PTH independent sex difference in renal handling of inorganic phosphate in the rat: effect of oophorectomy

In order to evaluate the sex difference in the renal handling of inorganic phosphate (Pi) in the rat we performed clearance experiments using intact, thyroparathyroidectomized (TPTX), oophorectomized (OophX) and orchiectomized (OrchX) rats. During stepwise elevation of the Pi concentration in plasma (Pi-titration) to about 6 mmol/l the reabsorptive mechanism of Pi was saturated. The ratio Pi-reabs./GFR in intact males was higher than in females. A significant difference in this parameter was also observed in thyroparathyroidectomized rats: in females this value was 3.47±0.13, and in males it was 4.54±0.37 mol/ml (P<0.001). Oophorectomy in the absence of parathyroid hormone (PTH) increased Pi-reabs./GFR from 3.18±0.36 to 4.12±0.24 mol/ml (P<0.001); however, orchiectomy did not significantly change the reabsorption of Pi. In conclusion, the present results demonstrate a PTH independent sex difference in the renal handling of inorganic phosphate and are consistent with the hypothesis that estrogens may play a dominant role in this differentiation.This work was supported by a grant from the Deutsche Forschungsgemeinschaft (Fr 239/9-1)Dedicated to Professor Dr. Karl Julius Ullrich     

睾丸横纹肌肉瘤的诊治分析

睾丸横纹肌肉瘤较为罕见,本文回顾性分析北京大学第三医院自1994年5月至2019年2月收治的4例睾丸横纹肌肉瘤的患者资料,主要治疗方案为睾丸根治性切除联合腹膜后淋巴结清扫,根据情况行术后辅助化疗。4例睾丸横纹肌肉瘤患者平均年龄17.5岁(14~21岁),平均住院时间22.0 d(17~31 d),平均体重指数19.6 kg/m²(14.7~25.8 kg/m²),平均肿瘤最大径为10.0 cm(4.5~15.0 cm)。中位血清绒毛膜促性腺激素(chorionic gonadotropin,HCG)0.20 IU/L(0.06~0.86 IU/L),中位血清甲胎蛋白(alpha-fetoprotein,AFP)1.03 g/L(0.65~1.66 g/L),均为正常。睾丸横纹肌肉瘤患者预后较差,多数在两年内复发。推荐行睾丸根治性切除合并腹膜后淋巴结清扫,腹膜后淋巴结转移是重要的预后不良因素,术后辅助化疗的患者可获得较长生存时间。     

Acute Infusion of hCG and Thyroid Hormone Pattern Before and After Bilateral Orchiectomy

An acute infusion of 5000 IU of hCG was given to a group of 10 elderly men affected by prostatic carcinoma prior to and 1 month after castration to evaluate the possibility of any aspecific effect on thyroid hormones. No significant change was documented for TT4 and TT3, and a significant increase in fT4 occurred only in the presurgical experiment. From these results the authors conclude that the thyroid movement documented may be correlated to the decreased binding capacity of thyroxine-binding globulins promoted by the increase in Te levels.     

GnRH antagonist associates with less adiposity and reduced characteristics of metabolic syndrome and atherosclerosis compared with orchiectomy and GnRH agonist in a preclinical mouse model

ObjectivesObservational studies relate androgen deprivation therapy (ADT) to metabolic syndrome (MS) and cardiovascular disease, an association potentially subject to uncontrollable confounding factors, especially diet and genetic/metabolic risk factors. In the absence of prospective randomized clinical trials, causality remains unproven. We comparatively investigated the effects of different ADT modalities on the development of MS and atherosclerosis in a mouse model.Materials and methodsLow-density lipoprotein receptor knockout mice underwent orchiectomy plus vehicle (2.5% mannitol), sham surgery plus vehicle (control), sham surgery plus gonadotropin-releasing hormone (GnRH) antagonist (degarelix), or sham surgery plus GnRH agonist (leuprolide) (n = 9–13/group) and were followed for 4 months. Visceral fat accumulation, lean body mass, adipocyte size, fasting blood glucose, glucose tolerance, serum levels of leptin, follicle-stimulating hormone, luteinizing hormone, and testosterone, along with atherosclerotic plaque size and characteristics were measured.ResultsAll 3 modes of ADT decreased circulating testosterone levels in mice, although leuprolide treatment reached nadir levels of testosterone later. Orchiectomized and leuprolide-treated mice gained significantly more visceral fat compared with degarelix-treated mice. Improved glucose tolerance tests were recorded in degarelix-treated mice. The aortic atherosclerotic plaque area in leuprolide-treated and orchiectomized mice was larger than in control mice (P<0.005 and P = 0.002, respectively), but it was not significantly different from control in degarelix-treated mice. The necrotic core area in degarelix-treated mice was smaller compared with leuprolide-treated and orchiectomized mice (P = 0.011 and P = 0.002, respectively).ConclusionsOur results suggest that ADT induced MS and atherosclerosis in a preclinical mouse model to a mode-specific extent. GnRH antagonist generated the least atherosclerosis and characteristics of MS compared with orchiectomy and GnRH agonist.     

高分化乳头样睾丸鞘膜间皮瘤伴对侧非典型间皮增生1例并文献复习

目的探讨高分化乳头样睾丸鞘膜间皮瘤伴对侧非典型间皮增生的临床表现、病理特征、治疗方法和预后情况。方法回顾分析1例高分化乳头样睾丸鞘膜间皮瘤伴对侧非典型间皮增生患者的临床资料。结果患者接受了左睾丸鞘膜切除术,术中见鞘膜腔内淡黄清亮积液约30ml,睾丸鞘膜腔囊壁见多个实性乳头状突起,单个肿瘤最大直径9mm。术后病理：组织学上,结节表现为明显的外生性,伴有复杂的乳头状改变;细胞学上,尽管没有表现出恶性间皮瘤的基质侵袭性,但可见由扁平上皮细胞连接的单个小管样结构延伸入睾丸鞘膜浅层下组织。免疫组化Calretinin（＋）、细胞角蛋白（CK）（＋）、Vimentin（4-＋）、上皮膜抗原（EMA）（一）。患者拒绝进一步行睾丸和阴囊皮肤切除术。术后1个月行右侧睾丸鞘膜切除术,病理回报非典型间皮增生。结论根治性睾丸切除术加患侧阴囊皮肤切除是睾丸鞘膜恶性间皮瘤的推荐治疗方法,对双侧睾丸鞘膜发病的患者,建议行根治性睾丸切除术。本例患者未接受睾丸根治术和术后放化疗等辅助治疗,密切随访36个月患者未见肿瘤复发或转移,说明高分化乳头样睾丸鞘膜间皮瘤是否需要根治性切除治疗仍有待进一步临床观察。     

羟乙膦酸钠对支睾丸大鼠骨代谢的影响

目的：通过骨组织形态计量学方法观察药物羟乙磷酸钠对去睾丸大量代谢的影响。方法：30只3．5月龄SD雄性大鼠,随机分成基础对照组,年龄对照组,去睾丸组和去睾丸后加羟乙膦酸钠组,前3组每日生理盐水5ml,kg^-1,羟乙膦酸钠（邦得林）组每日36mg.kg^-1,灌胃90d,实验结束,取胫骨近心端行不脱钙骨制片进行骨组织形态计量学分析。结果：去睾丸90d大鼠的骨量与年龄对照组相比明显下降（骨小梁面积百分率降低了50％）,羟乙膦酸钠用药组骨量明显高于去睾丸组（骨小梁面积百分率增加了92％）,达到年龄对照组的水平,但未达到基础对照组的水平,结论：羟乙膦酸钠能防止大鼠去睾丸引起的骨丢失,但未能完全克服增相关的骨丢失。     

骨形态计量学对增龄及去睾丸大鼠骨代谢的实验研究

目的 探讨３月半龄雄性大鼠增龄及去睾丸后骨量的变化,比较两之间骨代谢的变化。方法 ２０只３月半龄ＳＤ雄性大鼠,随机分成基础对照组、年龄对照组和去睾丸组,同等条件下饲养９０天。实验结束,取胫骨近端行不脱钙骨制片进行骨组织形态计量学分析。结果 年龄对照组（６月半龄）与基础对照组（３月半龄）相比,骨组织静态参数骨小梁面积百分率有下降趋势,骨的显微结构明显变差,动态参数如荧光标记周长百分率、骨形成率和单     

Burden and seasonality of testicular torsion in tropical Africa: Analysis of incident cases in a Nigerian community

Introduction

Children, adolescents and young adults in tropical Africa occasionally presents to the emergency department with testicular torsion. However, no estimates of the burden of the condition is available and there is also sparse evidence of a seasonal variation in incidence.