成人睾丸良性肿瘤诊断与治疗——附3例报告

目的探讨成人睾丸良性肿瘤的诊断与治疗。方法回顾性分析我院10年间诊治的3例睾丸良性肿瘤患者的临床资料,包括病史、肿瘤标志物、B超、CT等影像学检查。结幕所有病例经腹股沟径路行根治性睾丸切除术。病理证实腺瘤样瘤一例,Leydig细胞瘤一例,微血管瘤一例,术后随访2个月～2年,均无复发或转移。结论睾丸良性肿瘤发病有增高趋势,但术前明确诊断较难,需引起足够的重视。对于可疑病例难应积极行术中冰冻切片,一旦确诊可行保留丸的保守手术。     

Testicular circulatory isolation: a Phase I study

Antineoplastic agents may damage germinal epithelium. Testicular circulatory isolation (TCI) is a regional drug exclusion technique designed to minimize this. We evaluated the technical and anaesthetic aspects of TCI in 10 patients who underwent bilateral orchiectomy immediately thereafter. A modified aortic clamp was placed trans-scrotally across the left testicular pedicle without pre-medication or anaesthesia and left in place for 1 h, occluding testicular blood flow. Minimal pain and anxiety were reported during the procedure. There were no complications related to TCI in any patient. This study supports the institution of trials of TCI in young men about to receive fertility-threatening chemotherapy.     

静磁场暴露对于大鼠睾丸组织电学特性的影响

目的研究静磁场暴露对于大鼠睾丸组织介电特性与导电特性的影响,从细胞水平和分子水平分析静磁场对于大鼠睾丸组织的影响。方法在10 kHz～10 MHz范围内测量被1700 Gs静磁场暴露作用大鼠的睾丸组织的电容和电阻,并进一步通过测试结果计算其介电与导电特性。结果通过静磁场暴露作用的大鼠其睾丸组织的介电常数总体上呈现降低趋势,在第7天以后开始恢复,在频率较高时恢复的时间较早,其电导率的变化趋势则是先上升,在第5天以后开始下降,具有显著差异的结果主要集中在较低频率的10 kHz～100 kHz范围内。结论静磁场对于大鼠睾丸组织电学特性的显著的影响主要集中在细胞水平,对于分子水平的影响不显著,并且这些影响在一段时间后可以自行恢复。     

Relationship between the number of veins ligated in a varicocelectomy with testicular volume,hormonal levels and semen parameters outcome

Purpose: Correlate semen analysis, hormones, and testicular volume with the number of veins ligated.Methods: Patients were divided into three groups: Group 1 (≤5 veins), Group 2 (6–10 veins), and Group 3 (> 10 veins). We evaluated testicular volume, hormonal levels, sperm concentration, and motility before and after the surgical procedure.Results: In Group 1, even though there was an improvement in both testicular volume and sperm concentration; testosterone levels and sperm motility did not improve with surgery. In Group 2, no changes were detected in the both testicular volumes, in sperm concentration, motility, and testosterone levels. In Group 3, an improvement was seen in the right testicle volume, testosterone levels, and sperm concentration. Follicle-stimulating hormone levels decreased following the surgical procedure in all groups.Conclusion: Patients with more than 10 ligated veins have better chances to improve sperm concentration. FSH levels decreased in all groups of patients.     

The differences in testicular volumes in boys 8-36 months old with undescended, retractile and hydrocele testis--usefulness of scrotal screening ultrasound

Purpose

The aim of the study was quantitative and qualitative assessments of scrotal abnormalities diagnosed in boys 8 to 36 months old during ultrasound screening and estimation if these abnormalities influence testes volume.

Materials and methods

High frequency scrotal ultrasound was performed in 1448 patients aged 8–36 months as additional exam during screening ultrasound program for children including cervical and abdominal ultrasound. The mean age of examined boys was 17 months. For further analysis the children were divided in 5 age groups.

Results

The abnormalities in scrotal ultrasound were found in 20.1% of boys. Undescended, cryptorchid testes were found in 4.8% of patients, mobile testicle in 7.6% and hydrocele in 2.8%. The volume of undescended testes was statistically lower than volume of the descended testes in 3 youngest groups of boys (p = 0.003–0.011). The volume of mobile testicles did not increase with age, while in patients with hydrocele the testicular volume decreased with age.

Conclusion

Scrotal screening ultrasound performed in boys up to 3 years old may deliver information about the number and type of existing pathologies as well as their influence on the testicular volume. The volume of the pathological testes was lower than the volume of the normal ones. Improper growth of testes may potentially have important clinical implication for the function of testes in the future.     

Brucella ceti associated pathology in the testicle of a harbour porpoise (Phocoena phocoena)

Brucellosis is reported increasingly in marine mammals and the marine species of Brucella are capable of causing community acquired zoonotic infections in humans as well as abortion in cattle as a result of experimental infection. This case report describes pathology associated with an isolate of Brucella ceti that was successfully cultured from, and immunolabelled in, the testis and epididymis of an adult sexually mature free-living harbour porpoise (Phocoena phocoena). This is the first report of such pathology in any species of cetacean, and suggests the potential for sexual transmission and/or sterility as sequelae to infection similar to those reported in terrestrial animals.     

Is there an optimal contralateral testicular cut-off size that predicts monorchism in boys with nonpalpable testicles?

ObjectiveTo identify a contralateral testicular cut-off size that would predict monorchism (intra-abdominal vanishing testis or inguinal/scrotal nubbin) in boys with unilateral nonpalpable testis (NPT).Materials and methodsBoys with cryptorchidism, treated by a single surgeon at a tertiary care center from 2009 to 2013, were grouped based on intra-operative findings: boys with a solitary gonad (monorchism group, M) and two control groups: intra-abdominal testis (IAT) and palpable undescended testis (pUDT). Immediately before the procedures, the contralateral descended testes were measured using callipers. Boys with NPT underwent diagnostic laparoscopy. Sensitivity, specificity, positive and negative predictive values, likelihood ratios and receiver operating characteristic (ROC) curves were calculated.ResultsOut of the 324 boys with cryptorchidism, 58 were found to have pUDT and 85 had NPT. Of these 85 boys with NPT, 50 had an IAT and 35 had monorchism. Mean ages at surgery for groups M, IAT and pUDT were similar (28.0, 31.3 and 30.4 months, respectively; P = 0.4). Mean length of the contralateral descended testes in groups M, IAT and pUDT was 24.3, 16.5 and 18.8 mm, respectively. Contralateral testicular cut-off lengths of 18, 19 and 20 mm had positive likelihood ratios (LR+) of 6.5, 7.4 and 10.1, respectively. The area under the ROC curve was 95% (95% CI: 91–100%).ConclusionA contralateral testicular cut-off length of 19–20 mm had the best accuracy in predicting monorchism in boys aged 11–30 months with unilateral NPT.     

Effects of increased nerve growth factor plasma levels on the expression of TrkA and p75 in rat testicles

In addition to their well-known roles within the nervous system, the neurotrophins and their receptors regulate some functions in the reproductive system. In this study we used combined morphological and immunohistochemical techniques to investigate the presence and cellular localization in the rat testicle of the two receptors of nerve growth factor (NGF), i.e. TrkA and p75(NTR). Furthermore, to evaluate whether increased plasma levels of NGF affect the ageing process, 4-methylcathechol (4-MC), an inductor of NGF synthesis, was administered. Both TrkA and p75(NTR) were expressed in rat testicles, but the pattern and intensity of immunoreaction were marginally different between them. In adult rats TrkA was expressed in spermatozoa and spermatids, and p75 was expressed in spermatogonia. In newborn rats TrkA immunoreactivity was found in the Leydig cells, whereas p75 was detected in a cellular layer that surrounds the seminiferous tubules. In adult treated animals the immunoreaction for TrkA and p75(NTR) was also localized in the spermatocytes, whereas in newborn treated rats no changes in the pattern of immunoreaction was observed. The present findings suggest a role of the NGF/TrkA/p75 system in the physiology of reproduction, but the practical relevance of this remains to be established.     

玉米赤霉醇染毒对雄性小鼠睾丸及生精功能的影响

目的研究玉米赤霉醇对小鼠生精功能的影响及可能机制。方法选择健康性成熟的雄性昆明种小鼠40只,随机分为对照组和染毒组(玉米赤霉醇25、50、100mg/kg),连续灌胃染毒35天后脱臼处死。检测睾丸、附睾、精囊腺重量及脏器系数,附睾尾精子数、精子的形态结构及活力,并观察睾丸组织病理学改变。结果玉米赤霉醇各染毒组小鼠的精囊腺系数及精子计数均低于对照组,差异有显著性(P<0.05);50、100mg/kg组精子活动率下降,与对照组比较差异有显著性(P<0.05);睾丸组织有明显的病理改变,生精上皮细胞排列疏松、紊乱,层次减少,成熟精子数明显减少。结论在本实验剂量条件下,玉米赤霉醇对小鼠生精功能有毒性作用。     

出生前后低蛋白饲料对仔鼠睾丸细胞数的影响

<正>"胎儿期起源学说"和"程序化学说"认为,生命早期如胎儿期受到刺激或损伤会对以后的器官结构、生理功能和代谢产生持续性的影响[1-4]。以往研究表明,出生时低体重的人群成年后发生2型糖尿病和心血管病的危险性显著增加[1-4]。妊娠期母亲过量进食肉类食物会使其子代在成年后血中皮质醇水平增高,易患高血压[3]。动物实验表明,妊娠期限制母羊的总能量会导致其后代睾丸Sertoli细胞数目减少[5]。本研究用不同蛋白含量饲料喂养妊娠期母鼠及其生后的子代鼠,观察出生前后低蛋白饮食对睾丸细胞数的影响。