Twin pregnancy achieved through TESE in an adult male exstrophy.

Bladder exstrophy is a rare anomaly, it compromises bladder functions, and in males it occurs with an impairment of reproductive functions, because of erectile and ejaculatory deficit. Advancements in the surgical treatment of bladder exstrophy have allowed an improvement of the bladder functions while spontaneous conception is still impaired. This is a case report of a pregnancy and subsequent birth of twins following testicular sperm extraction, on a man born with classical bladder exstrophy with infertility due to an ejaculation.

Serotonin and acetylcholine release response in the rat hippocampus during a spatial memory task.

By using in vivo microdialysis we monitored the extracellular levels of acetylcholine and serotonin in the hippocampus of rats performing a spatial memory task. After rats were trained for 10 consecutive days to master a food-reinforced radial-arm maze task, they were implanted with a microdialysis probe in the dorsal hippocampus. On day 12, rats were tested in the maze and acetylcholine and serotonin outputs were monitored before the test, during the waiting phase and while performing the trials. In trained, food-rewarded rats, hippocampal acetylcholine levels increased during the waiting period (181 +/- 90 of baseline) and further increased during the radial-maze performance to 236 +/- 13% of baseline values, while serotonin levels did not change during the waiting period but increased to 142 +/- 3% during the maze performance. To discriminate whether the increase of acetylcholine and serotonin levels during the testing was associated with memory performance or with food consumption, we monitored hippocampal acetylcholine and serotonin release in rats that were trained, but not food rewarded, or in rats that were not trained, but rewarded only on the test day. In the trained, non-rewarded group, acetylcholine release increased during the waiting phase to 168 +/- 6%, but did not increase further during the task performance. In contrast, no change in serotonin release was observed in this group in any phase of the test. In rats which were not trained, but food rewarded, acetylcholine increased only during the maze period (150 +/- 5%). Serotonin increased gradually and become significant at the end of the trials. (130 +/- 3%). While both neurotransmitters could be implicated in feeding behaviour, only activation of cholinergic neurotransmission appears to be associated with memory function. Our results support the following hypotheses: (i) hippocampal acetylcholine could be involved in attentional and cognitive functions underlying motivational processes; (ii) serotonin could be implicated in non-cognitive processes (i.e. in the control of motor and feeding behaviour). Since serotonin and acetylcholine neurotransmission is simultaneously activated during the spatial memory task, this suggests that these neurotransmitter systems regulate behavioural and cognitive functions.

The decrease of serotonin release induced by a tryptophan-free amino acid diet does not affect spatial and passive avoidance learning.

We assessed whether consumption of a diet lacking in tryptophan (TRP) resulted in alteration in learning and memory performance and hippocampal 5-HT release in rats. Two hours after the acute administration of TRP-free (T) and balanced (B) diet rats were trained in a one-trial passive avoidance task. The two groups of rats showed no significant difference in retention latencies. Two other groups of rats, fed with the above diets during the acquisition of a radial-arm maze task, showed no difference in baseline performance. The acute ingestion of the T diet produced a significant and long lasting decrease of hippocampal and cortical 5-HT release in rats when compared to the B diet, while the 12th day of the T diet, 5-HT was not detectable in the dialysate. These data indicate that the diminished brain release of 5-HT induced by a T diet is not sufficient to impair cognitive processes.

Acute administration of a tryptophan-free amino acid mixture decreases 5-HT release in rat hippocampus in vivo.

The effect of oral administration of a tryptophan-free amino acid mixture or the same mixture containing tryptophan (Trp) on hippocampal serotonin (5-HT) extracellular levels was studied using in vivo brain microdialysis of freely moving rats. During chloral hydrate anesthesia rats were implanted with dialysis probes in the dorsal hippocampus, and experiments were performed 24 h later. In vehicle-treated rats, the extracellular levels of 5-hydroxyindolacetic acid (5-HIAA) and 5-HT did not change during 240 min after ingestion. Oral administration of the Trp-free amino acid mixture significantly decreased basal 5-HT and 5-HIAA output 100 min after ingestion (65 and 81% of basal value, respectively) and remained at this level for another 140 min. The amino acid mixture containing Trp failed to significantly change basal extracellular levels of 5-HT, but enhanced that of 5-HIAA by approximately 134%. Moreover, in rats receiving the Trp-free amino acid mixture, the increase of hippocampal 5-HT release induced by d-fenfluramine (206%) was smaller than that released by the same drug in rats receiving the nutritionally balanced amino acid mixture (271%). Thus these results show that removal of Trp from the balanced amino acid mixture decreases spontaneous and d-fenfluramine-induced release of 5-HT in the hippocampus. In conclusion, our study supports the hypothesis that the mood-lowering effect observed in man after ingestion of a Trp-free amino acid mixture is associated with diminished 5-HT release in the brain.