男性乳腺癌研究进展

男性乳腺癌是一种少见的恶性肿瘤。本文综述与男性乳腺癌相关的分子生物学特征(BRCA-1、BRCA-2、HER-2/new、p53 Bcl-2 p21waf1、p27kip1)、诊断、治疗。诊断主要依靠病理学;淋巴结转移是主要预后因素。治疗以手术为主,综合治疗有利于提高生存率。     

Angiomyxoma diagnosed in a man presenting for abdominal lipectomy

Aggressive angiomyxoma is a rare tumour that is locally infiltrative but nonmetastasizing. It occurs nearly exclusively in adult women of childbearing age and almost always arises in the perineum and pelvic area. A case of angiomyxoma occurring in a middle-aged, morbidly obese man is reported. The clinical presentation was one of progressing scrotal edema and enlargement with subsequent development of scrotal abscesses, requiring several incisions and drainages as well as oral and intravenous antibiotics. His symptoms and body habitus left him in a significantly debilitated state, prompting him to seek treatment for his conditions. He initially presented for abdominal lipectomy. However, due to the chronic scrotal infections and enlargement, scrotectomy was recommended before any other surgical procedures. A scrotectomy was performed by the urology service. Pathological diagnosis of the excised tumour was an aggressive angiomyxoma. Given the rarity of this tumour, especially in males, the proper diagnosis and treatment of angiomyxoma is still being investigated. With this in mind, the physical signs and symptoms that characterize this condition are presented and treatment options are reviewed.     

Isolated polyarteritis nodosa of the male reproductive system associated with a germ cell tumor of the testis: a case report

Polyarteritis nodosa (PAN) presents mostly as a systemic disease with poor prognosis, rarely in an isolated form with a usually favorable outcome. Both forms may affect the male reproductive system and both forms have been associated with malignancies. We describe for the first time the occurrence of isolated PAN in the reproductive system combined with a mixed germ cell tumor of the testis in a 21-year-old man presenting with symptoms of chronic epididymitis. Two years after surgery he is without evidence of recurrence of either the tumor or PAN.     

Sex differences in plasma cocaine levels and subjective effects after acute cocaine administration in human volunteers

Gender differences after acute cocaine administration have received little attention in spite of the fact that males and females respond differently to many drugs. Seven male and seven female occasional cocaine users received both an intranasal dose of cocaine hydrochloride (0.9 mg/kg) and placebo powder in a randomized order and reported subjective effects via an instrumental joystick device and various questionnaires. Blood samples were withdrawn at 5-min intervals to assess pharmacokinetic differences. Male subjects achieved the highest peak plasma cocaine levels (144.4 ± 17.5 ng/ml), detected cocaine effects significantly faster than females and also experienced a greater number of episodes of intense good and bad effects. Women studied during the follicular phase of their menstrual cycle had peak plasma cocaine levels of 73.2 ± 9.9 ng/ml, which was significantly higher than when they were studied during their luteal phase (54.7 ± 8.7 ng/ml), but there were no differences in their subjective reports of cocaine effects. In spite of the different cocaine blood levels and subjective effects, peak heart rate increases did not differ between males and females suggesting that women may be more sensitive than males to the cardiovascular effects of cocaine. These data suggest that there are significant gender and menstrual cycle differences in the response to acute intranasal cocaine administration and these differences may have implications for the differential abuse of this drug.This paper is dedicated to Xavier Lamas, MD, PhD, who lost his life while ascending Mt. Everest, August 1995     

“美容牌”染发剂对雄性小鼠生殖细胞非程序DNA合成的诱导

本文应用雄性小鼠生殖细胞非程序DNA合成(UDS)检测方法研究了“美容牌”染发剂对雄性生殖细胞DNA的损伤作用。发现该染发剂诱发的UDS与药物剂量呈线性正相关。提示此类染发剂对雄性生殖细胞DNA有损伤作用。其遗传毒理效应应引起注意。     

Induction of light hydrocarbon nephropathy by p-dichlorobenzene

In order to clarify the etiology of a dose-related increase in the incidence of tubular cell adenocarcinomas of the kidney in male rats, the nephrotoxicity of p-dichlorobenzene (p-DCB) was investigated in a subchronic study. Groups of ten male and ten female Fischer 344 rats were dosed by gavage with 0 (controls), 75, 150, 300 or 600 mg p-DCB/kg/day in corn oil. Half of the animals were sacrificed after 4 weeks and the remainder after 13 weeks. Increased urinary LDH and epithelial cell excretion and exacerbation of hyaline droplet accumulation in the cytoplasm of renal cortical cells were observed in male rats over the entire dose range investigated. Tubular single cell necrosis, dilated tubules with granular cast formation in the outer zone of the medulla, were evident in male rats after 4 and 13 weeks of treatment with doses of 150–600 mg/kg/day. In female rats there was no indication of a nephrotoxic action of p-DCB. The effects on the kidney, both in their morphological characteristics and the fact that they occur exclusively in male animals, correspond to the light hydrocarbon nephropathy observed as a result of short-term treatment with a number of aliphatic and cyclic hydrocarbons. The development of cortical renal tumors seems to be associated with this kind of kidney damage which is unique to male rats. The literature on this subject generally regards these renal effects as not predictive for man.     

120例精子发生障碍的遗传缺陷研究

目的探讨无精子症,严重少精子症和少、弱精子症患者的遗传缺陷与男性不育的关系。方法采用外周血染色体核型分析技术和Y染色体基因微缺失检测方法,对120例无精子症,严重少精子症和少弱精子的患者进行了遗传咨询。结果在被筛查患者中发现异常染色体核型13例,异常核型发生率为10.83%;而其Y染色体微缺失检测中存在AZFc/SPGY基因缺失31例,缺失率25.83%。结论染色体核型异常和Y染色体微缺失与精子生成障碍有直接逻辑关系。Y染色体AZFc/SPGY区域的微缺失是中国男性不育的重要原因,因此,中国男性不育症患者有必要进行Y染色体AZFc/SPGY微缺失的常规筛查。     

Screening assays for immunologic infertility: a comparison study.

Because the immunobead antisperm antibody test (IBT) is difficult to learn and results are heavily operator-dependent, we compared findings on IBT with those of SpermMAR and SpermCheck in 58 patients to determine whether the latter two tests could demonstrate improved screening ability. Assays performed on both sperm and serum (i.e., direct and indirect) yielded 100% positive predictive values when IBT was used as the standard. Both SpermCheck and SpermMAR are easier to perform, and, as the former has a slightly greater sensitivity, we recommend SpermCheck for the detection of immunologic infertility.     

Rostral midbrain lesions and copulatory behavior in male rats

Discrete electrolytic lesions were placed in the mesencephalic dorsal noradrenergic (DNE) bundle of 22 male Sprague-Dawley rats, and sham operations were performed on 14 control animals. Eight components of copulatory behavior were compared in 2 preoperative and 2 postoperative heterosexual mating tests. A significant postlesion decrease in the postejaculatory interval (PEI), number of intromissions, number of incomplete mounts and the ejaculation latency from the first intromission (ELI) occurred. Norepinephrine levels were significantly reduced in the hippocampus, amygdala and hypothalamus, but not in the preoptic area. The only statistically significant correlations between NE concentrations and behavior in the lesioned animals were negative (hippocampal NE with PEI and ELI). The results support the hypothesis that rostral midbrain lesions disinhibit some components of male rodent copulatory behavior, but suggest that a system or systems other than the DNE bundle may be responsible for this disinhibition.     

男性抗精子抗体对体外受精一胚胎移植的影响

目的;评价男性抗精子抗体对体外受精-胚胎移植(IVF-ET)的影响。方法:以ELISA方法测定施行IVF-ET的150对不育夫妇中男方精浆抗精子抗体(AsAb)并分组:AsAb阳性组22例,AsAb阴性组128例。对比分析抗精子抗体及抗体类型对体外受精、卵裂和早期胚胎发育的影响,同时对移植后的妊娠率和流产率进行分析。结果:AsAb阳性组体外受精数明显低于AsAb阴性组(P<0.01),两组的卵裂数则无明显差异(P>0.05),而在阳性组中,不同抗体类型间体外受精、卵裂及胚胎质量无明显差异(P>0.05)。在移植日,AsAb阳性组的I级胚胎较阴性组低,而ⅢⅣ级胚胎和2原核受精细胞(2PN)明显增加(P<0.01)。两组移植后临床妊娠流产率无显著差异(P>0.05)。结论:AsAb能明显降低精子体外受精能力,对早期胚胎发育有损害。精子体处理不能完全清除AsAb对IVF影响。