The effect of BMI and age on the outcomes of microsurgical vasoepididymostomy: a retrospective analysis of 181 patients operated by a single surgeon / 亚洲男科学杂志(英文版)

To design a treatment plan for patients with epididymal obstruction, we explored the potential impact of factors such as body mass index (BMI) and age on the surgical outcomes of vasoepididymostomy (VE). In this retrospective study, 181 patients diagnosed with obstructive azoospermia (OA) due to epididymal obstruction between September 2014 and September 2017 were reviewed. All patients underwent single-armed microsurgical intussusception VEs with longitudinal two-suture placement performed by a single surgeon (KH) in a single hospital (Peking University Third Hospital, Beijing, China). Six factors that could possibly influence the patency rates were analyzed, including BMI, age, mode of anastomosis, site of anastomosis, and sperm motility and quantity in the intraoperative epididymal fluid. Single-factor outcome analysis was performed via Chi-square test and multivariable analysis was performed using logistic regression. A total of 159 (87.8%, 159/181) patients were followed up. The follow-up time (mean ± standard deviation [s.d.]) was 27.7 ± 9.3 months, ranging from 12 months to 48 months. The overall patency rate was 73.0% (116/159). The multivariable analysis revealed that BMI and age significantly influenced the patency rate (P = 0.008 and 0.028, respectively). Younger age (≤28 years; odds ratio [OR] = 3.531, 95% confidence interval [95% CI]: 1.397-8.924) and lower BMI score (<26.0 kg m-2; OR = 2.352, 95% CI: 1.095-5.054) appeared to be associated with a higher patency rate. BMI and age were independent factors affecting the outcomes of microsurgical VEs depending on surgical expertise and the use of advanced technology.

Epididymis cell atlas in a patient with a sex development disorder and a novel NR5A1 gene mutation / 亚洲男科学杂志(英文版)

This study aims to characterize the cell atlas of the epididymis derived from a 46,XY disorders of sex development (DSD) patient with a novel heterozygous mutation of the nuclear receptor subfamily 5 group A member 1 (NR5A1) gene. Next-generation sequencing found a heterozygous c.124C>G mutation in NR5A1 that resulted in a p.Q42E missense mutation in the conserved DNA-binding domain of NR5A1. The patient demonstrated feminization of external genitalia and Tanner stage 1 breast development. The surgical procedure revealed a morphologically normal epididymis and vas deferens but a dysplastic testis. Microfluidic-based single-cell RNA sequencing (scRNA-seq) analysis found that the fibroblast cells were significantly increased (approximately 46.5%), whereas the number of main epididymal epithelial cells (approximately 9.2%), such as principal cells and basal cells, was dramatically decreased. Bioinformatics analysis of cell-cell communications and gene regulatory networks at the single-cell level inferred that epididymal epithelial cell loss and fibroblast occupation are associated with the epithelial-to-mesenchymal transition (EMT) process. The present study provides a cell atlas of the epididymis of a patient with 46,XY DSD and serves as an important resource for understanding the pathophysiology of DSD.

Clinical features and microsurgical reconstruction of congenital unilateral absence of the vas deferens with obstructive azoospermia: a tertiary care center experience / 亚洲男科学杂志(英文版)

Patients with congenital unilateral absence of the vas deferens (CUAVD) manifest diverse symptoms from normospermia to azoospermia. Treatment for CUAVD patients with obstructive azoospermia (OA) is complicated, and there is a lack of relevant reports. In this study, we describe the clinical features and evaluate the treatments and outcomes of CUAVD patients with OA. From December 2015 to December 2020, 33 patients were diagnosed as CUAVD with OA in Shanghai General Hospital (Shanghai, China). Patient information, ultrasound findings, semen analysis, hormone profiles, and treatment information were collected, and the clinical outcomes were evaluated. Of 33 patients, 29 patients were retrospectively analyzed. Vasoepididymostomy (VE) or cross VE was performed in 12 patients, the patency rate was 41.7% (5/12), and natural pregnancy was achieved in one of the patients. The other 17 patients underwent testicular sperm extraction as the distal vas deferens (contralateral side) was obstructed. These findings showed that VE or cross VE remains an alternative treatment for CUAVD patients with OA, even with a relatively low rate of patency and natural pregnancy.

Application of lectins for detection of glycomic differences in the epididymal duct in water buffalo (Bubalus bubalis) and dromedary camel (Camelus dromedarius) / Aplicación de lectinas para la detección de diferencias glucómicas en el conducto epididimario en búfalos de agua (Bubalus bubalis) y dromedarios (Camelus dromedarius)

SUMMARY: The present study was conducted to detect the differences in glycohistochemical features in the epididymal duct of the dromedary camel and the water buffalo. Epididymal sections (caput, corpus and cauda) from both species were stained with fluorescein isothiocyanate (FITC) conjugated lectins. Binding sites for five lectins (DBA, GSA-1, HPA, PNA and WGA) have been found in both species. The binding sites of different lectins showed significant variations in the pattern of distribution in both a species. This included both species-specific and region-specific order. Additionally, only three (GSA-1, PNA and WGA) out the five lectins studied exhibited binding sites in all epididymal regions in both species. The other two lectins (DBA and HPA) followed the same order recorded for the other three (GSA-1, PNA and WGA) in buffalo, but failed to show any binding sites in cauda epididymis in camel. In conclusion, the variable regional and species-specific distribution features of lectins revealed that both species have diverse glycomic characteristics that may be related to their different reproductive patterns. However, the glycome-associated functional capacities remain obscured and need further profound investigations.

RESUMEN: El presente estudio se realizó para detectar las diferencias en las características glicohistoquímicas del conducto epididimal del dromedario y el búfalo de agua. Las secciones del epidídimo (cabeza, cuerpo y cola) de ambas especies se tiñeron con lectinas conjugadas con isotiocianato de fluoresceína (FITC). Se encontraron sitios de unión para cinco lectinas (DBA, GSA-1, HPA, PNA y WGA) en ambas especies. Los sitios de unión de diferentes lectinas mostraron variaciones significativas en el patrón de distribución en ambas especies. Esto incluía tanto el orden específico de la especie como el específico de la región. Además, solo tres (GSA-1, PNA y WGA) de las cinco lectinas estudiadas exhibieron sitios de unión en todas las regiones del epidídimo en ambas especies. Las otras dos lectinas (DBA y HPA) siguieron el mismo orden registrado para las tres restantes (GSA-1, PNA y WGA) en búfalos, pero no mostraron ningún sitio de union en la cola del epidídimo en camellos. En conclusión, las características de distribución regionales y específicas de especies variables de las lectinas revelaron que ambas especies tienen características glucómicas diversas que pueden estar relacionadas con sus diferentes patrones reproductivos. Sin embargo, las capacidades funcionales asociadas con el glicoma permanecen desconocidas y requieren mayor investigación.

Epididymal disjunction anomalies in undescended testis - a factor associated with spermatic obstruction

ABSTRACT Background: To analyze the incidence of epididymal anomalies (EAs) associated to spermatic obstruction in patients with undescended testis (UT) according to testicular position and age. Materials and Methods: We studied 87 patients (110 testis) with cryptorchidism and analyzed the presence of EAs correlated with the testicular position, age and patency of the processus vaginalis (PV). To analyze the relations between the testis and epididymis we considered three situations: (a) Normal pattern: the epididymis was attached to the testis at the head and tail and epididymis totally attached to the testis; (b) EAs: when the epididymis was attached to the testis only at the head (Figure-1A) and (c) EAs associated to spermatic obstruction: epididymis was attached to the testis only at the tail (Figure-1B) and when there are no visible connection between testis and epididymis (Figure-1C). We used the Wilcoxon-Mann-Whitney test and the Chi-square test for contingency analysis (p <0.05). Results: The mean age of the patients was 5.18 years (SD=2.867). Of 110 testes analyzed, 14 were abdominal (12.72%); 83 inguinal (75.45%) and 13 suprascrotal (11.81%). Normal relationships between testis and epididymis were observed in 54 patients (62.1%) with no significant differences in relation to the patient's age (p=0.666). Epididymal tail disjunction was observed in 23 patients (26.44%), with no significant differences in relation to age (p=0.59). EAs associated to spermatic obstruction were observed in 16 patients (18.4%), also with no significant differences in relation to age (p=0.684). We did not observe significant correlation between the testis position and the incidence of EAs (p=0.119). We did not observe significant correlations between patency of the PV (64.7%) and incidence of EAs (p=0.742). Conclusions: Epididymal anomalies associated with spermatic obstruction are present in almost 20% of undescended testes, without significant correlation with age, testicular position and patency of the PV. This information needs to be correlated to the infertility risk of this congenital anomaly.

Effect of acupoint thread-embedding on macrophage polarization of epididymis adipose tissue in obese mice / 中国针灸

OBJECTIVE@#To observe the effect of acupoint thread-embedding at "Zusanli" (ST 36) and "Fenglong" (ST 40) on the macrophage polarization of epididymis adipose tissue in obese mice, and to explore the action mechanism of acupoint thread-embedding on weight control.@*METHODS@#Among 30 male C57BL/6 mice, 10 mice were randomly selected and fed with normal diet, and the remaining 20 mice were fed with high-fat diet to establish the obesity model. Sixteen mice with successful obesity model were randomly divided into a model group and an acupoint thread-embedding group, 8 mice in each group. Eight mice were selected from mice which were fed with normal diet as the normal group. On the next day of successful modeling, acupoint thread-embedding was performed at "Zusanli" (ST 36) and "Fenglong" (ST 40) in the acupoint thread-embedding group, once every 10 days for 4 times. The body weight was recorded at 0, 8, 16, 24, 32, 40 days into intervention; the level of glucose metabolism was compared after intervention; the level of lipid metabolism and weight of epididymal adipose tissue were compared at the end of the intervention; the mRNA expression of M1 and M2 macrophage-related cytokines interleukin-10 (IL-6), monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) were detected by real-time PCR; the mRNA and protein expression of M1 macrophage labeled inducible nitric oxide synthase (iNOS) and M2 macrophage labeled arginase-1 (Arg-1) were detected by real-time PCR and Western blot.@*RESULTS@#Compared with the normal group, the body weight at 0, 8, 16, 24, 32, 40 days into intervention in the model group was increased (@*CONCLUSION@#Acupoint thread-embedding at "Zusanli" (ST 36) and "Fenglong" (ST 40) may play a role in weight control by regulating the polarization of macrophages.

Circadian effects of ionizing radiation on reproductive function and clock genes expression in male mouse

BACKGROUND@#Exposure to the ionizing radiation (IR) encountered outside the magnetic field of the Earth poses a persistent threat to the reproductive functions of astronauts. The potential effects of space IR on the circadian rhythms of male reproductive functions have not been well characterized so far.@*METHODS@#Here, we investigated the circadian effects of IR exposure (3 Gy X-rays) on reproductive functional markers in mouse testicular tissue and epididymis at regular intervals over a 24-h day. For each animal, epididymis was tested for sperm motility, and the testis tissue was used for daily sperm production (DSP), testosterone levels, and activities of testicular enzymes (glucose-6-phosphate dehydrogenase (G6PDH), sorbitol dehydrogenase (SDH), lactic dehydrogenase (LDH), and acid phosphatase (ACP)), and the clock genes mRNA expression such as Clock, Bmal1, Ror-α, Ror-β, or Ror-γ.@*RESULTS@#Mice exposed to IR exhibited a disruption in circadian rhythms of reproductive markers, as indicated by decreased sperm motility, increased daily sperm production (DSP), and reduced activities of testis enzymes such as G6PDH, SDH, LDH, and ACP. Moreover, IR exposure also decreased mRNA expression of five clock genes (Clock, Bmal1, Ror-α, Ror-β, or Ror-γ) in testis, with alteration in the rhythm parameters.@*CONCLUSION@#These findings suggested potential health effects of IR exposure on reproductive functions of male astronauts, in terms of both the daily overall level as well as the circadian rhythmicity.

Influence of age, body weight and season on testicular and epididymis biometrics in donkeys (Equus asinus) / Influencia de la edad, el peso corporal y la estación en la biometría testicular y el epidídimo en burros (Equus asinus)

SUMMARY: The objective of this present investigation was undertaken to study the testicular and epididymal biometrical characteristics in Algerian donkeys throughout the year according to age, body weight and seasonal changes. The study was conducted from February 2019 to January 2020. A total of 24 sexually mature donkeys (Equus asinus) were selected randomly. The testis and epididymis were collected after slaughter of donkeys and separated from the conjunctive and adherent tissues. The epididymis has been carefully removed at the testicular junction. In total, 10 biometric measures were selected and performed. Our results revealed that there are significant differences (P<0.05) between groups in most biometrics values. All biometric parameters varied throughout the year and were affected by the season. Significant differences of the GSI and SC values (P<0.05) were observed in different age groups and seasons. On the other hand, no significant differences were observed between the body weight categories of donkeys. The analysis of the correlation coefficients between the biometric values shows high positive correlations, ranged between 0.98 and 0.72 (P<0.001). There was a high positive correlation between age and all the parameters, ranged from 0.85 to 0.61 (P<0.001). However, there were low negative correlations between season and; testicular and epididymal biometrics. It is the first investigation that describes the male reproductive organs in donkeys of the Algerian race (Equus asinus), on the basis of biometric testicular and epididymal measurements. Our results showed that the essential differences were noted between some biometric parameters and the age, season and body weight of donkeys. In addition, the correlation coefficients were supported between biometric measurements and these factors. However, other approaches are necessary to undertake, such as histology of reproductive organs and hormone measurement, for a deeper understanding of the physiology of reproduction in donkeys.

RESUMEN: El objetivo de esta investigación fue estudiar las características biométricas testiculares y epididimarias en burros Argelinos durante todo el año de acuerdo con la edad, el peso corporal y los cambios estacionales. El estudio se realizó entre febrero de 2019 y enero de 2020. Se seleccionó al azar un total de 24 burros sexualmente maduros (Equus asinus). Los testículos y el epidídimo se recogieron después del sacrificio de los burros y se separaron de los tejidos conjuntivos y adherentes. El epidídimo se eliminó cuidadosamente en la unión testicular. En total, se seleccionaron y realizaron 10 medidas biométricas. Nuestros resultados revelaron que existen diferencias significativas (P <0,05) entre los grupos en la mayoría de los valores biométricos. Todos los parámetros biométricos variaron a lo largo del año y se vieron afectados por la temporada. Se observaron diferencias significativas de los valores de GSI y SC (P <0,05) en diferentes grupos de edad y estaciones. Por otra parte, no se observaron diferencias significativas entre las categorías de peso corporal de los burros. El análisis de los coeficientes de correlación entre los valores biométricos muestra altas correlaciones positivas, entre 0,98 y 0,72 (P <0,001). Hubo una alta correlación positiva entre la edad y todos los parámetros, que varió de 0,85 a 0,61 (P <0,001). Sin embargo, hubo bajas correlaciones negativas entre temporada y biometría testicular y epididimaria. Es la primera investigación que describe los órganos reproductores machos en burros de la raza Argelina (Equus asinus), sobre la base de mediciones biométricas testiculares y epididimarias. Nuestros resultados mostraron que se observaron las diferencias esenciales entre algunos parámetros biométricos y la edad, la estación y el peso corporal de los burros. Además, los coeficientes de correlación fueron compatibles entre las mediciones biométricas y estos factores. Sin embargo, son necesarios otros enfoques, como la histología de los órganos reproductivos y la medición de hormonas, para una mayor comprensión de la fisiología de la reproducción en burros.

Eficiência de duas técnicas de recuperação de espermatozoides epididimários de cães e avaliação seminal pós-criopreservação / [Efficiency of two techniques for recovering epididymal spermatozoids from dogs and seminal evaluation post cryopreservation]

O objetivo deste trabalho foi avaliar a recuperação de espermatozoides epididimários de cães castrados, utilizando as técnicas de fluxo retrógrado (FR) e flutuação (FL) em diluidor Tris-gema, antes e após a criopreservação. Foram coletados 30 complexos testículo-epididímos (CTE), sendo 15 para FR e 15 para FL, e, logo após a recuperação dos espermatozoides, foram analisadas as alterações morfológicas nessas células espermáticas. Após a adição do diluidor, foram avaliados os parâmetros de motilidade total (MOT) e vigor (V) espermáticos. O sêmen pós-criopreservado foi submetido ao teste de termorresistência nos tempos T0, T30, T60 e T90 minutos, além da avaliação das membranas plasmática e acrossomal por sondas fluorescentes. Não houve diferença estatística entre as técnicas quanto à MOT e ao vigor no sêmen diluído (FR-MOT: 82,3% e V: 3,4; FL-MOT: 79,6% e V: 3,2) e pós-criopreservado (FR-MOT: 34% e V: 2,8; FL-MOT: 30% e V: 2,7). A partir do T30, houve diferença significativa quanto à MOT e ao vigor nas técnicas utilizadas, e o tempo também prejudicou o acrossoma espermático a partir do T30. Conclui-se que as técnicas de recuperação de espermatozoides epididimários de cães castrados, testadas neste trabalho, podem ser utilizadas para refrigeração e criopreservação de sêmen.(AU)

The objective of this work was to evaluate the recovery of epididymal spermatozoa from castrated dogs using retrograde flow (FL) and flotation (FL) techniques in Tris-egg yolk diluent, before and after cryopreservation. Thirty testicle-epididymal complexes (CTE) were collected, 15 for FR and 15 for FL and soon after spermatozoid recovery, morphological changes in these spermatic cells were analyzed. After addition of the diluent, the parameters of total motility (MOT) and vigor (V) were evaluated. The post-cryopreserved semen was submitted to thermoresistance (TTR) test at T0, T30, T60 and T90 minutes, as well as the plasma and acrosomal membrane evaluation by fluorescent probes. There was no statistically significant difference between techniques tested for MOT and vigor in the diluted semen (FR-MOT: 82.3% and V: 3.4, FL-MOT: 79.6% and V: 3.2) and post-cryopreserved (FR-MOT: 34% and V: 2.8, FL-MOT: 30% and V: 2.7). From the T30 there was a significant difference regarding MOT and vigor in the used techniques, and the time also damaged the spermatic acrosome from the T30. It is concluded that the epididymal spermatozoa recovering techniques from castrated dogs, tested in this study, can be used for semen refrigeration and cryopreservation.(AU)

Reporte del primer caso de cistoadenoma papilar de epidídimo en Colombia, Hospital Universitario de Santander / Report of the first case of papillary cystadenoma of the epididymis in Colombia

Resumen La presencia de una masa en la región escrotal comprende un amplio espectro de patologías, unas con mayor urgencia para el manejo que otras, dado el riesgo asociado de pérdida testicular o desarrollo de cáncer. Dentro de las posibilidades diagnósticas se encuentran las neoplasias, destacando las originadas en el epidídimo, con un 75% de casos de etiología benigna, correspondiendo un 9% al cistoadenoma papilar de epidídimo que sobresale por su baja frecuencia dado que en la literatura mundial existen aproximadamente 70 reportes publicados con escasos provenientes de literatura médica en castellano, en los que se incluye el presente caso expuesto en el que se confirma histopatológicamente un cistoadenoma papilar de epidídimo y se presenta una revisión del tema acerca del enfoque de un paciente con masa escrotal. Asimismo se resalta el hecho de que esta lesión puede asociarse con la enfermedad de Von Hippel Lindau, sobre todo en presentaciones bilaterales. MÉD.UIS. 2020;33(2):95-100.

Abstract The presence of a mass in the scrotal region comprises a wide spectrum of pathologies, some with greater urgency for management than others, given the associated risk of testicular loss or cancer development. Among the diagnostic possibilities are the neoplasms, highlighting those originating in the epididymis, with 75% of cases of benign etiology, 9% corresponding to the papillary cystadenoma of the epididymis that stands out for its low frequency given that in the world literature there are approximately 70 published reports with few from medical literature in Spanish, which include the present case presented in which a papillary cystadenoma of the epididymis is confirmed histopathologically and a review of the topic about the approach of a patient with scrotal mass is presented. Also the fact that this lesion can be associated with von Hippel Lindau disease, especially in bilateral presentations is highlighted. MÉD.UIS. 2020;33(2):95-100.

Effect of refrigeration at -1°C on spermatozoa quality of domestic cats / Efeito da refrigeração a -1°C na qualidade de espermatozoides de gatos domésticos

The objective of this study was to evaluate the sperm quality obtained of domestic cats by electroejaculation and recovery of the tail of the epididymis after cooling at -1°C and 4°C for 24 and 48 hours. Twenty-nine adult cats (2 to 6kg) were used. Sperm collection was performed by electroejaculation (EEJ), and after 48 hours, the cats were orchiectomized, and sperm sample was obtained from the vas deferens and epididymis tail (EPD). The samples were diluted in ACP-117® extender, and the sperm characteristics were evaluated at three different moments: when still fresh, 24 and 48 hours after cooling. The objective of this study was to evaluate the sperm quality obtained of domestic cats by electroejaculation and recovery of the tail of the epididymis after cooling at -1°C and 4°C for 24 and 48 hours. Twenty-nine adult cats (2 to 6kg) were used. Sperm collection was performed by electroejaculation (EEJ), and after 48 hours, the cats were orchiectomized, and sperm sample was obtained from the vas deferens and epididymis tail (EPD). The samples were diluted in ACP-117® extender, and the sperm characteristics were evaluated at three different moments: when still fresh, 24 and 48 hours after cooling. In order to compare the two refrigeration temperatures, the first stage was to analyze if there was a difference between the harvesting techniques. After this, two experiments were conducted: in the first, sperm sample from 14 cats were used and the cooling was performed at -1°C; and in the second, sample from 15 cats were used and the sperm were refrigerated at 4°C. Sperm kinetics were evaluated by computerized analysis (CASA) and concentration by Neubauer chamber, spermatic morphology was evaluated by modified Karras staining, and membrane integrity was evaluated by eosin nigrosine. The results obtained were analyzed in R software, version 3.2.5 using the Mann-Whitney test for variables with abnormal distributions, considering significance at the level of 5%. In ejaculate samples, higher values of total morphological defects were observed after 24 and 48 hours of refrigeration at 4°C (P<0.022) compared to refrigeration at -1°C, using Friedman test. To quantify the decrease in sperm quality, parameter reductions were calculated among time points (F-24h/F-48h/24h-48h). In EPD samples, a greater reduction in sperm quality was detected after 24 hours of refrigeration at 4°C, both in motility and sperm kinetics and in the movement and velocity indices, compared to refrigeration at -1°C. Based on the results, it can be concluded that cooling of feline spermatozoa at -1°C for up to 48 hours was efficient in maintaining spermatic quality collected by EEJ and EPD, and it could be an alternative to spermatozoa cryopreservation in domestic felines.(AU)

O objetivo deste trabalho foi avaliar a qualidade espermática de gatos domésticos obtidos por eletroejaculação e recuperação da cauda do epidídimo após a refrigeração a -1°C e a 4°C por 24 e 48 horas. Vinte e nove gatos adultos (2 a 6kg) foram utilizados. A colheita de espermatozoides foi realizada por eletroejaculação (EEJ) e, após 48 horas, os gatos foram orquiectomizados, e as amostras espermáticas foram obtidas a partir do ducto deferente e da cauda do epidídimo (EPD). As amostras foram diluídas em ACP-117® e as características espermáticas foram avaliadas em três momentos distintos: fresco, 24 e 48 horas após a refrigeração. Para ser possível comparar as duas temperaturas de refrigeração, a primeira etapa foi analisar se havia diferença entre as técnicas de colheita. Após isto, dois experimentos foram conduzidos: no primeiro, espermatozoides de 14 gatos foram utilizados e a refrigeração foi realizada a -1°C; e no segundo, amostras de 15 gatos foram utilizados e os espermatozoides foram refrigerados a 4°C. A cinética espermática foi avaliada por análise computadorizada (CASA), a concentração por câmara de Neubauer, a morfologia espermática foi avaliada pela coloração de Karras modificada, e a integridade da membrana foi avaliada por eosina nigrosina. Os resultados obtidos foram analisados no software R, versão 3.2.5, utilizando o teste de Mann-Whitney para variáveis com distribuições anormais, considerando significância ao nível de 5%. No ejaculado, maiores valores de defeitos morfológicos totais foram observados após 24 e 48 horas de refrigeração a 4°C (P<0,022) em comparação com refrigeração a -1°C, usando o teste de Friedman. Para quantificar a diminuição na qualidade espermática, as reduções dos parâmetros foram calculadas entre os pontos de tempo (F-24h/F-48h/24h-48h). Na EPD, uma maior redução na qualidade espermática foi detectada após 24 horas de refrigeração a 4°C, tanto na motilidade e na cinética espermática quanto nos índices de movimento e velocidade, em comparação com a refrigeração a -1°C. Com base nos resultados, pode concluir-se que a refrigeração dos espermatozoides felino a -1°C, até 48 horas, foi eficaz na manutenção da qualidade espermático colhidos por EEJ e EPD, e pode ser uma alternativa para a criopreservação de espermatozoides em felinos domésticos.(AU)

Clinical Usefulness of Cancer Antigen (CA) 125, Human Epididymis 4, and CA72-4 Levels and Risk of Ovarian Malignancy Algorithm Values for Diagnosing Ovarian Tumors in Korean Patients With and Without Endometriosis

BACKGROUND: Tumor markers are useful for detection and preoperative evaluation of ovarian tumors. We evaluated the clinical usefulness of cancer antigen (CA) 125, human epididymis 4 (HE4), and CA72-4 levels and Risk of Ovarian Malignancy Algorithm (ROMA) values for differential diagnosis of malignant and borderline tumors among suspected ovarian tumors, and the effects of endometriosis on these tumor markers. METHODS: In a total of 266 patients (213, 14, and 39 with benign, borderline and malignant tumors, respectively), CA125, HE4, and CA72-4 levels were measured, and ROMA values were calculated. Medians of each marker were compared among the three groups. The area under the ROC curve (AUC), sensitivity, and specificity were calculated to analyze the diagnostic performance of each marker. RESULTS: All markers were significantly higher in the malignant group than in the benign group. HE4 levels and ROMA values were significantly higher in the malignant group than in the borderline group. ROMA value had the highest AUC for distinguishing the malignant and borderline groups from the benign group in premenopausal (0.773) and postmenopausal (0.927) patients. CA125 level was significantly higher in patients with endometriosis than in those without (P<0.001), whereas HE4 and CA72-4 levels were not affected by endometriosis (P=0.128 and 0.271, respectively). CONCLUSIONS: ROMA value is the best marker to distinguish malignant and borderline tumors from benign tumors in pre- and postmenopausal patients. HE4 and CA72-4 levels provide information on possible CA125 elevation due to endometriosis.

Antioxidant action of alpha lipoic acid on the testis and epididymis of diabetic rats: morphological, sperm and immunohistochemical evaluation

ABSTRACT Introduction Chronic hyperglycemia is caused by diabetes mellitus-committed genital morphophysiology, and oxidative stress is one of the main factors involved in this process. Alpha lipoic acid (ALA) can prevent metabolic and morphological changes in diabetic individuals. Objectives In present study, we evaluated the effects of regular ALA consumption on the spermatogenesis and histoarchitecture in the male genital system of diabetic rats. Materials and Methods Thirty-two Wistar rats were divided into groups: Control (CG); Diabetic Control (DCG), receiving commercial diet: ALA Group (ALAG) and Diabetic ALA Group (DALAG), fed diets with added ALA (300 mg/Kg bw). The diabetic groups received a single injection of streptozotocin (60 mg/kg). After sixty days of the diet, the animals were euthanized, and semen, testis and epididymis samples were collected. A histomorphometric analysis was performed to determine the epithelial height, tubular and luminal diameter, tubular and luminal area of seminiferous tubules and each epididymal region. Sertoli cells were evidenced using the antivimenti antibody and were quantified. The results were statistically analyzed by the ANOVA test. Results At the end of the experiment, the DALAG glycemia was significantly lower than DCG. The histomorphometric parameters of the seminiferous and epididymal tubules did not show improvement in the DALAG. However, there was an improvement in the DALAG in terms of the concentration, motility and percentage of spermatic pathologies, as well as in the number of Sertoli cells (p<0.001). Conclusions The results demonstrated that supplementation with the ALA antioxidant retards testicular lesions and preserve the process of spermatogenesis in diabetes.

Morphology and biometry of the reproductive organs of adult males of Trachemys scripta elegans reared in São Paulo state, Brazil / Morfologia e biometria dos órgãos reprodutivos de machos adultos de Trachemys scripta elegans criados em São Paulo, Brasil

Trachemys scripta elegans is an American underwater chelonian illegally marketed in Brazilian pet shops. When abandoned in nature, it compromises native species, threatening local biodiversity. However, little is known about the body development and structure of its reproductive tract. The objective of the present study was to investigate the morphology and biometry of testis, epididymis and penis, as well as the biometry of the body and secondary sexual characters in this species. Twenty-seven adult males were used aiming to contribute to preservation actions in captivity, population control, and scientific research, as well as to interspecific comparisons. Sex identification by the third claw length was effective, and the specimens presented harmonious and positive body development between mass, carapace, plastron, and height, with unimodal tendency and higher frequency of maximum carapace length at 15cm. The testes and epididymides presented biometric similarity between the antimeres and anatomical and histological structure similar to that of other species of chelonians and mammals, except for the type of epithelium. The findings suggest that there is conserved morphology between slider turtles and homology in relation to mammals. Histological similarity to the reproductive organs of other amniotes, including humans, may give rise to scientific and comparative studies, essential for the establishment of conservation strategies in reptiles.(AU)

Trachemys scripta elegans é um quelônio subaquático americano ilegalmente comercializado em pet shops brasileiros. Ao ser abandonado na natureza, compromete as espécies nativas, ameaçando à biodiversidade local. No entanto, pouco se conhece sobre o desenvolvimento corporal e a estrutura do seu aparelho reprodutor. O objetivo do presente trabalho foi investigar a morfologia e a biometria dos testículos, epidídimos e pênis, a biometria corporal e dos caracteres sexuais secundários. Foram utilizados 27 machos adultos desta espécie, visando contribuir com ações de preservação em cativeiro, controle populacional e pesquisas científicas, além de comparações interespecíficas. A identificação sexual pelo comprimento da terceira garra foi efetiva e os espécimes apresentaram desenvolvimento corporal harmônico e positivo entre massa, carapaça, plastrão e altura, com tendência unimodal e maior frequência de comprimento máximo de carapaça em 15,0cm. Testículos e epidídimos apresentaram semelhança biométrica entre os antímeros e estrutura anatômica e histológica semelhantes à de outras espécies de quelônios e mamíferos, excetuando-se pelo tipo de epitélio. Os achados sugerem haver morfologia conservada entre os cágados e homologia em relação aos mamíferos. A semelhança histológica com os órgãos reprodutivos de outros amniotas, incluindo os humanos, pode dar ensejo a estudos científicos e comparativos, essenciais para estabelecimento de estratégias de conservação em répteis.(AU)

Efeito da adição de plasma seminal oriundo de animais de alta e baixa fertilidade na criopreservação de espermatozoides da cauda do epidídimo e do ejaculado de garanhões subférteis / Effect of seminal plasma addition from high and low fertility animals on the cryopreservation of epididymal tail and ejaculated sperm from subfertile stallions

O objetivo do presente estudo foi avaliar o efeito da adição de plasma seminal de garanhões de alta e baixa fertilidade sobre a congelabilidade e a viabilidade de espermatozoides do ejaculado (EJ) e do epidídimo (EP) de garanhões subférteis. Foram utilizados seis garanhões com histórico de subfertilidade. Após coleta, espermatozoides do ejaculado foram divididos em três alíquotas: BotuSêmen® (EJ-CT); plasma seminal de alta qualidade espermática (EJ-PS1); e plasma seminal de baixa qualidade espermática (EJ-PS2). O mesmo protocolo foi realizado com espermatozoides da cauda do epidídimo após orquiectomia (EP-CT; EP-PS1; EP-PS2). Foram realizadas avaliações da cinética espermática pelo CASA e análises de integridade de membrana, acrossoma, fragmentação de DNA, capacitação espermática e peroxidação espermática por citometria de fluxo. Não foram observadas diferenças na cinética espermática entre EJ e EP, logo após a descongelação. Porém, foi observada maior (P<0,05) porcentagem de células com membranas plasmática e acrossomal íntegras nos grupos EP (EP-CT:31,7±7,5b; EP-PS1:35,2±7,0b; EP-PS2:33,9±7,2b) em comparação aos grupos EJ (EJ-CT:15,1±4,9a; EJ-PS1:11,7±4,5a; EJ-PS2:13,1±5,2a). Adicionalmente, foram observadas diferenças no índice de fragmentação de DNA (EJ-CT:2,6±0,6a; EJ-PS1:2,4±0,8a; EJ-PS2:3,0±0,8a; EP-CT:1,4±0,4b; EP-PS1:1,2±0,3b; EP-PS2:1,3±0,2b). Concluiu-se que a adição de 20% de plasma seminal, oriundo de animais férteis ou subférteis, previamente à congelação de espermatozoides epidídimários de animais subférteis não interfere na qualidade espermática.(AU)

The aim of this study was to compare the effect of the addition of seminal plasma from high and low fertility stallions on sperm viability of frozen-thawed sperm cells from ejaculate and from epididymal tail of subfertile stallions. Six stallions with a history of subfertility were used. After collection, ejaculate spermatozoa were divided into three aliquots: Botu-Semen® (EJ-CT); High-quality seminal plasma (EJ-PS1); Low-quality seminal plasma (EJ-PS2). The same was done with sperm cells from epididymis tail after orchiectomy (EP-CT; EP-PS1; EP-PS2). Evaluations of sperm kinetics were assessed by CASA and membrane and acrosome integrity, DNA fragmentation, sperm capacitation and sperm peroxidation were assessed by flow cytometry. After thawing, no differences were observed between ejaculated sperm (EJ) and epididymal sperm (EP) in any CASA evaluations. However, higher (P< 0.05) percentage of cells with intact plasma and acrossomal membranes was observed in EP groups (EP-CT:31.7±7.5b; EP-PS1:35.2±7.0b; EP-PS2:33.9±7.2b) compared to EJ groups (EJ-CT:15.1±4.9a, EJ-PS1:11.7±4.5a, EJ-PS2:13.1±5,2a). In addition, differences in DNA fragmentation index were observed (EJ-CT:2.6±0.6a; EJ-PS1:2.4±0.8a; EJ-PS2:3.0±0.8a; CT:1.4±0.4b; EP-PS1:1.2±0.3b; EP-PS2:1.3±0.2b). It was concluded that the addition of 20% seminal plasma from fertile or subfertile animals prior to the freezing of epididymal spermatozoa from subfertile animals does not interfere in sperm quality.(AU)

Hidrocele como manifestación inicial de tuberculosis genitourinaria y miliar / Hydrocele as initial manifestation of genitourinary and miliary tuberculosis / Hidrocele como manifestação inicial da tuberculose geniturinária e miliar

Introducción. La tuberculosis es una enfermedad infectocontagiosa que puede afectar cualquier órgano del cuerpo, incluyendo el sistema genitourinario, representando el 33.7-45.5 % de las tuberculosis extrapulmonares. El objetivo de este trabajo es reportar el caso de un paciente con hidrocele como manifestación inicial de tuberculosis genitourinaria y miliar, enfermedad que no se sospechaba. Presentación del caso. Paciente masculino previamente sano, que consulta a urgencias por orquialgia e hidrocele bilateral, con secreción purulenta por escroto, requiriendo manejo antibiótico intravenoso e hidrocelectomía derecha, con hallazgos intraoperatorios de engrosamiento del epidídimo derecho, y drenaje de material caseoso y purulento. Se realizó epididimectomía ipsilateral, se solicitaron pruebas de detección de bacilos tuberculosos en espécimen y derivado proteico purificado, que fueron positivas. En el postoperatorio presentó sintomatología respiratoria; paraclínicos evidenciaron compromiso pulmonar, pleural y de la vía urinaria por bacilos tuberculosos. Se inicia manejo antituberculoso con evolución satisfactoria. Discusión. El genitourinario es considerado el segundo sistema con mayor afectación de tuberculosis extrapulmonar. El órgano más afectado es el riñón (en un 80 % con respecto a los demás) y el órgano genital es el epidídimo (22 - 55 %). Debe sospecharse en pacientes con síntomas urinarios crónicos sin causa aparente. Se asocia a una alta tasa de morbimortalidad por infertilidad y falla renal. Conclusiones. A pesar de su sintomatología inespecífica y de tratarse de una entidad poco sospechada, la tuberculosis genitourinaria debe descartarse al existir tuberculosis pulmonar. Su diagnóstico y tratamiento oportuno serán de gran importancia para evitar complicaciones secundarias. Cómo citar: Álvarez-Jaramillo J, Ortiz-Zableh AM, Tarazona-Jiménez P, Ortiz-Azuero A. Hidrocele como manifestación inicial de tuberculosis genitourinaria y miliar. MedUNAB. 2019;22(1):71-78. doi:10.29375/01237047.3534

Introduction. Tuberculosis is an infectious disease that can affect any organ in the body, including the genitourinary system, which accounts for 33.7 - 45.5 % of non-pulmonary tuberculosis cases. The purpose of this paper is to report a case of hydrocele as initial manifestation of genitourinary and miliary tuberculosis, which was an unsuspected disease. Case Presentation. Previously healthy male patient is admitted to emergencies due to orchialgia and bilateral hydrocele, with purulent secretion from the scrotum. Was managed with intravenous antibiotic and right hydrocelectomy. Intraoperative findings of thickening of right epididymis and drainage of caseous and purulent material. Ipsilateral epididymectomy was performed; testing for detection of tubercle bacillus in specimen and purified protein derivative was requested, and was found positive. In the postoperative period, respiratory symptoms arose; paraclinical tests found compromised lungs, pleura and urinary tract by tubercle bacillus. Antituberculous treatment was initiated with satisfactory evolution. Discussion. The genitourinary system is the second-most affected system by nonpulmonary tuberculosis. The most affected organ is the kidney (by 80 % compared to the others) and the most affected genital organ is the epididymis (22 - 55 %). It should be suspected in patients with chronic urinary symptoms with no apparent cause. It is associated with a high rate of morbidity and mortality due to infertility and kidney failure. Conclusions. Despite the non-specific symptoms and because it is not normally a suspected entity, genitourinary tuberculosis should be ruled out when pulmonary tuberculosis exists. Timely diagnosis and treatment are very important in order to prevent secondary complications. Cómo citar: Álvarez-Jaramillo J, Ortiz-Zableh AM, Tarazona-Jiménez P, Ortiz-Azuero A. Hidrocele como manifestación inicial de tuberculosis genitourinaria y miliar. MedUNAB. 2019;22(1):71-78. doi:10.29375/01237047.3534

Introdução. A tuberculose é uma doença infecciosa que pode afetar qualquer órgão do corpo, incluindo o sistema geniturinário, representando 33.7 a 45.5 % da tuberculose extrapulmonar. O objetivo deste trabalho é relatar o caso de um paciente com hidrocele como uma manifestação inicial de tuberculose geniturinária e miliar, uma doença que não se suspeitava. Apresentação do caso. Paciente do sexo masculino previamente saudável, que consultou a emergência para orquialgia e hidrocele bilateral, com secreção purulenta do escroto, necessitando de tratamento antibiótico endovenoso e hidrocelectomia direita, com achados intraoperatórios de espessamento do epidídimo direito e drenagem de material purulento e caseoso. Foi realizada uma epididimectomia ipsilateral e foram solicitados exames de bacilos tuberculosos em espécime e derivado proteico purificado, que foram positivos. No pós-operatório, apresentou sintomas respiratórios; testes para-clínicos mostraram comprometimento pulmonar, pleural e do trato urinário devido a bacilos da tuberculose. Começa-se o tratamento antituberculose com evolução satisfatória. Discussão. O sistema geniturinário é considerado o segundo com maior comprometimento da tuberculose extrapulmonar. O órgão mais afetado é o rim (80 % em relação aos demais) e o órgão genital é o epidídimo (22 a 55 %). Deve-se suspeitar em pacientes com sintomas urinários crônicos sem causa aparente. Está associada a uma alta taxa de morbimortalidade devido à infertilidade e insuficiência renal. Conclusões. Apesar de sua sintomatologia inespecífica e de ser uma entidade pouco suspeitada, a tuberculose geniturinária deve ser descartada quando existir tuberculose pulmonar. Seu diagnóstico e tratamento oportuno serão de grande importância para evitar complicações secundárias. Cómo citar: Álvarez-Jaramillo J, Ortiz-Zableh AM, Tarazona-Jiménez P, Ortiz-Azuero A. Hidrocele como manifestación inicial de tuberculosis genitourinaria y miliar. MedUNAB. 2019;22(1):71-78. doi:10.29375/01237047.3534

Production and Performance Evaluation of External Quality Assessment Materials for Human Epididymis Protein 4 Assay / 임상검사와정도관리

BACKGROUND: External quality assessment (EQA) is important for standardizing cancer biomarker assays, thereby, ensuring accurate and precise results. Although the human epididymis-specific protein 4 (HE4) assay has been increasingly used to detect and monitor ovarian malignancy in Korea, a nation-wide EQA program for HE4 has not been appropriately established. To conduct an EQA program, a large amount of quality control (QC) materials are required. This study aimed to produce HE4 QC materials for an EQA program and evaluate their homogeneity and stability. METHODS: QC materials for three different concentrations of HE4 were produced from the collected remnant sera of 275 patients for whom the HE4 assays were performed. These materials were evaluated for homogeneity between vials and stability during storage. The frozen QC materials were distributed to 13 representative organizations for a provisional EQA. RESULTS: The total coefficient of variation of the HE4 QC materials of three concentrations was 0.75%–1.24%, and no significant differences were noted between vials; therefore, the samples were considered to be homogenous. With respect to stability, the HE4 QC materials were found to be stable till 30 days when frozen and for 24 hours when refrigerated. The results of the provisional HE4 EQA were reviewed and the survey results were reported to each participant. CONCLUSIONS: The HE4 QC materials produced from remnant specimens were found to be homogenous between vials and stable in a frozen condition until 30 days. The findings of this study may be practically applied for establishing a future HE4 EQA program.

Expressions of HSP110 family members in the testes and epididymis of mice at different stages of development and their regulation by hormones / 南方医科大学学报

OBJECTIVE@#To study the expressions of the members of HSP110 family in the testis and epididymis of mice at different stages of development and whether they are regulated by hormones.@*METHODS@#The testicular and epididymis tissues of mice at different ages (14, 21, 28, 35, 42, 49, 70, and 90 days after birth, 3 mice at each age) were collected for RT-PCR detection of the expression levels of HSP110 family members. Forty-eight mice were randomized into 3 groups for sham operation, castration, or castration with testosterone injections every other day (starting at 7 days after castration), and at 1, 3, 5, and 7 days after first testosterone injection, the expressions of HSP110 family in the epididymis were detected using RT-PCR.@*RESULTS@#The mRNA expression levels of HSP110 family members underwent obvious variations with the development of the mice: , and expressions in the testicles of the mice first increased and then decreased, and gradually became stable; they also exhibited similar temporal patterns of changes in the epididymis. In the castrated mice, the mRNA expressions of and in the epididymis decreased significantly with the reduction of serum hormone levels ( < 0.05), and became normal after the supplementation of exogenous hormone.@*CONCLUSIONS@#The expression levels of HSP110 family are affected by developmental regulation, and the expressions of and are under the regulation by hormones.