<abstract>Prepubertal boys treated for cancer may exhibit impaired fertility in later life. A number of chemotherapeu tic agents have been identified as being gonadotoxic, and certain treatment regimens, such as...<abstract>Prepubertal boys treated for cancer may exhibit impaired fertility in later life. A number of chemotherapeu tic agents have been identified as being gonadotoxic, and certain treatment regimens, such as that used for Hodgkin's disease, are particularly associated with subsequent infertility. Radiotherapy may also cause gonadal damage, most notably following direct testicular irradiation or total body irradiation. Because of the varied nature of the cytotoxic insult, it can be difficult to predict the likelihood of infertility in later life. Currently it is not possible to detect gonadal damage early due to the lack of a sensitive marker of gonadal function in the prepubertal age group.Semen cryopreservation is currently the only method of preserving fertility in patients receiving gonadotoxic therapy. This is only applicable to postpubertal patients and can be problematic in the adolescent age group. At present there is no provision for the prepubertal boy, although there are a number of experimental methods currently being investigated. By harvesting testicular tissue prior to gonadotoxic therapy, restoration of fertility could be achieved following treatment, either by germ cell transplantation or by in vitro maturation of the germ cells harvested. Alternatively, rendering the testes quiescent during cytotoxic treatment may protect the germ cells from subsequent damage. In addition to the many scientific and technical issues to be overcome prior to clinical application of these techniques, a number of ethical and legal issues must also be addressed to ensure a safe and realistic prospect for future fertility in these patients.展开更多
The renin angiotensin system(RAS)appears to influence male fertility at multiple levels.In this work,we analyzed the relationship between the RAS and DNA integrity.Fifty male volunteers were divided into two groups(25...The renin angiotensin system(RAS)appears to influence male fertility at multiple levels.In this work,we analyzed the relationship between the RAS and DNA integrity.Fifty male volunteers were divided into two groups(25 each):control(DNA fragmentation≤20%)and pathological(DNA fragmentation>20%)cases.Activities of five peptidases controlling RAS were measured fluorometrically:prolyl endopeptidase(which converts angiotensin[A]I and A II to A 1–7),neutral endopeptidase(NEP/CD10:A I to A 1–7),aminopeptidase N(APN/CD13:A III to A IV),aminopeptidase A(A II to A III)and aminopeptidase B(A III to A IV).Angiotensin-converting enzyme(A I to A II),APN/CD13 and NEP/CD10 were also assessed by semiquantitative cytometry and quantitative flow cytometry assays,as were the receptors of all RAS components:A II receptor type 1(AT1R),A II receptor type 2(AT2R),A IV receptor(AT4R or insulin-regulated aminopeptidase[IRAP]),(pro)renin receptor(PRR)and A 1–7 receptor or Mas receptor(MasR)None of the enzymes that regulate levels of RAS components,except for APN/CD13(decrease in fragmented cells),showed significant differences between both groups.Micrographs of RAS receptors revealed no significant differences in immunolabeling patterns between normozoospermic and fragmented cells.Labeling of AT1R(94.3%normozoospermic vs 84.1%fragmented),AT4R(96.2%vs 95.3%)and MasR(97.4%vs 87.2%)was similar between the groups.AT2R(87.4%normozoospermic vs 63.1%fragmented)and PRR(96.4%vs 48.2%)were higher in non-fragmented spermatozoa.These findings suggest that fragmented DNA spermatozoa have a lower capacity to respond to bioactive RAS peptides.展开更多
Objective To evaluate the prevalence of functional ovarian cysts in users of two different types of contraceptive implants. Methods A total of 239 women were enrolled at 3 months of use of the etonogestrelreleasing ...Objective To evaluate the prevalence of functional ovarian cysts in users of two different types of contraceptive implants. Methods A total of 239 women were enrolled at 3 months of use of the etonogestrelreleasing implant （Implanon） and the levonorgestrel-releasing implant （Jadelle）. Bimanual pelvic examination and vaginal ultrasound were performed during routine 3, 6 and 12-month visits of asymptomatic women（control group）. Women with ovarian cysts （or enlarged ovarian follicles 〉25 mm） （cysts group） were assessed weekly until disappearence or reduction of the image （including estradiol （E2） and progesterone measurement and women with no ovarian enlargement underwent same evaluation for the same period of time. Results Ovarian cysts were detected in 5.1% and 13.0% of users of Implanon and Jadelle, respectively, at 3rd month. At the 6th month of use, prevalences were 7.1% and 7.8%, and at 12th month rates were 25.7% and 14.7% in the two groups, respectively. E2 levels were significantly higher in cysts group than in control group. The time until disappearance of the ovarian cyst was similar in Implanon and Jadelle group. There were more cases of menorrhagia in patients rveth ovarian cysts than in patients with no ovarian enlargement. Conclusions The finding of ovarian cysts or enlarged ovarian follicles during the first year of use of Implanon and Jadelle implants is common and transient and should not be interpreted as a pathologic ovarian cyst. No further medical interventions are necessary.展开更多
Introduction and Aim: Vitamin K acupuncture point injection is an effective and safe menstrual pain treatment derived from Traditional Chinese Medicine, commonly used in some Chinese hospitals. This case series invest...Introduction and Aim: Vitamin K acupuncture point injection is an effective and safe menstrual pain treatment derived from Traditional Chinese Medicine, commonly used in some Chinese hospitals. This case series investigated the effectiveness and safety of vitamin K acupuncture point injection on menstrual pain in patients with severe primary dysmenorrhea at a regional public health clinic at Bologna, Italy. Methods: From September 2006 to July 2010, 24 women were enrolled and treated during their first day of menstrual pain with an injection of 1 ml of solution containing 5 mg of vitamin K1 in an acupuncture point San Yin Jiao/Spleen 6 (SP6) bilaterally on the inside of each lower leg above the ankle. Results: Treatment was well tolerated and no major adverse events were reported. Pain relief was observed starting from 2 minutes after treatment and within 30 minutes. All treated women but one (96%) reported a substantial pain reduction (p 0.001). During the six post-treatment follow-up cycles, a trend toward a reduction of menstrual distress evaluated by the Cox Pain Intensity and Duration Scales was documented. Women reported fewer daily life restrictions and consumption of fewer analgesic tablets when compared to what they reported at the pre-treatment cycle. Conclusions: The results of this case series indicate that in primary dysmenorrhea a single vitamin K1 injection in the SP6 acupuncture point has an immediate pain-relieving effect and may ameliorate menstrual pain intensity and duration in post-treatment follow-up cycles.展开更多
文摘<abstract>Prepubertal boys treated for cancer may exhibit impaired fertility in later life. A number of chemotherapeu tic agents have been identified as being gonadotoxic, and certain treatment regimens, such as that used for Hodgkin's disease, are particularly associated with subsequent infertility. Radiotherapy may also cause gonadal damage, most notably following direct testicular irradiation or total body irradiation. Because of the varied nature of the cytotoxic insult, it can be difficult to predict the likelihood of infertility in later life. Currently it is not possible to detect gonadal damage early due to the lack of a sensitive marker of gonadal function in the prepubertal age group.Semen cryopreservation is currently the only method of preserving fertility in patients receiving gonadotoxic therapy. This is only applicable to postpubertal patients and can be problematic in the adolescent age group. At present there is no provision for the prepubertal boy, although there are a number of experimental methods currently being investigated. By harvesting testicular tissue prior to gonadotoxic therapy, restoration of fertility could be achieved following treatment, either by germ cell transplantation or by in vitro maturation of the germ cells harvested. Alternatively, rendering the testes quiescent during cytotoxic treatment may protect the germ cells from subsequent damage. In addition to the many scientific and technical issues to be overcome prior to clinical application of these techniques, a number of ethical and legal issues must also be addressed to ensure a safe and realistic prospect for future fertility in these patients.
基金This work was supported by grants from the University of the Basque Country(UPV/EHU GIU 17/19)the Gangoiti Barrera Foundation(Basque Country).
文摘The renin angiotensin system(RAS)appears to influence male fertility at multiple levels.In this work,we analyzed the relationship between the RAS and DNA integrity.Fifty male volunteers were divided into two groups(25 each):control(DNA fragmentation≤20%)and pathological(DNA fragmentation>20%)cases.Activities of five peptidases controlling RAS were measured fluorometrically:prolyl endopeptidase(which converts angiotensin[A]I and A II to A 1–7),neutral endopeptidase(NEP/CD10:A I to A 1–7),aminopeptidase N(APN/CD13:A III to A IV),aminopeptidase A(A II to A III)and aminopeptidase B(A III to A IV).Angiotensin-converting enzyme(A I to A II),APN/CD13 and NEP/CD10 were also assessed by semiquantitative cytometry and quantitative flow cytometry assays,as were the receptors of all RAS components:A II receptor type 1(AT1R),A II receptor type 2(AT2R),A IV receptor(AT4R or insulin-regulated aminopeptidase[IRAP]),(pro)renin receptor(PRR)and A 1–7 receptor or Mas receptor(MasR)None of the enzymes that regulate levels of RAS components,except for APN/CD13(decrease in fragmented cells),showed significant differences between both groups.Micrographs of RAS receptors revealed no significant differences in immunolabeling patterns between normozoospermic and fragmented cells.Labeling of AT1R(94.3%normozoospermic vs 84.1%fragmented),AT4R(96.2%vs 95.3%)and MasR(97.4%vs 87.2%)was similar between the groups.AT2R(87.4%normozoospermic vs 63.1%fragmented)and PRR(96.4%vs 48.2%)were higher in non-fragmented spermatozoa.These findings suggest that fragmented DNA spermatozoa have a lower capacity to respond to bioactive RAS peptides.
基金This study received partial financial support from the Fundaǎo de Amparo a Pesquisa do Estado de So Paulo (FAPESP), Brazil under award #03/083917.
文摘Objective To evaluate the prevalence of functional ovarian cysts in users of two different types of contraceptive implants. Methods A total of 239 women were enrolled at 3 months of use of the etonogestrelreleasing implant （Implanon） and the levonorgestrel-releasing implant （Jadelle）. Bimanual pelvic examination and vaginal ultrasound were performed during routine 3, 6 and 12-month visits of asymptomatic women（control group）. Women with ovarian cysts （or enlarged ovarian follicles 〉25 mm） （cysts group） were assessed weekly until disappearence or reduction of the image （including estradiol （E2） and progesterone measurement and women with no ovarian enlargement underwent same evaluation for the same period of time. Results Ovarian cysts were detected in 5.1% and 13.0% of users of Implanon and Jadelle, respectively, at 3rd month. At the 6th month of use, prevalences were 7.1% and 7.8%, and at 12th month rates were 25.7% and 14.7% in the two groups, respectively. E2 levels were significantly higher in cysts group than in control group. The time until disappearance of the ovarian cyst was similar in Implanon and Jadelle group. There were more cases of menorrhagia in patients rveth ovarian cysts than in patients with no ovarian enlargement. Conclusions The finding of ovarian cysts or enlarged ovarian follicles during the first year of use of Implanon and Jadelle implants is common and transient and should not be interpreted as a pathologic ovarian cyst. No further medical interventions are necessary.
文摘Introduction and Aim: Vitamin K acupuncture point injection is an effective and safe menstrual pain treatment derived from Traditional Chinese Medicine, commonly used in some Chinese hospitals. This case series investigated the effectiveness and safety of vitamin K acupuncture point injection on menstrual pain in patients with severe primary dysmenorrhea at a regional public health clinic at Bologna, Italy. Methods: From September 2006 to July 2010, 24 women were enrolled and treated during their first day of menstrual pain with an injection of 1 ml of solution containing 5 mg of vitamin K1 in an acupuncture point San Yin Jiao/Spleen 6 (SP6) bilaterally on the inside of each lower leg above the ankle. Results: Treatment was well tolerated and no major adverse events were reported. Pain relief was observed starting from 2 minutes after treatment and within 30 minutes. All treated women but one (96%) reported a substantial pain reduction (p 0.001). During the six post-treatment follow-up cycles, a trend toward a reduction of menstrual distress evaluated by the Cox Pain Intensity and Duration Scales was documented. Women reported fewer daily life restrictions and consumption of fewer analgesic tablets when compared to what they reported at the pre-treatment cycle. Conclusions: The results of this case series indicate that in primary dysmenorrhea a single vitamin K1 injection in the SP6 acupuncture point has an immediate pain-relieving effect and may ameliorate menstrual pain intensity and duration in post-treatment follow-up cycles.
