性釋素(GnRH)主要透過與腦垂體細胞膜上的受體結合,活化磷脂酶C,進而產生肌醇三磷酸(IP3),促使細胞內鈣離子釋放,引發一系列的細胞內信號傳導,最終刺激腦垂體前葉分泌促濾泡激素(FSH)和黃體生成素(LH),達到調節生殖功能的目的。
Gonadotropin-releasing hormone (GnRH) primarily acts by binding to specific receptors on pituitary cells, activating phospholipase C. This enzyme catalyzes the production of inositol triphosphate (IP3), which triggers the release of intracellular calcium ions. The subsequent intracellular signaling cascade ultimately stimulates the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH), thereby regulating reproductive function.
男性生殖系統
睪丸
精子發生過程的位置是男性生殖系統的數個結構。最開始的階段發生在睪丸,一直到附睪結束。附睪是發展中的精子成熟和儲存直到射精的地方。
曲細精管
曲細精管,又稱生精小管,位於睪丸。主要功能為產生精子
精子
主要在睪丸中生成,並且在附睾(epididymis)中進一步成熟和儲存,不是主要儲存在儲精囊(seminal vesicle)中。儲精囊(seminal vesicle)主要分泌精液的成分,與精子的生成和儲存無直接關聯。
人類精子最適生存溫度略低於體溫,大約在 34-36℃ 之間。
人類的精子和卵子是生殖細胞,它們各自擁有23個染色體,總共46個染色體。這是因為在有性生殖中,精子和卵子各自提供一半的染色體數量,當它們結合時,就會形成一個具有完整染色體數量的受精卵,即46個染色體。
인간의 정자와 난자는 생식세포로, 각각 23개의 염색체를 가지고 있으며 총 46개의 염색체가 있습니다. 이것은 유성생식에서 정자와 난자가 각각 반씩의 염색체를 제공하며 결합할 때 완전한 염색체 수인 46개의 염색체를 가진 수정란이 형성되기 때문입니다.
濾泡刺激激素(Follicle-Stimulating Hormone,簡稱FSH)是由腦下垂體前葉分泌的一種激素。
在男性和女性的生殖系統中都扮演著重要角色。
在男性的生殖系統中,FSH的主要作用是刺激睪丸內的精子生成。
FSH通過刺激睪丸內的精子母細胞(稱為精原細胞)進行分裂和成熟,從而促進精子的生成。
폴리클 자극 호르몬(Follicle-Stimulating Hormone, FSH)은 뇌하수체 앞엽에서 분비되는 호르몬입니다. 남성과 여성의 생식계에서 중요한 역할을 합니다. 남성의 생식계에서 FSH의 주요 작용은 고환 내 정자 생성을 자극하는 것입니다. FSH는 고환 내에서 정자 전구세포(정자의 어머니 세포로 불리는)를 분열 및 성숙시켜 정자 생성을 촉진합니다
精囊
精囊的功能主要是分泌呈弱嗜鹼性的淡黃色黏稠液體,占精液的70%,有營養和稀釋精子的功能。 其主要成分有果糖(ructose)、多種氨基酸、纖維蛋白原、前列腺素和枸櫞酸(citri,acid),其中果糖有營養精子和促進增強精子活動的主要物質。
精囊:又稱儲精囊,位於膀胱底部的後側,輸精管壺腹部的外側,左右各一,主要功能是在提供及儲存精液,但並不儲存精子
輸精管
附睾下端向上,從陰囊上升,穿過腹股溝管進入盆腔內,其末端與精囊腺的排泄管匯合成射精管,開口於尿道的前列腺部
前列腺
恥骨聯合的後面,膀胱的下方
有關良性前列腺肥大症狀與導因
良性前列腺肥大(BPH)是一種常見於中老年男性的泌尿系統疾病。隨著年齡增長,前列腺會逐漸增生,壓迫尿道,導致一系列排尿問題,需進行肛門指診檢查
常見症狀:
膀胱儲存症狀: 頻尿、夜尿、尿急等。這些症狀主要源於前列腺增生導致尿道阻塞,使得膀胱無法完全排空,膀胱過度活躍而引起。
排尿困難: 尿流變細、變弱、尿流中斷、排尿時間延長等。這是因為前列腺增生壓迫尿道,增加了排尿阻力。
其他症狀: 血尿、尿失禁等。
成因:
BPH的確切成因尚未完全清楚,但與年齡、荷爾蒙變化等因素有關。隨著年齡增長,男性體內的雄性激素會轉化為一種物質,刺激前列腺細胞增生。
病理生理機轉:
膀胱出口阻塞: 前列腺增生壓迫尿道,導致尿道狹窄,增加排尿阻力。
膀胱過度活躍: 為了克服排尿阻力,膀胱會過度收縮,導致頻尿、尿急等症狀。
膀胱憩室形成: 長期膀胱出口阻塞,膀胱壁承受過大壓力,可能形成向外的囊袋狀突起,即膀胱憩室。
泌尿道感染: 尿液滯留為細菌提供了繁殖的溫床,容易引起反覆泌尿道感染,進而導致膀胱壁增厚。
常見誤解澄清:
頻尿和夜尿不是「代償現象」: 而是由於膀胱出口阻塞導致膀胱無法完全排空所致。
尿流速變慢不是因為內括約肌鬆弛: 主要原因是前列腺增生壓迫尿道。
鼠蹊部疝氣(inguinal hernia)
嚴重時,擠入鼠蹊管(inguinal canal)的腸子,最容易直接壓迫到精索(spermatic cord)
女性內外生殖器官
前庭球(bulb of vestibule)位於陰蒂的內側。它位於陰道前庭,接近於陰蒂、陰蒂腳,並在尿道、尿道海綿體和陰道的兩側。
尿道外口(external urethral orifice)介於陰蒂與陰道口之間
陰蒂包皮(prepuce)是連接兩側小陰唇的皮膚皺褶
陰道前庭(vaginal vestibule)是介於兩側小陰唇之間的區域
血液供應主要來自:卵巢動脈、子宮動脈、陰道動脈及陰部內動脈。
子宮
子宮頸部(cervix)
子宮頸部(cervix)直接與陰道(vagina)相接,可以藉由陰道擴張器(vaginal dilator)直接觀察檢測
Bishop 計分法評估
Bishop 計分法是一種用來評估產婦子宮頸成熟度的方法,藉此預測陰道分娩的成功率,以及引產是否能順利進行。
評估的項目
Bishop 計分法主要評估以下五個項目,每個項目給予0-3分:
子宮頸擴張 (Cervical dilatation):
0公分: 子宮頸完全閉合。
1-2公分: 子宮頸開始擴張,但進展緩慢。
3-4公分: 子宮頸擴張進一步,進入活躍期。
5-7公分: 子宮頸擴張迅速,接近全開。
10公分: 子宮頸完全擴張,可以讓胎兒通過。
子宮頸消退 (Cervical effacement):評估子宮頸變薄的程度。
子宮頸位置 (Cervical position):評估子宮頸的位置
子宮頸硬度 (Cervical consistency):評估子宮頸的軟硬程度。
胎頭位置 (Station):評估胎頭下降進入骨盆的程度。
評分標準
0分: 表示子宮頸尚未成熟,離分娩還有一段時間。
1-3分: 表示子宮頸成熟度中等,可能需要一些時間才能分娩。
7-10分: 表示子宮頸已經很成熟,可以考慮進行陰道分娩。
子宮肌膜(英語:myometrium)
也稱子宮肌層,是子宮壁的中間層,包括主要的子宮平滑肌細胞(uterine smooth muscle,也稱子宮肌,uterine myocytes),也包括一些間質及血管組織。 它主要的功能是進行子宮收縮。
病理性收縮環
生產過程中,子宮會規律且強烈的收縮,目的是將胎兒娩出。然而,當收縮過於強烈或過於頻繁時,就可能導致病理性收縮環的形成。
During childbirth, the uterus undergoes regular and strong contractions to expel the fetus. However, when these contractions become excessively strong or frequent, they can lead to the formation of a pathological retraction ring.
病理性收縮環是指子宮收縮過強、過久,導致胎盤供氧不足,可能影響胎兒的健康。
A pathological retraction ring refers to a condition where the uterus contracts so vigorously and for such a prolonged period that placental blood flow is compromised, potentially endangering the fetus.
引起的原因有:子宮過度興奮、胎兒過大、子宮異常等因素有關
子宮圓韌帶(round ligament)
支持子宮的韌帶中,子宮圓韌帶(round ligament)是位於子宮兩側的兩條韌帶,起於子宮側壁上部,輸卵管附著部稍下方,向下經過腹股溝管,經過鼠蹊管(inguinal canal)連結到大陰唇(labia majora)上部,作用是幫助子宮維持前傾。
Among the ligaments that support the uterus, the round ligament is a pair of ligaments located on either side of the uterus. It originates from the upper part of the lateral wall of the uterus, slightly below the attachment of the fallopian tube, and extends downward through the inguinal canal, connecting to the upper part of the labia majora. The round ligament helps to keep the uterus in a forward position.
在懷孕期間,子宮圓韌帶會隨著子宮的增大而變長、增粗。在分娩時,子宮圓韌帶可以幫助胎兒通過產道。
During pregnancy, the round ligament lengthens and thickens as the uterus grows. During childbirth, the round ligament can help the baby pass through the birth canal.
子宮內膜/Endometrium
月經期Menstrual Phase
月經週期功能層會脫落剩下1mm基底層:子宮內膜整個緻密層和大部分的海綿層會成為月經。殘留的海綿層和基底層保留下來在下一次子宮內膜的增生期中進行再生。
During menstruation, the functional layer of the endometrium, consisting of the spongy and compact layers, is shed. Only a thin basal layer, approximately 1 mm thick, remains. This shedding results in menstrual bleeding. The basal layer serves as a regenerative source for the next menstrual cycle.
濾泡期Follicular Phase-增生期
卵巢中的濾泡發育,分泌雌激素,刺激子宮內膜增生。
In the ovary, follicles develop and produce estrogen, stimulating the proliferation of the endometrium.
增生期: 動情素「增生」子宮內膜。
The proliferative phase is when the uterine lining grows
排卵期Ovulation
成熟的卵子從卵巢排出。
A mature ovum is released from the ovary.
黃體期(即分泌期)Luteal Phase (Secretory Phase)
排卵後,卵泡形成黃體,分泌大量的黃體素,使子宮內膜繼續增厚,血管增生,腺體分泌,為受精卵著床做準備。
所以女性體內黃體素(progesterone)的含量在子宮週期中的分泌期(secretory phase) 最高。
如果沒有受精,黃體會退化,黃體素水平下降,子宮內膜剝落,再次進入月經期。
After ovulation, the ruptured follicle develops into a corpus luteum, which produces large amounts of progesterone. Progesterone causes the uterine lining to thicken further, blood vessels to grow, and glands to secrete, preparing the uterus for implantation of a fertilized egg. Therefore, progesterone levels in the female body are highest during the secretory phase of the menstrual cycle. If fertilization does not occur, the corpus luteum degenerates, progesterone levels decline, and the uterine lining sheds, resulting in menstruation.
分泌期: 黃體素「分泌」使內膜準備好迎接胚胎。
the secretory phase is when the lining is prepared for a baby.
卵巢
卵巢中的濾泡由卵母細胞和圍卵細胞組成。
The follicles in the ovaries are composed of oocytes and granulosa cells.
圍卵細胞又分為兩層,外層為顆粒細胞,內層為內鞘膜細胞。
The granulosa cells are further divided into two layers: the outer theca cells and the inner theca interna cells.
雄性素主要由卵巢和腎上腺分泌,由內鞘膜細胞合成雄性素的能力。
Androgens are primarily produced by the ovaries and adrenal glands, and the theca interna cells have the ability to synthesize androgens.
促卵泡激素 (FSH):FSH可以促進內鞘膜細胞合成雄性素。
Follicle-stimulating hormone (FSH) can promote the synthesis of androgens by the theca interna cells.
黃體生成素 (LH):LH可以抑制內鞘膜細胞合成雄性素。
Luteinizing hormone (LH) can inhibit the synthesis of androgens by the theca interna cells.
多囊卵巢綜合症 (PCOS):PCOS 患者的內鞘膜細胞可能會過度合成雄性素。
Polycystic ovary syndrome (PCOS) patients may have theca interna cells that overproduce androgens.
內鞘膜細胞合成的雄性素有下列作用:
The androgens synthesized by the theca interna cells have the following effects:
促進卵泡發育、調節排卵、維持女性生殖系統的健康
Promote follicular development, regulate ovulation, and maintain the health of the female reproductive system.
顆粒細胞(granulosa cells)參與雌激素(estrogen)的合成,濾泡內含23條染色體的卵母細胞(oocyte)和單一大濾泡腔(antrum)。
Granulosa cells are involved in the synthesis of estrogen. The follicle contains an oocyte with 23 chromosomes and a single large antrum.
卵母細胞
此為雌性生殖細胞,卵母細胞是未經減數分裂的生殖細胞,含有23條染色體。次級卵母細胞是卵母細胞經過減數分裂第一次分裂後的產物,含有23條染色體和一個極體。
人類絨毛膜促性腺激素(hCG)
是由受精卵著床後形成的滋養層細胞分泌的,可以維持黃體的功能,繼續分泌孕激素,以維持妊娠。
隨著胎盤的形成,hCG的分泌主要由胎盤負責。但早期胚胎階段,hCG主要由滋養層細胞分泌
Human chorionic gonadotropin (hCG) is a hormone secreted by the trophoblast cells after fertilization. It maintains the function of the corpus luteum, which continues to secrete progesterone to support pregnancy. As the placenta develops, the placenta becomes the primary source of hCG secretion. However, in the early stages of embryonic development, hCG is primarily secreted by the trophoblast cells.
遺傳性疾病
唐氏症
唐氏症是一種最常見的體染色體異常疾病,第 21 對染色體數目多了 1 條,導致染色體總數為 47 條。這種染色體異常可以發生在卵子或精子形成過程中,也可以發生在受精後的早期胚胎發育過程中。
Down syndrome is the most common autosomal chromosomal disorder. It is caused by an extra copy of chromosome 21, resulting in a total of 47 chromosomes. This chromosomal abnormality can occur during the formation of eggs or sperm, or in the early stages of embryonic development after fertilization.
研究表明,唐氏症的發生率和母親年齡呈正相關,即母親年齡越大,生下唐氏症寶寶的風險越高。這是因為隨著母親年齡的增長,卵子染色體的異常率也會增加。
而父親年齡對唐氏症發生率的影響較小,只有在父親年齡超過 55 歲時,才會略有增加。
Studies have shown that the incidence of Down syndrome is positively correlated with maternal age, meaning that the risk of having a child with Down syndrome increases as the mother's age increases. This is because the risk of chromosomal abnormalities in eggs increases with increasing maternal age.
The paternal age has a smaller impact on the incidence of Down syndrome. Only when the father's age is over 55 years old will the risk increase slightly.
唐氏症的發生率約為 1/1000。
The incidence of Down syndrome is about 1 in 1,000.
唐氏症患者通常有智力障礙、身體發育遲緩、面部特徵異常等症狀。
People with Down syndrome typically have intellectual disabilities, delayed physical development, and abnormal facial features.
唐氏症患者的平均壽命約為 60 歲。
The average life expectancy of people with Down syndrome is about 60 years old.
目前,唐氏症尚無治癒方法,但可以通過早期診斷和干預,改善患者的智力和生活水平。
There is currently no cure for Down syndrome, but early diagnosis and intervention can improve the intellectual and quality of life of people with Down syndrome.
唐氏症可以用 FISH(fluorescence in situ hybridization)輔助診斷。
Down syndrome can be diagnosed with the help of FISH (fluorescence in situ hybridization).
FISH 技術是一種分子生物學技術,可以用來檢測細胞中的特定染色體或基因。
FISH is a molecular biology technique that can be used to detect specific chromosomes or genes in cells. In the diagnosis of Down syndrome, FISH can be used to detect the number of chromosome 21.
產前診斷:可以用於孕婦的羊水穿刺或絨毛膜取樣檢查中,檢測胎兒是否患有唐氏症。
Prenatal diagnosis: FISH can be used in amniocentesis or chorionic villus sampling tests for pregnant women to detect whether the fetus has Down syndrome.
新生兒篩查:可以用於新生兒血液中,檢測是否存在唐氏症的先天性染色體異常。
Newborn screening: FISH can be used in the blood of newborns to detect congenital chromosomal abnormalities, such as Down syndrome.
羊水
羊水中含有豐富的鹽類,當羊水塗抹在玻片上乾燥後,鹽類會形成一種獨特的結晶形態,看起來就像蕨類植物的葉子,因此稱為「羊齒狀結晶」。
Amniotic fluid contains abundant salts. When a smear of amniotic fluid is allowed to dry on a glass slide, these salts form a characteristic crystalline pattern resembling fern leaves, hence the term "ferning."
科林菲特氏症(Klinefelter's syndrome)
患者有一個額外的X染色體,因此他們的核型為47,XXY,患者的白血球細胞核旁最多可以看到1個巴氏體(Barr body),所以巴氏體的存在與否也是診斷科林菲特氏症的指標,巴氏體是由X染色體的非活性部分形成的,男性通常只有一個X染色體,所以較會影響男性。
科林菲特氏症的症狀可能有性腺發育不全、不孕、身材高大、四肢細長、肌肉無力、乳房發育、學習障礙、社交障礙,科林菲特氏症無法治癒,但可使用激素治療改善症狀。
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