In vivo Gonadoprotective Effects of Myricetin on Cisplatin- Induced Testicular Damage via Suppression of TLR4/NF-kB Inflammation Pathway and Heat-Shock Response / Efectos Gonadoprotectores in vivo de la Miricetina sobre el Daño Testicular Inducido por Cisplatino Mediante la Supresión de la Vía de Inflamación TLR4/NF-kB y la Respuesta al Choque Térmico

SUMMARY: The aim of this study is to reveal the gonadoprotective effects of myricetin (MYC), which has many biological properties, on cisplatin (CP)-induced testicular damage in rats. For this purpose, 40 male Wistar albino rats were divided into 4 groups as Control (group given no treatment), MYC (group given 5 mg/kg/i.p myricetin for 7 days), CP (group given 7 mg/kg/i.p cisplatin at 7th day) and MYC + CP (group given 5 mg/kg/i.p myricetin for 7 days before 7 mg/kg/i.p cisplatin injection). After administrations, testicular tissues of animals were extracted and processed according to tissue processing protocol. Hematoxylin & Eosin staining were performed to evaluate the histopathological changes and Johnsen'sTesticular Biopsy Score (JTBS) was applied and mean seminiferous tubule diameters (MSTD) were measured to compare experimental groups in terms of histopathological changes. Moreover, TLR4, NF-kB, HSP70 and HSP90 expression levels were detected by immunohistochemical staining and the density of immunoreactivity were measured to determine the difference in the expression levels of these factors among groups. Additionally, testicular apoptosis was detected via TUNEL assay. JTBS and MSTD data were significantly lower in CP group compared to other groups and MYC administrations significantly protects testicular tissue against CP-induced damage. Moreover, TLR4, NF-kB, HSP70 and HSP90 expressions and apoptotic cells significantly increased in the CP group (p<0.05). However, MYC administrations exerted a strong gonadoprotective effect on testicular tissue in terms of these parameters in MYC+CP group (p<0.05). According to our results, we suggested that MYC can be considered as a protective agent against cisplatin-induced testicular damage.

El objetivo de este estudio es revelar los efectos gonadoprotectores de la miricetina (MYC), que tiene muchas propiedades biológicas, sobre el daño testicular inducido por cisplatino (CP) en ratas. Para este propósito, se dividieron 40 ratas albinas Wistar macho en 4 grupos: Control (grupo que no recibió tratamiento), MYC (grupo que recibió 5 mg/kg/i.p de miricetina durante 7 días), CP (grupo que recibió 7 mg/kg/i.p de cisplatino al séptimo día) y MYC + CP (grupo que recibió 5 mg/ kg/i.p de miricetina durante 7 días antes de la inyección de 7 mg/ kg/i.p de cisplatino). Después de las administraciones, se extrajeron y procesaron tejidos testiculares de animales según el protocolo de procesamiento de tejidos. Se realizó tinción con hematoxilina y eosina para evaluar los cambios histopatológicos y se aplicó la puntuación de biopsia testicular de Johnsen (JTBS) y se midieron los diámetros medios de los túbulos seminíferos (MSTD) para comparar los grupos experimentales en términos de cambios histopatológicos. Además, los niveles de expresión de TLR4, NF-kB, HSP70 y HSP90 se detectaron mediante tinción inmunohistoquímica y se midió la densidad de inmunorreactividad para determinar la diferencia en los niveles de expresión de estos factores entre los grupos. Además, se detectó apoptosis testicular mediante el ensayo TUNEL. Los datos de JTBS y MSTD fueron significativamente más bajos en el grupo CP en comparación con otros grupos y las administraciones de MYC protegen significativamente el tejido testicular contra el daño inducido por CP. Además, las expresiones de TLR4, NF-kB, HSP70 y HSP90 y las células apoptóticas aumentaron significativamente en el grupo CP (p<0,05). Sin embargo, las administraciones de MYC ejercieron un fuerte efecto gonadoprotector sobre el tejido testicular en términos de estos parámetros en el grupo MYC+CP (p<0,05). Según nuestros resultados, sugerimos que MYC puede considerarse como un agente protector contra el daño testicular inducido por cisplatino.

Quercetin Inhibits ROS-p53-Bax-caspase-3 axis of apoptosis and augments gonadotropin and testicular hormones in chronic unpredictable stress-Induced testis injury / La quercetina inhibe el eje de apoptosis ROS-p53-Bax-caspasa-3 y aumenta la gonadotropina y las hormonas testiculares en la lesión testicular inducida por estrés crónico e impredecible

SUMMARY: A large body of evidence supports the protective role of the flavonol antioxidant compound quercetin in mammals. We tested the hypothesis that quercetin can protect against the hypothalamus-pituitary-gonadal (HPG) axis defect like a reduction in gonadotropins and testicular hormones and abnormal semen analysis induced by chronic unpredictable stress (CUS), possibly via the downregulation of oxidative stress (ROS) and p53-Bax-caspase-3 pathways. Rats were either exposed to a variety of unpredictable stressors daily before being sacrificed after 3 weeks (model group) or were treated with quercetin (50 mg/kg body weight/day) at the same time the CUS were induced (treated group). Harvested testicular tissues were stained with basic histological staining, and testis homogenates were assayed for the tumor suppressor p53, apoptosis regulator Bax, B-cell lymphoma 2 (Bcl-2), caspase-3, malondialdehyde (MDA), glutathione peroxidase (GPx), and superoxide dismutase (SOD). In addition, harvested epididymis tissues were used to assess semen analysis, and blood samples were assayed for the testicular hormone testosterone, the adrenal cortex hormone corticosterone, and the anterior pituitary gonadotropins, follicular stimulating hormone (FSH) and luteinizing hormone (LH). CUS induced profound testicular damage and significantly (p<0.05) induced p53, Bax, caspase-3, MDA, and corticosterone, which were significantly (p<0.05) inhibited by quercetin except corticosterone. Whereas, quercetin significantly (p<0.05) increased FSH, LH, testosterone, Bcl-2, GPx, and SOD levels that were inhibited by CUS. In addition, CUS induced oligozoospermia, asthenozoospermia, and teratozoospermia, which were significantly (p<0.05) protected by quercetin. Thus, Quercetin protects against CUS-induced HPG defects in rats, which is associated with the inhibition of ROS-p53-Bax-caspase-3 axis.

RESUMEN: El papel protector del compuesto antioxidante flavonol quercetina en los mamíferos ha sido ampliamente reportado. Probamos la hipótesis que la quercetina puede proteger contra el defecto del eje hipotálamo-hipofisiario- gonadal (HHG) como una reducción de gonadotropinas y hormonas testiculares y análisis de semen anormal inducido por estrés crónico impredecible (ECI), posiblemente a través de la regulación reducida del estrés oxidativo (REO) y las vías p53- Bax-caspasa-3. Las ratas fueron expuestas a una variedad de fac- tores estresantes impredecibles diariamente antes de ser sacrificadas después de 3 semanas (grupo modelo) o fueron tratadas con quercetina (50 mg / kg de peso corporal / día) al mismo tiempo que se indujo la ECI (grupo tratado). Los tejidos testiculares fueron teñidos con tinción histológica básica y los homogeneizados de testículo se analizaron para determinar el supresor de tumores p53, el regulador de apoptosis Bax, el linfoma de células B 2 (Bcl-2), la caspasa-3, el malondialdehído (MDA), la glutatión peroxidasa (GPx) y superóxido dismutasa (SOD). Además, se utilizaron tejidos del epidídimo recolectados para evaluar el análisis de semen y se analizaron muestras de sangre para determinar la hormona testicular testosterona, la hormona corticosterona de la corteza suprarrenal y las gonadotropinas de la hipófisis anterior, la hormona estimulante folicular (FSH) y la hormona luteinizante (LH). El ECI indujo daño testicular importante e indujo significativamente niveles de (p <0,05) p53, Bax, caspasa-3, MDA y corticosterona, que fueron inhibidos (p <0,05) por la quercetina. La quercetina aumentó significativamente (p <0,05) los niveles de FSH, LH, testosterona, Bcl-2, GPx y SOD que fueron inhibidos por ECI. Además, ECI indujo oligozoospermia, astenozoospermia y teratozoospermia, protegidos de manera significativa (p <0,05) por la quercetina. Por lo tanto, la quercetina protege contra los defectos de HHG inducidos por ECI en ratas, lo que está asociado con la inhibición del eje ROS-p53-Bax-caspasa-3.

Effects of ketoprofen in spermatogenesis of mice exposed to continuos hypobaric hypoxia / Efecto del ketoprofeno en la espermatogénesis de ratones expuestos a hipoxia hipobárica continua

Hypoxia hypobaric (HH) can cause alterations at testicular level, with temperature increase, intrascrotal alteration and deterioration of spermatogenesis. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ketoprofen have anti-angiogenic properties, and can decrease testicular abnormalities. The objective of the study was to evaluate the effect of ketoprofen on spermatogenesis of mice exposed to continuous hypobaric hypoxia. 78 Mus musculus CF-1 male mice 3 to 4 months old were used and subjected to HH in chamber at 4200 m. They were divided into 13 groups (G) of 6 animals: 10 with HH cycles (1, 2, 3, 4 and 8, lasting 8.3 days each cycle, two groups each) and 3 in normoxia (Nx). Intraperitoneal ketoprofen 25 mg/kg was administered every 4 days. Euthanasia of these animals was performed at the end of each cycle and in the case the Nx groups at the end of cycles 1, 4 and 8. Percentage of microhematocrit and reticulocytes were measured in blood smears and a morphometric and histopathological analysis of the height of the epithelium, the tubular diameter and the diameter of the tubular lumen was made. It was shown that hematocrit increases continuously up to 8 cycles, while reticulocytes increase up to 3 cycles. Continuous HH decreases the tubular diameter in a sustained manner and proportional to HH cycles, and the height increased only in the groups subjected to 8 cycles. The groups treated with ketoprofen saw a decrease in angiogenesis, presenting some degree of protection at the testicular level.

La hipoxia hipobárica (HH) puede provocar alteraciones a nivel testicular, con aumento de la temperatura, alteración intraescrotal y deterioro de la espermatogénesis. Los antiinflamatorios no esteroidales (AINEs) como el ketoprofeno tienen propiedades antiangiogénicas, pudiendo disminuir las alteraciones testiculares. El objetivo de estudio fue evaluar el efecto del ketoprofeno en la espermatogénesis de ratones expuestos a hipoxia hipobárica continua. Se utilizaron 78 ratones macho Mus musculus CF-1 de 3 a 4 meses de edad y se sometieron a HH en cámara a 4200 m. Se dividieron en 13 grupos (G) de 6 animales: 10 con ciclos de HH (1, 2, 3, 4 y 8, con duración de 8,3 días cada ciclo, dos grupos cada uno) y 3 en normoxia (Nx). Se administró ketoprofeno intraperitoneal 25 mg/kg cada 4 días. La eutanasia de estos animales se realizó al final de cada ciclo y en el caso los grupos Nx al final de los ciclos 1, 4 y 8. Se midió porcentaje de microhematocrito y reticulocitos en frotis de sangre y se hizo un análisis morfométrico e histopatológico de la altura del epitelio, el diámetro tubular y el diámetro de la luz tubular. Se evidenció que el hematocrito aumenta de manera continua hasta los 8 ciclos, en cambio los reticulocitos aumentan hasta los 3 ciclos. La HH continua disminuye el diámetro tubular de forma sostenida y proporcional a los ciclos de HH, y la altura aumentó sólo en los grupos sometidos a 8 ciclos. Los grupos tratados con ketoprofeno se vio una disminución de la angiogénesis, presentando algún grado de protección a nivel testicular.

Role of JNK and ERK1/2 MAPK signaling pathway in testicular injury of rats induced by di-N-butyl-phthalate (DBP)

BACKGROUND: Di-N-butyl-phthalate (DBP) is an endocrine disrupting substance. We investigated the adverse effect of DBP on testis of male rat and reveal its potential mechanism of MAPK signaling pathway involved this effect in vivo and in vitro. Gonadal hormone, sperm quality, morphological change and the activation status of JNK, ERK1/2 and p38 was determined in vivo. Primary Sertoli cell was established and cultivated with JNK, ERK1/2 inhibitors, then determine the cell viability, apoptosis and the expression of p-JNK, p-ERK1/2. Data in this study were presented as mean ± SD and determined by one-way analysis of variance (ANOVA) followed by Bonferroni's test. Difference was considered statistically significant at P < 0.05. RESULTS: In vivo experiment, DBP impaired the normal structure of testicular tissue, reduced testosterone levels in blood serum, decreased sperm count and increased sperm abnormality, p-ERK1/2 and p-JNK in rat testicular tissue increased in a dose-dependent manner. In vitro studies, DBP could decrease the viability of Sertoli cells and increase p-ERK1/2 and p-JNK. Cell apoptosis in SP600125 + DBP group was significantly lower than in DBP group (P < 0.05). p-JNK was not significantly decreased in SP600125 + DBP group, while p-ERK1/2 was significantly decreased in U0126 + DBP group. CONCLUSIONS: These results suggest that DBP can lead to testicular damage and the activation of ERK1/2 and JNK pathways, the JNK signaling pathway may be primarily associated with its effect.

Ectopic testis in coati (Nasua nasua Linnaeus, 1766) / Testículo ectópico em quati (Nasua nasua Linnaeus, 1766)

This paper reports a case of unilateral extracorporeal ectopic testes in a captive coati (Nasua nasua) in the State Park of Dois Irmãos Zoo, Recife/PE, Brazil. The testicle was located in the subcutaneous tissue of the inguinal region not adhered to the surrounding tissues. After bilateral orchiectomy, both testes were measured, fixed with 10% formalin buffered and embedded in paraffin for histopathological evaluation. The left testis measured 1.2 cm width by 1.7cm length, and the right one measured 1.5 cm width by 2.0 cm length. The ectopic testes had seminiferous epithelium without post-meiotic germ cell lines. The non-ectopic testis had several changes in the seminiferous epithelium that indicated degeneration. In both epididymis, the lumen did not contain sperm and the major epithelial structural alterations were more distinct in the epididymis associated to the ectopic testicle. In conclusion, the ectopic testis and epididymis had lesions compatible with testicular exposition to body temperature. Non-ectopic epididymis and testis had minor lesions but could be related to the infertility of the coati.(AU)

O artigo relata um caso de testículo ectópico em quati de cativeiro (Nasua nasua) no Zoológico do Parque Estadual Dois Irmãos, Recife/PE. O testículo encontrava-se localizado no tecido subcutâneo da região inguinal, sem estar aderido aos tecidos circunvizinhos. Após orquiectomia bilateral, ambos os testículos foram mensurados, fixados em formol a 10% e embebidos em parafina para avaliação histopatológica. O testículo esquerdo mediu 1,2cm de largura por 1,7cm de movimento; e o testículo direito mediu 1,5cm de largura por 2,0cm de comprimento. O testículo ectópico apresentou epitélio sem linhagem de células germinativas pós-meióticas. O testículo não ectópico apresentou alterações no epitélio seminífero caracterizando degeneração. Em ambos os epidídimos, o lúmen não continha espermatozoides e as principais alterações estruturais do epitélio foram mais distintas no epidídimo associado ao testículo ectópico. Conclui-se que o testículo ectópico e epidídimo apresentaram lesões características de aumento de temperatura. O testículo e epidídimo não ectópico apesentaram lesões menores mas que puderam ser associadas à infertilidade do quati.(AU)

Acoustic radiation force impulse (ARFI) elastography of testicular disorders in dogs: preliminary results / Elastografia acoustic radiation force impulse (ARFI) de afecções testiculares em cães: resultados iniciais

The aim of this study was to describe the use of acoustic radiation force impulse (ARFI) elastography in the evaluation of testicular disorders in dogs. Eighteen dogs with testicular disorders (thirty-six testicles) were assessed. Echotexture, size, contours and margins of testes were analysed by ultrasonography. Deformities and tissue stiffness (greyscale and homogenous or heterogeneous) were evaluated by qualitative elastography and shear velocity was determined quantitatively. Subsequent to orchiectomy, testicular samples were collected for histopathology analysis and thirty-six disorders were identified. Qualitative elastography revealed that normal healthy testicular tissues were homogenous and not pliable while the affected testicles had alterations in tissue stiffness and homogeneity. The values obtained for quantitative elastography of the testicular tissues were: normal/healthy - 1.30±0.12 m/s; degenerated - 0.97±0.08 m/s; atrophied - 2.00±0.35 m/s; hypoplastic - 0.82±0.2 m/s; cystic - 1.32±0.18 m/s; orchitis - 2.68±0.42 m/s; interstitial cell tumours - 3.32±0.65 m/s; sertolioma - 2.99±0.07 m/s and leydigoma - 2.73±0.37. ARFI elastography of abnormal testes proved to be an applicable and complementary technique in the diagnosis of testicular disease in dogs.

O objetivo deste estudo foi descrever o uso da elastografia ARFI (acoustic radiation force impulse) para avaliar as afecções testiculares em cães. Dezoito cães com distúrbios testiculares (36 testículos) foram avaliados. Ecotextura, tamanho, contornos e margens dos testículos foram avaliados por meio da ultrassonografia modo-B. A presença de deformidades e a rigidez tecidual (escala de cinza; homogênea ou heterogênea) foram avaliadas pela elastografia qualitativa; e a velocidade de cisalhamento foi determinada pela avaliação quantitativa. Amostras dos tecidos testiculares foram coletadas após orquiectomia para o diagnóstico histopatológico. Após ultrassonografia, orquiectomia e histopatologia, foram identificados 36 distúrbios em tecidos testiculares. Durante a elastografia qualitativa, os tecidos normais apresentaram-se homogêneos e não deformáveis; os testículos alterados demonstraram alterações na rigidez tecidual e de sua homogeneidade. Para a elastografia quantitativa, os valores obtidos foram: tecidos normais - 1,30±0,12m/s; degenerados - 0,97±0,08m/s; atrofiados - 2,00±0,35m/s; hipoplásicos - 0,82±0,2m/s; cistos - 1,32±0,18m/s; orquite - 2,68±0,42m/s; tumores de células intersticiais - 3,32±0,65m/s; sertolioma - 2,99±0,07m/s; e leydigoma - 2,73±0,37m/s. A elastografia ARFI de testículos anormais em cães demonstrou ser uma técnica aplicável e complementar para o diagnóstico de doenças testiculares nessa espécie animal.

Effects of traction on the spermatic cord of rats

PURPOSE: To determine whether tension in the spermatic cord of rats causes lesions in the testis, epididymis or vas deferens. METHODS: Forty Wistar rats were randomly allocated into four groups. A traction force of 1.6 Newton (N) in group I and 1 N in group II was applied to the right spermatic cord. Group III was the sham, and group IV served as the control. RESULTS: Testicular lesions occurred on the right side in 66.7% of the rats and on the left side in 46.1% of the rats. The testes showed a decreased number of Sertoli cells, necrosis and a decreased number of germ cells in the seminiferous tubules. Anatomopathological changes in the vas deferens were not identified. There was no decrease in the thickness of the muscle wall of the vas deferens. In the right epididymis, 71.8% of the animals showed a reduction and 5% showed an absence of intraluminal sperm. In the left epididymis, 37.5% of the rats showed a reduction. The volume and the final testicular weight of the right side in group IV was different from those in the other groups. CONCLUSIONS: Anatomopathological lesions were found in the testis and epididymis. .

Protective effect of orange and grapefruit peel extracts against testicular toxicity induced by sulfasalazine in male albino rats

Sulfasalazine is a drug commonly used for the treatment of inflammatory bowel diseases such as ulcerative colitis and Crohn's disease. However, the histological changes in the testes are not well defined. Also, orange and grapefruit peels are powerful antioxidants that have come into use recently for the treatment of infertility. This study aimed to elucidate the histological, immunohistochemical, and ultrastructural changes in the testes after sulfasalazine treatment and evaluate the possible protective role of orange and grapefruit peel extracts. This study included 48 adult male albino rats divided into six equal groups: the control group [group I]; the orange peel extract group [group II]; the grapefruit peel extract group [group III]; the sulfasalazine group [group IV]; the sulfasalazine and orange peel extract group [group V]; and the sulfasalazine and grapefruit peel extract group [group VI]. At the end of the experiment [2 weeks], all animals were sacrificed and their testes were excised. Paraffin sections were prepared and stained with H and E and immunohistochemical staining was performed for proliferating cell nuclear antigen. Other pieces of the testis were used for ultrastructural study. Sulfasalazine was shown to affect the testes. The changes were in the form of irregular degenerated seminiferous tubules, germ cells, decrease in proliferating cell nuclear antigen, ultrastructural alterations of spermatogenic cells, and thickened basement membranes. These changes were present in some tubules in the testes. Treatment with orange or grapefruit peel extracts proved to improve these changes. Sulfasalazine has deleterious effects on the structure of the testes and supplementation with orange or grapefruit peel extracts with sulfasalazine can overcome the toxicity of sulfasalazine on the testis and protect testicular tissue from the detrimental effects of sulfasalazine

Protective effect of sildenafil citrate on contralateral testis injury after unilateral testicular torsion/detorsion

OBJECTIVES: This study was designed to investigate prevention of contralateral testicular injury with sildenafil citrate after unilateral testicular torsion/detorsion. METHODS: Thirty-seven adult male rats were divided into four groups: sham operated (group 1, n = 7), torsion/detorsion + saline (group 2, n = 10), torsion/detorsion + 0.7 mg of sildenafil citrate (group 3, n = 10) and torsion/detorsion + 1.4 mg of sildenafil citrate (group 4, n = 10). Unilateral testicular torsion was created by rotating the right testis 720º in a clockwise direction for 2 h in other groups, except for group 1, which was served as sham group. After torsion (2 h) and detorsion (2 h) periods, rats were killed. RESULTS: The level of reduced glutathion (GSH) (p<0.05) and the activities of catalase (p<0.01) and glutathione peroxidase (p<0.05) in the contralateral testis from group 2 were significantly lower and nitric oxide (NO) (p<0.05) level in the contralateral testis were significantly higher than those of group 1. Administration of low-dose sildenafil citrate (group 3) prevented the increases in malondialdehyde and NO levels and decreases in glutathione peroxidase activities and GSH values induced by testicular torsion. However, administration of high-dose sildenafil citrate (group 4) had no effect on these testicular parameters (p>0.05). Histopathological changes were detected in groups 2, 3 and 4. CONCLUSION: These results suggest that biochemically and histologically torsion/detorsion injury occurs in the contralateral testis following 2-h torsion and 2-h detorsion and that administration of low-dose sildenafil citrate before detorsion prevents ischemia/reperfusion cellular damage in testicular tissue.

Hormonal levels, semen parameters and presence of antisperm antibodies in patients treated for testicular torsion

In spite of prompt diagnosis and either orchiectomy or preservation of the affected testis, infertility remains a significant sequel of testicular torsion. The objective of this study was to evaluate late endocrine profile, seminal parameters and antisperm antibody levels after testicular torsion and to analyze the impact of orchiectomy or detorsion on the organ's fate. This is a cross-sectional study that involves 17 patients evaluated after testicular torsion 12 patients were treated with orchiectomy [group 1] and 5 were treated with orchiopexy [group 2]. All patients were assessed by semen analysis, endocrine profile [follicle-stimulating hormone [FSH], luteinizing hormone [LH] and testosterone] and seminal antisperm antibody levels. A group of 15 proven fertile men was used as the control group. Results: Median ischemia time in group 1 [48hs] was significantly higher than in group 2 [7hs]. Both groups demonstrated a decrease in sperm count and morphology compared with controls.; Group 1 showed a significantly higher motility than group 2 [p=0.02]. Group 1 also showed a significantly better morphology than group 2, [p=0.002]. All patients presented an endocrine profile within normal ranges and no significant difference in antisperm antibody levels was detected between the groups. However, a trend for higher levels was found in patients treated for testicular torsion, regardless of the fate of the testis. Moreover, no significant correlation was found between antisperm antibody levels and age at torsion, ischemia time, seminal parameters or treatment applied. We found that after torsion, patients maintain hormonal levels within normal ranges. Testicular fate did not have any correlation with the formation of antisperm antibodies. Although sperm quality is preserved in most of the patients with the exception of sperm morphology, patients treated with orchiectomy presented better motility and morphology compared with the detorsion group

Ruptura testicular traumática: papel de la exploración quirúrgica / Traumatic testicular rupture: the role of surgical exploration

Se presenta un hombre de 20 años de edad que sufre lesión traumática testicular durante práctica de artes marciales. Se discute el papel de la ecografía y de la exploración quirúrgica.

We present a man 20 years of age that suffered a traumatic testicular injury during the practice of martial arts. The role of echography and surgical exploration are discussed.

Accuracy of ultrasound diagnosis after blunt scrotal trauma (10 years experience)

Objectives:To evaluate the role of ultrasonography (US) and its accuracy; sensitivity and specificity for the diagnosis of testicular rupture after blunt scrotal trauma. Moreover; tunica albuginea breach; testicular hematoma; testis avulsion; epididymal injuries and hematocele are particularly examined. Patients and Methods: Between 1998 and 2008; 24 patients presented to Suez Canal University Hospital after blunt scrotal trauma and underwent surgical exploration. All patients had an emergency scrotal US examination with the use of a 7.5-10 MHz linear transducer. US findings were compared with the surgical findings to calculate the sensitivity and specificity of US for each type of lesion. Results: Out of 24 patients; 12 were diagnosed as having testicular rupture and tunica albuginea breach was visualized on US in 6 patients. Sensitivity and specificity of US were 92and 50for testicular rupture; 85and 75for hematocele; 80and 79for testicular hematoma; and 100 and 96 for testicular avulsion; respectively. US diagnosis of epididymal injuries was poor as it failed to detect 3 out of 5 epididymal lesions. Conclusion: US was highly sensitive in the diagnosis of testis rupture. This can provide information on the integrity of the scrotal contents that can help the physician to determine the optimal treatment

Gunshot wound injuries to the male external genitalia

To identify the patterns of civilian gunshot wound [GSW] injuries to the male external genitalia, and to present our experience in the management of such injuries. This descriptive study was carried out in the Urology and Nephrology Center, Al-Thawra Modern General and Teaching Hospital, Sanaa, Yemen from June 2005 to April 2008, and included 20 men that presented with GSW injuries to the external genitalia. After clinical and radiological evaluation with retrograde urethrography when indicated, early surgical repair was undertaken for all patients with evident, or suspected deep genito-urinary wounds. The mean age of the patients was 33.2 years. In 15 [75%] patients, injuries were inflicted by high-velocity weapons, and in 5 by low-velocity pistols, and 18 [90%] patients had other associated injuries. The penis was involved alone in 10 [50%], scrotum in 4 [20%], and the penis and scrotum in combination in 6 [30%] patients. In 5 patients, the lesions were superficial. Corporeal injuries were detected in 13 patients, and urethral injuries were detected in 6 patients. In post-repair, mild curvature during erection was experienced by 5 patients, severe angulation by one, and sexual dysfunction by 2 patients. We encountered 9 testicular ruptures, and our testicular salvage rate was 45.5%. Although the dominant inflicting weapons were high-velocity automatic rifles, the severity of injuries and their related outcomes were almost comparable to other low-velocity series. This is possibly due to the primary involvement of nearby bulky muscles in 90% of cases, which may absorb the blasts' effect of the projectiles on the genitalia

Ultrastructural study of poxvirus causing myxomatosis in rabbits, in São Paulo and Santa Catarina, Brazil / Estudio ultraestructural del poxvirus causal de mixomatosis en conejos, en São Paulo y Santa Catarina, Brasil

The myxomatosis is a contagious worldwide disease caused by poxvirus which infects domestic and wild rabbits. In the present study we present two distinct outbreaks of myxomatosis when raising rabbits, one for commercial purpose of production of meat and skins and, another one for the commercialization of ornamental rabbits. The observed signs were ocular, auricular, nasal, testis lesions and many times scattered throughout the body of the animals. The lesions were characterized by formation of nodules that by palpation disclosed gummy or gelatinous aspect. At the transmission electron microscopy, all the skin and crust samples were analyzed by negative staining technique. A great number of particles with morphology similar to the poxvirus, some enveloped in a brick-shaped and irregular disposition of tubules on the external membrane, measuring 300x240 nm on the average were visualized. Ultra thin sections revealed the presence of intracytoplasmic inclusion bodies surrounded by membrane containing oval particles, measuring 270 x 130 nm, containing nucleus or an internal biconcave (dumbbell-shaped) core. Immature particles (empty), surrounded by membrane were also observed. In addition, intracytoplasmic electron dense inclusion bodies containing viral particles budding of dense amorphous material and intranuclear fibrillar or "digital" inclusions showing a regular striation and arranged in groups were found in the middle of granular material. The nuclei were deformed with densely condensed chromatin forming amorphous and electron dense inclusion bodies. In the immunocytochemistry technique, the antigen-antibody reaction was strongly marked by the particles of colloidal gold, emphasizing the viral particles. The techniques used in this study were important in the diagnosis of the affected animals.

La mixomatosis es una enfermedad contagiosa de distribución mundial, causada por poxvirus que infecta conejos domésticos y salvajes. En este estudio presentamos dos distintos surtos por mixomatosis que ocurrieron en producciones de conejos, una para fines comerciales de producción de carne y pieles y otra para el comercio de conejos domésticos. Las señales observadas fueron afecciones oculares, nasales, testiculares y, a veces, también distribuida por todo el cuerpo de los animales. Estas se caracterizaban por formación de nódulos que a la palpación tenían un aspecto gelatinoso o gomoso. En la microscopía electrónica de transmisión, por la técnica de contrastación negativa, se pudo observar en todas las muestras examinadas de piel y de costras, un gran número de partículas típicas de poxvirus, con envoltura y forma de ladrillo, mostrando disposición irregular de los túbulos sobre la membrana externa, midiendo 300 x 240 nm en el promedio. Cortes ultrafinos de fragmentos de piel y de costras revelaron la presencia de cuerpos de inclusión intracitoplasmáticas, envueltos por membrana y conteniendo partículas ovales, midiendo 270 x 130 nm, conteniendo núcleo o centro interno bicóncavo (forma de mancuernas). Partículas inmaduras (vacías) envueltas por membrana fueron observadas. También fueron analizados cuerpos de inclusión intracitoplasmáticos, electrodensos, conteniendo partículas virales brotando del material denso y amorfo. Fueron observadas inclusiones intranucleares fibrilares o "digitales" mostrando una estriación periódica y disposición en grupos en medio del material granular. Los núcleos estaban deformados con cromatina densamente condensada formando cuerpos de inclusiones electrodensas y amorfas. En la técnica de imunocitoquímica la reacción antígeno-anticuerpo fue intensamente marcada por las partículas de oro coloidal realzando fuertemente las partículas virales.

Manejo de urgencias genitourinarias en cirugía pediátrica / Management of genitourinary surgical emergencies

Las urgencias en pediatría siempre han constituido un problema frecuente y, muchas veces, difícil de resolver, ya sea por la poca historia aportada por los padres -lo que es propio de la preocupación y ansiedad de la situación-, como también por la falta de información en relación a algunas maniobras simples que pueden ser realizadas por cualquier médico. Las lesiones genitourinarias suelen desestimarse en una evaluación de urgencia, a pesar de la trascendencia que éstas pudieran tener a futuro, por lo que suelen pesquisarse en una evaluación secundaria, o luego de la aparición de complicaciones. El presente artículo tiene como objetivo dar a conocer los conceptos que componen el manejo de urgencias genitourinarias en cirugía pediátrica, haciendo énfasis en aquellas que ocurren con mayor frecuencia y que implican un riesgo de complicaciones deletéreas, así como también en las que, por simplicidad de maniobras, pueden ser realizadas en cualquier servicio de atención de urgencia. Los temas expuestos son: torsión testicular, torsión de hidátide testicular, parafimosis, lesiones del tracto urinario y atrapamiento de prepucio en cremallera del pantalón.

Penile lesion from gunshot wound: a 43-case experience

OBJECTIVE: To demonstrate the main aspects of diagnosis, treatment and follow-up of 43 patients with gunshot wounds to the penis. MATERIALS AND METHODS: The location of the lesion, the presence of associated lesions, the performance of complementary exams, surgical treatment, postoperative complications and long term follow-up of 43 patients with penile lesions from gunshot wounds were retrospectively analyzed. RESULTS: Of 43 cases assessed, 41 were submitted to surgical exploration (95.3 percent) and 2 were submitted to conservative treatment (4.7 percent). We found penile lesions involving the corpus cavernosum in 37 cases; the remaining 4 patients presented no lesions involving the corpus cavernosum, urethra or testicles but did in the superficial structures. Ten cases presented an association with testicular lesions and 14 cases association with anterior urethral lesions. CONCLUSION: Penile lesions from gunshot wounds should be treated with immediate surgical intervention. In exceptional situations featuring superficial lesions only conservative treatment may be applied.

Total amputation of Penis and left testis; case report

Penile amputation is one of the rare complications of genitourinary tract injuries. Most cases of penile amputation are the result of self mutilation in patients suffering from psychiatric diseases. Penile amputation with less common causes is accidental trauma and felonious assault. In this paper we present a case with total amputation of penis and left testis who was treated by a complete team of surgery. A 44 year old man who was injured by combine farm machine and developed total penile amputation from the base and total amputation of left testis from spermatic cord in inguinal area. Patient with hypovolemic shock due to severe bleeding was admitted to emergency ward. After resuscitation of patient and stabilization of vital signs he underwent open cystostomy, perineal urethrostomy and right testis fixation based on severity of trauma, necrosis of amputated segment and nonvisualization of proximal of penis. Now, patient has complete urinary continence and is candidated for penile prosthesis or repair via radius or gracilis muscles but he refuses this procedure. However total amputation of penis and testis in accidental trauma is very rare, a complete surgical team including urologist, microsurgeon and plastic surgeon should be organized and replantation should be performed if distal part of penis is viable

External genitalia injuries, a study of aetiological factors and management options

This study includes 35 patients, more than 12 years of age, with external genitalia injuries. They presented in the emergency Department of the Sir Ganga Ram Hospital, Lahore, during last 4 years [2000-2004]. Our main aim was to highlight the fact that most of these injuries are caused by rotating belt or wheel of a machine and are potentially preventable if proper precautionary measures are taken. Another aim was to discuss different management options. It has been concluded that rotating belt or wheel of a machine is the most common cause of these injuries, especially if someone is wearing loose traditional clothes