Semen quality and reproductive hormones before and after orchiectomy in men with testicular cancer

PURPOSE: We clarify the impact of removal of the tumor bearing testis on semen quality and reproductive hormones in men with testicular cancer. MATERIALS AND METHODS: Semen quality and levels of reproductive hormones were investigated in 48 men before and after orchiectomy for testicular cancer. Semen analysis was done in 35 of these men and hormone analyses were done in 47. The hormone data of patients with (14) or without (33) elevated values of human chorionic gonadotropin (HCG) were analyzed separately. RESULTS: Median sperm concentration and total sperm count decreased from 17 x 10(6)/ml. (range 0 to 117) and 39 x 10(6) (0 to 433), respectively, before to 7 x 10(6)/ml. (0 to 69) and 30 x 10(6) (0 to 200), respectively, after orchiectomy. After orchiectomy sperm concentration was decreased in 30 of 35 men (p = 0.001) and azoospermia developed in 3 (9%). In men without detectable HCG median follicle-stimulating hormone levels increased (p <0.001) from 5.7 IU/l. (range 0.01 to 30) before to 10.0 IU/l. (4.6 to 48) after orchiectomy in 33 of 33 patients. Median inhibin B significantly decreased (p = 0.003) from 108 pg./l. (range 60 to 193) before to 95 pg./l. (less than 20 to 141) after orchiectomy. Median luteinizing hormone increased significantly from 3.1 IU/l. (range 1.1 to 9.9) before to 5.2 IU/l. (2.1 to 27) after treatment (p <0.001). Testosterone and sex hormone-binding globulin did not change significantly after orchiectomy. Patients with detectable serum HCG before orchiectomy had a considerable increase in follicle-stimulating hormone after orchiectomy, and a concomitant decrease in testosterone and estradiol. CONCLUSIONS: Semen quality was poor at diagnosis and deteriorated further after orchiectomy compared with pretreatment values. Our findings indicate that in some patients the most appropriate time for cryopreservation of semen is before orchiectomy. Androgen production was maintained by increased luteinizing hormone stimulation after orchiectomy.     

孕鼠铅暴露对子代记忆功能及生长因子的影响

目的　探讨孕鼠铅暴露对子代学习记忆功能及神经生长因子表达的影响。方法　用石墨炉原子吸收法测定仔鼠海马组织中的铅含量 ;用RT PCR和免疫组化法观测仔鼠海马组织神经生长因子mRNA和蛋白表达的改变 ;用水迷宫法测试仔鼠学习记忆能力的改变。结果　醋酸铅染毒后 ,低、中、高剂量组仔鼠海马组织中铅含量 (μg/ g湿重 )分别为 1 0 8± 0 37,1 71± 0 33,2 6 3± 0 4 1,显著高于对照组 (0 0 3± 0 0 1) (P <0 0 1) ;神经生长因子 (NGF)mRNA表达的灰度比分别为 0 81± 0 0 8,0 73± 0 17,0 4 1± 0 0 4 ,明显低于对照组 (1 13± 0 0 4 ) ,(P <0 0 5 ) ;NGF蛋白表达的面密度分别为 0 118± 0 0 2 0 ,0 0 80± 0 0 14 ,0 0 2 6± 0 0 12 ,明显低于对照组 (0 175± 0 0 4 1) (P <0 0 1) ,平均灰度分别为 186 4 2± 10 4 3,193 85± 15 73,2 0 1 4 6± 19 2 7,明显高于对照组 (16 3 2 7± 19 5 7) (P <0 0 5 ) ;水迷宫实验逃逸时间分别为 (2 2 4± 10 4 ) ,(30 5± 12 7) ,(37 6± 17 2 )s,明显高于对照组 (12 7± 5 7)s ,(P <0 0 1)。结论　孕期母体铅暴露对子代学习记忆能力有明显影响 ,且这种影响可能与海马组织神经生长因子表达的改变有关系     

The Efffects of Acute Bleeding on Acid–Base Balance, Erythropoietin (Ep) Production and in Vivo P50 in the Rat

The mechanism of erythropoietin (Ep) production after acute haemorrhage has been thought to be due to a reduction in blood volume and tissue perfusion leading to tissue hypoxia. In the present study we have evaluated the effect of acute haemorrhage in the rat on the acid-base status, the red cell affinity for oxygen in vivo, and Ep production. Within a few hours after acute blood loss there was a respiratory alkalosis with an increase in blood pH, a decrease in pCO2 and an increase in the red cell affinity of Hb for oxygen in vivo that was temporally related to an increase in Ep production. Within 24 h after the acute haemorrhage, the blood pH AND PCO2, red cell affinity for oxygen in vivo, and Ep level returned towards normal. The decrease in in vivo red cell affinity for oxygen was associated with an increase in red cell 2,3-DPG levels and a decrease in Ep production.     

Cisplatin in the treatment of advanced gastric carcinoma: a phase II study

Twenty-one patients with advanced local or metastatic gastric carcinoma were treated with 75 mg/m2 of cisplatin every 3 weeks. Six patients had received no prior chemotherapy. One patient achieved complete tumor regression lasting 5 months, while three patients had partial responses of 2, 4, and 11 months' duration, respectively, resulting in an overall response rate of 18% (95% confidence limits: 5%-40%). All four responding patients had improvement in performance status. Two of six patients who had had no prior chemotherapy responded, while only two of 16 patients previously treated with 5-FU and doxorubicin responded.     

Employment status at time of first hospitalization for heart failure is associated with a higher risk of death and rehospitalization for heart failure

Aims

Employment status at time of first heart failure (HF) hospitalization may be an indicator of both self‐perceived and objective health status. In this study, we examined the association between employment status and the risk of all‐cause mortality and recurrent HF hospitalization in a nationwide cohort of patients with HF.

Methods and results

We identified all patients of working age (18–60 years) with a first HF hospitalization in the period 1997–2015 in Denmark, categorized according to whether or not they were part of the workforce at time of the index admission. The primary outcome was death from any cause and the secondary outcome was readmission for HF. Cumulative incidence curves, binomial regression and Cox regression models were used to assess outcomes. Of 25 571 patients with a first hospitalization for HF, 15 428 (60%) were part of the workforce at baseline. Patients in the workforce were significantly younger (53 vs. 55 years) more likely to be male (75% vs 64%) and less likely to have diabetes (13% vs 22%) and chronic obstructive pulmonary disease (5% vs 10%) (all P < 0.0001). Not being part of the workforce was associated with a significantly higher risk of death [hazard ratio (HR) 1.59; 95% confidence interval (CI) 1.50–1.68] and rehospitalization for HF (HR 1.09; 95% CI 1.05–1.14), in analyses adjusted for age, sex, co‐morbidities, education level, calendar time, and duration of first HF hospitalization.

Conclusion

Not being part of the workforce at time of first HF hospitalization was independently associated with increased mortality and recurrent HF hospitalization.

     

Aging‐related changes of cognitive performance and stress regulation in high functioning elderly individuals

This article aims to analyse long‐term changes in cognitive performance and psychophysiological stress regulation in a specific sample of 10 young‐old (age at pre‐test: M ± SD = 63.2 ± 1.5) and 12 old‐old (age at pre‐test: M ± SD = 69 ± 2) persons possessing a high psychosocial status and a physically active lifestyle. Psychophysiological parameters were recorded prior to, during, and after the administration of a cognitive performance test battery. The measurements took place three times within a 6‐month period, and again 6 years later in a follow‐up test. Considering practice and habituation effects, findings provide no compelling evidence of an aging‐associated cognitive decline in attention, multiple choice reaction performance, and information processing speed, either in the young‐olds, or in the old‐olds. Furthermore, psychophysiological stress regulation showed no long‐term alteration regarding skin conductance level and heart rate. Based on these findings, it is assumed that psychosocial health and physical activity might contribute to the preservation of cognitive abilities and stress regulation into the 70s. Finally, this study demonstrated the significance of considering practice and habituation effects elicited through test repetitions in order to estimate long‐term effects.     

Immature ovarian teratoma in a postmenopausal woman

We report the first case of immature ovarian teratoma occurring after menopause in a 57-year-old, 3 years postmenopausal woman. Within one year after resection of the teratoma she developed peritoneal botryoid rhabdomyosarcoma, which probably originated from initially unrecognized rhabdomyoblasts in the teratoma. The patient died 6 months later from progressive disease after a transient adriamycin-induced tumor response. The literature on ovarian immature teratoma and ovarian rhabdomyosarcoma is briefly reviewed, and the available treatment is discussed.     

Localized irradiation of testes with carcinoma in situ: effects on Leydig cell function and eradication of malignant germ cells in 20 patients

Twenty men (median age, 31 yr) previously treated for unilateral testicular cancer received localized irradiation in a dose of 20 Gray in 10 fractions for carcinoma in situ of the remaining testis. Follow-up testicular biopsies performed 3 (n = 19) and 24 (n = 14) months after the treatment showed in all cases a Sertoli cell-only pattern. Hormonal evaluation was performed before as well as 3, 12, 24, and 36 months after radiation treatment. Endocrine parameters were followed for a median of 30 months (3-36 months). Baseline serum testosterone values decreased during the follow-up period from 13.3 +/- 6.0 to 10.8 +/- 6.4 nmol/L (mean +/- SD), although the decrease was not statistically significant (P = 0.06). Serum LH values increased during the first 3 months of follow-up from 10.4 +/- 5.4 to 15.6 +/- 7.3 IU/L (P less than 0.0001) and then remained unchanged. Significant decreases in GnRH- and hCG-stimulated testosterone levels also indicated an impairment of Leydig cell function. FSH levels increased (P less than 0.0001) during the first 3 months of follow-up from 21.8 +/- 11.1 to 33.2 +/- 13.2 IU/L. We conclude that localized irradiation of 20 Gray eradicated carcinoma in situ germ cells. Development of a second testicular cancer has until now been prevented. Leydig cell function was partially impaired by the radiation dose given.     

Extracochlear eight-channel electrode system

The Cologne-Düren research group has developed a new extracochlear eight-channel electrode system. The first observations on six cases have shown encouraging psychoacoustic results.