Paratesticular tumor of Müllerian duct origin

A 65 year old Caucasian male presented with a 4 year history of persistent right epididymal discomfort. There was no history of urinary tract infection, dysuria urethral discharge or trauma. Despite several courses of antibiotics and prolonged use of anti-inflammatory medications, his symptoms were unrelenting and had become unbearable. Past history revealed that he had undergone an uncomplicated transurethral prostatectomy for obstructive benign prostatic hyperplasia 6 years previously and a left inguinal herniorrhaphy 15 years ago. There was no history of estrogen use. Physical examination revealed a normal penis, penile urethra, urethral meatus, testes and left epididymis. There was induration of the right epididymis and the caput was exquisitely tender. Complete blood count and urinalysis were normal and urine culture was negative. A scrotal ultrasound failed to show any abnormality. The patient underwent scrotal exploration and a right epididymectomy. An incidental, soft, 2 cm mass was discovered within the spermatic cord adjacent to the superior aspect of the testicle and this was excised. Histologic examination of the epididymis was unremarkable and the other lesion was shown to be a cystic paratesticular müllerian tumor (Figure 1). The epididymalgia resolved post operatively and he has been asymptomatic with no evidence of recurrence for 4 years.     

Contributions of Max Bürger to the development of sports medicine

The paper describes and appreciates the merits of Max Bürger who--as a clinician--realized very early the preventive and health-promoting role of regular physical training which can be principally carried out, from his point of view, up to the older age. He proved this opinion over more than 3 decades by numerous results of examinations especially in the field of the cardiopulmonary system and metabolism. Max Bürger became in several ways one of the forerunners of modern sports medicine by his important publications (among others "Normale und pathologische Physiologie des Blutkreislaufes bei sportlichen Anstrengungen", "Die Methodik der k?rperlichen Leistungsprüfungen mit Einschluss der Eignungsprüfungen für Beruf und Sport") by influencing the development of new research apparatuses and the installation of a larger performance diagnostic unit within his hospital as well as by the understanding between his aging research and sports medicine promoted by him and by his inititative to invite interested sports physicians to the foundation session of a "working group for sports medicine" the 13th and 14th November 1954.     

High specificity of Müllerian-inhibiting substance signaling in vivo

Female transgenic mice that ectopically express high levels of human Müllerian-inhibiting substance (hMIS) under the control of the mouse metallothionein (MT) promoter lack a uterus, oviducts, and ovaries. The loss of the uterus and oviducts is consistent with the known activities for MIS. However, it is not clear if the loss of the ovaries in these transgenic females is caused by interactions of MIS with its normal receptor signaling pathway or by abnormal interactions with other transforming growth factor-beta (TGF-beta) super family receptor signaling pathways. To address this question, female mice carrying the MT-hMIS transgene that were also homozygous for a targeted deletion of the MIS type II receptor gene were generated. Although these females had high levels of circulating hMIS, they had normal reproductive tracts and ovaries with germ cells. In addition, these females were able to become pregnant and gave birth to pups. These findings demonstrate that all of the abnormalities of the reproductive system that are found in female transgenic mice that ectopically express high levels of hMIS are caused by signaling through the MIS type II receptor. These in vivo data demonstrate a high specificity for MIS and its receptor.     

Influence of insulin on glutamine synthetase in the Müller glial cells of retina

Glutamine synthetase (GS), a Müller cell specific enzyme in the retina, is the key enzyme involve in glutamate metabolism. The goal of this study was to investigate the expression and regulation of GS by insulin in the cultured rat retinal Müller cells. Immunocytochemical and immunoblotting experiments showed that the cultured Müller cells express GS protein under normal cell culture conditions. Insulin treatments decreased the GS expression both in a time and dose dependent manner. Insulin also decreased the hydrocortisone induced GS expression. Furthermore, we investigated the expression and regulation of two other Müller cell specific enzymes known to be involved in glutamate metabolism, the mitochondrial branched chain aminotransferase (BCATm) and pyruvate carboxylase (PC). Immunoblotting experiments showed that Müller cells expressed both BCATm and PC. Treatments of cells with hydrocortisone or insulin did not influence the BCATm expression level. Hydrocortisone treatment of cells increased the PC expression but this induced expression was suppressed by insulin treatment. Müller cells expressed insulin receptor proteins (IRβ and IRS-1) and insulin activation induced the phosphotyrosine level of insulin receptor proteins. Moreover, hydrocortisone did not influence the expression or activation of these receptor proteins. The data suggests that insulin modulates the GS synthesis and may influence glutamate metabolism in the cultured retinal Müller cells but not by influencing the insulin signaling pathway.