鸦胆子油乳治疗中、晚期前列腺癌疗效观察(附33例报告)

为探讨治疗中、晚期前列腺癌（PCa）的有效方法，采用中药鸦胆子油乳注射疗法治疗中、晚期PCa33例，其中14例C期PCa采用鸦胆子油乳腺体内注射加卓九切除术（含2例未作睾丸切除术者）治疗，19例D期PCa采用鸦胆子油乳腺体内注射和静脉内滴注加睾丸切除术（含4例未作睾丸切除术者）治疗。结果2年内近期疗效满意，14例C期PCa达到完全缓解，19例D期PCa中有3例达到完全缓解，16例达到部分缓解。3年生存率达78．8％。认为，与既往常用的单纯睾丸切除内分泌治疗和放疗相比，鸦胆子油乳注射治疗中、晚期PCa患者的3年生存率高，且无副作用。     

Pentoxifylline mitigates detrimental impact of chronic nonbacterial prostatitis on sperm characteristics,reproductive hormones and histopathology in rats

The protective role of pentoxifylline (PTX) on sperm characteristics, reproductive hormones and histopathology following carrageenan‐induced chronic nonbacterial prostatitis (CNP) was investigated in male Wistar rats. Thirty‐six rats were grouped into six rats per group. Group 1 (control) received saline normal. Group 2 received a single intraprostatic dose of 3% carrageenan (50 μl) on day 1 (CNP). Groups 3 and 5 received cernilton (standard drug) and PTX orally at 100 and 50 mg/kg for 14 consecutive days respectively. Groups 4 and 6 received a single dose of 3% carrageenan (50 μl) intraprostatically on day 1 followed by cernilton and PTX orally at 100 and 50 mg/kg on the eighth day for 14 consecutive days respectively. Prostatic index, serum prostatic specific antigen, malondialdehyde, testosterone and luteinising hormone levels were significantly increased (p < .05), whereas serum follicle‐stimulating hormone, sperm count, motility and viability were significantly decreased (p < .05) in CNP group. Histopathology of prostate revealed leucocyte infiltration, large involutions and projection into the lumen in CNP group and these aberrations were improved by PTX. According to these findings, we concluded that PTX effectively mitigated detrimental impact of CNP on sperm characteristics, reproductive hormones and histopathology in rats.     

不同治疗方法对动物慢性细菌性前列腺炎前列腺分泌功能的影响

目的：探讨不同治疗方法对实验动物慢性细菌性前列腺炎(CBP)前列腺分泌功能的影响。方法：①选用健康雄性大白兔，依文献方法，通过后尿道反复灌注大肠埃希菌制备CBP动物模型；②将CBP动物随机分为3个治疗组，1个对照组，分别予口服氧氟沙星、口服氧氟沙星和特拉唑嗪、在B超引导下行前列腺局部穿刺注射氧氟沙星和地塞米松，同时以注射生理盐水作为对照组；③应用原子吸收光谱方法测定前列腺组织中锌、钙离子浓度，应用α—萘酚磷酸法测定前列腺组织中酸性磷酸酶活性，借以评价不同治疗方法对前列腺外分泌功能的影响。结果：3种治疗方法均可改善前列腺分泌功能，而且三者相比差异无显著性意义。结论：口服氧氟沙星加特拉唑嗪，用于治疗CBP具有良好效果；前列腺穿刺注射氧氟沙星和地塞米松对于CBP前列腺分泌功能的改善效果无明显优势。     

Value of intraprostatic injection of zinc and vitamin C and of ultrasound application in infertile men with chronic prostatitis

Seventy infertile men with chronic prostatitis were treated by prostatic massage and wide-spectrum chemotherapy as basic treatment to which intraprostatic injection of zinc or vitamin C with or without ultrasound application was added as a new line of treatment. Comparison showed no significant improvement of the additive treatment over the conventional treatment used alone. Pus cells in the expressed prostatic smear diminished significantly after treatment, which was associated with significant increase of percentage of motile spermatozoa and significant decrease of abnormal forms. Bacterial flora was studied in comparison with findings in 20 cases of infertile males without prostatitis; staphylococci predominated in both patient and control groups.     

Transrectal ultrasound-guided intraprostatic injection of absolute ethanol with and without carmustine: a feasibility study in the canine model

Objectives. To develop a reliable intraprostatic injection technique and to define the local and systemic toxicity of intraprostatic injection of dehydrated ethanol with and without carmustine.Methods. Twenty-three random-source male canines were divided into a control group (n = 3), a dehydrated ethanol-alone group (group 1, N = 10), and a dehydrated ethanol-plus-carmustine group (group 2, N = 10). A reliable intraprostatic injection technique was developed with the control animals. The optimal volume of dehydrated ethanol for intraprostatic injection and the local tissue effects of dehydrated ethanol injection were defined with group 1. The local tissue effects of escalating doses of carmustine were defined with group 2. All animals were injected under general anesthesia using transrectal ultrasound (TRUS) guidance. Fourteen days after injection, a repeated TRUS of the prostate was done, the animals were killed, and the bladder, prostate, and periprostatic tissues were excised for pathologic examination.Results. Sonographic changes in the prostate 2 weeks after injection were present in all group 1 and 2 animals. All prostates had varying amounts of hemorrhagic and coagulative necrosis, which correlated with the TRUS findings. There were no differentiating pathologic features between group 1 and group 2 specimens. The relative amount of necrosis varied with the doses of dehydrated ethanol and carmustine injected, but was not predictable on the basis of the doses administered. Subclinical prostatic microabscesses were identified in 6 of 10 group 1 animals and 4 of 10 group 2 animals. Only group 2 animals had alterations in their blood chemistry results, all of which were self-limited. Two had white blood cell nadirs of less than 2000 5 days after injection. No animals developed incontinence, and there were no rectal injuries.Conclusions. Intraprostatic dehydrated ethanol and carmustine injections were readily controllable under TRUS guidance and resulted in hemorrhagic and coagulative necrosis of prostatic tissue with minimal associated morbidity and no incontinence in the dog model. Hematologic changes observed in the animals that received carmustine were self-limiting.     

Experimental intraprostatic injection of bacillus Calmette-Guerin: a feasibility and safety study

PURPOSE: We investigated the feasibility and safety of intraprostatic administration of bacillus Calmette-Guerin (BCG) and determined the histological changes induced by this approach. MATERIALS AND METHODS: A total of 36 healthy male beagle dogs 2.2 to 3.6 years old weighing 10.0 to 14.8 kg were randomly assigned to 6 experimental groups. Four groups were given intradermal BCG vaccination and 6 weeks later they were given 0 (group 1), 10 (group 2), 5 x 10 (group 3) or 10 (group 4) BCG organisms intraprostatically. An additional group received prevaccination, followed 6 weeks later by a dose of 10 BCG organisms intraprostatically and then 6 weeks of antibiotics (group 5). Another group receiving no prevaccination and 5 x 10 BCG organisms intraprostatically at week 6 were included (group 6). RESULTS: Adverse reactions (ARs) were seen in 12 dogs, including inguinal lymphadenopathy in 3, an anal lesion in 5, constipation in 7 and dysuria in 3. There was a trend toward an increased incidence of ARs in high dose groups 3 and 4, fewer ARs in group 5 and no ARs in group 6. There was minimal evidence of systemic dissemination of BCG in any group. Post-necropsy histological analysis indicated higher inflammation as well as glandular destruction in high dose groups 3 and 4. Antibiotics did not seem to lessen the histological response to intraprostatic BCG injection (group 5). Interestingly in nonvaccinated group 6 the level of inflammation as well as glandular destruction was higher. CONCLUSIONS: Our results indicate that intraprostatic BCG administration in dogs is a safe and well tolerated procedure. It is free of major or long lasting serious complications.     

蜂毒肽对大鼠慢性前列腺炎疼痛的作用

目的 观察蜂毒肽(melittin)对大鼠前列腺炎疼痛模型的治疗作用.方法 通过手术将弗氏完全佐剂(CFA)注射到SD大鼠前列腺中建立模型,继续饲养12 d后再次通过手术将蜂毒肽注射到大鼠前列腺内进行干预.在注射CFA后的第6、12、18天进行机械痛阈测定,然后取前列腺和脊髓标本分别进行组织学、环氧合酶-2(COX-2)以及脊髓背角胶质原纤维酸性蛋白(GFAP)的测定.对照组大鼠,前列腺内注射等量生理盐水,饲养相同时间后同方法检测.结果 CFA诱导的大鼠前列腺炎模型能产生痛觉过敏,前列腺内炎症细胞数量和COX-2表达均增加,脊髓中GFAP表达增加.同对照组比较,蜂毒肽注射后大鼠机械痛压力阈值提高,前列腺中炎症细胞数量和COX-2表达均降低,脊髓中GFAP表达降低.结论 蜂毒肽注射能够有效提高前列腺炎大鼠的痛阈,抑制炎症细胞、COX-2和GFAP的表达,发挥镇痛和抗炎作用.     

Effects of androgens on the ultrastructure and subcellular zinc distribution in the prostatic epithelium of castrated rats

Sprague Dawley rats were maintained on testosterone propionate or 5 alpha-dihydrotestosterone for 3 days following bilateral orchidectomy for a 7-day period. Ultrastructural examination showed only partial recovery of the prostatic epithelium with testosterone propionate while 5 alpha-dihydrotestosterone caused the lateral and ventral lobes to revert to the appearance of control tissues. The latter metabolite induced greater stimulation of the prostate evidenced by increased mitotic division of the epithelial cells and an increased number of basal cells exhibiting ciliary formation was observed. Zinc concentrations in subcellular regions of both lateral and ventral prostate lobes were affected by the two androgens. Testosterone propionate was most effective in elevating zinc in the lateral lobe, particularly within the secretory components. In the ventral lobe both androgens caused an increase in subcellular zinc concentrations above control levels. The increase of nuclear and nucleolar zinc was related to the increase in nuclear activity and cellular response to the androgen administration.     

High-dose dietary zinc promotes prostate intraepithelial neoplasia in a murine tumor induction mode

To evaluate the role of high-dose dietary zinc in the process of prostate malignancy,60 Sprague-Dawley rats were randomly divided into four groups：tumor induction with carcinogen and hormone （group 1）,oral zinc administration without tumor induction （group 2）,oral zinc administration with tumor induction （group 3） and a control without zinc administration or tumor induction （group 4）. Zinc was supplied orally in the form of zinc sulfate heptahydrate dissolved in drinking water to groups 2 and 3 for 20 weeks. Although the serum level of zinc measured at 20 weeks was maintained similarly in each group （P = 0.082）,intraprostatic zinc concentrations were statistically different. Group 1 prostates contained the least amount of zinc in both the dorsolateral and ventral lobes at levels of 36.3 and 4.8 μg g^-1,respectively. However,in group 3,zinc levels increased in both lobes to 59.3 and 12.1 μg g^-1,respectively,comparable with that of group 4 （54.5±14.6 and 14.1±2.4 μg g^-1）. In spite of these increases in zinc concentration,the prevalence of prostate intraepithelial neoplasm was rather increased in group 3 （53.3% and 46.7%） compared with group 1 （33.3% and 33.3%） in both dorsolateral and ventral prostate lobes. Although prostate intraepithelial neoplasm did not develop in any prostate in group 4,zinc administration did induce prostate intraepithelial neoplasm in group 2 （46.7% and 40.0%）. Thus,although high dietary zinc increased intraprostatic zinc concentrations,it promoted,instead of preventing,prostate intraepithelial neoplasm in a murine prostate malignancy induction model.     

中药鸦胆子油乳治疗中、晚期前列腺癌

本文报道33例中、晚期前列腺癌采用中药鸦胆子油乳(以下称鸦油乳)注射疗法,对14例C期用鸦油乳腺体内注射+去势术(含2例未去势术)治疗,对19例D期采用鸦油乳腺体内注射和静肪内滴注+去势术(含4例未去势术)治疗后,近期疗效满意。C期14例达CR,D期3例达CR和16例达PR效果。与既往常用之单纯去势、内分泌治疗和放疗相比3年生存率高且无副作用。     

Diffusion properties of transurethral intraprostatic injection

OBJECTIVES: To evaluate the location and extent of diffusion that occurs when liquid is injected transurethrally into the prostate gland, by correlating real-time fluoroscopy and gross pathology, and to quantify the variables that influence intraprostatic diffusion during chemoablation of the prostate. MATERIALS AND METHODS: A solution of diatrizoate meglumine (Hypaque, Nycomed, Princeton, NJ) gentamicin and methylene-blue dye (HGM) was injected transurethrally into the prostate in six dogs, using a passive-deflection needle injection system. The intraprostatic diffusion characteristics were evaluated during each injection using real-time C-arm fluoroscopy, and following each injection by gross examination of methylene blue staining within the prostatic tissues. HGM back-flow into the urethra at the time of injection was assessed by measuring gentamicin levels in the collected bladder irrigant after each injection, using a standard dilution formula. RESULTS: There was variability in the intraprostatic diffusion both fluoroscopically and grossly. The needle occasionally assumed a straighter trajectory than its intended curve. Intraprostatic diffusion was detected in 12 of 36 injections (33%). Using standard manipulations of various devices increased the intraprostatic diffusion in these injections to almost 80%. There was less intraprostatic diffusion when the injection resistance was either extremely high or absent. There was no extraprostatic extravasation of HGM beyond the prostatic capsule. CONCLUSION: Current methods of transurethral intraprostatic injection are variable for both the diffusion of HGM solution and in needle deployment. The gross diffusion patterns with the HGM solution were consistent with the diffusion patterns documented in our previous research using absolute ethanol. These and other factors may partly explain the variability of the lesions produced with ethanol injection. Therefore, more research is needed to further elucidate the diffusion characteristics of solutions injected intraprostatically using the transurethral approach.     

肉毒毒素A腺体内注射对大鼠前列腺增生组织的影响

目的:探讨肉毒毒素A(BTX-A)腺体内注射对大鼠前列腺增生模型的影响。方法:SPF级雄性SD大鼠64只,丙酸睾酮造模成功后,随机均分为BTX-A高、中、低(20U、10U、5U,n=12)剂量组和阴性对照组(生理盐水,n=12)行腺体内注射,假手术组(n=12)为对照。注射后2周和4周切取前列腺,观察各组腺体外观、腹侧叶称重。HE染色观察组织学改变;千屏病理图像分析系统半定量检测各组腺体面积、间质面积。结果:BTX-A20U注射后3d内有2只大鼠死亡,余均存活。2周后,与阴性对照组相比,高、中、低剂量组大鼠前列腺明显萎缩(P<0.01,0.01,0.05),重量减轻,光镜下腺管上皮细胞萎缩,腺管面积和间质面积均缩小。4周后影响有所降低,以5UBTX-A组大鼠最为明显。结论:大鼠前列腺内注射BTX-A可使前列腺体积缩小,组织学变化明显,但大剂量有可能导致大鼠死亡。     

The effects of estradiol-17 beta on the ultrastructure and subcellular distribution of zinc in the prostatic epithelium of castrated rats

Male Sprague-Dawley rats, previously castrated for a 7-day period, were maintained on either a low or high dose of estradiol-17 beta for 3 days. Some areas of the prostatic epithelium in the lateral lobe exhibited the ultrastructural characteristics of the untreated, intact animals in response to the small dose of estrogen. The ventral lobe by comparison was not similarly affected. This stimulation in the lateral prostate was not reflected by comparable changes in the subcellular distribution of zinc.     

Impact of altered thyroid hormone status on prostatic glycosidases

The impact of hyper- and hypothyroidism on prostatic glycosidases was investigated. Hyper-thyroidism was induced by administering L-thyroxine (25 μg/100 g body weight/day) for 60 days and hypothyroidism was induced by total thyroidectomy. To test the direct influence of thyroid hormones, prostatic lobes were incubated with different concentrations (10, 25 and 50 ng/mL) of T₃ and β-N-acetylglucosaminidase and β-N-acetylgalactosaminidase were assayed. Serum levels of thyroid hormones, oestradiol and testosterone increased in hyperthyroid, and decreased in hypothyroid rats. TSH decreased in hyperthyroid, and an opposite trend was seen in thyroidectomized, rats. Prostatic [anterior (coagulating glands), dorsolateral and ventral prostates] β-glucosidase, β-galactosidase, β-N-acetylglucosaminidase and β-N-acetylgalactosaminidase activities increased uniformly in hyperthyroid, and decreased in thyroidectomized, rats. In vitro studies showed a dose-dependent stimulatory effect of T₃ on β-N-acetylglucosaminidase and β-N-acetylgalactosaminidase in all three lobes of the prostate. From the present study, it is concluded that hyperthyroidism augments and hypothyroidism inhibits prostatic glycosidases and T₃ has a direct stimulatory effect on these enzymes.     

Intravenous vs. intraprostatic administration of N-methyl-N-nitrosourea to induce prostate cancer in rats

To develop an improved model of human prostate cancer, 16-wk-old Wistar rats were treated orally for 18 days with the antiandrogen, flutamide (50 mg/kg body weight[BW]/day), weight followed by 3 days of s.c. testosterone (100 mg/kg BW). These were the only treatments the control animals received (Group 1, n = 10). On the day after the third testosterone injection, N-methyl-N-nitorsourea (MNU) was administered via the tail vein at a dose of 50 mg/kg BW (Groups 2, n = 40 and 3, n = 20); in some rats, a second dose was delivered by the same route 22 wk later (Group 3). A smaller dose of MNU (15 mg/kg BW) was administered intraprostatically Group 4, n = 20) to a fourth group. In Groups 2, 3, and 4, silastic capsules containing testosterone were implanted s.c. approximately every 6 wk beginning 1 wk post-MNU. Accessory sex gland tumors arose in MNU-treated rats in Group 2 (12/40, 30%), Group 3 (8/20 40%), and Group 4 (8/20, 40%); 90% were macroscopic (25/28). There were no neoplasms in these organs in the control rats (Group 1, 0/10). These accessory sex gland neoplasms were adenocarcinomas or undifferentiated carcinomas which appeared to be derived from the prostate based on location and histological characteristics, although the size and spread of some of the tumors precluded definitive localization of the tissue of origin. The incidence of these neoplasms was similar in rats given a single dose of MNU intraprostatically or two doses of MNU i.v., but the animals treated intraprostatically maintained higher body weights and developed fewer extraneous tumors. The average (± SD) latent period for clinical or postmortem detection of prostate neoplasia after MNU was shortest in the rats given two i.v. doses (39 ± 3 wk) compared with the single i.v. dose (45 ± 6 wk) or an intraprostatic dose (56 ± 7 wk). In 57% of the cases (16/28), the prostate tumors metastasized to distant sites. An activating point mutation was detected in codon 12 of the Ki-ras oncogene in the MNU-induced primary prostate tumors (8/10 examined), and metastases arising from these prostate tumors (2/3) but was absent in normal prostate tissue (0/6). This study demonstrates that two systemic doses of MNU increase the incidence and decrease the latency of prostate neoplasms compared with a single dose, and that a single dose of MNU injected intraprostatically induces prostate adenocarcinoma without many of the other tumors and weight loss typically found after i.v. administration. © 1995 Wiley-Liss, Inc.     

Evidence for the regulation of prostatic oxytocin by gonadal steroids in the rat

Oxytocin and its receptor are present in the mammalian prostate, and the peptide has been shown to increase prostatic growth, 5alpha-reductase activity, and contractility. This study was performed to investigate whether local concentrations of the peptide were regulated by gonadal steroids in order to establish whether oxytocin has a physiological role in the prostate. Both intact and castrated adult Wistar rats were treated daily for 7 days with either testosterone propionate or the antiandrogen cyproterone acetate. Animals were then killed, and plasma hormone and prostatic oxytocin concentrations were measured. A separate group of rats was treated with the 5alpha-reductase inhibitor finasteride to investigate whether testosterone or dihydrotestosterone (DHT) was involved in regulating oxytocin concentrations. In a further series of experiments, rats were treated with diethylstilbestrol (DES) or the antiestrogen tamoxifen. Treatment with testosterone significantly decreased prostatic oxytocin, whereas reduction of androgens by castration or by administration of cyproterone acetate increased prostatic peptide concentrations without altering circulating levels of the peptide. Treatment with finasteride increased plasma testosterone but decreased DHT concentrations. Prostatic oxytocin concentrations were higher in finasteride-treated animals than in control animals with comparable testosterone levels. The data suggest that both testosterone and DHT are capable of decreasing prostatic oxytocin concentrations. Treatment with DES did not significantly alter prostatic oxytocin, but administration of tamoxifen decreased concentrations of the peptide, suggesting that low levels of estrogen may be necessary for oxytocin production. These data provide evidence that oxytocin is regulated by androgens, and we hypothesize that this regulatory mechanism may be involved in controlling prostatic growth.     

尿道不全梗阻致大鼠尿液返流性前列腺炎模型

目的:用手术方法建立大鼠尿道不全梗阻致尿液返流至前列腺内,探讨慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)的发病机制。方法:54只雄性SD大鼠随机分为实验组(n=30)和假手术组(n=24)。实验组:严格参照Shinsuke Takechi手术方法行大鼠阴茎根部不全结扎,形成尿道不全梗阻,假手术组作为对照,在造模3d解除梗阻后第1、3、7d观察前列腺形态并取材行光镜观察,免疫组化方法检测环氧化酶-2(COX-2)的表达。结果:①实验组在尿道不全梗阻3d解除梗阻后在第1、3、7d前列腺出现可见的炎症变化,且随时间延长炎症逐渐减轻;而假手术组为正常前列腺组织。②免疫组织化学染色显示实验组前列腺内COX-2染色较假手术组明显增强(P<0.05);随着时间延长,COX-2染色加深(P<0.05)。结论:该试验提供了尿液返流性前列腺炎动物模型;前列腺内COX-2在尿液刺激后表达增强可能与CP/CPPS患者的疼痛不适症状有着密切的关系。     

前列腺活检对血清T-PSA F-PSA及F/T比值的影响

目的 :研究经直肠前列腺穿刺活检对血清总前列腺特异抗原 (T PSA)、游离前列腺特异抗原 (F PSA)及游离 /总前列腺特异抗原 (F/T)比值的影响。方法 :对 36例前列腺活检示良性病变的患者 ,分别于活检前及活检后 0 .5h、1周、30d检测T PSA、F PSA值 ,并计算F/T比值。结果 :活检前及活检后 0 .5h、1周、30d患者血清T PSA分别为 (11.76± 7.82 ) μg/L、(36 .90± 2 4 .76 ) μg/L、(2 4 .36± 16 .18) μg/L和 (12 .2 1± 6 .4 9) μg/L ;F PSA分别为 (2 .4 1± 0 .96 ) μg/L、(2 5 .14± 12 .5 6 ) μg/L、(4 .0 2± 1.90 ) μg/L和 (2 .6 1± 0 .87) μg/L ;F/T比值分别为 0 .2 1± 0 .0 6、0 .6 8± 0 .18、0 .15± 0 .0 4和 0 .2 2± 0 .0 5。与活检前相比 ,活检后 0 .5h、1周T PSA、F PSA值显著升高 (P <0 .0 1、P <0 .0 5 ) ;F/T比值活检后 0 .5h显著升高 (P <0 .0 1) ,活检后 1周时显著降低 (P <0 .0 5 ) ;活检后 30d时 ,以上指标与活检前相比 ,差异均无统计学意义 (均P >0 .0 5 )。结论 :前列腺穿刺活检 ,会导致血清T PSA、F PSA及F/T比值的显著升高 ,临床上要获得有意义的PSA的指标 ,最好在活检 30d后检测     

大鼠慢性非细菌性前列腺炎模型的建立

目的建立大鼠慢性非细菌性前列腺炎模型。方法参考Robinette[1]的方法选取1周岁SD大鼠经去势后用苯甲酸雌二醇0.25mg/kg皮下注射,观察实验大鼠前列腺组织的病理学表现。结果建模30d后,大鼠前列腺出现不同程度的慢性炎症改变和炎症细胞的浸润。结论运用诱导去势大鼠成功建立了慢性非细菌性前列腺炎模型,为以后进一步研究前列腺炎的发病机理以及临床用药提供了较好的途径。     

Zinc concentrations and total amount of zinc in seminal plasma of infertile men with special reference to prostatic secretory function

The exact relationship between seminal plasma zinc and fertility is not known. Zinc is secreted mainly by the prostate, and zinc concentration in seminal plasma is regarded as an excellent indicator of prostatic secretory function. However, low zinc concentration may result not only from poor secretory function of the prostate but also from dilution due to excessive secretion of seminal vesicular fluid. This assumption is supported by the present result that zinc concentration was inversely correlated with fructose concentration. Therefore zinc concentration is thought to reflect prostatic function in proportion to seminal vesicular function. Total amount of zinc in seminal plasma seems to be an appropriate indicator for prostatic secretory function. In the present study, concentrations and total amount of zinc were examined in seminal plasma of men with various fertility problems. There were no significant differences between men with normal spermodiagram and those with abnormal spermodiagram, seminal inflammation or varicocele in concentration or total amount of zinc. No changes were observed in any of them after various therapies including oral zinc sulfate. However, the percentage of men with normal spermodiagram was low in the group with extremely low or high zinc concentration and total sperm count tended to increase with increase in total amount of zinc. Furthermore, the spermatozoal motility was better in the prostatic fraction than in the vesicular fraction of split ejaculates, and the percentage of men with decreased motility and normal sperm concentration was significantly high in the group with lower zinc concentration or decreased total amount of zinc. These observations indicate that prostatic secretion has a stimulatory effect on spermatozoal motility. The secretory activities of the prostate and the seminal vesicle are generally known to be closely controlled by androgens, but our findings indicate that the secretory functions of these accessory organs are independent because there was no correlation between total amount of zinc and fructose. Analysis of the relative concentrations in prostatic secretion, split ejaculates, and seminal plasma confirmed an almost exclusively prostatic origin of zinc. As part of the routine andrologic examination, measurement of concentration and total amount of zinc in seminal plasma is useful for evaluating prostatic function, but measurement of acid phosphatase, magnesium, calcium or potassium will provide almost as much information, since they also seem to be secreted primarily by the prostate.