Klinefelter syndrome and fertility—Impact of X‐chromosomal inheritance on spermatogenesis

With the use of testicular sperm extraction (TESE), spermatozoa can be retrieved in about 30%‐50% of men with Klinefelter syndrome (KS). The reason for the absence or presence of spermatozoa in half of the men with KS remains unknown. Therefore, the search for an objective marker for a positive prediction in finding spermatozoa is of significant clinical value to avoid unnecessary testicular biopsies in males with (mostly) low testicular volume and impaired testosterone. The objective of this study was to determine whether paternal or maternal inheritance of the additional X‐chromosome can predict the absence or presence of spermatogenesis in men with KS. Men with KS who have had a testicular biopsy for diagnostic fertility workup TESE were eligible for inclusion. Buccal swabs from nine KS patients and parents (trios) were taken to compare X‐chromosomal inheritance to determine the parental origin of both X‐chromosomes in the males with KS. Spermatozoa were found in TESE biopsies 8 of 35 (23%) patients after performing a unilateral or bilateral TESE. Different levels of spermatogenesis (from the only presence of spermatogonia, up to maturation arrest or hypospermatogenesis) appeared to be present in 19 of 35 (54%) men, meaning that the presence of spermatogenesis not always yields mature spermatozoa. From the nine KS‐trios that were genetically analysed for X‐chromosomal inheritance origin, no evidence of a correlation between the maternal or paternal origin of the additional X‐chromosome and the presence of spermatogenesis was found. In conclusion, the maternal or paternal origin of the additional X‐chromosome in men with KS does not predict the presence or absence of spermatogenesis.     

我是协和人--65年践行转化医学的轨迹

曹兴午教授就转化医学国内外概况进行简介,结合20世纪40年代北京协和医学院细菌学系和寄生虫系始建“实验室与临床密切联系”的模式,通过65年细菌学、寄生虫学和男科学的检验与临床事例与践行,诠释这一模式在实验室与临床实践中的相关性、可行性,在观念、模式、方法、思路、宏观及微观创新的实践中,介绍了以病人为中心,从检验到病房的密切配合取得的成绩。抛砖引玉,启迪后人,开拓进取,创新未来。
　　展望未来,对人才培养检验医师和转化医学---实验室到病房模式的普及与应用,提出建议,进一步促进医学检验学与男科事业的发展。     

Penisprothesen bei erektiler Impotenz

In den letzten 20 Jahren wurden zur OP Indikation bei organischer und fixierter Impotenz verschiedenartige halbrigide, gelenkige und hydraulische Penisprothesen entwickelt. Nachdem unilaterale Implantate verlassen wurden, zeigen penile Doppelprothesen hervorragende kosmetische und funktionelle Resultate. Die bislang bei 350 Patienten implantierten hydraulischen Prothesen sind zur Zeit mit einer Komplikationsrate von 22%, insbesondere durch mechanischen Defekt, belastet. Die am häufigsten verwendete Prothese ist zur Zeit die Small-Carrion-Silikon-Doppelprothese, welche nach 580 Implantationen eine Komplikationsrate von 5% aufweist. Indikationstellungen sowie Vor- und Nachteile der verschiedenen auf dem Markt befindlichen Prothesen werden dargestellt. Dem operativen Übereifer einiger subspezialisierter Chirurgen stent der sexualtherapeutische Hang zum Konservatismus gegenüber. Durch exakte Anamnese, psychiatrischen Test und insbesondere Messung der nächtlichen Penistumeszensen im Schlaflabor können Unsicherheitsfaktoren beseitigt werden. Bei richtiger Diagnose, strenger Indikation, perfektionierten Implarr taten und einwandfreier Operationstechnik sind jetzt konstant gute Ergebnisse der penilen Prothesenimplantation erreichbar.     

《中华男科学杂志》与《Asian Journal of Andrology》引文比较分析

目的:了解我国主办的两种男科学期刊引文引用规律及情报吸收能力,发现我国男科学研究领域科研人员的文献需求特征,为该学科研究人员查阅文献提出建议。方法:采用引文计量分析法统计《中华男科学杂志》(以下简称NJA)与《Asian Journal of Andrology》(以下简称AJA)2004年刊载的论文所引用的参考文献从引文数量、引文类型、引文年代、普赖斯指数、自引率、高被引期刊等几个方面进行了比较分析。结果:AJA和NJA篇均引文数分别为20.43和10.18条,期刊占引文比例为95.84%和93.00%;AJA和NJA的普赖斯指数分别为38.50%和55.01%,自引率分别为6.20%和5.82%,AJA和NJA分别引用了358种和725种期刊,引用前12种期刊占期刊引用的比例42.47%和37.41%。结论:AJA与NJA引文类型以期刊为主,NJA涉猎文献范围广,引用文献比较新,专业人员利用新文献能力较强,作者能紧跟本学科的发展。AJA篇均引文数较高,引用文献半衰期较长,引用期刊相对集中。     

从3例诊疗报告看精子形态学与生精细胞学检测在男科临床中的应用

近年来,精子形态学和生精细胞学检测越来越受到男科特别是生殖中心的重视,然而将未染色的精液进行形态学和细胞学分析,其对精子的畸形率及圆细胞的判断存在极大的误差。笔者通过将3例典型患者的精液染色后分析精子形态和生精细胞,做出新的病情诊断及治疗方案,从而探讨精子细胞学与生精细胞学检测在男科临床中的应用价值。     

Reversible azoospermia induced by an androgen-progestin combination regimen in Indonesian men

The suppression of spermatogenesis by a combination of depot medroxyprogesterone acetate (DMPA) and testosterone enanthate (TE) was studied in Indonesian men. Twenty healthy, fertile volunteers were allocated randomly to either of two treatments each consisting of four intramuscular injections at monthly intervals. Group I (n = 10 men) received 100 mg DMPA plus 100 mg TE monthly while group II (n = 10 men) received 200 mg DMPA plus 250 mg TE monthly. Sperm concentration was suppressed markedly, with all men attaining azoospermia between the third and fourth month after the start of treatment. There was no significant difference in the suppression of spermatogenesis between the two dosage regimens. The median time to reaching azoospermia was 2.5 months from the onset of injections and the median time to recovery of sperm in the ejaculate was 2.0 months after cessation of treatment. Both steroid regimens were equally effective in suppressing LH, FSH and testosterone levels. Testosterone levels returned to baseline by the fourth post-treatment month while LH and FSH demonstrated significant rebound above baseline levels from 3 to 5 months after cessation of treatment. No serious clinical side effects were observed. Weight gain and increases in libido were reported during treatment by most volunteers. A transient decrease in libido was noted in 5/20 (25%) men between 1-2 months after cessation of injections, presumably due to the prolonged effects of DMPA relative to TE. These results indicate that uniform induction of reversible azoospermia with minimal side effects can be achieved in a non-Caucasian population.(ABSTRACT TRUNCATED AT 250 WORDS)     

A snapshot of intralesional verapamil injection in the treatment of Peyronie's disease today

Studies assessing the efficacy of intralesional verapamil injection in the treatment of Peyronie's disease have yielded mixed results. The purpose of this meta‐analysis is to systematise the existing literature on the efficacy of intralesional verapamil injection when used in the treatment of Peyronie's disease. The treatment outcomes of seven different study groups identified by computerised literature search were compared with natural history outcomes and data from control groups of three studies involving placebo saline injection. An exploratory meta‐analysis was performed on the data due to differing patient populations, treatment protocols, and inconsistent selection and reporting of outcomes. Intralesional verapamil injection significantly improved sexual function (p < .0005) and penile curvature (p < .005) in individuals with Peyronie's disease. Decreases in pain may be significant after therapy but are questionable. The effect of verapamil on plaque size remains less impressive (p > .05). Intralesional verapamil injection has promise to positively impact a number of clinical outcomes of Peyronie's disease; however, a large, multicentre, randomised, controlled study with reliable protocols is needed to confirm the efficacy of treatment.     

The effects and prospects of the integration of traditional Chinese medicine and Western medicine on andrology in China

Andrology has a long history in traditional Chinese medicine (TCM) discussions concerning andropathies, and documentation of relevant therapeutic methods abound in the ancient literature on TCM. Integrated treatment combining TCM and Western medicine has seen both broad and in-depth development, with formidable status in the field of modern andrology in China. This article attempts to demonstrate the unique advantage of integrated treatment in the therapy of andropathies through a review of the ancient literature on andrology in the field of TCM and on the integrative treatment of prostatic diseases, sexual dysfunction, male infertility and late-onset hypogonadism. There is a need for the advancement of a medical theory that integrates TCM and Western medicine practices to create a new therapeutic system with standardized therapeutic and evaluative protocols for diseases involving male sexual health.