著者

Nobutake Matsuo Tomohiro Ishii John I Takayama Masayuki Miwa Tomonobu Hasegawa

出版者

(社)日本内分泌学会

雑誌

Endocrine Journal (ISSN:09188959)

巻号頁・発行日

pp.EJ14-0069, (Released:2014-06-13)

被引用文献数

4 21

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The present study set forth the reference values for penile size and determined the prevalence of buried penis in Japanese full-term newborns. The stretched penile length was measured and the presence of buried penis was assessed at 1-7 days of age in 547 Japanese full-term newborn infants born between 2008 and 2012 in Tokyo. The stretched penile lengths were compared at 1-12 hours and 1-7 days of age in 63 infants and by two observers in 73 infants to estimate postnatal changes and interobserver variation, respectively. The mean stretched penile length was 3.06 cm (SD, 0.26; 95% confidence interval [CI], 3.04-3.08) and the mean ratio of penile length to body length was 6.24×100-1 (SD, 0.55×100-1), both of which were significantly smaller than those in Caucasian newborn infants. Buried penis was identified in 20 of 547 infants (3.7%; 95% CI, 2.1-5.2%). The first measurements of penile length at 1-12 hours were significantly smaller than the next measurements at 1-7 days (95% CI of the difference, 0.22-0.34). The 95% CI for the limits of agreement in the penile lengths measured by the two observers was -0.58 to -0.40 for the lower limit and 0.33 to 0.51 for the upper limit. These findings indicate that the penile length should be assessed after 24 hours of age by the reference standard of the same ethnicity for identifying micropenis and that buried penis is not uncommon in Japanese full-term newborns.

著者

Goro Sasaki Tomohiro Ishii Naoaki Hori Naoko Amano Keiko Homma Seiji Sato Tomonobu Hasegawa

出版者

The Japan Endocrine Society

雑誌

Endocrine Journal (ISSN:09188959)

巻号頁・発行日

vol.66, no.9, pp.837-842, 2019 (Released:2019-09-28)

参考文献数

30

被引用文献数

3 11

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Steroid 5α-reductase type 2 deficiency (5αRD2) is a congenital disorder of sex development caused by impairment of conversion from testosterone (T) to 5α-dihydrotestosterone (DHT). DHT deficiency leads to various degrees of undervirilized external genitalia including micropenis, primarily correlated with mutations of the SRD5A2 gene that encodes 5α-reductase type 2. Four Japanese boys with isolated micropenis were diagnosed as 5αRD2 by elevated ratios of serum T/DHT, and decreased ratios of urinary 5α/5β-reduced steroid metabolites. Genetic analyses for SRD5A2 identified that the four patients shared a hypomorphic mutation R227Q that has a residual activity related to the mild-form of 5αRD2. For prepubertal micropenis, DHT was transdermally applied to the four patients at the ages of 4–11 year, increasing a median of stretched penile lengths (SPLs) from 2.6 cm (–2.5 SD) to 4.4 cm (–0.2 SD). Nevertheless, the post-pubertal penile growth was apparently retarded, despite normal levels of T secreted from well-developed testes. The second course of DHT treatment underwent at ages of 12–18 year, but unable to normalize SPLs at a range of 6.0 to 7.0 cm (–3.4 to –2.4 SD). The prostate volumes of two patients were variable at 8.1 and 21 cm3, and a sperm cell count of one patient was normal as young adult. DHT treatment contributes to development of the penis and prostate, which are favorable for the potential fertility of 5αRD2 adults. Meanwhile, the retarded penile growth and a risk of prostate overgrowth may complicate the post-pubertal management with DHT for 5αRD2 males.

著者

Yurie Kobashi Kazato Saeki Masaharu Tsubokura Lihorn Srou Tiny Prum Norifumi Kuratani Tomohiro Ishii Kayako Sakisaka

出版者

THE JAPANESE ASSOCIATION OF RURAL MEDICINE

雑誌

Journal of Rural Medicine (ISSN:1880487X)

巻号頁・発行日

vol.15, no.2, pp.57-62, 2020 (Released:2020-04-01)

参考文献数

15

被引用文献数

1

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Objective: The surgical workforce needs to at least double by 2030. To increase the workforce, training for non-physician healthcare professionals and community health workers (CHWs) in rural areas is promising to decrease the numbers of untreated surgical patients. Nevertheless, few studies have been conducted on surgical activities of non-physician healthcare professionals and CHWs in rural Cambodia. We sought to measure the level of knowledge of surgical symptoms, and identify factors associated with it. A questionnaire survey was administered to people in rural areas of Kratie Province to determine their knowledge of surgical symptoms, and to strengthen the surgical workforce among medical staff and CHWs.Patient/Materials and Methods: To evaluate the knowledge of surgical symptoms among medical staff and CHWs, a self-reported questionnaire was administered to medical staff, CHWs, and villagers in a rural area of Kratie province, Cambodia. The rating score of the number of correct answers among medical staff, CHWs, and villagers was set as the primary outcome.Results: A total of 91 participants, including 31 medical staff, 24 CHWs, and 36 villagers, completed the survey. The median scores for knowledge of symptoms indicative of surgery were 8 (7–8) [median (interquartile range)] in medical staff, 8 (7–8.5) in CHWs, and 8.5 (8–9) in villagers. There was no significant difference in the scores of surgical symptoms among each of the occupational groups. The group of people who recognized low subjective knowledge of surgical symptom by themselves had significantly higher objective score of knowledge of surgical symptom.Conclusion: Knowledge of surgical symptoms among medical staff and CHWs was inadequate. To at least double the surgical workforce by 2030 successfully, accurate evaluation and improvement of surgical symptomatic knowledge among medical staff in rural areas is crucial.