The psychological significance of testicular problems.
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Adult↗
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Orchidopexy in cryptorchidism assessed by clinical, histologic and sperm examinations.
A study was undertaken of 187 patients with unilateral and 41 patients with bilateral cryptorchidism before and after orchidopexy. The mean tubular diameter and the mean tubular fertility index were used as quantitative criteria for assessment of the development of the testes. Before orchidopexy, no significant differences were found between scrotal and cryptorchid testes in patients up to six years of age. Thereafter, the scrotal testis showed marked development in distinction to the cryptorchid testis. After orchidopexy, follow-up examinations were carried out when the patients had reached the age, at least, 18 years. Based on the results of the mean tubular diameter and the mean tubular fertility index, a reasonable degree of fertility would be expected in both the unilateral and the bilateral cryptorchid testes. However, histologic assessment of spermatogenesis in the unilateral cryptorchid testes after orchidopexy showed spermatogenic arrest in 81 per cent and in all patients with bilateral cryptorchid testes after orchidopexy. In the unilateral orchidopexy patients, in distinction to the histologic assesment of spermatogenesis, sperm counts gave good results in 80 per cent; evidently, in these patients, the source of the spermatozoa was the contralateral scrotal testis. That spermatogenesis was defective in 20 per cent of the patients after unilateral orchidopexy suggests and underlying systemic factor affecting both testes.
Adolescent↗
Congenital testicular lymphangiectasis.
Testicular lymphangiectasis are described for the first time in a patient with bilateral inguinal cryptorchidism. A great number of irregular lymphatic channels was observed within the parenchyma and the tunica vasculosa in both testes. Large and numerous anastomosis between the lymphatic vessels of these two areas could also be seen. The MTD and the TFI of the left testis were normal. Both parameters were very low in the right testis. The association of this fact with the greater development of the lymphatic vessels in this testis strongly supports the idea that testicular lymphangiectasis interfere mechanically with the testis tubular development.
Biopsy↗
Immunological unresponsiveness during induction of experimental autoimmune orchitis in guinea-pigs: studies in vivo and in vitro.
Groups of male and female guinea-pigs were immunized with homologous sperm derived from testis (TS) or epididyimis (ES) in Freund's complete adjuvant (FCA). In vivo investigations included skin tests at 2 weeks and development of aspermatogenesis (testis weight) at 4 weeks; in vitro assays were inhibition of migration of peritoneal exudate cells (PEC) and culture of blood leucocytes (lymphocyte transformation) at weekly intervals after immunization. Antigens used were heat-treated extracts of sperm used for immunization (BTS, BES); cells were also cultured simultaneously with PPD. Skin tests revealed anergy in males as compared with females: a larger quantity of antigen which caused partial unresponsiveness in females, caused profound unresponsiveness in males although the aspermatogenesis was less severe. In vitro tests also showed anergy during the active stages of the orchitis. This was non-specific for PEC (specific unresponsiveness was not excluded), but blood leucocytes showed only specific unresponsiveness (to BES). These and previous studies suggest that the unresponsiveness results from a desensitisation by sperm antigens released during the development of aspermatogenesis.
Animals↗
LH-hCG receptors and testosterone content during differentiation of the testis in the rabbit embryo.
The development of gonadotropin receptors for LH and hCG in the fetal rabbit testis from 17-29 days of gestation was followed by quantitative binding studies with [125I]iodohCG and compared with gonadal testosterone content and the histological differentiation of the fetal Leydig cells. The concentrations of gonadotropin receptors and testosterone in the fetal testis were low on days 17 and 18 and increased strikingly on day 19. This time sequence for development of LH-hCG receptors and steroid content of the testis was correlated exactly with the histological appearance of the endoplasmic reticulum characteristic of the differentiated Leydig cell. When fetal testes were examined at 12-h intervals between days 17 and 19, gonadotropin binding and testosterone content were closely correlated at all times studied. Thus, no dissociation between the two functions was demonstrable in the testis at any time during gestation. In the fetal ovary, LH-hCG binding and testosterone content were low or undetectable at all stages of gestation. These observations demonstrate a close temporal relationship between the appearance of the LH-hCG receptor and the synthesis of testosterone by the fetal testis and demonstrate that the histological and functional differentiation of the Leydig cell occurs within a few hours at approximately day 18 of gestation. The simultaneous appearance of LH-hCG receptors and testosterone synthesis in the gonad can be regarded as the biochemical manifestations of Leydig cell differentiation in the testis of the fetal rabbit.
Aging↗
[Clinical development of the malignant process in retained testis with a contribution of 5 cases].
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Adult↗
[Familial case of male pseudohermaphroditism due to 17-ketoreductase defect: late diagnosis in the "aunt" of a patient with the same defect (author's transl)].
A 42 year old (46 XY) subject with 17-ketosteroid reductase deficiency was investigated. The patient reared as female, has developed masculine features (facial hair, male distribution of body hair, male body habitus, acne and clitoridomegaly) at about 15 years of age but never consulted. She married at 22 years and for 20 years thought to have a "normal" female sex life. Only when her 14 year old "niece" was investigated (1) and treated for similar problems she realized hers. She had a small phallus with perineal urethra, vaginal pouch absence of labia minora and undescended testis, no breast development. Baseline peripheral studies showed plasma testosterone (T) in the range of Tanner II stade of puberty (150 ng/dl), elevated delta 4-androstenedione (delta 4) (930 ng/dl) and estrone (E1) (33,5 NG/DL) LEVELS 6--8 times above normal, but subnormal estradiol levels. Increased basal gonadotropins showed an hyper-response to LHRH stimulation. Dynamic tests (ACTH test, Dexamethasone suppression, and hCG stimulation) showed that abnormal delta 4 and E1 were not of adrenal origin. In the spermatic veins delta 4 levels were extremely high (239 micrograms/dl) but T levels low (11.4 micrograms/dl). delta 4/T ratio in the spermatic vein was much higher than in the peripheral blood suggesting intact peripheral conversion of delta 4 to T. After castration all hormone levels returned to the range usually seen in agonadic male or female adults.
17-Hydroxysteroid Dehydrogenases↗
An improved perfusion fixation method for the testis.
A reliable and uniform vascular perfusion fixation method for the testis has been developed by using an initial washout solution containing a vasodilator and an anticoagulant. This is followed by a brief fixation with a sodium phosphate buffered formaldehyde-glutaraldehyde solution of conventional strenght, and then a second more concentrated aldehyde fixative solution containing picric acid. The method takes into account some of the unique features of the vascular supply of the male genital tract for its favorable perfusion and fixation. The advantages of this method are: (1) consistently favorable preservation of the testis; (2) simple and inexpensive apparatus; and (3) stable and relatively innocuous stock solutions.
Animals↗
[Tumours of the undescended testis (author's transl)].
It has now been clearly demonstrated that cryptorchidism is accompanied by a very marked increase in malignancy of the ectopic testis as well as in that in place. Amongst 80 patients undergoing surgery for carcinoma of the testis 14 (17.5%) had a past history of unilateral undescended. The risk of malignancy developing in an ectopic testis is 12 to 48 times greater than that of a testis which has descended normally. It would appear that the higher the position of the testis, the greater is the risk. Orchidopexy may decreased the risk if performed before the age of 11. When the tumour is situated in an ectopic testis, the clinical picture is often misleading. When the ectopic testis has been brought down the special feature of these tumours is the frequency of spread to inguinal lymph nodes. In terms of its basic principles the treatment of these tumours does not differ from that of those affecting normal testis. The aetiology of these tumours remains uncertain. There would seem to be a consensus in favour of a disgenetic origin, possible secondary to hormonal deficiency.
Adult↗
[Transformation of the rete ovarii into a rete testis and the epoophoron into an epididymis after experimental sex reversal in Gallus domesticus].
Transformation of the rete ovarii into a rete testis and of the epoophoron into an epididymis after experimental sex reversal in Gallus domesticus is described. After castration of female chicks, the medulla of the left ovary and/or the right gonadal rudiment develop into a testoid or an ovotestis. From general view, this is observed as sex reversal. In case of formation of a testoid, the epoophoron develops into an epididymis and the rete ovarii develops into a rete testis which consists of intra- and extratesticular and intracapsular parts. Thus, a luminated duct system is developed which allows the transport of semen. In case of formation of an ovotestis, the discontinuously side-by-side located parts of the rete ovarii and of the epoophoron are maintained.
Animals↗
Malignant germ cell tumor in situ in a cryptorchid testis.
A case of a malignant undifferentiated germ cell tumor in situ of an undescended testis diagnosed by needle biopsy is described. Four similar cases have been so far recorded in the literature, all of them in the infertile men with normally descended descended testes. Two of them developed embryonal carcinoma of testis 4 1/2 later and one had a concomitant seminoma. In a high-risk group of patients (atrophic testis, cryptorchidism), a needle biopsy of a testicle may discover malignancy in its very early phase of development (Stage 0), at which time an orchiectomy alone may be a curative treatment.
Adult↗
Torsion of the testis and allied conditions.
In 15 years at Bristol there have been 293 cases of torsion of the testis, 55 cases of torsion of a testicular appendage and 5 cases of testicular ischaemia due to other causes. The risk of a male developing torsion of the testis or its appendix by the age of 25 is about 1 in 160. Both conditions occurred primarily in adolescents, but among prepubertal boys torsion of an appendage was as common as torsion of a normally descended testis. There was a slight left-sided preponderance in testicular torsion, more marked in torsion of the appendages; the incidence of bilateral torsion was 2-0 and 1-8 per cent respectively. The clinical features and differential diagnosis of the two conditions are compared. Torsion of a testicular appendage is the most commonly misdiagnosed scrotal lesion, the preoperative diagnosis being correct in only 11 per cent of cases compared with 90 per cent for torsion of the testis. Twenty-one cases of recurrent torsion underwent prophylactic bilateral orchidopexy. There were 20 cases of torsion of undescended testes, with a salvage rate of only 20 per cent. The overall testicular survival rate was 55-3 per cent. Viability depends upon the possibility of spontaneous reduction, the preoperative delay after the onset of symptoms, the degree of torsion of the cord and the length of follow-up in doubtful cases. Urgent scrotal exploration is advised in every case of acute testicular pain unless there is overwhelming evidence of epididymoorchitis. Exploration of the opposite side is mandatory in torsion of the testis and advisable in torsion of an appendage.
Adolescent↗
Early orchiopexy and testis tumors.
A testicular tumor developed in a twenty-year-old man who had undergone orchiopexy at age six. The case illustrates that early orchiopexy affords no protection against subsequent malignant degeneration. The importance of an inguinal approach and a high orchiectomy are stressed.
Adult↗
Epidemiology of cancer of the testis in upstate New York.
We collected data on the 434 individuals reported with cancer of the testis to the New York State Tumor Registry, 1960-64, from upstate New York. We compared these with the 410 members of a random sample of the upstate population interviewed from 1959 to 1962. A high risk of developing cancer of the testis was associated with professional occupations, native-born parentage, rural residence, and having been married, especially while young. These findings paralleled some other studies, as well as our earlier inquiry. Each of these factors carried a higher risk even when considered in the context of the other traits, and risk increased with an increase in the number of characteristics possessed.
Adolescent↗
Follitropin receptors in rat testis. Characterization with enzymatically 125I-labeled human follitropin.
The interaction between enzymatically radioiodinated human follitropin and the follitropin receptors in testis homogenate was investigated in immature and adult rats. The 125I-labeled human follitropin exhibited high binding activity with specific binding of up to 17% in the presence of an excess of testis homogenate. Approx. 50% of the bound hormone could be eluted at pH 5, and the receptor purified tracer exhibited a 3.6-fold increase in binding activity when compared with the original tracer preparation. Quantitative analysis of equilibrium binding data was performed with corrections for the measured specific activity and maximum binding activity of the tracer hormone. The equilibrium association constants (Ka) determined 24 degrees C were not significantly different in immature and adult rat testis, and the mean value for Ka was 3.9 . 10(9) M-1. At 37 degrees C, the Ka value obtained using immature rat testis was 1.3 . 10(10) M-1. The association of 125I-labeled human follitropin with immature rat testis homogenate was time and temperature dependent. In the presence of an excess of unlabeled hormone, 30--60% of the preformed hormone . receptor complex was dissociated after 24 h incubation. A specific and sensitive radioligand-receptor assay for follitropin was developed using immature rat testis homogenate. The minimum detectable dose of purified human follitropin was 0.6 ng, and human urinary and pituitary follitropin, ovine follitropin and pregnant mare serum gonadotropin reacted in the assay with equivalent slopes. The potencies of highly purified pregnent mare serum gonadotropin and highly purified human follitropin were similar in the radioligand-receptor assay, consistent with the follitropin bioactivity of the equine gonadotropin.
Animals↗
Carcinoma in situ of the ectopic testis.
A young man with a palpable ectopic testis underwent right testis biopsy and orchiopexy. Since histological findings of the biopsy specimen revealed an unsuspected intratubular carcinoma in situ and evidence of diminished spermatogenic potential, an inguinal orchiectomy was done. This appears to be the first reported case of a tumor of this type developing in an undescended testis.
Adult↗
Induction of testicular sarcomas in Fischer rats by intratesticular injection of nickel subsulfide.
Nickel subsulfide (Ni3S2) was injected in various amounts into the testis of adult Fischer rats for the study of the acute and chronic effects of Ni3S2 on testicular cells. Rats given injections of 0.6 to 10 mg of Ni3S2 developed an immediate inflammatory response at the site of injection, followed by a delayed, slowly evolving coagulation necrosis of seminiferous tubules and interstitial cells. The extent of testicular necrosis was dose dependent, but at doses of 5 or 10 mg of Ni3S2 the rats invariably developed subtotal destruction of the testis. The testis became atrophic, without regeneration of seminiferous tubules. No damage was seen in the other testis, and no systemic effects were noted. Malignant testicular neoplasms developed in 16 of 19 rats within 20 months after an injection of 10 mg of Ni3S2. These neoplasms were classified by light and electron microscopy as fibrosarcomas, malignant fibrous histiocytomas, and rhabdomyosarcomas. None of the testicular neoplasms was derived from germ cells or genital cord cells. The occurrence of rhabdomyosarcomas in the testis, an organ normally devoid of striated muscle, suggests that Ni3S2 induces malignant transformation of undifferentiated, pluripotential mesenchymal cells.
Animals↗
Reversal of vasectomy.
Vasovasostomy to reverse a previous vasectomy for sterilization was attempted for 27 men, the procedure being technically impossible in only one case. A testicular biopsy was performed at the time of operation and a number were investigated for cell-mediated immunity to sperm and for the presence of circulating sperm-agglutinating and cytotoxic antibodies. The first 17 cases have been studied and of these there have been 11 pregnancies, ten of which have already come to term with the birth of normal infants, including one set of twins. Of the rest, two are known to have oligozoospermia and four have been lost to follow-up, although two of them were euspermic when last examined. In spite of these encouraging results, it is considered that there are no grounds for alterning the present basis of vasectomy counseling which is that the operation is likely to be irreversible.
Adult↗