Evaluation of the scrotal testis before and after orchidopexy in experimental unilateral cryptorchidism.

Unilateral cryptorchidism was induced in newborn Wistar rats. With standard histological techniques, no abnormality was found in the scrotal testis at any age. Using DNA flow cytometry to measure the proportion of cells in the haploid phase in the testis, secondary degenerative changes were noted at 40 days of age. Orchidopexy carried out at 30 days of age prevented these changes appearing; at 50 days reversed the abnormality already present; and at 90 days failed to reverse the degeneration of the scrotal testis. These data would suggest that although early orchidopexy can prevent secondary changes in the scrotal testis, operation up to puberty will allow these changes to be reversed.     

Reversal of degenerative changes in the scrotal testis after orchidopexy in experimental unilateral cryptorchidism.

Unilateral cryptorchidism was induced in newborn Wistar rat pups. Using DNA flow cytometry to compare scrotal testes of control and cryptorchid animals, there was a significant difference decrease in the haploid cell population in cryptorchid animals from 40 days of age. Orchidopexy was performed at 30 days (at the time of normal descent), 50 days (pubertal), and 90 days (fully mature adult). When with sham-operated control and cryptorchid animals of the same age were compared, there was no decrease in the haploid population at any age in the scrotal testis if orchidopexy was performed at 30 days; the degenerative changes could be reversed to normal if orchidopexy was performed at 50 days; however, if operation was delayed to 90 days, the decreased numbers of haploid cells in the scrotal testis were neither prevented nor reversed and remained significantly lower than normal controls (P less than .005). This study shows that orchidopexy performed before adulthood reverses secondary degenerative changes in the scrotal testis in an animal model of unilateral cryptorchidism.     

经阴囊联合经脐腹腔镜隐睾无瘢痕下降固定术的临床研究

目的:探讨经阴囊联合经脐腹腔镜隐睾无瘢痕下降固定术的应用价值.方法:经改进Hesselbach三角路径,为38例、45侧隐睾患者施行经阴囊联合经脐腹腔镜隐睾无瘢痕下降固定术.结果:38例手术均一期完成,无需额外切口.术后平均3d痊愈出院.随访无睾丸回缩、萎缩、坏死、恶变等并发症发生,提睾反射存在.结论:经阴囊联合经脐腹...     

Alendronate influences bending force of femoral diaphysis after orchidectomy in rats.

BACKGROUND AND AIMS: We examined the effect of alendronate on bone following orchidectomy-induced osteoporosis. MATERIAL AND METHODS: Eighty male rats were used. Group I (C) served as the untreated control. In group II (ALN), alendronate was administered subcutaneously (18 microg/kg). In group III (ORC), rats were castrated only. In group IV (ORC+ALN), administration of alendronate (18 microg/kg) was started immediately after castration, and in group V (ORC + ALN-21) medication was started 21 days after castration. Alendronate was given twice a week for eight weeks in the treatment groups. Bone mineral density (BMD) of the proximal femur, ultimate bending forces of femoral diaphyses, ash weights of femurs (AWcc) and the calcium content (Ca) of femoral ash were determined. Histomorphometric analysis was performed on trabecular bone of proximal tibiae. RESULTS: BMD of the proximal femur was significantly decreased by orchidectomy compared with C and ALN. However, no statistical difference was observed between alendronate-treated groups (ORC + ALN and ORC + ALN-21) and the ORC group. Histologically, alendronate reduced the trabecular bone turnover. Ultimate bending force increased significantly in the ORC+ALN-21 group compared with group C, and had a good correlation with the cortical width of tibia (r = 0.53, p < 0.001). Ash weight per bone volume (AWcc) was lowest in the ORC group, whilst alendronate maintained AWcc after orchidectomy. CONCLUSION: Alendronate increased the ultimate bending force of the femoral diaphysis after orchidectomy. On the other hand, ALN treatment was not able to maintain the BMD of the proximal femur at the pre-orchidectomy level. Our results suggest that the remodelling and modelling of bone may influence the response to ALN treatment.     

Effects of experimental cryptorchidism and subsequent orchidopexy on seminiferous tubule functions in the lamb

The reversibility of damage caused by cryptorchidism to the seminiferous tubules of the lamb was investigated at various ages. Lambs were made bilaterally cryptorchid either at birth or at 2 months of age. Then orchidopexy was performed at either 2 or 4 months of age. In permanently cryptorchid lambs, spermatogenesis stopped completely, and Sertoli cell function, as measured by FSH receptors, androgen receptors and ABP, was much reduced (-96%, -86% and -81%, respectively). Orchidopexy allowed the cryptorchid seminiferous epithelium to grow again, but the more differentiated the germ cells, the less they were capable of restoration. Even in 0- to 2- and 0- to 4-month-old temporarily cryptorchid lambs that had recovered normal Sertoli cell function, 16 to 49% of the tubules still were empty. It was concluded that cryptorchidism irreversibly damages the seminiferous tubules at a level other than the hormone receptors.     

隐睾患者术后抑郁情况及抑郁相关因素分析

目的:研究隐睾患者手术6~16年后抑郁症状的发生情况及有关原因。方法:使用抑郁自评量表(SDS)及关联因子调查表对70例隐睾术后6~16年患者及70例健康男性的抑郁症状发病率进行调查,并对抑郁症状的相关因素进行分析。结果:隐睾患者术后的抑郁症状发生率为50.0%,对照组为4.3%,差异有统计学意义(χ2=23.5,P<0.01)。多元逐步回归分析发现:自然生育能力(F=15.899 2,P<0.01)、阴囊外观形态满意度(F=4.600 3,P<0.05)、已婚(F=4.100 2,P<0.05)三者是影响患者抑郁症状的危险因素。结论:隐睾患者术后常发生抑郁症状,主要影响因素为不育、阴囊外观形态满意度和婚姻状态。     

Effect of cryptorchidism and orchidopexy on 3B hydroxysteroid dehydrogenase activity in rat testicle

The activity of 3B hydroxysteroid dehydrogenase (3BHSD), an enzyme intimately involved in the biosynthesis of testosterone, was histochemically examined in cryptorchid testes of the rat and also after subsequent orchidopexy. Enzyme activity was severly depressed in testes held 15 days or longer in the abdominal cavity but promptly returned to normal in testes that were returned to the scrotum. This particular enzyme system was not permanently injured in the rat by the cryptorchid condition up to 40 days.     

Change of serum adrenal androgens in prostatic cancer patients after bilateral orchidectomy or LHRH agonist treatment

Bilateral orchidectomy (ORX) or administration of luteinizing hormone releasing hormone agonist (LHRH) for prostatic cancer patients causes suppression of testicular androgens. However, the suppression of adrenal androgens by these treatments is controversial. We measured serum concentrations of testosterone (T), 4-androstene-3, 17-dione (A-dione), dehydroepiandrosterone (DHEA), LH, follicle-stimulating hormone (FSH), adrenocorticotropic hormone (ACTH) and cortisol before and after 3-12 months of the first hormonal treatment in 17 prostatic cancer patients who had received ORX (8 cases) or LHRH (9 cases). ORX and LHRH decreased serum T to the castration level significantly (ORX: p < 0.001, LHRH: p < 0.0001). ORX increased serum LH and FSH significantly (LH: p < 0.001, FSH: p < 0.001), whereas LHRH decreased LH and FSH significantly (LH: p < 0.05, FSH: p < 0.05). Neither treatment caused any significant change in ACTH or cortisol. ORX and LHRH decreased the serum A-dione significantly (ORX: p < 0.01, LHRH: p < 0.001). LHRH decreased the serum DHEA significantly (p < 0.01), whereas ORX did not decrease serum DHEA. These data suggest that "medical" and "surgical" castration, especially LHRH agonist, may decrease not only testicular androgens but also adrenal androgens.     

Evolution of somatic and germ cell populations after busulfan treatment in utero or neonatal cryptorchidism in the rat

Summary.  In order to elucidate the respective effects of depletion of germ cells and of increase in testicular temperature, rats of the same Wistar strain were rendered experimentally bicryptorchid or sterilized by a busulfan injection in utero and compared to control animals. In both models, germ cells were depleted but numeric evolution and functions of somatic cells differed. The aim of that work was to compare the numeric evolutions of testicular somatic and germ cells to their respective functions in each model before puberty and in adult rats of the same strain. Serum concentrations of FSH, LH and testosterone were compared at 20, 40 and 110 days of age. Histological analyses of Sertoli and germ cells in the seminiferous tubules and of Leydig cells in the intertubular tissue were performed before puberty and at adulthood. Testosterone serum concentrations were depleted in both models starting at 40 days of age and more in busulfan-treated rats. Both FSH and LH levels were increased from 20 days onwards in experimental rats. Additional cryptorchidism in busulfan-treated rats depressed the serum testosterone concentration. At 17 days of age, the cryptorchidism do not modify somatic or germ cell populations while busulfan treatment has induced a decrease of both these populations. Conversely, the cross sectional area of the somatic testicular cells was not affected whatever the treatment. In adult testes of busulfan-treated and cryptorchid rats, the total numbers of Sertoli and Leydig cells and of germ cells per testis were decreased. The cellular size of the perivascular Leydig cells was not modified by any of the treatments whereas the size of the Sertoli cells was reduced.
In conclusion, in both models the absence of germ cells induces a decrease in Sertoli cell function, while the increase in testicular temperature provokes degeneracies of Sertoli and germ cells in the seminiferous tubules of the rat.     

Effect of pregnancy and birth on the course of myasthenia gravis before or after transsternal radical thymectomy.

OBJECTIVE: Myasthenia gravis (MG) affects women at childbearing age. Therefore, the question arises if these patients should become pregnant and if thymectomy has a positive effect on the course of MG in pregnant patients. METHODS: Fifteen pregnancies had been followed retrospectively. All patients underwent transsternal radical thymectomy for MG. The course of MG in the period before, during, and after the pregnancy was scored according to Ossermann's classification. The effect of thymectomy on delivery and on the newborns was evaluated. RESULTS: Patients were divided in two groups: pregnancies before (group I, n=8) and after (group II, n=7) thymectomy. During pregnancy, in group I, one deterioration was observed and in seven patients the disease was unchanged. In group II, one deterioration, five unchanged courses, and one improvement were observed. In the postpartum period, in group I, seven patients did not change and one improved. In group II, two deteriorations, three unchanged courses, and two improvements were observed. Before pregnancy, group II patients were in a better Ossermann stage in comparison with those in group I. Eight of the 12 deliveries were spontaneous (three abortus). Myasthenic symptoms were observed in two newborns in group I. CONCLUSION: Our data suggest that MG is not prohibitive to have children. The course of MG after transsternal radical thymectomy is often ameliorated. A better MG-stage, reached after thymectomy, before pregnancy seems to be correlated with a better course during pregnancy.     

Adjuvant treatment in the management of testis-confined germ cell tumours after orchidectomy

Germ cell tumours are highly curable, especially when still at the localized stage, which is the case for most testicular tumours. Various options are available for organ-confined disease; depending on the histological review, patients with clinical stage I seminomas can be offered radiotherapy, surveillance or chemotherapy, whereas those with clinical stage I nonseminomas can be offered retroperitoneal lymph node dissection, surveillance or chemotherapy. As it is unlikely that any of these approaches will have a clear survival advantage, the most appropriate variables to be considered are acute and late side-effects, acceptability and quality of life. In recent years adjuvant chemotherapy has been extensively evaluated in patients with seminoma or nonseminoma. In this review we discuss the advantages and disadvantages of the different strategies for treating seminomas and nonseminomas, and their associated prognostic factors, and then consider future developments.     

Peri-articular calcinosis after craniocerebral trauma--the natural course and treatment concepts]

Occurrence of periarticular ossification (PAO) is a serious complication in the rehabilitation of patients with neurological diseases, especially those with severe head injuries. The present concept for operative intervention in PAO postulates late surgical treatment after "maturation" of these heterotopic ossifications, because of a suspected higher rate of reoccurrence after early removal. In a retrospective analysis of nine arthrolysis in six patients with neurological diseases suffering from PAO (five patients with traumatic apallic syndrome and one patient with spontaneous subarachnoidal haemorrhage), the validity of a new concept of treatment of primary neurological diseases was investigated. Because of the well-known secondary and tertiary problems (fibrotic stiffness, osteoporosis, compression syndrome of peripheral nerves, muscle atrophy), we chose early removal of the ossifications. Our results demonstrate that the former concept of surgical intervention in "mature PAO" only can no longer be recommended as superior to early surgical treatment in neurological diseases, particularly in patients with traumatic apallic syndrome associated with PAO.     

先天性隐睾症术式改良及疗效分析

目的 研究先天性隐睾症术式改良的临床疗效.方法 选取本院在2009年3月～2014年3月间收治的42例先天性隐睾症患者的临床资料,随机将患者平分为两组,每组各21例病例.对照组行肉膜囊睾丸固定术治疗,观察组采用腹横纹切口保留睾丸引带阴囊皮下睾丸固定术治疗,比较两组患者术后的治疗优良率.结果 观察组有13例患者治疗情况为优,7例患者恢复良好,总优良率为95.2％;对照组有7例患者治疗情况为优,8例患者恢复良好,总优良率为71.4％.观察组治疗优良率明显优于对照组,对比差异显著,具有统计学意义(P＜0.05).结论 采用腹横纹切口保留睾丸引带阴囊皮下睾丸固定术有利于减少对患者身体的损伤,切口瘢痕较小,同时不会增加并发症的发生,具备较高的安全性与可靠性,有利于促进患者疾病的好转,值得临床推广应用.     

补骨脂盐炙前后对去卵巢大鼠的骨保护作用及其机制

目的 比较补骨脂盐炙前后对去卵巢（OVX）大鼠骨质疏松的治疗作用,并探讨其炮制机理。方法 制备大鼠骨质疏松模型,分别用补骨脂生、盐品灌胃,给药12周后称重,取子宫,测血清中钙（Ca）、磷（P）、碱性磷酸酶（ALP）、骨钙素（OC）以及雌二醇（E2）含量,测骨生物力学强度和骨密度（BMD）,观察骨小梁微结构。制备补骨脂生、盐品含药血清,检测含药血清对成骨细胞增殖和分化影响。检测补骨脂生、盐品水煎液和含药血清中主要有效成分含量。结果 补骨脂生、盐品均能有效抑制去卵巢所致的大鼠体重增加和子宫萎缩,升高血清Ca、P含量,降低ALP、OC和E2含量,显著提高BMD、骨生物力学强度,改善骨小梁结构的完整性。补骨脂生、盐品对成骨细胞的增殖和分化均有明显的促进作用,且盐品效果优于生品。此外,补骨脂盐炙后有效成分的煎出和入血成分的含量存在明显差异。结论 补骨脂生、盐品对OVX所致的大鼠骨质疏松症有良好的治疗效果,并且补骨脂盐品的抗骨质疏松作用更强,这与补骨脂盐炙促进补骨脂苷、异补骨脂苷等有效成分煎出和盐炙后补骨脂素、异补骨脂素等入血有效成分增加有关。