Chakraborty J, Sinha Hikim A P, Jhunjhunwala J S
J Androl. 1985 Sep-Oct;6(5):291-9. doi: 10.1002/j.1939-4640.1985.tb00848.x.
Bilateral testicular biopsies from four men with a short duration (3 hours 10 minutes to 4 hours 30 minutes) of unilateral spermatic cord torsion and testicular biopsies from six men with irreversible brain death were used for the present investigation. Extensive light and electron microscopic studies and quantitative analyses of all biopsy materials were performed. The torsioned testes revealed variable degrees of damage to the seminiferous tubules, including germ cell disorganization and sloughing of immature germ cells. Ninety-five percent of the blood vessels from the biopsied tissue specimens were clogged with blood cells. The seminiferous tubules of the contralateral testis had normal germ cell arrangements and counts. However, 88% of the microvessels from the tissue biopsied from the contralateral testes were packed with blood cells, whereas only 10% of the blood vessels in the control biopsy specimen were clogged with blood cells. At the electron microscopic level, fewer tight junctions and enlarged pores were found between the endothelial cells of the affected vessels, and microvilli were completely absent from these endothelial cells. The clogging caused by blood cells in the affected vessels was so severe that no space was found between the membrane of the endothelial cell and the membrane of the blood cells. It has been suggested that local clogging by blood is responsible for the initiation of degenerative changes in the testes of men with unilateral torsion of the spermatic cord.
本研究采用了4例单侧精索扭转病程较短（3小时10分钟至4小时30分钟）男性的双侧睾丸活检组织，以及6例不可逆脑死亡男性的睾丸活检组织。对所有活检材料进行了广泛的光镜和电镜研究及定量分析。扭转侧睾丸的生精小管显示出不同程度的损伤，包括生殖细胞排列紊乱和未成熟生殖细胞脱落。活检组织标本中95%的血管被血细胞堵塞。对侧睾丸的生精小管生殖细胞排列和计数正常。然而，对侧睾丸活检组织中88%的微血管被血细胞充满，而对照活检标本中只有10%的血管被血细胞堵塞。在电镜水平上，发现受影响血管的内皮细胞之间紧密连接减少、孔隙增大，这些内皮细胞完全没有微绒毛。受影响血管中血细胞造成的堵塞非常严重，在内皮细胞膜和血细胞膜之间没有发现间隙。有人提出，血液的局部堵塞是导致单侧精索扭转男性睾丸发生退行性变化的原因。
