Hideki Fuse

Internal spermatic vein prostaglandins in varicocele patients

Blood was collected from 20 patients with varicocele (15 in the infertile group and 5 in the incidental varicocele group) at the time of high ligation by insertion of a catheter into the internal spermatic vein toward the renal side. Simultaneously, blood was obtained from the antecubital vein. The levels of cortisol, prostaglandin (PG)(A + B), PGE, and PGF in these blood samples were measured. Although no differences in cortisol and PG(A + B) levels were observed between internal spermatic and peripheral vein bloods in varicocele patients examined, PGE and PGF levels were higher in internal spermatic venous bloods than in peripheral venous bloods. Differences in PGF levels between the samples of blood from the internal spermatic vein and from the peripheral vein in cases of the infertile group were larger than those of the incidental varicocele group. PGE and PGF in internal spermatic vein blood samples were correlated. The possibility that PGE and PGF, refluxed from the renal vein to the testes via the internal spermatic vein in varicocele patients, disturbs spermatogenesis is discussed.

Treatment of hemospermia caused by dilated seminal vesicles by direct drug injection guided by ultrasonography.

Bilateral seminal vesicle puncture and injection of drugs with ultrasound guidance were performed in patients with hemospermia resistant to conservative therapy and with dilated seminal vesicles. Of 7 patients 6 had resolution of hemospermia for 2 to 3 months and then relapse. No side effect was noted.

A case of decapitated spermatozoa in an infertile man

Summary A case of headless or decapitated spermatozoa of an infertile man is reported. The 33‐year‐old patient showed almost normal spermi‐ogram except for a high percentage (more than 90%) of headless spermatozoa. Both hypoosmotic swelling and zona‐free hamster egg tests showed that most headless spermatozoa appeared to be normal in their function as tails. The ultrastructure of the ejaculated spermatozoa was observed using a surface replica method and by conventional ultrathin sectioning. The headless spermatozoa were almost normal in structure except for the absence of the head. Tailless heads were rarely observed. Varieties of ultrastructural abnormalities were observed in spermatozoa heads. Among them, abnormalities in the nuclear membrane covering the posterior pole of the nucleus were prominent. The implantation fossa and the basal plate were not formed. Instead, the nuclear membrane with numerous nuclear pores was found in this region. The decapitation seemed to take place between the region of the basal plate and the proximal centriole.

A case of an infertile man with short-tailed spermatozoa

Summary. Ejaculated spermatozoa from an infertile patient were examined by scanning and transmission electron microscopy. All spermatozoa had abnormalities in the tail region. The abnormalities were divided into three types:

Ultrasonography of testicular tumors.

The ultrasonograms obtained from 20 cases with testicular tumors were reviewed to correlate the ultrasonographic findings with the histologic features. Some seminomas and all metastatic tumors (leukemia, malignant lymphoma and prostatic cancer) showed homogeneous and hypoechoic findings ultrasonographically. All nonseminomatous germ cell tumors had heterogeneous findings on ultrasonography. In patients with leukemia or malignant lymphoma, ultrasonography can serve as a marker in assessing the efficacy of chemotherapy or in the early diagnosis of recurrence. Scrotal ultrasonography also seems to be useful in detecting the small tumor and seems to be convenient for the follow-up of the contralateral testis of a patient who has undergone extirpation of a testicular tumor.

Androphilic protein studied histochemically in stage D2 prostatic cancer.

Androphilic protein in prostatic cancer was histochemically observed with dihydrotestosterone (DHT), R 1881, and mibolerone as ligands. Cancer cells were equally stained with fluorescent R 1881 and mibolerone, and this fluorescence seems to be made up of both the androgen receptor and progestin‐binding protein. The staining with fluorescent DHT was weak. Sixty‐two Stage D2 prostatic cancer patients were examined with histochemical androphilic protein, and they then received endocrine therapy. The presence of fluorescence of R 1881 was not correlated with grade, but a relationship between the presence of fluorescence and the response to endocrine therapy was noticed 6 months after the start of treatment. Moreover, fluorescence‐positive patients showed better survival than fluorescence‐negative patients. An examination with fluorescent DHT revealed a similar tendency to that of R 1881, but the frequency of positive fluorescence was lower, indicating that R 1881 is a suitable ligand in this type of study.

Aspiration and Tetracycline Sclerotherapy of Hydrocele

Seventeen patients with hydrocele of the testis were treated by aspiration of fluid and substitution with tetracycline supplemented with 1% lidocaine. In 15 patients (88%) symptoms disappeared by sclerotherapy. After sclerotherapy scrotal ultrasonography was useful to diagnose either relapse or thickened tunica vaginalis. No side effect was noticed.

Benign prostatic hypertrophy in a young male.

A 20-year-old male with complaints of dysuria and a sense of residual urine was diagnosed as having benign prostatic hypertrophy. He was treated by suprapubic prostatectomy. Benign prostatic hypertrophy in young men is very rare; this case seems to be the largest (380 g) among juvenile benign prostatic hypertrophy reported in the literature so far.

A Case of Klinefelter’s Syndrome with Bilateral Absence of the Vas Deferens

A 33-year-old male presented to the Chiba University Hospital with the main complaint of right flank pain. Bilateral vas deferens were not palpable. Hormonal examination revealed hypergonadotropic hypogonadism and cytogenetic studies a 47,XXY karyotype. The significance of the association of this karyotype with the absence of vas deferens is discussed.

Spontaneous rupture of the ureter of a patient with Cushing's syndrome.

A case of spontaneous rupture of the ureter with Cushings syndrome is presented. The fragility of the tissue in Cushings syndrome is thought to render the ureter more susceptible to rupture.