男性生殖器全套断离再植一例

男性生殖器全套断离再植一例鲁胜武孙传友曹家树魏光先刘恩靖阴茎断离报道较常见，但男性生殖器自根部连同双侧睾丸及阴囊阴茎均断离较罕见。我们于１９９３年１１月２０日遇１例男性生殖器全套断离患者，并进行再植获得成功，随访两年半，外阴形状正常，阴茎能勃起，正常...     

醋酸白试验显示亚临床病灶治疗阴茎尖锐湿疣

尖锐湿疣是一种由人类乳头瘤病毒（ＨＰＶ）引起的发生于生殖器、肛门等部位的性传播疾病。近年来发病率上升较快，在性传播疾病中占第二位。１９９３年以来，我们对门诊就诊的男性阴茎尖锐湿疣患者采用５％的醋酸外敷外生殖器，显示其亚临床感染灶，并同时与肉眼观察病灶一并烧灼去除，收到良好效果。对象与方法门诊男性患者２１例，年龄２４～５３岁，平均３１．７岁。因发现阴茎丘疹或新生物就医。病理诊断符合尖锐湿疣。起病前均有非婚性接触史。发病潜伏期３周至３个月不等，平均２个月。病灶分布多寡依次为阴茎冠状沟部、系带、龟头。…     

Budd－Chiari综合征的病因、诊断、分型和处理

自１９８６年１月至１９９３年４月我们采用ＩＶＣ切开直视根治术证实ＢＣＳ６７例，凡有原因不明的淤血性肝肿大、腹水与躯干浅表静脉上行性曲张者．首应考虑本病．ＢＵＳ、ＣＴ、ＩＶＣＧ可确诊，有定位定性价值．经手术证实ＢＵＳ对ＩＶＣ单纯性病变正确诊断率为９７．０％，复合病变确诊率为８３．６％，病变定位准确率１００％；ＩＶＣＧ定位准确率９５．３％，定性符合率７４．５％．本组病例曾作ＣＴ１０例和ＥＣＴ３例，对病变定位定性诊断尚缺乏经验。术中发现ＩＶＣ膜性梗阻３７例（５５．２％），ＩＶＣ狭窄１５例（２２．４％），单纯栓塞９例（１３．４％，包括癌栓１例），缺损或闭塞３例（４．８％），外压３例（４．８％），其中复合病变２３例（３４．３％）．本组均为ＩＶＣ病变，未发现单纯ＨＶ病变．作者将本病分为５型和５种根治原则：Ⅰ型为膜性梗阻（ＭＯＶＣ，５５．２％），需行膜切除；Ⅱ型为肝段ＩＶＣ狭窄（ＳＶＣ，２２．４％），应行腔静脉扩大成形术；Ⅲ型为ＩＶＣ血栓型（ＴＶＣ，１３．４％），应摘除血栓或癌栓；Ⅳ型为ＩＶＣ缺损型（ＣＶＣ，４．８％），应行血管移植；Ⅴ型为外压型（ＥＰＶＣ，４．８％），应解除外压因素（索带或肿瘤切除等）；各型可有复合型（     

聚合酶链反应和核酸杂交在检测阴茎癌人乳头状瘤病毒中的作用

人乳头状瘤病毒（ＨＰＶ）为一种潜在的癌基因，可能为多种泌尿生殖道肿瘤的致病因子。作者用高敏感的聚合酶链反应（ＰＣＲ）结合和核酸杂交方法，检测２８例阴茎癌组织中的ＨＰＶ１６，１８型病毒，结果表明：阴茎癌组织中ＨＰＶ１６的阳性检出率为５０％（１４／２８），ＨＰＶ１８的阳性检出率为１０．６％（３／２８）。提示ＨＰＶ１６感染在阴茎癌的发生过程中可能具有重要作用，并且与患者吸烟有关     

艾滋病的临床表现和抗HIV治疗

艾滋病的临床表现和抗ＨＩＶ治疗邵海枫关键词艾滋病，临床表现，抗艾滋病毒药物中图法分类号Ｒ５１２．９１艾滋病的主要病变为免疫缺陷，导致机会性感染、恶性病变、多器官多系统损害。由人类免疫缺陷病毒（ＨＩＶ）感染发展为艾滋病，不同阶段可出现不同的临床表现，通...     

人乳头状瘤病毒与前列腺癌相关性研究

用高敏感聚合酶链反应（ＰＣＲ）技术检测６３例前列腺组织标本（２８例前列腺癌，３０例良性前列腺增生症和５例正常前列腺组织）中人乳头状瘤病毒（ＨＰＶ）阳性率。结果显示：前列腺癌中ＨＰＶ（１６）感染率为４６．４％（１３／２８），ＨＰＶ（１８）感染率为１０．７％（３／２８）。良性前列腺增生症患者ＨＰＶ（１６）阳性率为２０％（６／３０），ＨＰＶ（１８）阳性率为６．１７％（２／３０）。５例正常前列腺组织无ＨＰＶ感染。提示ＨＰＶ感染与前列腺癌有相关性，ＨＰＶ感染可能在前列腺癌发展中起着重要作用。     

同卵双生克氏综合征1例

克氏综合征（Klinefelter’s syndrome）又称“小睾丸症”，是男性特有的染色体异常性疾病，常伴有睾丸功能及内分泌紊乱、小阴茎、性功能低下和精子形成障碍和不育。在无精子症患者中其发病率为7％～13％，新生儿中的发病率为0．1％-0．2％。但是同卵双生兄弟同患此病的病例报道较少，现在报道一例。     

小儿服囊急症

目的：总结小儿阴囊急症手术或非手术治疗的可行性。方法：回顾性研究５２６例小儿阴囊急症患者的临床资料和诊疗经验。睾丸附件扭转３６８例（７０．０％）,急性鞘膜炎４９例（９．４％）,睾丸扭转４２例（８．０％）,急性附睾炎１９例（３．５％）,急性阴囊感染１８例（３．４％）,阴囊血肿１８例（３．４％）,睾丸炎６例（１．１％）,特发性阴囊水肿６例（１．１％）。前４种常见疾病共４７８例,占９０．９％。住院前误诊     

肝细胞肝与乙,丙及庚型肝炎病毒感染相关的组织学证据

目的 探讨肝细胞肝癌（ＨＣＣ）与乙、丙及庚型肝炎病毒（ＨＢＶ、ＨＣＶ，ＨＧＶ）感染的相关性。方法 采用免疫组化方法检测ＨＣＣ患者癌及癌直组织中ＨＢＶ，ＨＣＶ表达状况。结果 ６５例ＨＣＣ患者中，共计５２例（８０．％）检出以上三种肝类病毒抗原，其中乙型肝炎表面抗原（ＨＢｓＡｇ０，ＨＣＶＮＳ５和ＨＧＶＮＳ５怕阳性者分别为４７（７２．３％），３０（４６．２％）和１０（１５．４％）例。５２例病毒标志阳性者中     

122例不育症睾丸活检病理学观察

对122例不育症睾丸活检标本进行观察分析。结果表明，病变累及的部位主要为曲细精管生精上皮（122／122），依次为曲细精管界膜（78／122）、睾丸间质（68／122）。病理组织学分类为生精细胞脱落管腔雍塞50例（40．9％），生精障碍26例（21．3％），生精功能低下18例（14．8％），生精细胞发育不全17例（14．0％）．曲细精管透明变性7例（5．8％），克氏征3例（2．5％），混合病变1例。睾丸活检对男性不育症的诊断、分型、治疗及预后判断均具有重要价值。本文亦对精索静脉曲张致使不育进行了讨论。     

A case of testicular tunica albuginea cyst with psammoma body

Cystic testicular masses have been considered rare but due to advances in ultrasonographic technologies their incidence has risen. Many testicular cystic masses are benign but there is a chance of malignancy. Psammoma bodies are found in various malignancies that occur in the genital tract of women but rarely in men. We report a case of testicular tunica albuginea cyst with psammoma bodies.     

Varicoceles in adolescents and young adults after surgery for hepatosplenic schistosomiasis

INTRODUCTION: This case-control study aimed at evaluating testicular volume, pubertal and genital development, and incidence of varicoceles in adolescents and young adults after surgery for hepatosplenic schistosomiasis associated with bleeding oesophageal varices. PATIENTS AND METHODS: The study involved 26 young males with schistosomiasis who were submitted to splenectomy, left gastric vein ligature, and auto-implantation of splenic tissue in the major omentum during childhood. The mean follow-up period was 4 years after surgery. The control group included 15 healthy volunteers from a school in the same region where the cases lived. They were randomly selected, matched by age and epidemiological characteristics, and had schistosomiasis ruled out. All participants underwent thorough clinical and ultrasound examinations. Special attention was paid to sexual characteristics, testicular ultrasonography, and Doppler flowmetry of spermatic veins. RESULTS AND CONCLUSIONS: The patients with schistosomiasis had significant deficits in pubertal and genital development and in testicular volume, especially the left one, and a high incidence of varicoceles (61.5%) without a straight association with testicular atrophy.     

Testicular position in the androgen insensitivity syndrome: implications for the role of androgens in testicular descent

PURPOSE: We compared testicular position with genital phenotype in a clinical series and a literature review of androgen receptor mutations to assess the role of androgens in testicular descent. MATERIALS AND METHODS: Our clinical reports, the androgen receptor mutations database and selected literature were reviewed. Subjects with a proved androgen receptor mutation were included in our study when a female or ambiguous phenotype was present (Quigley grade 3 to 7) and testicular position was documented. Comparison among groups was done by Fisher's exact or chi-square test. RESULTS: Of the 7 patients with detailed clinical records 5 had abdominal (bilateral in 4) and 2 had bilateral inguinal testes. Four patients with abdominal testes also had aberrant pelvic ligaments extending medially from the gonads. Including an additional 102 cases identified in the literature, abdominal testes were present in 52% and 3% of those with complete and partial androgen insensitivity, respectively. The incidence of abdominal testes was highest (86%) in patients with a complete female phenotype and no pubic hair (grade 7). It decreased significantly with increasing masculinization and was higher in phenotypic females diagnosed at or after (67%) than in those identified before (22%) puberty. Hernia was associated with inguinal and abdominal testes. CONCLUSIONS: Testicular position correlates with genital phenotype in patients with androgen receptor mutations, supporting a major role for androgens in testicular descent. Inguinal hernia and abnormal pelvic ligaments in these individuals may partially determine testicular position but to our knowledge the role of androgen receptors, if any, in their development is unknown.     

Histopathology of testis in acquired immune deficiency syndrome

Histologic sections from the testes of 32 autopsied patients with acquired immune deficiency syndrome (AIDS) were examined. Almost invariably the testes displayed decreased spermatogenesis, and 20 of the 32 cases showed marked hypospermatogenesis with Sertoli cells predominantly lining the tubules. Although the seminiferous tubules were generally of normal size, the tunica propria at the periphery of the tubules was mildly to moderately thickened in 19 cases and markedly thickened in 10. The interstitial cells of Leydig were unaltered in most patients, with only 4 testes showing Leydig cell hyperplasia. The testicular blood vessels were slightly thickened in many patients, but 5 exhibited moderate to marked intimal proliferation with narrowing of the lumen. Mononuclear inflammatory infiltration of the testicular interstitium was slight in 11 cases, moderate in 6. Only 7 of the 28 AIDS patients with opportunistic infections had evidence of direct involvement of the testes by the infectious organisms. We concluded that the extragonadal endocrine balance of AIDS patients may be deranged due to the infectious process and so deserves clinical evaluation.     

Microsurgery of the male genital organs]

Microsurgery of the male genital organs is especially useful when obstructive anatomical causes are responsible for sterility. The authors report on their results with 4 cases, very successful ones, of vas reanastomosis; 13 cases of epididymo-deferential anastomoses which yielded 50% of surgical successes, but only 25% of pregnancies; 2 cases of testicular autotransplant; and 12 cases of revascularization of cavernous bodies in impotent males, which yelded 50% of successful results. These data show that microsurgery has definitely improved the effectiveness of reversibility techniques, but has not yet solved all problems connected with it.     

Teratomas in childhood: analysis of 142 cases

This report concerns 142 infants and children with teratomas treated from 1960 to 1984. The primary site of tumor was sacrococcygeal in 84, ovarian in 15, testicular in 15, mediastinal in 14, retroperitoneal in 7, cervical in 3, and other in 4. Malignancy occurred in 40 of 142 (28%) patients. Serum for alphafetoprotein (AFP) was obtained preoperatively in 29 patients. Elevated AFP was seen in all patients with malignancy, 3 of 6 with immature lesions and 1 of 19 with a benign lesion. Postoperative rise in AFP levels was a good indicator of malignant recurrence. Beta human chronic gonadotropin (BHCG) levels were only helpful in following teenage boys with testicular lesions. Benign tumors were treated by complete excision alone with a 97% survival. Testicular malignancies had a good prognosis with 13 of 15 surviving (87%) despite distant metastasis in four. In contrast, survival was only 32% with nontesticular malignancies. Survival was 17% for resectable malignant cases treated with surgery alone compared with 100% when operation was followed by multiagent chemotherapy. Unresectable malignant lesions were usually fatal despite multiagent chemotherapy and/or second-look procedures.     

Pattern of urological malignancy in Zambia. A hospital-based histopathological study.

The pattern of urological malignancy among the indigenous population of Zambia (determined on the basis of histopathological reports from a major national hospital during an 8-year period) is presented. A total of 6514 malignancies were observed, of which 784 (12%) were of urological origin. Bladder carcinoma, predominantly squamous type, was the commonest urological tumour (51%), followed by carcinoma of the prostate (26%), carcinoma of the penis (18%), renal tumours (4.3%) and testicular malignancy (0.7%). In nearly 32% of the bladder tumours, bilharzial ova were demonstrated histopathologically. Nephroblastoma accounted for 70% of the renal tumours and from a total of 7 cases of testicular tumours 5 were embryonal carcinoma and 2 seminoma. A brief reference is made to the pattern and aetiology of urological malignancies in some neighbouring countries.     

Detection of testicular ultrasonographic lesions in severe male infertility

PURPOSE: We retrospectively assessed the number and histology of testicular lesions diagnosed clinically and by ultrasonography in a population of infertile men. MATERIALS AND METHODS: From October 2000 to January 2003, 560 infertile men underwent physical examination, hormonal assessment (follicle-stimulating hormone, luteinizing hormone, testosterone) and scrotal ultrasonography. Eight men were diagnosed with focal testicular ultrasonographic lesions. In 4 cases there was a palpable lesion and in the other 4 cases the lesion was not palpable, diagnosed by ultrasonography (1 was cryptorchid). Only cases of lesions with clear-cut ultrasonographic edges and no history of recent genital infections were considered for explorative surgery through the groin. Microcalcifications were reported if present. The testicle was only preserved when frozen section examination revealed a benign lesion and the margins were negative. RESULTS: Gynecomastia was not present in any patient. No microcalcifications were observed. Follicle-stimulating hormone was high in all patients (range 19.8 to 66.0 mUI/ml, mean 34.4). Luteinizing hormone levels were variable (range 1.32 to 28 mUI/ml, mean 12.3). Testosterone was normal in all cases (range 2.82 to 6.25 ng/ml, mean 4.2). Ultrasonographic features of the lesions were hypoechoic area (6 patients) and mixed hyper-hypoechoic area (2 patients). Histological outcomes of Leydig cell tumor (in 3 patients), focal Leydig cell hyperplasia (1 patient), fibrosis (1 patient), diffuse Leydig cell hyperplasia (1 patient), classic seminoma (1 patient) and embryonal carcinoma (in 1 patient) were observed. CONCLUSIONS: Of 560 infertile patients 8 (1.4%) showed focal testicular lesions, 2 (0.4%) were diagnosed with germ cell tumors and 3 (0.5%) with interstitial cell neoplasms. The malignant tumors were both palpable and in 2 of 3 cases Leydig cell tumors were diagnosed only with ultrasonography.     

The multiple tumor syndrome. Personal experience

The multiple tumor syndrome is an unusual pathologic condition, which consists in association of multiple malignancies in the same patient. Seven cases are discussed: two women, five men, aged 32-70 years. The period between the two neoplasias was 2-23 years (in 6 cases). In one case the two malignancies appeared concomitantly. The hematological malignancies were: multiple myeloma: 2 cases; chronic granulocytic leukemia: 2 cases; chronic lymphatic leukemia: 3 cases. In four cases, the solid tumor followed the hematological malignancy at variable periods (2 and 4 years). In other two cases, the solid tumors preceded the hematological malignancy with 2 years, 23 years respectively. The solid tumors were genital cancers, malignant melanoma, spino-cellular carcinoma, thyroid cancer, hemangiosarcoma. In a single case the second tumor was a hematological malignancy too (NHL-diffuse lymphocytic lymphoma). Possible implications of previous therapy and environmental factors are discussed.