Evaluación de la eficacia de los laboratorios de embriología y anatomía patológica en el análisis de las biopsias testiculares de pacientes azoospérmicos / Evaluation of the Efficacy of the Laboratories of Embryology and Pathological Anatomy in the Analysis of Testicular Biopsies of Patients with Azoospermia

Objetivos: El propósito de este estudio es evaluar la eficacia de los laboratorios de embriología y de anatomía patológica para hallar espermatozoides en las muestras de tejido testicular obtenido por biopsia testicular (testicular sperm extraction, TESE) en pacientes con azoospermia no obstructiva. Materiales y métodos: Se realizó un análisis retrospectivo y prospectivo de todos los pacientes con azoospermia no obstructiva atendidos en CRECER y en la Clínica Privada Pueyrredón, entre enero de 2006 y diciembre de 2016. En este estudio solo se incluyeron aquellos pacientes en los que la muestra obtenida con TESE fue enviada simultáneamente al anatomopatólogo y al laboratorio de embriología. Para el análisis de los resultados de las biopsias el estudio se detuvo a fines de 2016, pero el seguimiento de los pacientes continuó hasta el mes de octubre de 2017, registrándose todos aquellos casos que realizaron procedimientos de inyección intracitoplasmática de espermatozoides (intracytoplasmic sperm injection, ICSI) con muestras obtenidas de TESE y se anotó la obtención de embriones, embarazos y nacimientos. Resultados: El laboratorio de embriología halló espermatozoides en 36 de los 68 pacientes (52,9%), mientras que el laboratorio de patología solo informó presencia en 21 pacientes (30,88%). Hubo acuerdo en el hallazgo de espermatozoides entre ambos laboratorios en 20 de los 68 casos (29,41%), mientras que en 16 pacientes el laboratorio de embriología encontró espermatozoides donde el de patología no pudo hacerlo (23,53%). Al mismo tiempo, el laboratorio de patología halló espermatozoides solo en un caso en el que el de embriología informó su ausencia para la misma muestra analizada (1,47%) (p=0,0003). Conclusiones: El laboratorio de embriología es significativamente más eficaz para determinar la presencia de espermatozoides en las muestras de TESE, teniendo mejor rendimiento que el de patología, por lo que consideramos que, si las muestras fueran analizadas solo por el patólogo, se perdería la posibilidad de lograr muchos embarazos realizando ICSI más TESE.(AU)

Objectives: The purpose of this study is to evaluate the efficacy of embryology and pathological anatomy laboratories to find spermatozoa in testicular tissue samples obtained by testicular sperm extraction (TESE) in patients with non-obstructive azoospermia. Materials and methods: It was carried out a retrospective and prospective analysis of all the patients with non-obstructive azoospermia treated at CRECER and at Clínica Privada Pueyrredón, between January 2006 and December 2016. This study only includes patients in whom the sample obtained with TESE was sent at the same time to the pathology and embryology laboratory. For the analysis of the results of the biopsies, the study was stopped at the end of 2016, but the follow-up of the patients continued until October 2017, registering all those cases that performed intracytoplasmic sperm injection (ICSI) with samples obtained from TESE and wrote down the patients who´ve got embryos, pregnancies, and births. Results: The embryology laboratory found sperm in 36 of the 68 patients (52.9%), while the pathology laboratory only reported presence in 21 patients (30.88%). There was agreement in the finding of sperm between both laboratories in 20 of the 68 cases (29.41%), while in 16 patients the embryology laboratory found sperm where the pathology department could not do so (23.53%). At the same time, the pathology laboratory found sperm only in one case in which the embryology department reported its absence for the same sample analyzed (1.47%) (p=0.0003). Conclusions: The embryology laboratory is significantly more efficient to determine the presence of sperm in the samples of TESE, having better performance than the pathology one. Taking into account that, we believe that if the samples are only analyzed by the pathologist, the possibility of getting many pregnancies performing ICSI plus TESE would be lost. (AU)

Interacciones epitelio-mesenquimáticas en el desarrollo testicular / Epithelial-mesenchymal transitions in the development of testis

RESUMEN: La espermatogénesis es un proceso continuo que se inicia durante el desarrollo embriofetal. Las relaciones auto, para y yuxtacrinas indican la interdependencia de las células intersticiales (de Leydig) con las células peritubulares (lamina propia) y células sustentaculares (de Sertoli). Ciertos morfógenos son fundamentales en este proceso. Las células sustentaculares son capaces de regular la diferenciación y función de las células peritubulares e intersticiales a través de la producción de IGF1, TGFA, TGFB y DHH. Las células peritubulares son capaces de producir P-Mod-S, regulando la diferenciación de las células sustentaculares, y a través de FGF2 y FGF9 modulan las transiciones epitelio-mesenquimática entre células sustentaculares y mesonefros. También remodelan la membrana basal del condón testicular y regulan la diferenciación y función de las células intersticiales por medio de IGF1, TGFA y TGFB. Las células intersticiales son las reponsables de la producción de testosterona e INSL3, influyendo en la diferenciación sexual masculina. Se plantea que provienen de células mesenquimales del epitelio celómico y mesonefros. Sin embargo, otros autores proponen su origen a partir de células de la cresta neural. Estas influyen a través de mecanismos paracrinos en la proliferación de las células sutentaculares por medio de activina A, teniendo como resultado la expansión del cordón testicular. Las interacciones entre las distintas poblaciones celulares a través de morfógenos inducen una transición epitelio-mesénquima fundamental en la formación y diferenciación de la gónada masculina.

SUMMARY: Spermatogenesis is a continuous process which starts during the embryo-fetal development. Auto, para and juxtacrine relations indicate the interdependence of the interstitial cells (Leydig) with the peritubular cells (lamina propria) and sustentacular cells (Sertoli). Certain morphogens are fundamental in this process. Sustentacular cells are able to regulate differentiation and function and peritubular interstitial cells through production of IGF1, TGFA, TGFB and DHH. Peritubular cells are able to produce P-Mod-S regulating differentiation sustentacular cells and through FGF2 and FGF9 modulate epithelial-mesenchymal transitions between sustentacular cells and mesonephros. They also remodel the basal membrane of the testicular condom and regulate the differentiation and function of the interstitial cells by means of IGF1, TGFA and TGFB. Interstitial cells are responsible for the production of testosterone and INSL3, influencing male sexual differentiation. It is suggested that they come from mesenchymal cells of the coelomic epithelium and mesonephros. However, other authors propose their origin from cells of the neural crest. These influence through paracrine mechanisms proliferation sutentaculares cells by activin A, resulting in the expansion of cord testicular. The interactions between the different cell populations through morphogens induce a fundamental epithelial-mesenchymal transition in the formation and differentiation of the male gonad.

Do retractile testes have anatomical anomalies?

ABSTRACT Objectives: To assess the incidence of anatomical anomalies in patients with retractile testis. Materials and Methods: We studied prospectively 20 patients (28 testes) with truly retractile testis and compared them with 25 human fetuses (50 testes) with testis in scrotal position. We analyzed the relations among the testis, epididymis and patency of the processus vaginalis (PV). To analyze the relations between the testis and epididymis, we used a previous classification according to epididymis attachment to the testis and the presence of epididymis atresia. To analyze the structure of the PV, we considered two situations: obliteration of the PV and patency of the PV. We used the Chi-square test for contingency analysis of the populations under study (p <0.05). Results: The fetuses ranged in age from 26 to 35 weeks post-conception (WPC) and the 20 patients with retractile testis ranged in ages from 1 to 12 years (average of 5.8). Of the 50 fetal testes, we observed complete patency of the PV in 2 cases (4%) and epididymal anomalies (EAs) in 1 testis (2%). Of the 28 retractile testes, we observed patency of the PV in 6 cases (21.4%) and EA in 4 (14.28%). When we compared the incidence of EAs and PV patency we observed a significantly higher prevalence of these anomalies in retractile testes (p=0.0116). Conclusions: Retractile testis is not a normal variant with a significant risk of patent processus vaginalis and epididymal anomalies.

Is there a trans-abdominal testicular descent during the second gestational trimester? Study in human fetuses between 13 and 23 weeks post conception

ABSTRACT Objectives To confirm if a real inner descend of testis occurs, correlating the testicular position with fetal parameters and analyzing the position of the testes relative to the internal ring. Material and Methods Twenty nine human fetuses between 13 and 23 weeks post conception (WPC) were studied. The fetuses were carefully dissected with the aid of a stereoscopic lens with 16/25X magnification and testicular position observed. With the aid of a digital pachymeter the distance between the lower pole of the kidney and the upper extremity of the testis (DK-T) was measured to show the position of the testis. During the dissection we also indicated the position of the testes relative to the internal ring. Means were statistically compared using simple linear regression and the paired T-test. Results The 58 testes had abdominal position. The DK-T in the right side measured between 0.17 and 1.82cm (mean=0.79cm) and in the left side it was between 0.12 and 1.84cm (mean=0.87cm), without statistically differences (p=0.0557). The linear regression analysis indicated that DK-T in both sides correlated significantly and positively with fetal age. All fetuses with more than 20 WPC, heavier than 350g and with CRL over 22cm had a greater distance than the average DK-T. We xobserved that the 58 testis remains adjacent to the internal ring throughout the period studied. Conclusions The testes remains adjacent to the internal ring throughout the period studied, indicating that there is no real trans-abdominal testicular descent during the second gestational trimester.

The importance of the gubernaculum in testicular migration during the human fetal period

Objectives The objective of this review is to study the role of the gubernaculum in the testicular migration process during the human fetal period. Materials and Methods We performed a descriptive review of the literature about the role of the gubernaculum in testicular migration during the human fetal period. Results In the first phase of testicular migration, the gubernaculum enlarges to hold the testis near the groin and in the second phase the gubernaculum migrates across the pubic region to reach the scrotum. The proximal portion of the gubernaculum is attached to the testis and epididymis and the presence of multiple insertions in the distal gubernaculum is extremely rare. The presence of muscle and nerves in the human gubernaculum is very poor. The gubernaculum of patients with cryptorchidism has more fibrous tissue and less collagen and when the patients are submitted to hormonal treatment, the gubernaculum components alter significantly. Conclusions The gubernaculum presents significant structural modifications during testicular migration in human fetuses. .

Histological and Histochemical Studies on the Prenatal Development of Testis in Goat (Capra hircus) / Estudios Histológicos e Histoquímicos del Desarrollo Prenatal del Testículo de Cabra (Capra hircus)

The study has been conducted on the prenatal development of testis on 70 goat embryo/foeti, categorized into group-I (0-30 days), Group-II (31-60 days), Group-III (61-90 days), Group-IV (91-120 days) and group V (121days-till birth), having 14 embryos/ foeti in each group. The genital ridge was observed at 23 days of gestation. It contained an accumulation of mesenchymal cells, immature RBC's, differentiating fibroblasts and primordial germ cells. The formation of sex cords was evidenced on 44th day of gestation. It contained small mesenchymal cells and large cells arranged in a chain like manner. The convolution of the sex cords started between 61-90 days of gestation, which increased with the increase in the gestation period and at 125 day of gestation few sex cords attained the form of reverse question mark. The sustentocytes (Sertoli cells) were observed among the small cells of sex cords at 56th day of gestation. The tunica albuginia appeared just beneath the germinal epithelium at 44th day of gestation. It consisted of 2-4 layers of mesenchymal cells, fibroblasts and small capillaries. The thickness of tunica albuginia increased with the increase in the age of foetus and between 61-90 days of gestation, the outer thick fibrous and inner thin vascular layer could be demarcated separately. Few mesenchymal cells start differentiating into interstititial endocrine cells (Leydig cells) located in the interstitial spaces at 44th day of gestation.

El estudio se basó en el desarrollo prenatal de testículosde de 70 embriones / fetos de cabra, clasificados en el grupo I (0-30 días), Grupo-II (31-60 días), Grupo III-(61-90 días), grupo IV (91 a 120 días) y el grupo V (121 días-hasta el nacimiento), con 14 embriones / fetos en cada grupo. La cresta genital se observó a los 23 días de gestación. Contenía una acumulación de células mesenquimales inmaduras de RBC, fibroblastos de diferenciación y células germinales primordiales. La formación de los cordones sexuales se puso de manifiesto en el día 44 de gestación. Contenía pequeñas células mesenquimales y células grandes dispuestas en cadena. La convolución de los cordones sexuales se inició entre 61-90 días de gestación, que se incrementaron con el aumento en el período de gestación, a los 125 días de gestación pocos cordones sexuales alcanzaron la forma de signo de interrogación inversa. Los sustentocitos se observaron entre las pequeñas células de los cordones sexuales en el día 56 de gestación. La túnica albugínea apareció justo debajo del epitelio germinal en el día 44 de gestación. Se componía de 2-4 capas de células mesenquimáticas, fibroblastos y capilares pequeños. El espesor de la túnica albugínea aumentó con el avance en la edad del feto y entre 61-90 días de gestación, la capa fibrosa gruesa exterior y la capa interior delgada vascular podría ser demarcadas por separado. Pocas células mesenquimales inician diferenciación en los endocrinocitos intesticiales localizadas en los espacios intersticiales en el día 44 de gestación.

Splenogonadal fusion and testicular cancer: case report and review of the literature / Fusão esplenogonadal e câncer testicular: relato de caso e revisão da literatura

A 36 year-old man after tests for assessing male infertility was diagnosed with primary infertility, bilateral cryptorchidism, nonobstructive azoospermia and discontinuous splenogonadal fusion. Carcinoma in situ was found in his left testicle, which was intraabdominal and associated with splenogonadal fusion. To our knowledge, this is the fourth case of splenogonadal fusion associated with testicular cancer reported. One should always bear in mind the possibility of this association for the left cryptorchid testicle.

Um homem de 36 anos, depois de ser submetido a exames para avaliação de infertilidade masculina, foi diagnosticado com infertilidade masculina primária, criptorquidia bilateral, azoospermia não obstrutiva e fusão esplenogonadal descontínua. Carcinoma in situ estava presente no testículo esquerdo, que tinha localização intra-abdominal e estava associado à fusão esplenogonadal. Esse é o quarto caso de fusão esplenogonadal associada a câncer testicular, segundo nossa avaliação. Deve-se sempre ter em mente a possibilidade dessa associação em testículos criptorquídicos à esquerda.

Histogenesis of testicular parenchyma during prenatal life in buffalo / Histogénesis del parénquima testicular durante la vida intrauterina en el búfalo

The study was conducted on the testes of 18 buffalo foetii to reveal histogenesis and differentiation of different cells of testicular parenchyma. At 8.0 cm CVR (65 days) the seminiferous tubules were present at gonadal periphery and a network of polygonal mesenchymal cells was seen in the centre of testis. These tubules were surrounded by a distinct basement membrane and a single layer of peritubular cells at 10 cm CVR (74 days), which became double layered at 88.0 cm CVR (272 days). The testicular parenchyma at 12.0 cm CVR had two zones; outer zone having longitudinal tubules and inner zone having rounded tubules. But a reverse pattern of their arrangement was observed at 14.0 cm CVR (92 days). The pre-Sertoli cells were first observed in buffalo foetii of 8.0 cm CVR (65 days) in the periphery of seminiferous tubular epithelium whereas the gonocytes were demonstrable in the centre of tubules at 10.6 cm CVR (76 days). The fetal Leydig cells were also reported at 8.0 cm CVR (65 days) but at 14.0 cm CVR (92 days), the interstitium had considerably expanded due to the differentiation of mesenchymal cells into the Leydig cells.

El estudio fue realizado en los testículos de 18 fetos de búfalos, para revelar la histogénesis y diferenciación de las diferentes células de parénquima testicular. A los 8,0 cm de longitud corona-rabadilla (LCR) (65 días) los túbulos seminíferos estuvieron presentes en la periferia de la gónada y una red poligonal de células mesenquimales se observó en el centro del testículo. Estos túbulos estaban rodeados por una membrana basal y una sola capa de células peritubular a los 10 cm LCR (74 días), la cual se convirtió en una doble capa a los 88,0 cm LCR (272 días). El parénquima testicular a 12,0 cm LCR tenía dos zonas, zona exterior con túbulos longitudinales y zona interior con los túbulos redondeados transversalmente. Sin embargo, un patrón inverso en su disposición se observó a los 14,0 cm LCR (92 días). Las células pre-Sertoli se observaron primero en fetos de búfalos de 8,0 cm LCR (65 días) en la periferia del epitelio seminífero tubular, mientras que los gonocitos fueron visibles en el centro de los túbulos a 10,6 cm LCR (76 días). Las células de Leydig fetales también se observaron a los 8,0 cm LCR (65 días), pero a los 14,0 cm LCR (92 días), el intersticio tuvo una considerable expansión debido a la diferenciación de células mesenquimales en células de Leydig.

Anatomical Study on the Descent of Testis in Prenatal Goat (Capra hircus) / Estudio Anatómico del Descenso Testicular Prenatal en la Cabra (Capra hircus)

A study was conducted on 70 embryo/ foetii of goats to observe the descent of testis. These foetii were grouped into I (0-30 days), II (31-60 days), III (61-90 days), IV (91-120days) and V (121 days up to term, having 14 embryos/ foetii in each group. The genital ridge was observed at 1.2cm CRL (23 day) on the ventromedial aspect of mesonephros. At 42nd day, the genital ridge developed into cylindrical structure, the testis, located in the middle of metanephros. The abdominal migration was completed upto 88th day. The testes were situated in the inguinal canal from 89th to 95th day. From 90th day onward, scrotal migration had been observed, however the testis did not reach the base of the scrotum up to term. During the descent of testis, a peritoneal fold detached from the caudal end of the gonad and extended up-to the abdominal floor on 42nd day, known as gubernaculum. In the initial stages of pregnancy it was thin, whitish, jelly like. On 70th day it was enveloped by processus vaginalis. In group V, it became hardened, longer and cord like.

Para observar el descenso de los testículos se realizó un estudio en 70 embriones/fetos de cabra. Estos fetos se agruparon en 5 grupos: I (0-30 días), II (31-60 días), III (61-90 días), IV (91 120 días) y V (121 días hasta término, con 14 embriones / fetos en cada grupo. La cresta genital se observó a 1,2cm CRL (23 días) en la cara ventromedial del mesonefros. En el día 42 día, la cresta genital se convirtió en estructura cilíndrica y los testículos se encontraban en el centro del metanefros. La migración abdominal se completó en 88 días. Los testículos están situados en el canal inguinal entre los 89 y 95 días. Del día 90 en adelante, se observó la migración escrotal, sin embargo, el testículo no llegó a la base del escroto hasta el término del desarrollo. Durante el descenso de los testículos, a los 42 días, un pliegue peritoneal (gubernaculum testis) separado del extremo caudal de la gónada, se extendió hacia el suelo-abdominal. En las etapas iniciales de la preñez la gónada era delgada, blanquecina, gelatinosa. En el día 70 el testículo fue envuelto por el proceso vaginal. En el grupo V, el testículo se había endurecido y alargado asemejándose a una cuerda.

Protective effects of melatonin on testicular torsion and detorsion damage in sprague-dawley rats / Efectos protectores de la melatonina en el daño por torsión y destorsión testicular en ratas prague-dawley

In this study, we evaluated the ultrastructural findings of testis with systemic administration of different doses of melatonin during ischemic period in a rat model of testicular torsion/detorsion (T/D). Testis ischemia-reperfusion (I/R) injury was induced by torsion of the left testis, with a 720 degrees twisting of the spermatic cord so as to produce a total occlusion of testis for 2.5 hours. Subsequently, the same testis was then detorsioned. According to surgical procedure in each group, unilateral orchiectomies were performed for histopathologic examination. The groups were labelled as control group, torsion group (T), torsion and detorsion group (T/D), torsion-detorsion and melatonin group (T/D+20,50 and 100 mg/kg melatonin). For the histological examination, testicular tissues were fixed in 2.5 percent glutheraldehyde and postfixation 1 percent osmic acid solutions. They were examined under transmission electron microscopy after application of contrast stained. In torsion group testis cross-sections, cytoplasm residues of mature sperms and large vacuole-like structures were noticeable. In detorsion group testis cross-sections, dissociations in spermatocide nuclei, many vacuoles and residual particles resulting from organelle degeneration, local voids in cytoplasms of spermatogonia, dilatation in granulated endoplasmic reticulum, large lipid droplets, chromatid particles, along with mitochondrial crystalisis were determined. In the testis cross-sections of the group of T/D+50 mg/kg melatonin administration, sertoli and spermatogonia cells that showed membrane-like structures and cytoplasmic voids were observed. Testis cross-sections of rats that were administered with T/D+50 mg/kg melatonin showed small mitochondrions and vacuole-like structures placed on the edge. Testis cross-sections of rats that were administered with T/D+100 mg/kg melatonin resulted in views similar to those of controls in the microstructural level. As a result, the most effective...

Se evaluaron, en un modelo de torsión/detorsión (T/D) testicular en rata, los cambios ultraestructurales producidos en los testículos, posterior a la administración sistémica de diferentes dosis de melatonina, durante el período de isquemia. La lesión de isquemia-reperfusión (I/R) testicular fue inducida por la torsión del testículo izquierdo, con un giro de 720 grados del cordón espermático con el fin de producir una oclusión total de los testículos durante 2,5 horas. Posteriormente, los mismos testículos fueron detorsionados. De acuerdo con el procedimiento quirúrgico en cada grupo, fueron realizados exámenes histopatológicos de las orquiectomías unilaterales. Los grupos fueron divididos en grupo control, grupo torsión (T), grupo torsión/destorsión (T/D), y grupo torción/destorsión con melatonina (T/D +20, 50 y 100 mg/kg de la melatonina). Para el examen histológico, los tejidos testiculares fueron fijados en soluciones de glutaraldehído al 2,5 por ciento y postfijados al 1 por ciento en ácido ósmico. Luego fueron examinados, después de la aplicación de contrastes de colores, a través de microscopía electrónica de transmisión. En las secciones transversales del grupo con torsión testicular, fueron visibles residuos citoplas-máticos de espermatozoides maduros y grandes estructuras vacuolares. En las secciones transversales del grupo con destorsión testicular, se observaron disociaciones en los núcleos espermáticos, numerosas vacuolas y partículas residuales derivadas de la degeneración de organelos; además de espacios localizados en el citoplasma de las espermatogonias, dilatación en el retículo endoplasmático rugoso, grandes gotas de lípidos y partículas de cromátidas, junto con cristálisis mitocondrial. En las secciones transversales del grupo T/D +50 mg/kg de administración de melatonina, células sustentaculares y espermatogonias mostraron estructuras tipo membrana y vacíos citoplasmáticos. Las secciones transversales del grupo con torsión en la que fue ...

The position of the testis during the fetal period: an additional parameter to estimate fetal weight

PURPOSE: To establish a correlation between testicular position and fetal weight, in order to provide an additional prenatal parameter for fetal weight estimation. MATERIALS AND METHODS: We studied 288 testes from 144 human fetuses. The fetuses were assessed as regards weight, total length, crown-rump length and foot length. Fetal age was calculated according to the foot length criteria. The position of the testis was classified as abdominal, inguinal or scrotal. RESULTS: One hundred and ninety seven testes (68.4 percent) were abdominal, 43 (14.9 percent) were inguinal and 48 (16.6 percent) were scrotal. In the fetuses weighing up to 500 grams, 147 testes (93.5 percent) were abdominal and 5 testes (6.5 percent) were inguinal. In fetuses weighing between 501 and 1000 grams, 54 testes (68.6 percent) were abdominal, 28 testes (32.5 percent) were inguinal and 4 testes (4.6 percent) were scrotal. In fetuses weighing between 1001 and 1500 grams, 4 testes (13.3 percent) were abdominal, 3 (10 percent) were inguinal and 23 (76.6 percent) were scrotal. All fetuses weighing more than 1500 grams presented the testes with a migration to the scrotum (10 fetuses - 20 testes). CONCLUSIONS: To our knowledge, this is the first study correlating the testicular position to the fetal weight during testicular migration in human fetuses. Identification of the testes during the prenatal period could be a useful alternative parameter for estimating fetal weight.

Studies on the reproductive and developmental biology of Cichlasoma dimerus (Percifomes, Cichlidae): [review]

Many characteristics of the South American teleost fish Cichlasoma dimerus (body size, easy breeding, undemanding maintenance) make it amenable to laboratory studies. In the last years, many of the fundamental aspects of its reproductive and developmental biology have been addressed in our laboratory. Rather recently, the immunohistochemical localization of pituitary hormones involved in reproduction and in background color adaptation has been described in both adult and developing individuals, and the role of FSH in ovarian differentiation has been established. These findings have been correlated with mapping of some of their brain-derived controlling hormones. The latter include brain-derived gonadotropins which were shown to be active in vitro in the control of pituitary hormone secretions. The emerging picture shows C. dimerus as an interesting species in which many of their basic features have already been investigated and which conform a solid platform for comparative studies correlating neurohormones, pituitary hormones and behavior, from the molecular to the organismic level.

[Developmental study of prenatal goat testis]

There are some reports about development of prenatal ruminants' testis. But there is not any report about it in goat; so the present study was performed on 23 goats fetuses collected from Ahvaz slaughterhouse. After measuring fetuses crown rump length [CRL], their approximate ages were determined. On the basis of the CRL, the fetuses were divided into 6 groups. Then testes were extruded out and fixed and tissue sections were prepared by routine procedures and then were stained with Hematoxylin and Eosin and Periodic Acid Schiff. The biometric results showed a reasonable increase in the number of sertoli cells and gonocytes, diameter of sex cord and tunica albuginea during the development age dependences. The number of sex cords in each microscopic field showed an increase first and decreased thereafter. There is no difference between prenatal goat testis developments with prenatal testicular stages in other ruminants

Histological and functional organization in human testicle: expression of receptors c-kit and androgens / Organización histológica y funcional en el testículo humano: expresión de los receptores c-kit y andrógenos

The objective of this work was identify the presence of interstitial cells of Cajal, muscle cells, nerves and androgen receptor positive cells in adult human testicle, using immunohistochemical detection for c-kit/CD-117, actin smooth muscle specific (ASMS), neurofilament (N) and androgen receptor (AR), respectively. The samples were obtained from patients (n= 10) with diagnosis of prostate cancer, with surgery of orchiectomy. Subsequently were processed by histology and for immunohistochemistry using specific antibodies. It showed the presence of cells c-kit/CD-117, with diverse degrees of positivity, distributed mainly in the interstitial peritubular area of the human testicle. The peritubular myoides cells were positive to the presence of the actin smooth muscle and androgen receptor. The neurofilaments elements (+) only were observed in the vascular tunic. The specific immunohistochemistry describe the presence of the interstitial cells of Cajal in human testicular interstitium, opening a new perspective for the functional interpretation of the testicular cellularity and tubular motility. Possibly associated functionally to peribubulars cells of smooth muscle to regulate the mobility of the seminiferous tabules, whose integration and function would be androgen dependent. The cells that express the c-kit receptor, were found exclusively in the interstitial compartment. This cellular type in addition of the muscular cells of peritubules and the absence of nervous fibers to the interior of the testicle, could be responsible for the regulation of tubular mobility, as it happens in the gastrointestinal apparatus.

El objetivo de este trabajo fue identificar la presencia de células interticiales de Cajal, células musculares lisas, células nerviosas y células que expresan receptores de andrógeno en el testículo de humano adulto, usando inmunohistoquímica específica para: c-kit/CD-117, músculo liso actina específico (ASMS), neurofilamentos (N) y para receptores de andrógenos (AR). Las muestras fueron obtenidas de pacientes (n=10) con diagnóstico de cáncer prostático sometidos a cirugía de orquiectomía. Las biopsias se procesaron para histología e inmunohistoquímica usando anticuerpos específicos. Se muestra la presencia de células c-kit/CD-117, con diversos grados de positividad y distribuidas en el compartimento interticial del testículo. Las células peritubulares mioides fueron positivas para la presencia de músculo liso actina específico y para receptor de andrógenos. La marcación de neurofilamentos positivos, sólo fueron observados en la túnica vascular. Conclusiones: La inmunohistoquímica específica describe la presencia de células interticiales de Cajal en los interticios testiculares humanos, abriendo una nueva visión en la interpretación funcional de la celularidad testicular y la motilidad tubular. Lo anterior asociado a la funcionalidad de las células peritubulares (músculo liso) regularían la motilidad de los túbulos seminíferos. Este proceso posiblemente es andrógeno dependiente. Las células que expresan receptores c-kit se encuentran exclusivamente en los compartimentos interticiales, estas células en conjunto con las células musculares peritubulares agregado a la ausencia de fibras nerviosas al interior del testículo, podrían ser los responsables de la regulación de la motilidad tubular, similar a como se informa para el tracto gastrointestinal.

incidental finding in a 65 year-old man presenting with right-sided hydrocele

Polyorchidism is a rare congenital anomaly of the urogenital tract defines as the presence of more than two testes. We report the case of a 65 years-old man associated with right sided hydrocele and review the embryology and surgical management of the polyorchidism

Laparoscopy assisted versus standard inguinal orchiopexy for high palpable undescended testes

In high palpable undescended testes, many surgeons perform inguinal orchiopexy routinely. Some surgeons prefer a totally laparoscopic approach. Technically, this is not always possible. However, laparoscopy could still be valuable in dissecting the testicular pedicle before proceeding to the standard inguinal orchiopexy. The purpose of this study was to evaluate the advantages of such strategy. The study included thirty-eight children, with 48 high palpable undescended testes treated by the author over 2 1/2 years. These were divided into two groups. Group [I] comprised 34 high palpable undescended testes, treated by the standard-inguinal orchiopexy without laparoscopy. Group [II] comprised 14 high palpable undescended testes treated by laparoscopy assisted orchiopexy. Both groups were compared with regard to the need to divide the spermatic-vessels, level of fixation of the testis [at the bottom of the scrotum or at a higher level], the need for second stage operation and testicular volume during follow-up. In group [I], 3 cases [8.8%] required sectioning of the spermatic vessels; 8 cases [23.5%] required a second stage, 5 cases [14.7%] had high testicular fixation, and 5 cases [14.7%] showed testicular volume reduction during follow-up. In group [II], only 1 case [7%] required spermatic cord sectioning. In high palpable undescended testes, laparoscopic dissection of the testicular pedicle before standard inguinal orchiopexy is helpful. It gives the length required for bringing the testis into proper scrotalposition, avoids compromising vascularity of the testis or expose cord structures to injury and might completely eliminate the need for a second stage intervention with its potential complications

Relationship between the persistence of the processus vaginalis and age in patients with cryptorchidism

OBJECTIVES: To assess if there is an age group where the occurrence of persistent processus vaginalis is more frequent in patients with cryptorchidism. MATERIALS AND METHODS: We studied 24 fetuses with gestational age between 23 and 35 weeks postconception (control group) and 102 patients (137 testes) with cryptorchidism aged between 1 and 33 years (mean 10.3 years). We considered 2 situations for analysis of the processus vaginalis: a) complete persistence of processus vaginalis and, b) complete obliteration of the processus vaginalis between the internal inguinal ring and the upper pole of the testis. RESULTS: Of the 137 cases of cryptorchidism, the processus vaginalis was patent in 79 (57.6 percent) and obliterated in 58 (42.4 percent). Of the 55 patients between 1 and 4 years old, 37 (67.2 percent) had a patent processus vaginalis and 18 (32.8 percent) an obliterated one. Of the 37 patients between 5 and 8 years, 17 (45.9 percent) had patent processus vaginalis and 20 (54.1 percent) had an obliterated processus. In the 45 patients over 9 years of age, in 25 (55.5 percent) the processus vaginalis was patent and in 20 (44.5 percent) it was obliterated. In the fetuses, we found 4 cases (8.3 percent) of persistence of the processus vaginalis. CONCLUSIONS: There was no difference in the occurrence of patent processus vaginalis between the various age ranges under study. Patent processus vaginalis was more frequent in patients with cryptorchidism than in fetuses.

Mutations in SRY and WT1 genes required for gonadal development are not responsible for XY partial gonadal dysgenesis

The WT1 transcription factor regulates SRY expression during the initial steps of the sex determination process in humans, activating a gene cascade leading to testis differentiation. In addition to causing Wilms' tumor, mutations in WT1 are often responsible for urogenital defects in men, while SRY mutations are mainly related to 46,XY pure gonadal dysgenesis. In order to evaluate their role in abnormal testicular organogenesis, we screened for SRY and WT1 gene mutations in 10 children with XY partial gonadal dysgenesis, 2 of whom with a history of Wilms' tumor. The open reading frame and 360 bp of the 5' flanking sequence of the SRY gene, and the ten exons and intron boundaries of the WT1 gene were amplified by PCR of genomic DNA. Single-strand conformation polymorphism was initially used for WT1 mutation screening. Since shifts in fragment migration were only observed for intron/exon 4, the ten WT1 exons from all patients were sequenced manually. No mutations were detected in the SRY 5' untranslated region or within SRY open-reading frame sequences. WT1 sequencing revealed one missense mutation (D396N) in the ninth exon of a patient who also had Wilms' tumor. In addition, two silent point mutations were found in the first exon including one described here for the first time. Some non-coding sequence variations were detected, representing one new (IVS4+85A>G) and two already described (-7ATG T>G, IVS9-49 T>C) single nucleotide polymorphisms. Therefore, mutations in two major genes required for gonadal development, SRY and WT1, are not responsible for XY partial gonadal dysgenesis.

Diferenciación sexual embrio-fetal: de las móleculas a la anatomía / Fetal sex differentiation: from molecules to anatomy

El sexo del embrión queda determinado en el momento de la fecundación según que el espermatozoide contenga un cromosoma X o un cromosoma Y. Sin embargo, trascurren varias semanas durante la embriogénesis humana sin que existan diferencias evidentes-aún al microscopio- entre un feto de sexo femenino y uno de sexo masculino. A partir de la expresión del gen SRY en los fetos XY, las futuras gónadas inician una serie de eventos caracterizados por expresión de proteínas, que determinan cambios citológicos, histológicos y funcionales característicos de los testículos. Este evento relativamente temprano en el desarrollo del sexo se denomina determinación sexual, dada su importancia determinante en el resto de los eventos que se suceden luego. Los testículos secretan dos hormonas, hormona ani-Mülleriana y testorona, cuya acción provoca la masculinización de los esbozos de los órganos genitales internos y externos, que no mostraban hasta entonces diferencias entre los sexos. El proceso de diferenciación de los genitales se denominan diferenciación sexual fetal. Poco se conoce hasta hoy sobre los mecanismo que inducen a las gónadas a tomar caminos ováricos en el feto XX. Es sabido desde hace tiempo, en cambio, que la falta de las hormonas testiculares resulta en la feminización de los genitales internos y externos, independientemente de la existencia o ausencia de ovarios. El conocimiento de los mecanismos moleculares, celulares y endocrinos involucrados en el desarrollo sexual fetal permiten comprender mejor la patología resultante de sus respectivas alteraciones que generan cuadros clínicos conocidos como ambigüedades sexuales

Análise da incidência e dos tipos de assimetria durante a migraçäo testicular / Analysis of types and incidence of testicular asymmetric migration in fetal period

Objetivo: Determinar a incidência de assimetria durante a migraçäo testicular normal no período fetal humano. Material e Método: Foram estudados 137 fetos humanos bem preservados e sem fixaçäo prévia. A causa da morte dos fetos näo estava relacionada ao sistema urogenital e espécimes näo apresentavam nenhum tipo de malformaçäo congênita detectável. A idade gestacional foi calculada de acordo com critério de comprimento do maior pé e estava compreendida entre 10 e 35 semanas pós-concepçäo, o que corresponde a 12 e 37 semanas menstruais ou obstétricas. Após a abertura e dissecçäo do abdômen e da pelve, os testículos foram classificados como: a) abdominal, quando estava situado proximamente ao orifício inguinal interno; b) inguinal, quando estava localizado entre o anel inguinal interno e o externo, e, c)escrotal, quando estava situado inferiormente ao anel inguinal externo. Resultados: Os testículos eram abdominais em 69,35 porcento dos casos, inguinais em 13,15 porcento e escorrais em 17,5 porcento. Assimetria na migraçäo testicular foi encontrada em 8 casos (5,8 porcento) dos casos; em 3 casos um dos testículos era abdominal e o outro inguinal, em 3 casos um dos testículos era abdominal e o outro escrotal e em 2 casos um dos testículos era inguinal e o outro escrotal. Dentre os 8 casos de assimetria, em 5 (62,5 porcento) o testículo direito completou a migraçäo primeiro. Conclusäo: A incidência de assimetria durante a migraçäo testicular é baixa, representando 5,8 porcento dos casos estudados