The incidence of sterility in the male is very important for the all childless marriages and the sufficient density of sperm cells in a semen specimen has close relation to fertility. The cause of sterility in the male has its base on aspermatism, impossibility of impregnation of spermatozoa and the pathological changes of component of semen specimen.
The author had 32 cases complaining sterility in our clinic and especially examined the existence of spermatozoa in semen specimen. Among 32 cases its normal density was found in 17 cases, oligozoöspermia in 3 cases necrozoöspermia in one case, azoöspermia in 9 cases, necrozoöspermia with oligozoöspermia in one case and impotencia coeund in one case.
From the first the number of sperm cells in a semen specimen varies from very many to none. (polyzoöspermia, oligozoöspermia and azoöspermia) And it is necessary to know that the azoöspermia is sometimes a temporary condition and the sexual overloading produces bad breeding record. In a word it is important to have sufficient density of sperm cells in fertilization.
The sterility after the epididymitis was discussed and many opinions were published. From my record by both bilateral and lateral epididymitis the author found some obstruction of sperm cell's transportation. But azoöspermia was found only in one case each on both bilateral and lateral epididymitis.

抄録全体を表示

ヒトの性決定は精巣により決定され, Y染色体上のSRYに依存する.未分化性腺は, SRYが存在するときには精巣に,存在しない時には卵巣に分化する. SRYが性腺決定のswitchをonにすることによりX染色体や常染色体の性腺決定遺伝子が発現し,性の分化発達が起こる.これらの過程のいずれかに異常が生じた場合,性分化異常或いは性発達異常が起こる.

抄録全体を表示

Out of the two functions constituting male sexual functions, the reproductive and the coital one, the author has made a clinical study on the latter, that is, insufficiency and impotence in the narrow sense, which has hitherto been paid little scientific attention to. The sutudy has been on psychic impotence which accounts for the most part of clinical cases and on endocrine (androgen deficient) impotence which were found conciderable in frequency.
(1) The author has defined impotence as the deficiency of one or two factors of sexual pattern, that is, sexual desire, erection, ejaculation, and orgasm.
(2) The author's causal classification of 130 cases he treated is as follows: -a) organic cause: -penile (malformation or disease) 1.5%: endocrine (pituitary, testicular, or adrenal deficiency) 21.5%: nervous (central or distal motility, or sensory nerve damage) 4.6%. b) functional cause: -psychic (psychological 8 cases, psychic 81 cases which is 62.3%) 68.5%. c) other causes (urological cause by the disease in the urethra, in the accessory sexual glands, or by operation or external injury, diabetes mellitus, chronic consumption, physiological defect) 3. 8%. It is notworthy that out of the urological out-patient the psychic cause accounts for more than 50%.
(3) Various psychic causes inhibiting the male sexual pattern were the basic factors, as the authors calls, of psychic impotence and the classification of 89 cases he treated is as follows: -sexual organ inferiority 6 cases, new marital condition 23 cases, abnormal sexual behavior 16 cases, disease anxiety or fear of disease 24 cases, suppression from the wife 3 cases, fear of conception 1 case, subconscious homosexuality 1 case, neurosis sign 8 cases, and unknown 5 cases.
(4) The classification by age groups of psychic impotence is as follows: -the young group below 30 years old 45 cases, the prime-of-life group between 30 to 40 years old 18 cases, the more elderly and old age group 26 cases.
(5) The author found that there was a characteristic difference between the basic factor of the young-group psychic impotence and that of the elderly-and-old-age-groups psychic impotence. The formation process of psychic impotence was that it originated from the individual's unconscious fear, doubt, anxiety, inhibitory idea about his own sexual function.
(6) The treatment of psychic impotence was conducted primarily by psychotherapy through the interview at a regular interval and secondarily by medical therapy as a kind of trigger to cure. This method was sufficient and the most suitable even for a urologist.
(7) The author's therapeutic result was that, out of 19 cases of new-marital impotence which is typical of young-group impotence, 10 cases were successful, 2 cases unsuccessful, and uncertain of result 7 cases: and that, out of 22 cases of elderly-and-old-age-group impotence, 10 cases were successful, 5 cases improved, 7 cases uncertain.
(8) Endocrine impotence he treated was 28 cases and the classification of factors were that 17 cases were counted for the upper-central-nervous disorder, out of which 13 cases eunuchoidism: testicular disorders were 11 cases, out of which 8 cases post-pubertal castration, and 3 cases testicular atrophy.
(9) The characteristic features of sexual pattern in endocrine impotence were that sexual desire generally declined, erotic erection and reflexible erection were damaged to various degrees, ejaculation decreasing and orgasm weakened.
(10) Sexual function of castrate could be maintened and kept under control by supplying him with androgen. The author made investigation on the most efficacious method for it.

抄録全体を表示

CHAPTER I Urinary 17-KS
As a fundamental study on the effects of castration and of the administration of sexual hormone on a living body (male), determination of urinary 17-KS was conducted using clinical patients and rabbits as subjects with the following results obtained.
1. Both in human beings and rabbits, urinary 17-KS showed a temporary decrease as a result of castration and then returned to the former state after a certain period of time. This was also the case when unilateral orchiectomy was carried out, only the extent of decrease was slight and the length of time during which it returned to normalcy was shorter.
2. When hexestol (4, 4-Dihydroxy-γ, δ-diethyl-n-hexane) was administered, urinary 17-KS showed a low value permanently, and in the case of P. H. P. (Parahydroxy-propiophenone) it showed a temporary low value as in the case of castration. Honvan (Diethyl dioxystilben-diphosphate) showed a tendency of slight decrease, but the change was not remarkable.
3. When a comparison was made between the administration of estrogene and castration, the decrease of urinary 17-KS was permanent in the former case, and temporary in the latter. Judging from this, it seems advisable in the antiandrogenic therapy of prostatic carcinoma to administer estrogene continuously following castration.
4. In the case of rabbits which underwent bilateral adrenoectomy after castration, urinary 17-KS decreased almost to naught, and in cases where cortisone was administered after castration, it also decrease to between one-third and one-fifth the normal value. Judging from this, it seems that this therapy is worth trying in treating prostatic carcinoma resistant for female hormone though it is open to criticism from various quarters.
5. When testosterone propionate was administer continuously to rabbits simultaneously with bilateral orchiectomy, urinary 17-KS decreased to a slight extent and was restored to the former state in a short time.
6. In the case of testicular insufficiency or dysfunction of sexual gland, the decrease of urinary 17-KS was not striking in many cases owing to the compensative function of the suprarenal gland. It is thought, therefore, that urinary 17-KS plays no more than a secondary part in diagnosing these diseases.
CHAPTER II Humoral Metabolism
In order to investigate the effects of orchiectomy and the administration of sexual hormone on the living body (male), serum electrolyte (Na, Cl, K), body fluid (total body fluid, intracellular and extracellular fluid, circulating blood plasma, circulating blood, intercellular fluid, hematocrit index) and serum protein (volume, analysis, lipoprotein and glucoprotein analysis) were determined. The weight of the kidney and suprarenal gland and their tissue respiration were also determined, with the following results.
1. In the case of dysfunction of sexual gland (eunuchoidism, testicular retention, impotent), no changes in various body fluid metabolites were striking, and in the case of parasexual gland (prostatic hypertrophy and carcinoma) the changes in various body fluid metabolites were not remarkable so long as no dysfunction of kidney or general hyposthenia existed.
2. Orchiectomy, the administration of female hormone, P. H. P. and of Honvan as an antiandrogenic therapy for prostatic carcinoma have a slight effect, if any, on body fluid metabolites. When female hormone was sdministered, however, a decrease of volume of serum protein and increase of γ-globurin were perceived.
3. As a result of orchiectomy of male rabbits, changes appeared in various metabolites (total body fluid, intracellular and extracellular fluid, circulating blood, circulating blood plasma, intracellular fluid, Na, Cl, K, serum protein, A/G index, γ-globurin). But they were only temporary, and returned to normalcy in a short time. The suprarenal gland trophied, and seemed to make recompense.
4. When hexestrol was administered to male rabb

抄録全体を表示