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PubMed2004

[Radiological diagnosis: scrotal ultrasound and Doppler ultrasound in the diagnosis of male infertility].

OBJECTIVES: To review the ultrasound technique, normal anatomy, bibliography, as well as the most frequent scrotal ultrasound findings in infertile patients studied in our center over the last five years, with special emphasis in the diagnosis of varicocele and its follow-up after surgical treatment or embolization. METHODS: We reviewed a total of 439 male patients with the diagnosis of infertility referred to our vascular ultrasound section between 1998 and 2004, and 101 patients referred for ultrasound control after treatment of varicocele (endovascular or surgical). RESULTS: The most frequent diagnosis associated with infertility were left varicocele (146 patients, 33.3%), right varicocele (39 patients, 8.9%) and intratesticular varicocele (1 patient, 0.2%). Only one patient had a right-side-only varicocele (0.2%), the rest of the cases of right varicocele having bilateral affectation (38 patients, 8.7%). Other relevant diagnoses found were testicular atrophy, epididymal lesions, microlithiasis, inguinal scrotal hernias, testicular tumors, and dilation of the rete testis. CONCLUSIONS: Testicular ultrasound should be performed in every patient with unexplained infertility and abnormal sperm analysis. It allows diagnosis of more pathologic conditions than physical examination. Besides a rapid varicocele screening, colour Doppler ultrasound allows us to evaluate its hemodynamic repercussion, by studying the spectral display, colour and response to Valsalva's. It also provides an exact measure of testicular volume, allows to detect the presence of dystrophic changes in the testicle, as well as anomalies of the epididymis and vas deferens, such as cystic dilations. It is also the test of choice to detect non descended testicles. Ultrasound may also detect non palpable testicular tumors which are more prevalent in this group of patients.

Cryptorchidism↗
PubMed1992

Establishment of an experimental model of autoimmune epididymo-orchitis induced by the transfer of a T-cell line in mice.

A murine T-cell line derived from BALB/c mice (designated B.T.1) was established which was capable of adoptively transferring experimental autoimmune orchitis (EAO) in normal recipients. The protocol consisted of preparing lymphocytes obtained from the mice that were immunized with syngenetic testicular germ cells (TGC) and the subsequent repeated selection of the lymphocytes in vitro by stimulation with murine testicular antigens (mTA). Phenotypic analysis revealed that B.T.1 cells were CD4+ T-cells. Intra-peritoneal inoculation of as few as 1 x 10(5) B.T.1 cells, that were stimulated in vitro with mTA before the inoculation, was capable of transferring EAO to naive recipients. In the latter, both delayed type hypersensitivity (DTH) and humoral responses to TGC were augmented. The transferred lesion was characterized by infiltration of inflammatory cells into the epididymis and rete testis and widespread aspermatogenesis in the testis. The transfer of EAO was unsuccessful when the recipients received B.T.1 cells that were maintained in culture medium without stimulation with mTA. In these recipients, anti-TC DTH was not detected, although the specific humoral response was observed. In-vitro characterization of the biological activity of B.T.1 cells revealed that the line had no cytolytic activity against TGC but the culture supernatant had macrophage migration inhibitory activity involved in the DTH response. Therefore, the DTH responsiveness transferred by B.T.1 cells was found to correlate with their orchitis-inducing capacity.

Animals↗
PubMed1979

[Incorporation of tritiated thymidine into testicular deoxyribonucleic acid of the rat. Effect of inhibin].

tritiated thymidine is incorporated into DNA of spermatogonia type B as proved by autohistoradiography when injected in vivo three hours before the sacrifice. Maximum binding and specific activity (labelled thymidine expressed in DPM per mg DNA) are obtained in pubertal rats aged 42 days and weighting 150 g. Inhibin preparation extracted from rete testis fluid (RTF3) specifically inhibits tritiated thymidine into testicular DNA. Thus, no modification of incorporation into hepatic DNA is observed and the preparation loses its inhibitory effect when denatured by heating and trypsin digestion. Tritiated thymidine incorporation into testicular DNA is poor in normal adult rats and in pubertal hypophysectomized animals, RTF3 does not modify the thymidine incorporation in both conditions. The reasons for this lack of effect are discussed. An experimental condition of spermatogonial regeneration is obtained by testicular irradiation. Inhibin preparation inhibits the regenerative DNA synthesis.

Aging↗
PubMed1991

Pathology of testicular germ cell tumors.

The pathology report on a testicular germ cell tumor should include the following information: Tumor type: The histologic type of tumor present. If the tumor is of mixed type, the components should be listed, in order of relative abundance. The pathologist may endeavor to give a numeric estimate of the percentages of each element. Staging information: The size of the tumor should be listed. Local spread--into rete testis, tunica albuginea, epididymis, and spermatic cord--should be listed. If the cord is involved, possible involvement of its surgical resection margin should be assessed. Vascular/lymphatic invasion should be assessed for its presence or absence. Status of the remainder of the testis: Evidence of cryptorchidism or other dysgenetic features should be mentioned. Such features may imply a greater risk for the development of a contralateral tumor. Also, the presence of normal spermatogenesis elsewhere in the uninvolved testis should be reported. This finding may suggest a relatively decreased risk for contralateral tumor development and is a likely indicator of fertility should the patient consider sperm banking prior to retroperitoneal surgery and chemotherapy. The finding of mature sperm in the epididymis is an easy way to confirm spermatogenesis in the testis. Incidental findings: Lipomas or hydroceles of the cord, adrenal rests, and adnexal cysts may be found. The pathologist plays a crucial role in the diagnosis of germ cell tumors. In addition to elucidating tumor type, the pathologist is relied upon for precise local staging and for the classification of metastases, all of which have important implications in determining optimal therapy. As the clinical management of germ cell tumors evolves, the pathologist will continue to play a role in defining those features that have a bearing on patient outcome.

Adult↗
PubMed1976

Adenine nucleotide changes at initiation of bull sperm motility.

Testicular and cauda epididymal sperm were obtained via catheters previously implanted in the rete testis and proximal vas deferens of bulls and were used to examine the relationships among sperm motility, cyclic adenosine 3':5'-monophosphate (cAMP) level, adenine nucleotide levels, and rates of glucose and oxygen consumption. Testicular, cauda epididymal, and ejaculated sperm contain cAMP-stimulated protein kinase, adenylate cyclase, and nucleotide phosphodiesterase. Treatment of the nonmotile testicular sperm with phosphodiesterase inhibitors resulted in a doubling of cellular cAMP concentration and a 25% increase in their glucose consumption. No change in motility, ATP level, or rate of oxygen consumption was observed. Sperm in neat cauda epididymal semen had flagellating tails but no progressive motility. Dilution of these sperm into glucose-containing buffer resulted in an increase in intracellular cAMP concentration and a decrease in ATP level with concomitant increases in ADP and AMP levels. These biochemical changes occurred within 30 s after dilution and apparently preceded the initiation of progressive motility by most cells. Since sperm in neat cauda epididymal semen became progressively motile when diluted with neat cauda epididymal plasma as well as accessory sex gland fluid or buffer, composition of the fluid surrounding the sperm is not responsible for the initiation of progressive motility upon dilution nor does cauda epididymal plasma contain an inhibitory factor. Perhaps release from contact immobilization provides the stimulation for the initial acquisition of progressive motility by cauda epididymal sperm. We conclude that during epididymal passage sperm develop from a cell physically unresponsive to changes in cAMP concentration to a form which initiates progressive motility upon changes in cAMP concentration.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMedDate not supplied

Endocytosis of androgen-binding protein, clusterin, and transferrin in the efferent ducts and epididymis of the ram.

The amount of androgen-binding protein (ABP) in luminal fluid from the central caput epididymidis of the ram, on a per sperm basis, remains the same as that in rete testis fluid (RTF) entering the ductuli efferentes, although greater than 85% of the testicular protein is absorbed in proximal sites. To determine if ABP is spared from endocytosis in proximal sites and if proteins are differentially and selectively absorbed at specific sites in the excurrent ducts, we studied the endocytosis of ABP, clusterin, transferrin, and a 26/35-kd dimer isolated from ovine RTF. Each protein was labeled with colloidal gold and microinjected into the lumen of a ductulus efferens and five specific sites in the ductus epididymidis; uptake was quantified by electron microscopy. Endocytosis of each protein, including ABP, was substantially greater in the ductuli efferentes than in any site in the ductus epididymidis. More ABP was endocytosed in proximal regions of the epididymis than any other protein studied. Endocytosis of the 26/35-kd dimer, like ABP, was greater in proximal sites of the epididymis, whereas endocytosis of clusterin and transferrin was greater in distal sites. Thus, there was a differential absorption, since proteins were endocytosed in one or another specific region of the epididymis, depending on the protein. ABP was endocytosed in the ductuli efferentes and caput epididymidis in amounts similar to or greater than other major testicular proteins, and was not spared from endocytosis in the proximal excurrent ducts.(ABSTRACT TRUNCATED AT 250 WORDS)

Androgen-Binding Protein↗
PubMed1990

Testicular obstruction: clinicopathological studies.

Genital tract reconstruction has been attempted in subfertile men with obstructive azoospermia (370 patients) or unilateral testicular obstruction (80 patients), and in vasectomised men undergoing reversal for the first (130 patients) or subsequent (32 patients) time. Histopathological changes in the obstructed testes and epididymes, and immunological responses to the sequestered spermatozoa have been studied to gain insight into possible causes of failure of surgical treatment. The results of surgery have been assessed by follow-up sperm counts and occurrence of pregnancies in the female partners. The best results were obtained with vasectomy reversal (patency 90%, pregnancy 45%), even after failed previous attempts (patency 87%, pregnancy 37%). Epididymovasostomy gave good results with postinfective caudal blocks (patency 52%, pregnancy 38%), while postinfective vasal blocks were better corrected by total anatomical reconstruction (patency 73%, pregnancy 27%) than by transvasovasostomy (patency 9%, no pregnancies). Poor results were obtained with capital blocks (patency 12%, pregnancy 3%), in which substantial lipid accumulation was demonstrated in the ductuli efferentes; three-quarters of these patients had sinusitis, bronchitis or bronchiectasis (Young's syndrome). There is circumstantial evidence to suggest that this syndrome may be a late complication of mercury intoxication in childhood. After successful reconstruction, fertility was relatively reduced in those men who had antibodies to spermatozoa, particularly amongst the postinfective cases. Similarly, impaired fertility was found in men with unilateral testicular obstruction and antibodies to spermatozoa. Mononuclear cell infiltration of seminiferous tubules and rete testis was noted occasionally, supporting a diagnosis of autoimmune orchitis; although rare, this was an important observation as the sperm output became normal with adjuvant prednisolone therapy.

Autoantibodies↗
PubMed1987

A rapid, sensitive and reliable assay for inhibin bioactivity.

A rapid 2-day quantitative assay for inhibin bioactivity based on FSH secretion from pituitary cells of immature female rats is described. The bioassay exhibited steeper slopes, improved precision and greater (fourfold) sensitivity compared with a previously established pituitary FSH cell content assay. Whole pituitary glands were used for the preparation of pituitary cells and the method for cell dispersion required a single enzymatic treatment with trypsin. Cells (180,000 viable cells per well) were dispensed into culture media containing inhibin and incubated for 48 h. Media were removed and assayed for FSH by radioimmunoassay. Using a ram rete testis fluid preparation as standard the inhibin dose-response curves of 25 consecutive experiments showed indices of precision of -0.08(mean)[range -0.04 to -0.17] and Finney's G values of 0.017[0.003-0.06]. The mean ED40 was 0.17 units of inhibin activity per well with interassay variation of 16.2% at this point of the dose-response curve. The assay had a practical capacity of 400 wells, permitting the measurement of dose-response curves of at least 40 unknowns with three dose points and triplicate wells per dose. The assay is specific for inhibin-containing preparations from several animal species. Overall, the assay is simple, precise, and sensitive, indicative of its applicability to the measurement of inhibin samples with low inhibin bioactivity and to the screening of large numbers of fractions during inhibin purification.

Animals↗
PubMed1987

Spermatogenesis and Sertoli cell numbers and function in rams and bulls.

The two main types of cellular associations (type I, 2 generations of spermatocytes + 1 of spermatids; type II, 1 of spermatocytes and 2 of spermatids) occupy, respectively, more than half and about a third of the seminiferous epithelium cycle in rams and bulls. However, the duration of the cycle of the seminiferous epithelium and that of spermatogenesis differ between the species. A1 spermatogonia and Sertoli cell total numbers are highly correlated in adult rams and bulls. Mitosis in Sertoli cells occurs mostly in utero but may still occur for a short period after birth. Between birth and puberty there is about a 5-fold increase in the number of Sertoli cells. After that there are no seasonal- or age-related increases in the number of adult Sertoli cells. Some factors (season of birth; nutrition; genetics; hormones) affect mitosis of Sertoli cells in prepubertal animals. Sertoli cells differentiate after cessation of mitosis. Their differentiation is affected by cryptorchidism, nutrition, genetics and hormones. Their adult function is only poorly known. ABP and rete testis fluid secretions and nuclear Sertoli volume fluctuate under the influence of the same factors, but they are not always linked together. This reinforces the need for more knowledge of Sertoli cell secretions and function.

Animals↗
PubMed1977

Chemistry and physiology of inhibin--a review.

Several reports have appeared on the presence of inhibin, the second testicular hormone postulated by McCullagh, in such sources as testicular extracts, seminal plasma, rete testis fluid, spermatozoa as well as ovarian follicular fluid. The resurgence, in recent years, of interest in the physiology of inhibin is reviewed in the historical perspective of earlier work. This survey presents an outline of the general findings on the nature and characterization of this substance. Studies relating to its exact site of production as well as its site of action are briefly described and discussed.

Animals↗
PubMedDate not supplied

[Destruction and regeneration of the seminiferous tubules after local x-ray irradiation of the testes of sexually mature rats].

It was established that the local X-irradiation (1000 R) of testes of the adult rats results a total destruction of seminiferous tubules. The restitution of the organ structure proceeds via formation of new seminiferous tubules in which spermatogenic epithelium later develops. Rete testis and germ cells preserved in its epithelium from embryogenesis are a source of regeneration material. The results obtained favour the suggestion about the dynamic structure of mammalian testis.

Animals↗
PubMed1987

Identification of two testosterone-responsive testicular proteins in Sertoli cell-enriched culture medium whose secretion is suppressed by cells of the intact seminiferous tubule.

Of 30 proteins identified in medium from primary Sertoli cell-enriched cultures, five of these proteins appear to increase primarily in response to testosterone. Using high performance liquid chromatography, two of these proteins, designated CMB-22 and CMB-23, were purified to apparent homogeneity from medium. Both are monomeric proteins with apparent molecular weights of Mr 37,000 and Mr 40,000, respectively. Both interact with concanavalin A and wheat germ agglutinin on lectin blots. CMB-22 has a pI of 5.8; CMB-23 has two distinctive isoelectric variants with pIs of 5.4 and 5.2, the latter variant was designated CMB-23 Isoform. Polyvalent antisera raised against purified CMB-22 and CMB-23 in rabbits cross-reacted with one another. Removal of carbohydrate from these proteins by either enzymatic or chemical treatments reduced their apparent molecular weights but did not abolish their size differences on sodium dodecyl sulfate-polyacrylamide gels. Peptide maps generated by Staphylococcus aureus protease V8 and visualized by silver staining and immunoblots suggest that CMB-22 and CMB-23 are similar but distinctive proteins that share almost identical epitopes. A radioimmunoassay was developed and used to measure total immunoreactive CMB-22-like material (CMB-22 plus CMB-23 immunoreactivity) in culture media, biological fluids, and tissue extracts. The results of these studies showed that the secretion of CMB-22-like material is unique with regard to other proteins that have been identified in Sertoli cell-enriched cultures. That is, CMB-22-like material is secreted by Sertoli cell-enriched cultures, but cannot be detected in media from cultures of intact tubular segments in vitro. In addition, immunoreactive material is also not detected in the testicular fluids from interstitium, tubule, or rete testis. This is in striking contrast to other Sertoli cell proteins which are present in substantial concentrations in these fluids. These observations suggest that the secretion and possibly the hormone responsiveness of CMB-22 and CMB-23 are normally suppressed in the intact tubule both in vivo and in vitro. We propose that studies of CMB-22 and CMB-23 will provide important insights into cell-cell interactions in the seminiferous epithelium.

Animals↗
PubMed1985

[Carbonic anhydrase activity in the epididymis of the developing rat].

The enzyme, carbonic anhydrase (CA), has been studied by an histochemical procedure during the postnatal development of the rat epididymis. Its activity first appeared at Day 14 in the early differentiating cells, i.e. the narrow cells, and only in them. These cells, found in the initial segment and the head of the adult epididymis, showed considerable activity. At Day 35 they disappeared in the other segments (corpus and tail), while the light cells which became apparent immediately showed more discrete CA activity. No carbonic anhydrase activity was found in the seminiferous epithelium, the testicular interstitial tissue or the rete testis.

Age Factors↗
PubMed1977

[Involution of the mesonephros and differentiation of the epididymis in chickens: immunohistological study].

By means of purified rabbit anti-adult chicken kidney antibodies two types of antigens have been identified in the mesonephros: one, localised in the cells of the proximal segment of the secretory tubules, the other characteristic of the collecting segments derived from the Wolffian duct. During the transformation of certain mesonephric tubules into ductuli efferentes and conjugentes of the epididymis the collecting tubule antigen disappears whereas the proximal secretory tubule antigen not only persists but can also be detected in the parietal layer of Bowman's capsules as they transform before connecting with the rete testis.

Age Factors↗
PubMed1978

[Demonstration of a specific androgen binding protein (ABP) in the seminal plasma of the ram].

A specific androgen binding protein has been demonstrated in the seminal plasma of adult Ram. This protein binds especially to 5 alpha-DHT and testosterone and much lower to oestradiol-17 beta. Its characteristics such as Ka (in order 10(9) M(-1) at 4 degrees C), relative mobility (Rf) and its specificity are similar to those of the androgen binding protein (ABP) of the Rete Testis Fluid and the epididymal plasma of the Ram. It is probable that this protein secreted from the testis, crosses the epididymis before being secreted in the seminal plasma at the moment of the ejaculation.

Animals↗
PubMed1979

Micro-stereological study of the avian epididymal region.

Morphometric studies of the epididymal region of three avian species (Gallus domesticus, Coturnix coturnix japonica, Japanese quail, and Numida meleagris, guinea-fowl) were performed using a stereological compensating eyepiece graticule. The proportions of the volume of the region made up of rete testis lacunae, proximal and distal efferent ductules, connecting ducts, ductus epididymidis, blood vessels and connective tissue were determined. The efferent ductules constituted the largest proportion of the tubular components of the organs in the three birds (35.3% for the chicken, 56% for the quail and 61.9% for the guinea-fowl), while the ductus epididymidis formed only 7.6%, 2.4% and 1.8% of the total epididymal volume in the domestic fowl, quail and guinea-fowl respectively. The connective tissue component made up 38.7%, 27.3% and 22.6% respectively. The significance of these results is discussed in relation to the likely functions of the various components of the epididymal region.

Animals↗
PubMed1983

Ovarian Sertoli-Leydig cell tumors with a retiform pattern: a problem in histopathologic diagnosis. A report of 25 cases.

A review of 232 cases of ovarian Sertoli-Leydig cell tumors yielded 25 that contained a prominent component with a retiform pattern. A lack of awareness of this pattern, which has not been described adequately in the literature, resulted in frequent initial misinterpretation of these tumors as neoplasms of other types, including endodermal sinus tumor (seven cases) and serous adenocarcinoma (four cases). The patients ranged in age from 2 to 39 years. Three of them (12%) presented because of androgenic manifestations; most of the remainder complained of abdominal swelling or pain, but one of them was amenorrheic and hirsute and three had amenorrhea, suggesting androgen secretion by the tumor. All the tumors were Stage I; one was bilateral. Their average maximum dimension was 16 cm and they were typically cystic or both cystic and solid. In eight tumors the cysts were lined by papillae, which were edematous in five cases. On microscopic examination the retiform pattern, which predominated in 14 of the 25 tumors, was characterized by an irregular network of elongated, often slit-like tubules and cysts, which often contained papillae and resembled the rete testis. Follow-up of 21 patients from 6 months to 17 years (average 4 years) revealed that 16 of them were alive and free of disease; five had died of tumor from 6 months to 17 years postoperatively.

Adolescent↗