somatic Sertoli and Leydig cells without showing any immunoreactivity in any germ cells, despite their engagement of the acrosomal system. A strong immunoreactivity of anti-CAT-D was also detected in the epididymal epithelium, chiefly in the principal cells, which are known to actively synthesize and secrete proteins into the epididymal lumen. The absence of CAT-D in the clear cells was unexpected because these cells are known to engage the endosomal machinery. We further showed that CAT-D was anchored on the sperm surface confined to the postacrosomal region without any lateral redistribution within the membrane during sperm capacitation. However, the enzyme underwent changes to be an active form of a 29/30-kd doublet during sperm capacitation. Using CAT-D as a marker, we were able to demonstrate here localization of the enzyme in human reproductive tissues, as well as reveal membrane modification in human sperm during maturation and capacitation processes.     

Sonography of the testis and epididymis

Summary. Sonography (ultrasound) is the mainstay for imaging morphologic abnormalities of the scrotum and testis. It is used primarily for determining the location and nature of palpable lesions and to demonstrate clinically occult, nonpalpable lesions. This article describes the state of the art of scrotal sonography. After an initial presentation of the normal sonographic appearance of the testis and epididymis, the diagnostic evaluation of the most common scrotal disorders is described.
Scrotal sonography is characterized by high sensitivity in the detection of intrascrotal abnormalities and is a very good mode for differentiating testicular from paratesticular lesions. However, scrotal sonography is limited in determining whether a focal testicular lesion is benign or malignant. Unsatisfactory results are obtained by conventional sonography in the evaluation of testicular torsion. This gap in the diagnosis of scrotal pathologies is now being reliably filled by colour-coded duplex sonography.     

Sarcoidosis of testis and epididymis

A case of sarcoidosis involving the testes and epididymis is reported. The disease was bilateral, and evolved one year after discontinuation of corticoid therapy and was not accompanied by signs of systemic sarcoidosis.     

Malformations of the epididymis in undescended testis

Epididymal abnormalities in undescended testes are probably more common than suggested in the literature but only sporadic reports are found on this subject. For many years discussions have centered around the ideal age to operate on patients with undescended testes and consequently increase chances for future fertility. We analyzed 66 patients (82 testes) treated for undescended testis in our department, with special distinction between ectopia and cryptorchidism. Abnormalities ranged from simple epididymal elongation to more complex forms, such as complete disruption between the testis and epididymis. Among 49 ectopic testes the epididymides of 19 (38.8%) displayed more severe abnormalities in addition to elongation, while 16 (32.6%) showed only an elongated epididymis and 14 (28.6%) were normal. Among the 33 cryptorchid testes 29 (87.9%) showed the more complex anomalies and elongation, 3 (9.1%) were normal and only 1 (3%) was elongated. Our results demonstrate a much higher incidence of complex epididymal abnormalities in cryptorchidism (p less than 0.001). Elongated epididymis may present problems for sperm maturation and transportation, although with no other associated abnormality most can be regarded as patent. In our theory cases of elongation plus other major abnormalities probably are associated with severe impairment in sperm maturation and hindered transportation, with the future intrascrotal or extrascrotal position of the testis or early surgical repair being of little importance in terms of fertility.     

Dysplasia of the testis and epididymis.

Various congenital malformations of the testis and the seminal pathways are illustrated by 10 cases. Though these malformations are often free from symptoms, an increasing number of them are now being discovered in connection with investigations of male infertility. In cases of azoospermia where testicular biopsies show complete spermatogenesis, surgical exploration is indicated. Some of these malformations may then be treated by surgery, with fairly good prospects of restored fertility.     

一氧化氮合酶同功异构酶在大鼠睾丸中的表达和定位

目的 :了解一氧化氮 ( NO)在睾丸中的作用。方法 :运用免疫组织化学方法观察 3种一氧化氮合酶 ( NOS)同功异构酶在大鼠生后 4、7、1 4、3 0、60 d睾丸中的分布。结果 :( 1 )生后 4、7、1 4d大鼠睾丸未见 3种 NOS免疫阳性反应 ;( 2 )生后 3 0 d少数精母细胞及生后 60 d生精小管腔面精子和间质细胞呈 NOS1阳性 ;( 3 )生后 3 0 d少数精母细胞、支持细胞和管周类肌细胞呈 NOS2阳性 ,而生后 60 d NOS2阳性反应见于睾丸间质细胞、管周类肌细胞、支持细胞、极少数精母细胞和不成熟精子头部 ;( 4)生后 3 0 d睾丸内少数精母细胞和血管壁呈 NOS3阳性 ,生后 60 d NOS3阳性反应仅见于血管壁。结论 :NO可能参与精子发生、睾酮的分泌过程 ,并调节睾丸内的血流。     

Microlithiasis of the epididymis and the rete testis

Testicular microlithiasis is a well-defined clinical and pathologic entity easily diagnosed through testicular echography; however, its association with cancer and infertility is now under debate. Many efforts have been done in recent years to clarify the spectrum of lesions observed in testicular microlithiasis, but no published data as to the existence of a possible microlithiasis of the epididymis and the rete testis have been found. We have observed microlithiasis of the epididymis and the rete testis in surgical (8 epididymis and 6 testis) and autopsy specimens (12 cases). In decreased order of frequency, microliths of the proximal spermatic way were seen in rete testis, epididymal duct, and efferent ducts. Intraluminal, subepithelial, and interstitial microliths were localized along these segments of the spermatic way. Subepithelial microliths were the most frequently found. A granulomatous reaction around the interstitial epididymal microliths, mimicking malacoplakia, was observed in 1 case. The differential diagnosis of microliths includes corpora amilacea, Michaelis-Gutmann bodies, calcium deposits, hyaline globules, and parasites, like the giant kidney worm Dioctophyme renale. In infants and young adults, microlithiasis of the epididymis and the rete testis is frequently associated with alterations in the development of the proximal spermatic way. In elderly adults, it is related to ischemia and obstruction of the spermatic way.     

Limited Wegener's granulomatosis of the epididymis and testis

A case is presented of Wegener's granulomatosis limited to the testis and epididymis,simultaneously,in a 69-year-old man.Orchiectomy was carried out through an inguinal incision under the presumptive diagnosis of a righttesticular tumor.A hard,irregular mass occupied the upper testicle and a portion of the epididymal head was visualized.Histopathologic examination of the specimen showed granulomatous inflammation of the testis and epididymis withprominent angiocentric granulomata in the walls of arteries,veins and foci of fibrinoid necrosis,surrounded bypalisading inflammatory cells with a few giant cells.The diagnosis of limited Wegener's granulomatosis was considered,although antineutrophil cytoplasmic antibody(c-ANCA)test was negative 2 weeks after orchiectomy.The patientshowed an excellent response after local complete excision.He remains free of disease 18 months after orchiectomy.(Asian J Androl 2006 Nov,8:737-739)     

Fusional anomalies of the testis and epididymis.

Earlier, the cause of infertility in undescended testis (UT) had been widely accepted as a consequence of the higher temperature of the inguinal/abdominal region. Observations made in the past two decades, however, gave new evidences. The most important of these is that UT is often associated with the fusional anomalies (FA) of the testis and epididymis. FA is the consequence of pathological intrauterine hormonal processes and many authors believe FA to be the primary cause for infertility in UT. Since 80% of UT cases are of endocrine origin, it would be suspected that the very same factors are responsible for both UT and FA. FA and other anomalies of the epididymis often occur in testicular torsion (TT) as well. It is remarkable that infertility could follow the unilateral forms of UT and TT despite the presence of a "healthy" contralateral gonad. In both entities contralateral FA (probably associated with testicular dysgenesis) is suspected. These observations could influence the primary surgical treatment of patients with UT and TT, as well as the mode of further management of these cases.