Perinatal testicular torsion

Testicular torsion (TT) occurs when the testis rotates around the axis of the spermatic cord attachments and prevents blood flow to the testis, resulting in tissue ischemia. If this occurs in the first month of life it is referred to as “perinatal TT” (PTT) or “neonatal TT” (NTT). PTT has an incidence of 6.1 per 100,000 live births. Some of these cases occur prenatally. It can be missed on the initial newborn examination, as it can be asymptomatic. Hence, the true incidence is much higher since it is underdiagnosed. The types of TT include extravaginal, intravaginal, and mesorchial. Most cases of PTT are extravaginal. The diagnosis can generally be made on physical examination. Ultrasonography (US) can help exclude other rare diagnoses as long as surgical intervention is not delayed. There has been some debate regarding the timing of surgery. Although the torsed testicle may not be salvageable, the likelihood of asymptomatic bilateral TT has to be borne in mind and contralateral orchiopexy done at the time of exploration would prevent an asynchronous torsion. Nonoperative maneuvers to detorse in PTT are not recommended. The evaluation, diagnostic approach, and management of this relatively rare condition are described.     

Radiation therapy of seminoma of the testis

Seventy-three consecutive patients with seminom of the testis were treated by orcbiectomy followed by radiation alone. Sixty-six patients (9196) survived for more than five years. Forty-nine of fifty-six (87 %) survived for more than tan years. The five-year survival for 54 patients with Stage I disease was 100 % ; it was 92 % for 13 patients with Stage II disease. None of the six Stage III patients smviv All those who survived for five years were leading an active and normal life as of this writing. The Karoofsky's performance status was 90–100 for 50 patients who were followed is detail. Routine postoperative irradiation of the pare-aortic lymphatics was sufficient to produce a permanent cure without resorting to chemotherapy or prophylactic irradiation of mediastinum and supraclavicular regions. The optimal tissue does was 3000 rad. It may be increased to 3500–4000 rod by reducing the portal, but the total dose should be kept under 4000 rad. Pulmonary metastases were treated by bilateral whole hog irradiation of 1000–1500 rad followed by a coal boost dose of 2000–2500 rad. The treatment was well-tolerated by the patient. Large intra-abdominal metastases involving the internal organs should be treated by means other than radiation alone.     

切除家兔性腺对骨代谢的影响

本文选用家兔为实验模型，切除性腺后分成两组，即卵巢切除组１２只，睾丸切除组１２只，通过对钙、磷、碱性磷酸酶、尿羟脯氨酸及骨计量学、骨矿物质测定，分别观察术后４周、７周及１０周对骨质的影响。结果表明，卵巢切除后家兔骨质丢失明显增加，各指标与睾丸切除组比较有明显差异，说明卵巢功能障碍可导致骨质疏松，而睾丸功能障碍对骨质影响较小。     

Testicular cancer: The usage of central review for pathology diagnosis of orchiectomy specimens

Background

Radical orchiectomy specimens present a unique set of challenges for pathology assessment owing to their rarity and complexity. This study compares second opinion pathology reports generated at a single, large academic institution to primary reports from outside hospitals.

猪睾丸切除对舌下腺表皮生长因子表达的影响

观察睾丸切除后猪舌下泉表皮生长因子的改变。方法应用免疫组织化学ＡＢＣ方法。结果阉猪和未阉猪舌下泉组织ＥＧＦ的免疫染色颗粒均存在于舌下泉纹状管上皮细胞,其阳性率,免疫组织化学染色强度及在腺体细胞的分布均无显著性差异。结论睾丸缺失对舌下腺组织ＥＧＦ表达无明显影响。     

Orchiectomy modifies the antidepressant-like response of nicotine in the forced swimming test

Several studies have demonstrated that nicotine (NIC) exhibits antidepressant-like effects. In addition, it has been suggested that sexual hormones participate in the antidepressant actions of antidepressives. The present study was designed to analyze the effect of orchiectomy and the supplementation of testosterone propionate (TP) or 17β-estradiol (E₂) on the antidepressant properties of NIC using the forced swimming test (FST), as well as to determine possible changes in the FST during different time periods after orchiectomy. In order to evaluate the influences of orchiectomy on the effects of NIC, the study first evaluated the effects of different time periods on orchiectomized rats (15, 21, 30, 45 and 60 days) that were subjected to the FST. Then, different doses of NIC (0.2, 0.4, 0.8, 1.6 mg/kg, sc) were administered for 14 days to both intact and orchiectomized rats (after 21 day) which were then also subjected to the FST. Finally, the influence of the TP or E₂ supplementation on the antidepressant-like effect of NIC on orchiectomized rats (after 21 days) was also analyzed. Results reveal that orchiectomy significantly increased immobility behavior and decreased swimming and climbing up to 60 days after castration. In contrast, NIC decreased immobility behavior and increased swimming in intact rats; whereas orchiectomy suppressed this antidepressant effect of NIC. Only with E₂ supplementation was it possible to restore the sensitivity of the castrated rats to NIC. These results suggest that E₂ was able to facilitate the antidepressant response of NIC in orchiectomized rats.     

术中^125I粒子植入联合睾丸切除治疗前列腺癌

目的探讨术中125I放射粒子(种子源)植入联合睾丸切除在前列腺癌治疗中的意义。方法11例前列腺癌患者术中切除睾丸后,依据术前治疗计划所需粒子数目和位置,经膀胱切口将放射性125I放射性粒子植入前列腺癌组织中行内放射治疗。结果术后6~12个月随访,发现9例患者前列腺体积及前列腺特异性抗原(PSA)均有不同程度降低,1例死亡,1例病灶控制不理想,其余患者无一例出现尿潴留、尿失禁及便血等严重并发症。结论术中125I放射性粒子植入联合睾丸切除是治疗前列腺癌的一种有效手段。     

完全性雄激素不敏感综合征合并膀胱瘘1例报道及文献回顾

雄激素不敏感综合征（androgen insensitivity syndrome,AIS）是一种罕见遗传病。由于雄激素受体（androgen receptor,AR）基因的突变导致其对雄激素产生抵抗及不应答,男性生殖系统出现不同程度异常发育并呈现出女性表型。手术切除隐睾及不同类型成形术可纠正畸形,激素替代治疗也是术后康复的关键。本文报告1例43岁患者,社会性别为女性,初因反复腹水及间断腹痛原因待查收入消化内科。体格检查、超声、核型分析、激素水平等检验检查符合完全性AIS。转入泌尿外科行隐睾切除术,术中发现膀胱顶壁紧邻脐中韧带与膀胱交界处有一瘘道,遂明确腹水原因,予切除并送病理。病理结果提示睾丸组织Sertoli细胞腺瘤及Leydig细胞巢状增生,膀胱瘘口周围组织非典型增生。出院后予雌激素替代治疗。睾丸切除术后雄激素合成障碍导致促性腺激素、雌孕激素水平发生变化,后续雌激素替代治疗联合心理辅导可稳定激素水平并提高生活质量。患者有可疑家族史,系谱图分析为X连锁隐性遗传,但尚不能明确。对于膀胱顶壁瘘的成因本文提出3种假说：直接手术损伤、癌症局部复发以及脐尿管异常发育,但脐尿管发育异常与本病是否存在相关性仍需进一步研究。