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Uyar, Mehmet, Elif Nur Yıldırım, and Tahir Kemal. "Evaluation of Testicular Self-examination Technique and Testis Cancer Knowledge Levels of Final-year Medical Students." Bulletin of Urooncology 18, no. 1 (2019): 10–13. http://dx.doi.org/10.4274/uob.galenos.2018.1113.
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Vallo, Stefan, Jennifer Kloft, Jon Jones, et al. "Evaluation of Testicular Self Examination and Testicular Partner Examination in Medical versus Non-Medical Students." Current Urology 14, no. 2 (2020): 92–97. http://dx.doi.org/10.1159/000499253.
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Objectives: Although testicular cancer (TC) is the most common tumor in young men in Western countries, there is no official cancer detection/screening program for young men in Germany. The most important TC detection tool is self-examination of the testis. Hypothetically medical students may have a diagnosis lead time and detection superiority. This study was designed to analyze whether medical students have a possible knowledge advantage over students of other faculties concerning TC and to compare male and female cancer screening demeanor and mentality. Methods: Male and female students of various faculties at the Goethe University Frankfurt/Main, Germany were invited to participate in this internet-based anonymous questionnaire with questions about TC awareness/knowledge, testicular (self) examination, and cancer screening behavior. Results: In total 1,049 students (329 medical and 716 non-medical students) completed the questionnaire. In general, medical students had a significantly higher TC knowledge, especially in the more advanced stages of their medical studies (year 3-6). About 50% of medical students had knowledge of TC whereas only 21.3% of non-medical students knew about the disease (p < 0.01). In addition, medical students conducted scrotal examinations more frequently (34.7%) than non-medical students (18.8%). Conclusion: The knowledge about TC is low among students. In general, medical students are more aware of TC and perform more frequent testicular examinations compared to non-medical students. Female TC knowledge rises in the clinical part of studies to the same level as their male counterparts, with the result of more testicular partner examinations.
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Chhetri, PK, A. Tayal, and PK Deka. "USG in evaluation of patients with scrotal pain." Journal of College of Medical Sciences-Nepal 8, no. 1 (2012): 18–22. http://dx.doi.org/10.3126/jcmsn.v8i1.6821.
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Based on physical examination alone it is often difficult to accurately make a clinical diagnosis and decide whether a palpable scrotal pathology arises from the testis itself or from extratesticular elements within the scrotum. Clinical examination of the testis is especially difficult due to pain, tenderness or when obscured by a large hydrocele. The aim of the study was thus undertaken to evaluate the role of ultrasonography (USG) in patients presenting with scrotal pain. 50 patients who presented to the surgical department with scrotal pain were subjected to USG. The commonest cause for scrotal pain was epididymitis with or without orchitis (40 %), followed in descending order by cystic lesions of the epididymis (18 %), varicocele (12 %), trauma (8 %), torsion (4 %) and tumour (2 %). No abnormality was seen on USG in 7 patients ( 14 %). This study concludes that USG is a sensitive and specific examination in patients with scrotal pain. Besides differentiating testicular from extratesticular origin it can also differentiate solid from cystic masses. Colour flow imaging is especially helpful in varicocele and testicular torsion. Torsion of the testis remains the most urgent and important entity dependent on USG for diagnosis. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-1, 18-22 DOI: http://dx.doi.org/10.3126/jcmsn.v8i1.6821
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MR, Alam, Shin SH, Lee HB, IHChoi, and NSKim. "Hypospadias in three calves: a case report." Veterinární Medicína 50, No. 11 (2012): 506–9. http://dx.doi.org/10.17221/5655-vetmed.
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Two to three weeks old 3 male indigenous Korean calves weighing 35&ndash;40 kg were referred to the Animal Medical Centre,ChonbukNationalUniversitywith signs of urine scalding on the ventral perineum. Physical examination in all 3 cases revealed aplasia of the penis along with an undescended testis, bifid scrotum and ventrally incomplete sheath. In case 1, the urethra opened cranially to the bifid scrotum, whereas in case 2 and 3, the urethra opened at the ventral perineum. The diagnosis was made as hypospadias, along with penile aplasia and unilateral cryptorchidism. With an exploratory laparotomy, the abdominal testis was removed. The scrotal testis was also castrated and scrotal ablation was performed. In case 1, prescrotal urethrostomy and in case 2 and 3, perineal urethrostomy was performed. Two weeks after surgical correction, the caves appeared to be urinating normally.
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Woller, Michael J., Pam L. Tannenbaum, Nancy J. Schultz-Darken, Bruce D. Eshelman, and David H. Abbott. "Pulsatile gonadotropin-releasing hormone release from hypothalamic explants of male marmoset monkeys compared with male rats." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 298, no. 1 (2010): R70—R78. http://dx.doi.org/10.1152/ajpregu.00193.2009.
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The present study was conducted to quantify in vitro gonadotropin-releasing hormone (GnRH) release parameters in the male marmoset. We established primary cultures of marmoset hypothalamic tissues for ∼2 days (marmosets) to assess GnRH release profiles in vitro in hypothalamic explants from testis-intact and gonadectomized males. Pulsatile GnRH release profiles were readily demonstrated from in vitro hypothalamic explants isolated from adult male marmoset monkeys. Gonadectomy of male marmosets resulted in elevated mean GnRH and pulse amplitude from hypothalamic explants on the 1st day of culture ( day 0). GnRH pulse amplitude increased by day 2 in ∼67% of hypothalamic explants from testis-intact marmosets, suggesting release from an endogenous regulator of GnRH. We also measured GnRH release profiles in vitro in hypothalamic explants from testis-intact and gonadectomized rats. Male rats showed no changes in any concentration or frequency release parameters for GnRH following gonadectomy or during successive days in culture. The present study represents a unique examination of GnRH release from male marmoset monkey hypothalamic tissue and compares release dynamics directly with those obtained from male rat, suggesting a species difference in feedback regulation of GnRH release.
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Wang, Tian-Qi, Xin Zhang, and Jia Yang. "Dynamic Protective Effect of Chinese Herbal Prescription, Yiqi Jiedu Decoction, on Testis in Mice with Acute Radiation Injury." Evidence-Based Complementary and Alternative Medicine 2021 (June 1, 2021): 1–16. http://dx.doi.org/10.1155/2021/6644093.
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Objective. A Chinese herbal prescription, Yiqi Jiedu (YQJD) decoction, is used for injuries caused by radiotherapy. This study aimed to investigate the dynamic protective effects of YQJD decoction in mice on radiation damage at different time points of the testis. Methods. The 200 male Balb/c mice were randomly divided into 5 groups (blank, model, Anduolin, low-dose YQJD, and high-dose YQJD groups). Blank and model groups were all given stomach deionized water. Anduolin group and high and low dose of Chinese herb groups were treated with Chinese material medical decoction compound for 2 weeks before being irradiated. Except for the blank group, other groups were given whole-body one-time irradiation of 5.5 Gy 60Co gamma rays. Histopathology examination of testes was conducted on the 1st, 7th, 21st, and 35th day after irradiation, respectively. Indexes of sperm motility rate, sperm count, serum levels of testosterone (T), estradiol (E2), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were also measured correspondingly. Result. Compared to 1 day and 7 days after irradiation, most of the indexes, including testis index, sperm motility, and count, were decreased on the 21st and 35th day in all irradiated groups. However, compared with the model group, the indexes to assess sperm quality and the morphological structures of testis in low-dose and high-dose YQJD groups were significantly recovered on the 21st and 35th days. Additionally, reproductive hormones, including testosterone and estradiol, were recovered more in low-dose and high-dose YQJD groups on the 21st and 35th days. Conclusion. The YQJD decoction is able to accelerate the recovery of sperm indexes, testosterone, and estradiol levels of sex hormones in mice after irradiation and demonstrated good protective effects on the testis.
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Chekol, Seble S., and Chen-Chin Sun. "Malignant Mesothelioma of the Tunica Vaginalis Testis: Diagnostic Studies and Differential Diagnosis." Archives of Pathology & Laboratory Medicine 136, no. 1 (2012): 113–17. http://dx.doi.org/10.5858/arpa.2010-0550-rs.
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Malignant mesothelioma of the tunica vaginalis testis is an extremely rare tumor representing 0.3% to 5% of all malignant mesotheliomas. Gross examination of testicular mesotheliomas typically reveals tumor nodules studding the thickened tunica vaginalis and, in some cases, infiltrating the testicular parenchyma, leading to diagnostic challenges. Microscopically, the tumor is characterized by epithelioid cells arising from the tunica vaginalis with papillary, tubulopapillary, or solid architectural patterns. The papillae are usually lined by a single layer of cells with relatively bland cytologic features. An epithelial cell phenotype admixed with a sarcomatoid pattern has also been described in a few cases. Immunohistochemically, the tumor is usually positive for calretinin, Wilms tumor-1, epithelial membrane antigen, D2-40, thrombomodulin, cytokeratin 7, and cytokeratin 5/6. Electron microscopic studies reveal epithelial cells joined by tight junctions, forming lumina, and displaying long microvilli with length to width ratios often greater than 10. The most important differential diagnostic considerations include florid mesothelial hyperplasia, adenomatoid tumor, carcinoma of the rete testis, and serous papillary tumors. In addition, the various types of testicular germ cell tumors should be considered, including seminomas, embryonal carcinomas, and intratubular germ cell tumors, particularly in tumors with testicular parenchymal involvement. Pleomorphic sarcomas should also be considered, particularly when dealing with the biphasic variant. The prognosis for this entity is grave, with a median survival of 23 months. Aggressive therapy with radical orchiectomy remains the mainstay of treatment.
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Hagiwara, H., T. Nagasawa, T. Yamamoto, et al. "Immunochemical characterization and localization of endothelin ETB receptor." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 264, no. 4 (1993): R777—R783. http://dx.doi.org/10.1152/ajpregu.1993.264.4.r777.
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A highly specific antiserum was raised against purified bovine endothelin ETB receptor and used to determine the tissue distribution of the receptor subtype ETB and to localize the receptor immunohistochemically in the kidney, adrenal gland, lung, cerebellum, and pituitary gland whose functions are known to be under strong influence of endothelin. The antiserum raised in a rabbit specifically recognized the receptor band on Western blot analysis of membrane proteins. Furthermore, it immunoprecipitated only ETB, establishing its ETB specificity. By determination of the percentage of the total number of the endothelin receptors that is immunoprecipitable with the antiserum, the amounts of the ETB relative to those of the ET receptors were found to vary from tissue to tissue: lung (70%), cerebellum (55%), pituitary gland (50%), kidney (25%), adrenal gland (10%), and testis (< 2%). This means that, in the lung, ET is the major form, whereas in the testis, ETA is predominant, comprising >95% of the receptors. Immunohistochemical examination of tissue sections revealed endothelium localization of the ETB endothelin receptor.
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Arif, NUM, AU Shaikh, B. Ranen, and Z. Waheed. "Diagnosis of Testicular Choriocarcinoma: A Case Study." Bangladesh Medical Journal 40, no. 2 (2014): 60–62. http://dx.doi.org/10.3329/bmj.v40i2.18514.
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Testicular cancer, although relatively rare, is the most common malignancy in men at the age of 15 to 35 years. Germ cell tumor (GCT) is the most common testicular tumor (90%-95%) and peak age of incidence is between 20 years to 50 years. Choriocarcinoma is very rare in male as a pure testicular tumor (<1%) but may be seen as a component of mixed GCT. These tumors characteristically secrete hCG (human chorionic gonadotrophin) into the serum, which use as an important serum tumor marker for these tumors. A 30 years old male presented to us with the complaints of hard feeling of the left testis for 6 months which was initiated with mild pain but the size of the testis was unchanged. On examination there was an indurated area (2cm X 2cm) at lower part of the left testis and epididymis felt separately. He had no history crypto-orchidism, orchitis and scrotal trauma. Ultrasonogram showed a mixed echoic mass lesion (13 X 10mm) at infero-medial aspect left testis with an epididymal cyst. On laboratory investigation his ?-hCG and AFP level were 306 MIU/L(high) & 6.3 IU/L respectively. Contrast enhanced CT scan of the whole abdomen revealed no abnormality except enlarged lymph node (> 1 CM) in right lower lung. Fine needle aspiration cytology (FNAC) showed features of chronic orchitis. We explored his left testis because of high ?-hCG through inguinal approach and suspected testicular tissue was sent for frozen section biopsy which also revealed inconclusive findings. On the basis of his high ?-hCG, we performed left radical orchidectomy. Histopathology of the left testis showed features of Choriocarcinoma, epididymis and spermatic cord were normal. According to TNM classification, AJCC (American Joint Committee on Cancer) staging and international germ cell consensus prognostic classification it was T3N0MISI, stage IIIa and intermediate prognosis group respectively. Postorchidectomy ?-hCG dropped to 7.3 MIU/ML. Now he is on systemic chemotherapy BEP(bleomycin, etoposide, cisplatin). Choriocarcinoma, though is a rare malignancy, it may affect young men in the prime of life and is the most aggressive histologic variant of germ cell tumor. But it has a good prognosis if diagnosed early and treated accurately. Serum ?-hCG level plays most important role in diagnosis, in monitoring therapy and follow-up of patients with choriocarcinoma. DOI: http://dx.doi.org/10.3329/bmj.v40i2.18514 Bangladesh Medical Journal 2011 Vol.40(2): 60-62
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Yan, Y., S. Chen, Z. Chen, et al. "The applied value of medical history, physical examination, colour-Doppler ultrasonography and testis scintigraphy in the differential diagnosis of acute scrotum." Andrologia 50, no. 4 (2018): e12973. http://dx.doi.org/10.1111/and.12973.
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Umaoka, Ai, Hiroki Takeuchi, Kento Mizutani, et al. "Skin Inflammation and Testicular Function: Dermatitis Causes Male Infertility via Skin-Derived Cytokines." Biomedicines 8, no. 9 (2020): 293. http://dx.doi.org/10.3390/biomedicines8090293.
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The medical comorbidities including skin diseases are associated with male infertility. The most common cause of male infertility is the inability of testes to produce sperm; however, the influence of persistent dermatitis on testicular function has not been elucidated so far. We investigated the relationship between skin inflammation and impaired sperm production using a spontaneous dermatitis mouse model. We examined the breeding records of dermatitis mice and their wild-type littermates. Sperm count, motility, and viability were analyzed by direct microscopic observation and flow cytometry. In addition, testis and epididymis were histologically examined. Finally, sperm viability was evaluated in another dermatitis mouse model and in wild-type mice in which inflammatory cytokines were intraperitoneally administered. Compared to wild-type littermate mice, the number of children born was lower in mice with dermatitis. The body weight and testis size were decreased age-dependently. In the skin disease group, the sperm count and movement ratio were clearly decreased, and reduced sperm viability was observed. Histological examination revealed the detachment of Sertoli cells and reduced spermatogenesis. The fibrosis of epididymal stroma was severe, and it might affect defective sperm maturation in the epididymis. In addition, this phenomena was reproduced by a hapten applied dermatitis mouse model and the intraperitoneal administration of inflammatory cytokines. Once the skin is inflamed, inflammatory cytokines are produced and released, which may affect testicular and sperm function. Additional studies are needed to determine the relationship between male infertility and severe dermatitis in human.
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Alam, M. R., Y. G. Cho, S. J. Cho, et al. "Male pseudohermaphroditism in dogs: three case reports." Veterinární Medicína 52, No. 2 (2008): 74–78. http://dx.doi.org/10.17221/2056-vetmed.
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Three Cocker Spaniel dogs, 2&minus;3 months old, weighing 3&minus;4 kg, were presented to the Chonbuk Animal Medical Centre, Chonbuk National University, with intersex anomalies. Physical, radiological, gross, histological, hormonal and cytogenetic studies were performed. Physical examination of the external genitalia revealed that the dogs possessed the vulva with an enlarged clitoris protruding from the vulvar juncture and the scrotum with an undescended testis in Case 1 and 2, and both testes remained undescended in Case 3. Hyperoestrogenaemia and low testosterone serum concentrations were found. Laparotomy revealed persistent Mullerian ducts (PMD) in Case 1 and 2, and abdominally located testicle(s) in all the cases. Histological examinations of the gonads revealed inactive seminiferous tubules. Cytogenetic analysis showed 78XY male karyotype in Case 1 and 2, whereas Case 3 showed 79XX female karyotype. The congenital defects were diagnosed as male pseudohermaphroditism (MPH) and PMD in Case 1 and 2, and XX sex reversal MPH in Case 3.
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Kulchenko, N. G. "Prediction of success in assisted reproductive technology with the help of morphology of the testis." Research'n Practical Medicine Journal 5, no. 4 (2018): 18–25. http://dx.doi.org/10.17709/2409-2231-2018-5-4-2.
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In the structure of infertile marriage male factor of infertility occurs in about 40-50%. About 30% of infertile men who have sought medical care have oligozoospermia or azoospermia of unknown etiology. The question of the chances of spermatogenesis recovery and increased probability of sperm extraction in repeated assisted reproductive technology (ART) programs is important for both the doctor and the patient.Purpose. To evaluate the morphological changes of spermatogenic epithelium in patients with male infertility in terms of prognosis of ART success.Patients and methods. 264 men with infertility were examined. The scope of clinical study of all patients included: history, examination, determination of blood hormones, study of ejaculate, karyotype, ultrasound. We performed a biopsy of the testis according to the patient's symptoms. Testicular tissue was subjected to morphological examination.Results. Primary infertility was observed in 172 men (65.2%), secondary — 92 (34.8%). 112 (42.4%) patients had severe infertility. The results of morphological studies in these men showed a different degree of violation of spermatogenesis. Based on the study, a diagnostic algorithm of patients with male infertility is proposed, which allows to predict the success of ART taking into account morphological changes in the testicle.Conclusion. On the basis of clinical and morphological study of the features of spermatogenesis of a particular patient a plan can be made for further personal diagnostic and therapeutic measures.
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Guo, Xiang, Lan Sun, Wei Lei, Shuang Li, and Hui Guo. "Management of testicular torsion <360° in children: a single-center, retrospective study." Journal of International Medical Research 48, no. 4 (2019): 030006051989586. http://dx.doi.org/10.1177/0300060519895861.
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Objective This study aimed to summarize clinical manifestations, and physical examination, laboratory examination, and ultrasound results of children with testicular torsion <360°. Methods We performed a retrospective study of children who were diagnosed with testicular torsion <360° between October 2007 and October 2017. Results There were 11 (19.2%) patients with testicular torsion of 90°, 33 (58.0%) with 180°, and 13 (22.8%) with 270°. The median age of onset was 5.7 years (range, 1–14 years) and the median duration of symptoms was 4.2 days (range, 0.5–5 days). Ultrasound showed low blood flow in 46 (80.8%) patients. The testis was retained in 41 (72.0%) patients and resected in 16 (28.0%). The testes appeared necrotic at 2 to 3 days after onset for patients with 270° torsion, appeared necrotic at 3 to 4 days after onset for those with 180° torsion, and were not necrotic at 4 to 5 days after onset for those with 90° torsion. The duration of symptoms in children decreased as the torsion angle increased. Conclusion Children with testicular torsion <360° are relatively young, while the duration of symptoms is relatively long. A high postoperative testicular survival rate is one of the clinical features in this study.
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Bhargava, Eishaan K., Nikhil Arora, Varun Rai, Ravi Meher, Prerna Arora, and Ruchika Juneja. "Filariasis of Stensen’s Duct: An Index Case." Case Reports in Otolaryngology 2016 (2016): 1–3. http://dx.doi.org/10.1155/2016/7646451.
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Filariasis, a neglected tropical disease, is a global health problem and is endemic to 73 countries including India. It is caused by nematodes of Filariodidea family, namely, W. bancrofti and B. malayi in India, which have a predilection for the lower limbs and testis. We report a never before reported case of filariasis of the main parotid duct in a 25-year-old male that resolved on medical management, exemplifying the importance of maintaining a high index of suspicion and careful examination of cytological smears in endemic countries, allowing for an early diagnosis and treatment, decreasing the morbidity of this debilitating disease.
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Prelevic, Rade, Bosko Milev, Novak Milovic, Mihajlo Ignjatovic, Aleksandar Spasic, and Nikola Petrovic. "Gigantic spermatocytic seminoma: A rare tumor of germ cell origin." Vojnosanitetski pregled 73, no. 7 (2016): 679–81. http://dx.doi.org/10.2298/vsp150527081p.
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Indtorduction. Spermatocytic seminoma represents a rare hystologic type of malignant testicular germ cell tumor with slow course and low malignant potential. Case report. We presented a 69-year-old patient with atypical clinical presentation of spermatocytic seminoma initially diagnosed as gigantic hydrocoellae which compromised walking. After long term evolution clincal picture presented with signs and symptoms of acute scrotum. Preoperative echosonography was performed and the diagnosis of testicular infiltrative tumor was established. After that left scrotal orchiectomy was performed. Patohistological examination revealed spermatocytic seminoma. Conclusion. Inspite good prognosis there is a low probability of development of high grade malignancy sinchronous sarcoma within the testis with a high potential for lymphogenic and hematogenic dissemination. Individual approach is necessary in accordance with the pathohistological diagnosis.
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Carvalho, Nubyhélia Maria Negreiro de, Ana Clemilda Ximenes Marques, Ivon Teixeira de Souza, et al. "Bilateral Traumatic Testicular Dislocation." Case Reports in Urology 2018 (2018): 1–5. http://dx.doi.org/10.1155/2018/7162351.
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Traumatic testis dislocation is an uncommon condition and usually occurs after direct impact on the scrotum. We present an uncommon case of bilateral testicular dislocation caused by an automotive accident, which is the most frequently associated cause described in literature today. Although the fact that diagnosis can be made either by physical examination or with the use of basic exams such as Doppler ultrasound, it is not uncommon for cases to go undetected and diagnosed late. In this case, there was a late diagnosis, almost one year after the motorcycle accident. Despite this, studies describe preservation of spermatogenesis even after delayed surgical correction. The treatment can be made by manual reduction, but most of the cases need surgical correction. Therefore, it is always necessary to perform the complete physical examination of the polytrauma patient on the first medical exam, in order to avoid the risk of fertility loss, endocrine dysfunction, and future malignancy.
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Marcos-Santos, P., M. Bailon-Cuadrado, E. Choolani-Bhojwani, and D. Pacheco-Sanchez. "Femoral hernia containing the right fallopian tube: chronic pain with menstruation." Annals of The Royal College of Surgeons of England 101, no. 7 (2019): e157-e159. http://dx.doi.org/10.1308/rcsann.2019.0082.
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Femoral hernias represent less than 10% of groin hernias and appear mainly in adult women; incarceration is more usual than in other hernias. Content found within the sac is commonly small bowel or omentum. Other anatomical structures, such as appendix, bladder, Meckel’s diverticulum, ectopic testis, stomach and gynaecological organs are extremely unusual. A 48-year-old woman presented with intense right groin pain over 48 hours. Her past medical history revealed periodical moderate right groin pain coincident with her menstrual cycles, usually self-limited. No abdominal symptoms or fever were present. On physical examination, an incarcerated right femoral hernia was suspected. Subsequently abdominal ultrasound revealed a right femoral hernia containing an echogenic structure with conserved vascularisation. The patient underwent an emergency surgery. During the procedure the right fallopian tube and several small cysts were discovered as the hernia sac contents. As no ischaemic signs were observed, and the sac was sutured and reduced. Femoral hernioplasty was accomplished with polypropylene mesh. The postoperative course was uneventful and the patient was discharged within 24 hours. After an exhaustive literature review, we have found few cases reporting the presence of fallopian tube in adult women with femoral hernia, but none described a recurrent groin pain coinciding with menstruation, as in this case.
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Liu, Peter Y., H. W. Gordon Baker, Veena Jayadev, Margaret Zacharin, Ann J. Conway, and David J. Handelsman. "Induction of Spermatogenesis and Fertility during Gonadotropin Treatment of Gonadotropin-Deficient Infertile Men: Predictors of Fertility Outcome." Journal of Clinical Endocrinology & Metabolism 94, no. 3 (2009): 801–8. http://dx.doi.org/10.1210/jc.2008-1648.
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Abstract Background: The induction of spermatogenesis and fertility with gonadotropin therapy in gonadotropin-deficient men varies in rate and extent. Understanding the predictors of response would inform clinical practice but requires multivariate analyses in sufficiently large clinical cohorts that are suitably detailed and frequently assessed. Design, Setting, and Participants: A total of 75 men, with 72 desiring fertility, was treated at two academic andrology centers for a total of 116 courses of therapy from 1981–2008. Outcomes: Semen analysis and testicular examination were performed every 3 months. Results: A total of 38 men became fathers, including five through assisted reproduction. The median time to achieve first sperm was 7.1 months [95% confidence interval (CI) 6.3–10.1]) and for conception was 28.2 months (95% CI 21.6–38.5). The median sperm concentration at conception for unassisted pregnancies was 8.0 m/ml (95% CI 0.2–59.5). Multivariate correlated time-to-event analyses show that larger testis volume, previous treatment with gonadotropins, and no previous androgen use each independently predicts faster induction of spermatogenesis and unassisted pregnancy. Conclusions: Larger testis volume is a useful prognostic indicator of response. The association of slower responses after prior androgen therapy suggests that faster pregnancy rates might be achieved by substituting gonadotropin for androgen therapy for pubertal induction, although a prospective randomized trial will be required to prove this.
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Ulbright, Thomas M. "Protocol for the Examination of Specimens From Patients With Malignant Germ Cell and Sex Cord–Stromal Tumors of the Testis, Exclusive of Paratesticular Malignancies." Archives of Pathology & Laboratory Medicine 123, no. 1 (1999): 14–19. http://dx.doi.org/10.5858/1999-123-0014-pfteos.
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Fulton, Regan S., Robert V. Rouse, and Erik A. Ranheim. "Ectopic Prostate." Archives of Pathology & Laboratory Medicine 125, no. 2 (2001): 286–88. http://dx.doi.org/10.5858/2001-125-0286-ep.
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Abstract We report the unusual case of a 78-year-old man who presented with obstructive bowel symptoms and a 2.5-cm presacral mass. The mass was excised and found on pathologic examination to be ectopic prostate tissue complete with a muscular stroma. Review of the literature revealed a number of case reports describing variably sized fragments of ectopic prostate tissue involving a variety of organs, including spleen, uterine cervix, bowel wall, pericolic fat, anal submucosa, seminal vesicle, testis, and urinary bladder. However, to our knowledge, this case is unique in that it presented as a relatively large, isolated presacral mass causing functional bowel impairment. The ectopic location can be related to the normal embryonic development of the prostate, rectum, and bladder.
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Vukmirovic, Filip, Nihad Zejnilovic, and Jovan Ivovic. "Liposarcoma of the paratesticular tissue and spermatic cord: A case report." Vojnosanitetski pregled 70, no. 7 (2013): 693–96. http://dx.doi.org/10.2298/vsp1307695v.
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Introduction. Liposarcomas are malignant tumors derived from fat tissues. Liposarcoma of the paratesticular tissue is rare. Case report. We presented a 51-year-old man with liposarcoma of paratesticular tissue and the spermatic cord, mimicking a testicular tumor. Ultrasound examination of this scrotal mass was hyperechogenic and homogeneous and separated from the testis and epididymis. The patient was operated, and the orchidectomy was performed. Histology revealed well-differentiated lipoma-like liposarcoma of the paratesticular tissue and spermatic cord. After a 6 month follow-up the patient did not show any evidence of tumor-progression or recurrence. Conclusion. Liposarcomas of the paratesticular tissue and seminal cord represent a rare type of tumors, often misdiagnosed preoperatively. Therapy should include radical surgical excision, usually radical inguinal orchiectomy. If the margin status is in doubt, adjuvant radiation should be performed. Local relapse is common and may occur after several years, so follow- up period has to be sufficiently long.
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Watabe, Tadashi, Kazuko Kaneda-Nakashima, Kazuhiro Ooe, et al. "Extended single-dose toxicity study of [211At]NaAt in mice for the first-in-human clinical trial of targeted alpha therapy for differentiated thyroid cancer." Annals of Nuclear Medicine 35, no. 6 (2021): 702–18. http://dx.doi.org/10.1007/s12149-021-01612-9.
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Abstract Objective Astatine (211At) is a promising alpha emitter as an alternative to iodine (131I). We are preparing the first-in-human (FIH) clinical trial of targeted alpha therapy for differentiated thyroid cancer in consultation with Pharmaceuticals and Medical Devices Agency. Here, we performed an extended single-dose toxicity examination under a reliability standard, as a preclinical safety assessment of [211At]NaAt to determine the FIH dose. Methods [211At]NaAt solution was injected into normal 6-week-old mice (male (n = 50) and female (n = 50), body weight: male 33.2 ± 1.7 g, female 27.3 ± 1.5 g), which were then divided into four groups: 5 MBq/kg (n = 20), 20 MBq/kg (n = 20), 50 MBq/kg (n = 30), saline control (n = 30). The mice were followed up for 5 days (primary evaluation point for acute toxicity: n = 80) or 14 days (n = 20: evaluation point for recovery) to monitor general condition and body weight change. At the end of the observation period, necropsy, blood test, organ weight measurement, and histopathological examination were performed. For body weight, blood test, and organ weight, statistical analyses were performed to compare data between the control and injected groups. Results No abnormal findings were observed in the general condition of mice. In the 50 MBq/kg group, males (days 3 and 5) showed a significant decrease in body weight compared with the control. However, necropsy did not differ significantly beyond the range of spontaneous lesions. In the blood test, males (50 MBq/kg) and females (50 MBq/kg) showed a decrease in white blood cell and platelet counts on day 5, and recovery on day 14. In the testis, a considerable weight decrease was observed on day 14 (50 MBq/kg), and multinucleated giant cells were observed in all mice, indicating a significant change related to the administration of [211At]NaAt. Conclusions In the extended single-dose toxicity study of [211At]NaAt, administration of high doses resulted in weight loss, transient bone marrow suppression, and pathological changes in the testis, which require consideration in the FIH clinical trial.
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Madana, Padma, Vijayasree Mandava, Neelima Govada, Padmavathi Devi Chaganti, Zafrul Haque Mohammed, and Ratna Stephenson Basimalla. "Histopathological Scenario of Testicular Lesions with Few Uncommon Entities – 3 Years Study in a Tertiary Care Hospital." Journal of Evidence Based Medicine and Healthcare 8, no. 9 (2021): 467–70. http://dx.doi.org/10.18410/jebmh/2021/91.
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BACKGROUND The incidence of testicular malignancy has been increasing in men, orchidectomy is necessary for the removal of neoplastic lesions or in patients with chronic inflammatory conditions resistant to treatment. We wanted to evaluate the various histopathological patterns of lesions in testis. METHODS A retrospective study of 86 orchidectomy specimens over a period of three years with age wise distribution from March 2017 to February 2020 was done in the Department of Pathology, Guntur Medical College, Guntur. Histopathological slides stained with haematoxylin and eosin were retrieved and reviewed. Immunohistochemistry was done in two cases. RESULTS Of the 86 cases, 78 (90.7 %) cases were non neoplastic and 8 (9.3 %) cases were neoplastic. Youngest age in non-neoplastic group was four days and in neoplastic group was 18 years. The oldest age was 82 years in the non-neoplastic lesions and 60 years in the neoplastic lesions. Non neoplastic lesions were common in the 3 rd decade. In malignant lesions, highest number of cases was seen in the 6 th decade and equal distribution was observed in 3rd and 5th decade. Unilateral involvement was common than bilateral involvement. Out of all non-neoplastic lesions, undescended testis 20 (25.64 %) cases was the common finding followed by non-specific epididymo orchitis 19 (24.36 %) cases, abscess 14 (17.95 %) cases, torsion infarction 13 (16.67 %) cases, Leydig cell hyperplasia 4 (5.13 %) cases, 3 (3.85 %) cases each of tuberculous epididymo orchitis and granulomatous epididymo orchitis. 1 (1.28 %) case each of rare entities like vanishing testis and splenogonadal fusion were also found. Among the neoplastic lesions, all 8 cases were malignant tumours. Out of these malignant tumours, mixed germ cell tumours were seen in 3 (37.5 %) cases followed by seminomas 2 (25 %) cases, post pubertal teratoma 1 (12.5 %) case, non-Hodgkin’s lymphoma (NHL) 1 (12.5 %) case and primitive neuroectodermal tumour (PNET) 1 (12.5 %) case. CONCLUSIONS Histopathological examination on routine haematoxylin and eosin (H&E) stained sections primarily differentiate non neoplastic lesions from neoplastic group and benign tumours from malignant tumours as the treatment modality varies. Immunohistochemistry (IHC) is useful in the diagnosis of poorly differentiated small round cell tumours. KEYWORDS Orchidectomy Specimens, Neoplastic and Non-Neoplastic Lesions
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Peretti, Vincenzo, Katiuska Satué, Francesca Ciotola, et al. "An Unusual Case of Testicular Disorder in Sex Development of Arabian Mare (64,XX SRY-Negative)." Animals 10, no. 11 (2020): 1963. http://dx.doi.org/10.3390/ani10111963.
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A 3-year-old Arabian mare underwent medical examinations due to the presence of abnormalities of the reproductive apparatus and stallion behavior (nervous temperament, aggressiveness, masculine attitude). During the clinical visit, an anovulvar distance shorter than normal was observed; moreover, vulvar lips were dorsally fused except for the lower neckline, showing a blind ending from which a penis-like structure protruded. The ultrasound examination revealed the presence of a cervix and corpus of a uterus, hypoplastic uterine horns, and small gonads with an echogenicity similar to a testis. Blood testosterone levels ranged from 0.4 to 0.6 ng/mL. Cytogenetic analysis showed a normal female karyotype (2n = 64,XX), while PCR amplification of SRY and ZFY genes revealed the absence of a Y chromosome. At necroscopic examination, internal genitalia arising from the genital ridge in the form of masculine type structures were found, while those deriving from the Mullerian ducts were of feminine type. In addition, an infundibular portion of the salpinx at the cranial pole of the gonads was found. This is the first case in equine species of DSD 2n = 64,XX SRY-negative, with the simultaneous presence of male (hypoplastic testicles, epididymal portions, and a penis-like structure) and female (cervix, horn and body of a hypoplastic uterus) genital structures.
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Wang, Lin, Runyong Fan, Funeng Geng, Yongxiang Gao, and Qinwan Huang. "Protective effect of crude polysaccharide from Pao-TianXiong derived from monkshood, against chronic renal failure in mice." Tropical Journal of Pharmaceutical Research 18, no. 6 (2021): 1235–43. http://dx.doi.org/10.4314/tjpr.v18i6.13.
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Purpose: To investigate the effect of crude polysaccharide isolated from pao-tian-xiong on chronic renal failure in mice, and its monosaccharide composition.
 Methods: Male Kunming mice were orally treated with adenine (211.5 mg/kg/day) for 7 days, followed by either crude polysaccharides (125, 250 or 500 mg/kg), or positive drug solution (jinguishenqi pill, 2000 mg/kg) for another 7 days (each group had 15 mice). Mice in normal and negative control groups were given saline. Mental and physical states, blood urine nitrogen (BUN) and serum creatinine (SCr), kidney morphological changes and organ indices were determined. Histopathological examination of spleen and kidney tissues was also performed. The monosaccharide composition of crude polysaccharide was determined by high-performance liquid chromatography (HPLC) and gas chromatography and mass spectrometry (GC-MS).
 Results: Compared with negative control group, serum BUN (6.71 mmol/L vs. 8.61 mmol/L) and Cr (107.74 vs. 113.39 μmol/L) were significantly decreased by the crude polysaccharide isolate (p < 0.05), whereas epididymis index (0.2556 vs. 0.2135 %) and seminal vesicle index (0.5547 vs. 0.3945 %) were increased (p < 0.05). Histopathological examination showed that injuries to kidney, spleen, testis and epididymis decreased significantly. The crude polysaccharides contained mainly glucose, rhamnose, arabinose, galactose, mannose, galacturonic acid, glucuronic acid and xylose, and their contents ranged from 0.7 to 65 %.
 Conclusion: These results suggest that the crude polysaccharides of Pao-tian-xiong ameliorates CRF symptoms in mice, thereby providing experimental evidence in support of its use as an anti-CRF drug.
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Pelletier, R. Marc, Suk Ran Yoon, Casimir D. Akpovi, Emil Silvas, and María Leiza Vitale. "Defects in the regulatory clearance mechanisms favor the breakdown of self-tolerance during spontaneous autoimmune orchitis." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 296, no. 3 (2009): R743—R762. http://dx.doi.org/10.1152/ajpregu.90751.2008.
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We identified aberrations leading to spontaneous autoimmune orchitis (AIO) in mink, a seasonal breeder and natural model for autoimmunity. This study provides evidence favoring the view that a malfunction of the clearance mechanisms for apoptotic cell debris arising from imbalances in phagocyte receptors or cytokines acting on Sertoli cells constitutes a major factor leading to breakdown of self-tolerance during spontaneous AIO. Serum anti-sperm antibody titers measured by ELISA reflected spermatogenic activity without causing immune inflammatory responses. Orchitic mink showed excess antibody production accompanied by spermatogenic arrest, testicular leukocyte infiltration, and infertility. AIO serum labeled the postacrosomal region, the mid and end piece of mink sperm, whereas normal mink serum did not. Normal serum labeled plasma membranes, whereas AIO serum reacted with germ cell nuclei. Western blot analyses revealed that AIO serum reacted specifically to a 23- and 50-kDa protein. The number of apostain-labeled apoptotic cells was significantly higher in orchitic compared with normal tubules. However, apoptosis levels measured by ELISA in seminiferous tubular fractions (STf) were not significantly different in normal and orchitic tubules. The levels of CD36, TNF-α, TNF-α RI, IL-6, and Fas but not Fas-ligand (L), and ATP-binding cassette transporter ABCA1 were changed in AIO STf. TNF-α and IL-6 serum levels were increased during AIO. Fas localized to germ cells, Sertoli cells, and the lamina propria of the tubules and Fas-L, to germ cells. Fas colocalized with Fas-L in residual bodies in normal testis and in giant cells and infiltrating leukocytes in orchitic tubules.
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Juel Mortensen, Li, Martin Blomberg Jensen, Peter Christiansen, et al. "Germ Cell Neoplasia in Situ and Preserved Fertility Despite Suppressed Gonadotropins in a Patient With Testotoxicosis." Journal of Clinical Endocrinology & Metabolism 102, no. 12 (2017): 4411–16. http://dx.doi.org/10.1210/jc.2017-01761.
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Abstract Context Testotoxicosis is an autosomal-dominant, male-limited disorder. Activating mutations in the luteinizing hormone receptor gene (LHCGR) cause high autonomous testosterone secretion, resulting in early-onset peripheral precocious puberty. Little is known about long-term consequences of testotoxicosis. Case Description We present a rare case of a patient followed for 25 years with two remarkable outcomes: preserved fertility and germ cell neoplasia in situ (GCNIS). He presented with precocious puberty at 10 months of age and was diagnosed with testotoxicosis due to a de novo heterozygous Asp578Tyr mutation in LHCGR. Testicular biopsy in childhood showed Leydig cell hyperplasia with altered cell maturation. From infancy throughout adulthood, elevated testosterone and estradiol, low inhibin B and anti-Müllerian hormone, and completely suppressed follicle-stimulating hormone and luteinizing hormone were noted. Height acceleration and advanced bone age resulted in a reduced final height. Semen analysis revealed ongoing spermatogenesis, and the patient fathered a child by natural conception. Ketoconazole treatment decreased circulating testosterone in childhood, supported by experimental suppression of testosterone production in his adult testis tissue cultured ex vivo. At 25 years of age, ultrasound revealed a testicular tumor, identified as a Leydig cell adenoma, but unexpectedly with GCNIS present in adjacent seminiferous tubules. Conclusion The case illustrates that absence of gonadotropins but high intratesticular testosterone concentration is sufficient for spermatogenesis and to allow fatherhood. Our study is also the first description, to our knowledge, of GCNIS in a patient with testotoxicosis. We recommend regular clinical examination and ultrasonic evaluation of the testes in these patients due to potential increased risk of malignancy.
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Kubota, Hiroshi, and Ralph L. Brinster. "Spermatogonial stem cells†." Biology of Reproduction 99, no. 1 (2018): 52–74. http://dx.doi.org/10.1093/biolre/ioy077.
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Abstract Spermatogonial stem cells (SSCs) are the most primitive spermatogonia in the testis and have an essential role to maintain highly productive spermatogenesis by self-renewal and continuous generation of daughter spermatogonia that differentiate into spermatozoa, transmitting genetic information to the next generation. Since the 1950s, many experimental methods, including histology, immunostaining, whole-mount analyses, and pulse-chase labeling, had been used in attempts to identify SSCs, but without success. In 1994, a spermatogonial transplantation method was reported that established a quantitative functional assay to identify SSCs by evaluating their ability to both self-renew and differentiate to spermatozoa. The system was originally developed using mice and subsequently extended to nonrodents, including domestic animals and humans. Availability of the functional assay for SSCs has made it possible to develop culture systems for their ex vivo expansion, which dramatically advanced germ cell biology and allowed medical and agricultural applications. In coming years, SSCs will be increasingly used to understand their regulation, as well as in germline modification, including gene correction, enhancement of male fertility, and conversion of somatic cells to biologically competent male germline cells.
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Pei, Boyan, Chunxia Wang, Bin Yu, Dan Xia, Tian Li, and Zeyang Zhou. "The First Report on the Transovarial Transmission of Microsporidian Nosema bombycis in Lepidopteran Crop Pests Spodoptera litura and Helicoverpa armigera." Microorganisms 9, no. 7 (2021): 1442. http://dx.doi.org/10.3390/microorganisms9071442.
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Microsporidia are ubiquitous fungi-related parasites infecting nearly all vertebrates and invertebrates. Microsporidian Nosema bombycis is a natural pathogen of multiple insects, including the silkworm and many agricultural and forest pests. N. bombycis can transovarially transmit in silkworm and cause huge economic losses to the sericulture. However, it remains unclear whether N. bombycis vertically transmits in the crop pests Spodoptera litura and Helicoverpa armigera. Here, we investigated the infection of N. bombycis in S. litura and H. armigera to illuminate its infectivity and transovarial transmission. In result, tissue examination with light microscopy revealed that the fat body, midgut, malpighian tubules, hemolymph, testis, and ovary were all infected in both pest pupae. Immunohistochemical analysis (IHA) of the ovariole showed that a large number of parasites in maturation and proliferation presented in follicle cell, nurse cell, and oocyte, suggesting that N. bombycis can infect and multiply in these cells and probably transovarially transmit to the next generations in both pests. Microscopic examination on the egg infection rate demonstrated that 50% and 38% of the S. litura and H. armigera eggs were congenitally infected, respectively. IHA of both eggs manifested numerous spores and proliferative pathogens in the oocyte, confirming that N. bombycis can invade into the female germ cell from the parent body. After hatching of the infected eggs, we detected the infection in offspring larvae and found large quantities of proliferative pathogens, confirming that N. bombycis can transovarially transmit in S. litura and H. armigera, and probably persists in both pest populations via congenital infection. In summary, our work, for the first time, proved that N. bombycis is able to vertically transmit in S. litura and H. armigera via infecting the oocyte in the parent, suggesting that N. bombycis could be a biological insecticide for controlling the population of crop pests.
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Vega, Francisco, L. Jeffrey Medeiros, and Lynne V. Abruzzo. "Primary Paratesticular Lymphoma." Archives of Pathology & Laboratory Medicine 125, no. 3 (2001): 428–32. http://dx.doi.org/10.5858/2001-125-0428-ppl.
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Abstract Non-Hodgkin lymphoma arising in the paratesticular organs without testicular involvement is rare. In most previously reported cases, the classification systems that were used are now outdated and/or immunologic studies were not done. We report the clinical and pathologic features of 2 cases of non-Hodgkin lymphoma arising in the epididymis and the spermatic cord. Patient 1 was a 35-year-old man who presented with a painless scrotal mass. Patient 2 was a 61-year-old man who presented with a right inguinal mass. Orchiectomy performed in both patients revealed a mass confined to the epididymis in patient 1 and to the spermatic cord in patient 2. Histologic examination in both cases revealed diffuse large cell lymphoma, and immunohistochemical studies supported B-cell lineage. Subsequent staging studies showed no other site of disease in patient 1 and an isolated mass anterior to the right psoas muscle in patient 2. Malignant lymphoma involving testicular adnexal structures without involvement of the testis is extremely uncommon. To our knowledge, only 6 cases confined to the epididymis and 12 cases confined to the spermatic cord have been reported previously.
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Joda, Ali Egab. "Five different cases of ectopic testes in children: a self-experience with literature review." World Journal of Pediatric Surgery 2, no. 3 (2019): e000068. http://dx.doi.org/10.1136/wjps-2019-000068.
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BackgroundEmpty scrotum may be due to many reasons; besides true undescended testis these are monorchia, retractile testis, atrophy of testis due to torsion and ectopic testis. The location of testis in an aberrant site after passing through the inguinal canal and leaving it via external ring is a condition called ectopic testis. The most common aberrant locations of ectopic testes are superficial inguinal pouch (Denis Browne pouch), within anterior abdominal wall, perineum, femoral canal, contralateral scrotum (transverse testicular ectopia) and prepenile area.MethodsDescription of management of five different cases of ectopic testes over a period of 10 years’ experience in pediatric surgery have been done with review of the literature about this rarity.ResultsFive different cases of ectopic testes were as follows: infants 3 months of age with right ectopic testis in anterior abdominal wall near anterior superior iliac spine, 4 months of age with left perineal testis, 6 months of age with an ectopic femoral testis on left side, 8 months of age with transverse testicular ectopia on left side and 10 months of age with right true undescended testis and left perineal testis.ConclusionsSearch for ectopic sites of testes should always be in mind during examination of patients with empty scrotum. Early surgical repair of ectopic testes is recommended, as there is no chance of spontaneous correction to the normal location. Long-term follow-up is necessary due to relatively high incidence of infertility and malignant transformation. Surgeons should be aware of the rare possibility of transverse testicular ectopia in cases of inguinal hernia with impalpable testis on the contralateral side.
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Sunil V Jagtap, Pawar S J, Rohit S Kadam, Jyoti S Tele, Upadhey S R, and Avinash M Mane. "Clinicopathological Study of Orchidectomy Specimen." International Journal of Research in Pharmaceutical Sciences 11, SPL4 (2020): 2371–75. http://dx.doi.org/10.26452/ijrps.v11ispl4.4479.
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The present study was a five years descriptive type of study. In this five years study period June 2012 to May 2017, a total number of 62 surgically removed specimens of testing were received in the Department of Pathology of Krishna Institute of Medical sciences and research centre, Karad for histopathological examination. All orchidectomy specimens received from the surgery department in the period of June 2015 to May 2017. Archival data of cases were studied from June 2012. For prospective cases detail record brief clinical history with age, registration number, biopsy number, presenting signs & symptoms were noted, required serum marker assay for Alpha-fetoprotein, Human chorionic gonadotropin and Lactate dehydrogenase were noted wherever possible. The gross specimens received, they were fixed in 10% neutral buffered formalin/ Bouin‘s solution for overnight fixation. In the present study, the maximum number of cases involving the right side of testis. In this study, Germ cell tumours were the commonest found neoplastic lesion comprising of 16 cases that are 88% of all neoplastic lesions. Most common germ cell tumour in our study was seminoma. In seminoma, the most common age group was found to be in the 3rd and 4th decade. The present study shows one NHL case in 69 years old patient.
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Pozza, Carlotta, Riccardo Pofi, Marta Tenuta, et al. "Clinical presentation, management and follow-up of 83 patients with Leydig cell tumors of the testis: a prospective case-cohort study." Human Reproduction 34, no. 8 (2019): 1389–403. http://dx.doi.org/10.1093/humrep/dez083.
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Abstract STUDY QUESTION When should ‘not so rare’ Leydig cell tumors (LCTs) of the testis be suspected, diagnosed, and treated? SUMMARY ANSWER LCTs are more frequent than generally believed, are associated with male infertility, cryptorchidism and gynecomastia, and should be treated conservatively (in compliant patients) with active surveillance, which appears to be a safe alternative to surgical enucleation. WHAT IS KNOWN ALREADY Increasing referrals for testicular imaging have led to an increase in findings of LCTs. The features and natural history of these tumors remain largely unknown, as the available studies are small and heterogeneous. LCTs were previously treated aggressively and follow-up data are lacking. STUDY DESIGN, SIZE, DURATION A case-cohort study of consecutive patients diagnosed with LCTs over a 10-year period was prospectively enrolled from 2009 to 2018 and compared to matched cohorts of patients with seminomas or no testicular lesions screened in the same timeframe. PARTICIPANTS/MATERIALS, SETTING, METHODS Of the 9949 inpatients and outpatients referred for scrotal ultrasound, a total of 83 men with LCTs were included. Enrolled subjects underwent medical history and clinical examination and were asked to undergo routine blood tests, hormone investigations (FSH, LH, total testosterone, estradiol, inhibin B, sex hormone-binding globulin (SHBG), prolactin), and semen analysis. Patients who consented also underwent contrast-enhanced ultrasound, elastography, gadolinium-enhanced scrotal magnetic resonance imaging, and hCG stimulation test (5000 IU i.m.) with serum total testosterone and estradiol measured at 0, 24, 48, and 72 hours. MAIN RESULTS AND THE ROLE OF CHANCE In total, 83 patients diagnosed with LCTs were compared against 90 patients diagnosed with seminoma and 2683 patients without testicular lesions (NoL). LCTs were diagnosed by enucleation (48.2%), orchiectomy (13.3%), or clinical surveillance (38.5%). Testicular volume, sperm concentration, and morphology were lower (P = 0.001, P = 0.001, and P < 0.001, respectively) in patients with LCTs than in the NoL group. FSH, LH, and SHBG were higher and the testosterone/LH ratio was lower in LCTs than in the NoL group (P < 0.001). The LCT group showed higher SHBG (P = 0.018), lower sperm concentration (P = 0.029), and lower motility (P = 0.049) than the seminoma group. Risk factors for LCTs were cryptorchidism (χ2 = 28.27, P < 0.001), gynecomastia (χ2 = 54.22, P < 0.001), and low testicular volume (χ2 = 11.13, P = 0.001). Five cases were recurrences or bilateral lesions; none developed metastases during follow-up (median, 66 months). LIMITATIONS, REASONS FOR CAUTION This study has some limitations. First, hCG and second-line diagnostic investigations were not available for all tumor patients. Second, ours is a referral center for infertility, thus a selection bias may have altered the baseline features of the LCT population. However, given that the comparison cohorts were also from the same center and had been managed with a similar protocol, we do not expect a significant effect. WIDER IMPLICATIONS OF THE FINDINGS LCTs are strongly associated with male infertility, cryptorchidism, and gynecomastia, supporting the hypothesis that testicular dysgenesis syndrome plays a role in their development. Patients with LCTs are at a greater risk of endocrine and spermatogenesis abnormalities even when the tumor is resected, and thus require long-term follow-up and prompt efforts to preserve fertility after diagnosis. LCTs have a good oncological prognosis when recognized early, as tissue-sparing enucleation is curative and should replace orchiectomy. Conservative surgery and, in compliant patients, active surveillance through clinical and radiological follow-up are safe options, but require monitoring of testicular failure and recurrence. STUDY FUNDING/COMPETING INTEREST(S) The project was funded by the Ministry of University and Research Grant MIUR 2015ZTT5KB. There are no conflicts of interest. TRIAL REGISTRATION NUMBER ALCeP trial (ClinicalTrials.gov Identifier: NCT01206270).
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Beigh, Ambreen, Sheikh Junaid, Arshi Beg, Summyia Farooq, Lateef Ahmed Wani, and Farzana Manzoor. "Clinicopathological study of testicular tumors: an experience in a tertiary care hospital in Kashmir valley, Jammu and Kashmir, India." International Journal of Research in Medical Sciences 5, no. 6 (2017): 2741. http://dx.doi.org/10.18203/2320-6012.ijrms20172480.
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Background: Testicular and paratesticular neoplasia are rare type of tumors affecting adolescents and young adults in India, as observed by paucity of published data. This study was undertaken to analyze the patterns of testicular tumors at a tertiary level hospital in Kashmir valley, Jammu and Kashmir, India highlighting the patient’s demography, clinical presentation, diagnostic evaluation and pathological finding.Methods: This 5-year (retrospective and prospective) study was performed in the Department of Pathology, Government Medical College Srinagar, Jammu and Kashmir, India from January 2012 to December 2016. For the retrospective study, all cases of testicular tumors, their histopathological reports and required clinical details were searched from records maintained in the Department of Pathology, GMC Srinagar, Jammu and Kashmir, India. For the prospective study, the orchiedectomy specimens received in our department were subjected to routine histopathological processing followed by a detailed gross and microscopic examination. Tumour typing and subtyping was done according to WHO classification (2004).Results: A total of 37 cases of testicular and paratesticular neoplasia were included in present study with a mean age of 35.1 years. Out of these 37 cases, 31 (83.78%) were malignant and 6 cases (16.22%) were benign. Right testis was affected in 70.3% of cases. The most common clinical presentation was scrotal swelling. Germ cell tumor was the most common type accounting for 89.2% of tumors followed by lymphomas (8.1%).Conclusions:It is concluded that despite new techniques in imaging and tumor marker assay, the diagnosis of testicular tumors is dependent upon histopathological examination. The present study fairly provides an insight into the clinical presentations, prevalence and patterns of testicular tumors.
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Podberezin, Mark, Jianguo Wen, and Chung-Che (Jeff Chang. "Cancer Stem Cells: A Review of Potential Clinical Applications." Archives of Pathology & Laboratory Medicine 137, no. 8 (2013): 1111–16. http://dx.doi.org/10.5858/arpa.2012-0494-ra.
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Context.—Cancer stem cells (CSCs) comprise a minor cell population in a tumor; however, they possess self-renewal capacity and are responsible for tumor recurrence and the emerging issue of tumor resistance. Despite recent advances in the study of pathogenesis and mechanisms of CSC-mediated disease recurrence and multidrug resistance, many questions remain unanswered. Objectives.—To provide an overview of CSC theory and to describe major methods of CSC detection and isolation, with the emphasis on those techniques that are potentially relevant in clinical laboratory practice. Particular attention is given to CSC markers, such as cancer testis antigens, which could become promising targets in the development of immunotherapy in settings of minimal residual disease. Data Sources.—The review is based on analysis of peer-reviewed literature cited in PubMed, as well as preliminary results of studies conducted in our laboratory. Conclusions.—Despite a lack of consensus in the scientific community on research methodology, CSCs have demonstrated significant potential as therapeutic targets in the treatment of cancer. Further research of CSC biology and markers will eventually lead to the development of novel therapeutic approaches for targeting these cells to treat resistant and recurrent tumors and minimal residual disease.
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El Mehdi, Wichou, Bencherki Youssef, Ettanji Adnane, Mohammed Dakir, Debbagh Adil, and Aboutaieb Rachid. "Neglected Spermatic Cord Twisting: Experience of the University Hospital Center of Casablanca." European Journal of Medical and Health Sciences 3, no. 1 (2021): 181–85. http://dx.doi.org/10.24018/ejmed.2021.3.1.717.
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Introduction: Spermatic cord twisting (SCT) is a life-threatening emergency of the testis, causing testicular ischemic lesions by vascular constriction. Neglected SCT is an atypical variant of torsion with a late diagnostic delay. It is characterized by the presence of testicular necrosis, requiring an orchiectomy. The objective of our study is to investigate possible factors that may be responsible for the delayed diagnosis of TCS, and thus favor the occurrence of the neglected form. In order to act on these factors and prevent the harmful consequences of SCT, in particular testicular necrosis.
 Material and methods: This is a retrospective and descriptive study, conducted over a period of 7 years (January 2013-December 2019). Interesting 34 patients admitted to the urology department of the CHU Ibn Rochd of Casablanca, in a neglected SCT picture. The collection of information was carried out from the patients' files through an exhaustive exploitation sheet.
 Results: A total of 34 cases of neglected SCT were collected. The mean age was 17.97 years (extremes: 14-37 years). 94% of the subjects were less than 25 years old. 15% of the subjects were from rural areas. 77% of cases occurred during the cold season. The absence of employment characterized 61.5% of the major subjects and 42.8% of the guardians of the minor patients. Only 26.5% of subjects had health coverage. Non-education characterized 62% of adult patients and 65% of guardians of minor patients. The occurrence of neglected SCT was on an ectopic testicle in 1 case (3%) and on an oscillating testicle in 1 case (3%). The involvement was on the left side in 70.6% of cases. The average time to visit the emergency room at the CHU was 86 hours with extremes of 12 hours and 12 days. 38% of the patients had consulted directly at the CHU, while 62% were referred from other health structures. All patients were admitted to the emergency room after the pain had disappeared (scrotal in 94% and inguinal with vacuity of the homolateral bursa in 6%). Echodoppler allowed the dg to be applied in 100% of cases. Delayed consultation of the patient was present in 82.4% of cases. A diagnostic delay due to anaberration in medical management was found in 17.6%. Therapeutic management was orchidectomy in 100% of the cases, and orchidopexy of the contralateral testis was immediate in 24% of the cases and delayed in 76% of the cases. 24% of the cases and delayed in 76% of the cases. Only 29.4% of patients presented for medical check-up at 6 months postoperatively. 80% of these patients had testicular atrophy on clinical and ultrasound examination, and frank oligospermia with asthenospermia on spermogram.
 Conclusion: Multiple factors are likely to act on the prolongation of the diagnostic delay of SCT and may be at the origin of the occurrence of its neglected form. The delay in the diagnosis of SCT may be related to a delay in patient consultation or to an aberration in medical management, thus favoring the development of testicular necrosis and consequently requiring an orchiectomy. Hence the interest in knowing these factors in order to act on them by raising public awareness of the importance of emergency consultation in the face of acute scrotal pain, as well as continuing education of physicians and medical staff to prevent the occurrence of neglected SCT.
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Shin, Jaeho, and Ga Won Jeon. "Comparison of diagnostic and treatment guidelines for undescended testis." Clinical and Experimental Pediatrics 63, no. 11 (2020): 415–21. http://dx.doi.org/10.3345/cep.2019.01438.
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Cryptorchidism or undescended testis is the single most common genitourinary disease in male neonates. In most cases, the testes will descend spontaneously by 3 months of age. If the testes do not descend by 6 months of age, the probability of spontaneous descent thereafter is low. About 1%–2% of boys older than 6 months have undescended testes after their early postnatal descent. In some cases, a testis vanishes in the abdomen or reascends after birth which was present in the scrotum at birth. An inguinal undescended testis is sometimes mistaken for an inguinal hernia. A surgical specialist referral is recommended if descent does not occur by 6 months, undescended testis is newly diagnosed after 6 months of age, or testicular torsion is suspected. International guidelines do not recommend ultrasonography or other diagnostic imaging because they cannot add diagnostic accuracy or change treatment. Routine hormonal therapy is not recommended for undescended testis due to a lack of evidence. Orchiopexy is recommended between 6 and 18 months at the latest to protect the fertility potential and decrease the risk of malignant changes. Patients with unilateral undescended testis have an infertility rate of up to 10%. This rate is even higher in patients with bilateral undescended testes, with intra-abdominal undescended testis, or who underwent delayed orchiopexy. Patients with undescended testis have a threefold increased risk of testicular cancer later in life compared to the general population. Self-examination after puberty is recommended to facilitate early cancer detection. A timely referral to a surgical specialist and timely surgical correction are the most important factors for decreasing infertility and testicular cancer rates.
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Shankara-Narayana, Nandini, Christopher Yu, Sasha Savkovic, et al. "Rate and Extent of Recovery from Reproductive and Cardiac Dysfunction Due to Androgen Abuse in Men." Journal of Clinical Endocrinology & Metabolism 105, no. 6 (2020): 1827–39. http://dx.doi.org/10.1210/clinem/dgz324.
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Abstract Context Androgen abuse impairs male reproductive and cardiac function, but the rate, extent, and determinants of recovery are not understood. Objective To investigate recovery of male reproductive and cardiac function after ceasing androgen intake in current and past androgen abusers compared with healthy non-users. Methods Cross-sectional, observational study recruited via social media 41 current and 31 past users (≥3 months since last use, median 300 days since last use) with 21 healthy, eugonadal non-users. Each provided a history, examination, and serum and semen sample and underwent testicular ultrasound, body composition analysis, and cardiac function evaluation. Results Current abusers had suppressed reproductive function and impaired cardiac systolic function and lipoprotein parameters compared with non- or past users. Past users did not differ from non-users, suggesting full recovery of suppressed reproductive and cardiac functions after ceasing androgen abuse, other than residual reduced testicular volume. Mean time to recovery was faster for reproductive hormones (anti-Mullerian hormone [AMH], 7.3 months; luteinizing hormone [LH], 10.7 months) than for sperm variables (output, 14.1 months) whereas spermatogenesis (serum follicle-stimulating hormone [FSH], inhibin B, inhibin) took longer. The duration of androgen abuse was the only other variable associated with slower recovery of sperm output (but not hormones). Conclusion Suppressed testicular and cardiac function due to androgen abuse is effectively fully reversible (apart from testis volume and serum sex hormone binding globulin) with recovery taking between 6 to 18 months after ceasing androgen intake with possible cumulative effects on spermatogenesis. Suppressed serum AMH, LH, and FSH represent convenient, useful, and underutilized markers of recovery from androgen abuse.
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Koscinski, Isabelle, Manuel Mark, Nadia Messaddeq, et al. "Reproduction Function in Male Patients With Bardet Biedl Syndrome." Journal of Clinical Endocrinology & Metabolism 105, no. 12 (2020): e4417-e4429. http://dx.doi.org/10.1210/clinem/dgaa551.
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Abstract Purpose Bardet-Biedl syndrome (BBS) is a ciliopathy with a wide spectrum of symptoms due to primary cilia dysfunction, including genitourinary developmental anomalies as well as impaired reproduction, particularly in males. Primary cilia are known to be required at the following steps of reproduction function: (i) genitourinary organogenesis, (ii) in fetal firing of hypothalamo-pituitary axe, (iii) sperm flagellum structure, and (iv) first zygotic mitosis conducted by proximal sperm centriole. BBS phenotype is not fully understood. Methods This study explored all steps of reproduction in 11 French male patients with identified BBS mutations. Results BBS patients frequently presented with genitourinary malformations, such as cryptorchidism (5/11), short scrotum (5/8), and micropenis (5/8), but unexpectedly, with normal testis size (7/8). Ultrasonography highlighted epididymal cysts or agenesis of one seminal vesicle in some cases. Sexual hormones levels were normal in all patients except one. Sperm numeration was normal in 8 out of the 10 obtained samples. Five to 45% of sperm presented a progressive motility. Electron microscopy analysis of spermatozoa did not reveal any homogeneous abnormality. Moreover, a psychological approach pointed to a decreased self-confidence linked to blindness and obesity explaining why so few BBS patients express a child wish. Conclusions Primary cilia dysfunction in BBS impacts the embryology of the male genital tract, especially epididymis, penis, and scrotum through an insufficient fetal androgen production. However, in adults, sperm structure does not seem to be impacted. These results should be confirmed in a greater BBS patient cohort, focusing on fertility.
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Vasan, Cheryl Melovitz, Matthew Gentile, Susan Huff, and Nagaswami Vasan. "A STUDY OF TEST CONSTRUCT AND GENDER DIFFERENCES IN MEDICAL STUDENT ANATOMY EXAMINATION PERFORMANCE." International Journal of Anatomy and Research 6, no. 2.2 (2018): 5250–55. http://dx.doi.org/10.16965/ijar.2018.171.
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Casey, Rowan G., Ronald Grainger, Michael R. Butler, Thomas E. McDermott, and John A. Thornhill. "Public Awareness of Testis Cancer and the Prevalence of Testicular Self-examination—Changing Patterns Over 20 Years." Urology 76, no. 4 (2010): 915–18. http://dx.doi.org/10.1016/j.urology.2010.03.022.
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Tomasevic, Snezana, Danka Filipovic, and Nada Naumovic. "Neuropsychological tests in stroke patients during medical rehabilitation." Medical review 55, no. 7-8 (2002): 321–24. http://dx.doi.org/10.2298/mpns0208321t.
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Introduction There is a necessity for neuropsychological research in everyday clinical practice in stroke patients. Considering the fact that cognitive functions are very frequently impaired in stroke patients, there is a need to examine the level of impairment during recovery and rehabilitation therapy. Material and methods This study included 80 right-handed examinees of certain age and sex distribution. The clinical part of the study evaluated the cognitive recovery of patients by using Mini-Mental State examination and the complex reaction time test during the rehabilitation treatment, four weeks on average. The aim of this study was to establish the characteristics and dynamics of complex reaction time Mini-Mental State examination in patients during medical rehabilitation following brain stroke. Results The average values of Mini-Mental State at the beginning of treatment were 25.90 and at the end of treatment they were 28.93 (variation coefficient less than 30). Growth of average values of Mini-Mental State examination, during the rehabilitation treatment was 10.47%. In the group of patients after stroke, values of complex reaction time at the end of treatment were significantly shortened (p<0.05), but not to the levels established in the control group. Discussion and conclusion The overall results indicate that after rehabilitation treatment there is a statistically significant improvement in cognitive recovery in all patients. Improvement of complex reaction time at the end of treatment is conditioned with complex changes in the neural system. The results of studies point to the significance of early application of facilitatory techniques, as well as neuropsychological rehabilitation of patients after brain stroke.
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Penson, David F. "Re: Public Awareness of Testis Cancer and the Prevalence of Testicular Self-Examination—Changing Patterns Over 20 Years." Journal of Urology 185, no. 6 (2011): 2159–60. http://dx.doi.org/10.1016/s0022-5347(11)60252-8.
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Hynder, Wioleta, Małgorzata Piskorz-Szymendera, Aleksandra Zielińska, Katarzyna Plagens-Rotman, Agnieszka Dymek-Skoczyńska, and Agnieszka Ulatowska. "Diagnostic tests in women attempting pregnancy." Pielegniarstwo XXI wieku / Nursing in the 21st Century 16, no. 4 (2017): 5–8. http://dx.doi.org/10.1515/pielxxiw-2017-0032.
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AbstractIntroduction.Diagnosis of infertility usually begins after a year of waiting for pregnancy without any effect. Although it is usually woman who first reports to the doctor, the diagnostic tests should be conducted simultaneously with a woman and a man.Aim. The aim of the study was to evaluate the diagnostic tests performed in women seeking an offspring.Material and methods. The survey was conducted from February to April 2014 in the gynaecological wards of the Gynaecology and Obstetrics Clinical Hospital of the Karol Marcinkowski University of Medical Sciences in Poznan. The study included 104 patients during diagnosis and treatment of infertility. The research tool was the author's questionnaire.Results. The largest group comprised of women aged from 31 to 35 years (44%), the least numerous group – of women under 25 years of age (1%). The most commonly proposed trial was a detailed obstetric interview together with the general one (64%), then gynaecological examination (36%) and transvaginal ultrasound (30%). In 96% of the respondents diagnostic tests included conducted medical history, as well as physical gynaecological and ultrasound examination. Diagnostic methods, like hormonal profile, assessment of ovulation, laboratory tests were performed in 70% of patients. The survey also included questions concerning the diagnostic methods used in the partners of the respondents. In 35% of men one diagnostic test was performed, in 34% two tests and in more than 10% – 4 tests.Conclusion. Those who decide for the diagnosis of infertility are usually couples aged from 26 to 30 who do not an have offspring. Medical history, physical examination, gynaecological ultrasound and hormonal profile are the most commonly performed diagnostic tests for women applying for posterity.
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Millis, Richard M., Sharon Dyson, and Dawn Cannon. "Association of classroom participation and examination performance in a first-year medical school course." Advances in Physiology Education 33, no. 3 (2009): 139–43. http://dx.doi.org/10.1152/advan.00028.2009.
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The advent of internet-based delivery of basic medical science lectures may unintentionally lead to decreased classroom attendance and participation, thereby creating a distance learning paradigm. In this study, we tested the hypothesis that classroom attendance/participation may be positively correlated with performance on a written examination for first-year medical school instruction. The study subjects consisted of 115 first-year medical students. The introductory respiratory structure-function instruction was designed to include one noncompulsory pretest, four short postinstruction noncompulsory self-evaluation tests that were unannounced as to date and time, and one compulsory comprehensive examination. The relationship between attendance/participation, measured by the number of noncompulsory tests taken, and performance on the comprehensive examination was determined by Pearson's correlation coefficient, one-way ANOVA, and a χ2-test of significance. The average score on the pretest was 28%; for the same items on the comprehensive examination (posttest), the average score was 73%. For the 80 students who took the pretest, this translated to an overall score increase of 161%. Attendance/participation in four or five of the noncompulsory tests resulted in an 83.3% pass rate on the comprehensive exam compared with a rate of 52.9% for attendance/participation in three, two, one, or none of the five noncompulsory tests; the overall pass rate was 60.9%. There was a significant association between a high rate of classroom attendance/participation and a high score on the comprehensive examination (Pearson's χ2 = 8.599, P < 0.01). These findings suggest that classroom attendance/participation may be a significant determinant of performance of medical students on comprehensive examinations in first-year basic medical science courses. It is concluded that a substantial number of first-year medical students in this study could be at risk for poor performance because they may believe that there is an equivalency between internet- and classroom-based instruction in basic medical science courses.
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Pérez, Ignacio, Iara Yamila Taito-Vicenti, Catalina Gracia González-Xuriguera, Cristhian Carvajal, Juan Víctor Ariel Franco, and Cristóbal Loézar. "How to interpret diagnostic tests." Medwave 21, no. 07 (2021): e8432-e8432. http://dx.doi.org/10.5867/medwave.2021.07.8432.
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Healthcare professionals make decisions in a context of uncertainty. When making a diagnosis, relevant patient characteristics are categorized to fit a particular condition that explains what the patient is experiencing. During the diagnostic process, tools such as the medical interview, physical examination, and other complementary tests support this categorization. These tools, known as diagnostic tests, allow professionals to estimate the probability of the presence or absence of the suspected medical condition. The usefulness of diagnostic tests varies for each clinical condition, and studies of accuracy (sensitivity and specificity) and diagnostic impact (impact on health outcomes) are used to evaluate them. In this article, the general theoretical and practical concepts about diagnostic tests in human beings are addressed, considering their historical background, their relationship with probability theories, and their practical utility with illustrative examples.
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Huh, Sun. "Can computerized tests be introduced to the Korean Medical Licensing Examination?" Journal of the Korean Medical Association 55, no. 2 (2012): 124. http://dx.doi.org/10.5124/jkma.2012.55.2.124.
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Yazısız, Hatice, Özlem Koyuncu Özyurt, Feryal Öztürk Eryiğit, et al. "Trichomonas vaginalis Enfeksiyonu Tanısında Mikroskobik İnceleme, Kültür ve Polimeraz Zincir Reaksiyonu Testlerinin Değerlendirilmesi." Mikrobiyoloji Bulteni 54, no. 1 (2020): 135–43. http://dx.doi.org/10.5578/mb.68828.
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Sahin, Z., M. Meistrich, A. Szczepny, and K. Loveland. "234. Hedgehog signalling components in adult rat testis spermatogonial cells." Reproduction, Fertility and Development 20, no. 9 (2008): 34. http://dx.doi.org/10.1071/srb08abs234.
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In normal tissues, Hedgehog-induced progenitor cell proliferation is transient and tightly regulated, preventing continuous regeneration. However, activation of constitutive Hedgehog signalling results in unregulated self-renewal of progenitor cells in association with several human cancers. Although the contribution of Hedgehog signalling to cancers is widely accepted, its impact on spermatogonial stem cells and impact on male fertility are unknown. In this study, we aimed to clarify the possible role of Hh signalling on normal spermatogenesis in the adult rat and in adult testicular stem cells in the irradiated model {1}. Adult male rats were obtained from Monash University Central Animal Service and killed by cervical dislocation before tissue removal and fixation in Bouins for routine histochemical procedures. For studies on irradiated testes, adult LBNF1 male rats (hybrids between Lewis and Brown–Norway) were purchased from Harlan Sprague–Dawley, Inc. (Indianapolis, IN, USA). Testes were irradiated with 6 Gy to deplete all maturing germ cell types. At 15 weeks after irradiation the animals were injected simultaneously with 1.5 mg each of Cetrorelix pamoate and Cetrorelix acetate. Testes were collected 1, 2 or 4 weeks after injection. In situ hybridisation combined with immunohistochemistry was performed using DIG-labelled cRNA probes to identify the cells in which Hedgehog signalling components are made {2}. Signals for mRNAs encoding t he transmembrane receptors Ptc2 and Smo are most intensely detected in spermatogonia and spermatocytes and are much less intense in the round spermatids. The mRNA for the cytoplamic regulator, Fused, is restricted to the earliest germ cell types, whereas expression of the negative cytoplasmic regulator, SuFu, only begins in the round spermatids and persists in elongating spermatids. Gli1 and Gli3 are expressed from spermatogonia through to round spermatids, whereas Gli2 is restricted to spermatogonia and spermatocytes. This pattern mimics what was reported for mouse {2}. Examination of the irradiated rat testis model revealed that Hedgehog signalling machinery is produced by resting spermatogonial stem cells but is turned off when they differentiate in response to hormones. This matches the emerging understanding of Hedgehog signals in cancer stem cells and provides the first demonstration that Hedgehog signalling may influence stem cells in the adult testis. (1) Shuttlesworth G.A. et al. 2000. Endocrinology. 141: 37–49 (2) Szczepny A. et al. 2006. Dev Dyn. 235:3063–3070.