Contralateral testicular blood flow during unilateral testicular torsion

Changes in contralateral testicular blood flow during unilateral testicular torsion were evaluated using an electromagnetic flowmeter in 13 adult male New Zealand White rabbits. There was an immediate and then a progressive decrease during torsion and a gradual increase following detorsion. A decrease in testicular blood flow over a critical period of time may be associated with contralateral testicular damage following unilateral testicular torsion.     

Is ipsilateral testis mandatory for contralateral testicular deterioration encountered following spermatic cord torsion?

Although deteriorating effects of unilateral spermatic cord torsion are generally accepted, the mechanism remains controversial. An experimental study was performed to evaluate the necessity of testicular and spermatogenetic material for contralateral testicular deterioration following unilateral spermatic cord torsion in rats. The animals were allocated to four groups: control, spermatic cord torsion, subepididymal orchiectomy, and spermatic cord torsion 14 days after subepididymal orchiectomy. The testes were removed on the 14th days and mean seminiferous tubular diameters and mean testicular biopsy scores were determined. Although contralateral testicular deterioration was more pronounced in the presence of testicular tissue, the absence of testicular tissue and/or spermatogenetic material did not prevent its occurrence. This is highly suggestive that autoimmune mechanism does not play a role in contralateral testicular damage following unilateral spermatic cord torsion.     

Pubertal genitofemoral nerve division induces testicular ascent in adult rats

BACKGROUND/PURPOSE: Ascending testes, which normally are located at the bottom of the scrotum in early infancy and later ascend back out of the scrotum, have been reported by several investigators. However, little is known about the effect of the division of the genitofemoral nerve (GFN) on testicular ascent as boys grow. The purpose of this study is to investigate whether the division of the proximal genitofemoral nerve in prepubertal rats induces testicular ascent in adulthood. METHODS: Thirty-day-old Wistar King A Rats (n = 27) underwent a unilateral proximal GFN transection on either the right or left side. At 150 days of age, the rats were killed, and their testicular position was examined. The length of the processus vaginalis was measured, and the testes were removed and weighed. Sham-operated rats were used as controls (n = 10). Student's t and the chi2 test were used for the statistical analysis. RESULTS: At 150 days of age, 21 of the 27 operated rats (77.8%) showed unilateral testicular ascent on the operated side. All testes were located at the bottom of the scrotum in sham-operated control rats (20 testes). Both the length of the processus vaginalis and the testicular weight were decreased significantly more on the operated side than in the sham-operated rats. CONCLUSIONS: These findings suggest that the proximal division of the genitofemoral nerve in prepubertal rats may induce a relative ascent of the testis by preventing the growth of the processus vaginalis in adulthood. In patients with such ascending testes, an abnormal development or accidental trauma of the genitofemoral nerve may be involved in testicular ascent.     

An enigma: Contralateral effects of experimental unilateral testicular torsion

To investigate the effects of unilateral testicular torsion on both testes, we studied 4 groups of adult male New Zealand rabbits using sham operation, torsion and detorsion after one or eight hours and permanent torsion. Bilateral orchiectomy was performed 9 weeks after the operation, and testicular weights, Johnsen scores, quantitative analyses, tubular diameters were calculated and histopathologic diagnosis was determined. Testicular weights, Johnsen scores, spermatid counts and tubular diameters were all decreased in torsioned testes depending on the duration of torsion. The contralateral testes showed no significant change in any of the study groups when compared with the control group.     

Effect of division of genitofemoral nerve on testicular descent in the rat

The gubernaculum, which has an important role to play in testicular descent, is richly supplied by the genital branch of the genitofemoral nerve through its scrotal attachment. In neonatal rats the genitofemoral nerve overlying the psoas muscle was divided before inguinal descent would normally occur, and the effect of this procedure on subsequent testicular descent was observed. Denervation of the gubernaculum caused the testes to remain in the abdomen. The significance of this finding in the rat is that an intact genitofemoral nerve is an essential prerequisite for normal descent, perhaps by allowing the gubernaculum to evert.     

Contralateral motor rootlets and ipsilateral nerve transfers in brachial plexus reconstruction

OBJECT: The goal of this study was to evaluate outcomes in patients with brachial plexus avulsion injuries who underwent contralateral motor rootlet and ipsilateral nerve transfers to reconstruct shoulder abduction/external rotation and elbow flexion. METHODS: Within 6 months after the injury, 24 patients with a mean age of 21 years underwent surgery in which the contralateral C-7 motor rootlet was transferred to the suprascapular nerve by using sural nerve grafts. The biceps motor branch or the musculocutaneous nerve was repaired either by an ulnar nerve fascicular transfer or by transfer of the 11th cranial nerve or the phrenic nerve. The mean recovery in abduction was 90 degrees and 92 degrees in external rotation. In cases of total palsy, only two patients recovered external rotation and in those cases mean external rotation was 70 degrees. Elbow flexion was achieved in all cases. In cases of ulnar nerve transfer, the muscle scores were M5 in one patient, M4 in six patients, and M3+ in five patients. Elbow flexion repair involving the use of the 11th cranial nerve resulted in a score of M3+ in five patients and M4 in two patients. After surgery involving the phrenic nerve, two patients received a score of M3 + and two a score of M4. Results were clearly better in patients with partial lesions and in those who were shorter than 170 cm (p < 0.01). The length of the graft used in motor rootlet transfers affected only the recovery of external rotation. There was no permanent injury at the donor sites. CONCLUSIONS: Motor rootlet transfer represents a reliable and potent neurotizer that allows the reconstruction of abduction and external rotation in partial injuries.     

Contralateral testicular blood flow in unilateral testicular torsion measured by the 133Xe clearance technique.

Contralateral testicular blood flow was measured by the intratesticular injection of 133Xe in 9 controls (Group 1) and in 34 adult male albino rats with experimentally induced left testicular torsion. In Group 2 (n = 9) testicular torsion was maintained for 3 h; in Group 3 (n = 7) torsion was maintained for 9 h and in Group 4 (n = 10) for 15 days. In Group 5 (n = 16) torsion was maintained for 9 h in 8 rats and the sera were given to 8 normal animals. In Groups 3, 4 and 5 there was a significant increase in contralateral testicular blood flow on the fifteenth day. This increase may be the cause of contralateral testicular damage in prolonged unilateral testicular torsion.     

Capsaicin effectively prevents apoptosis in the contralateral testis after ipsilateral testicular torsion

OBJECTIVE: To evaluate the effect of afferent nerve blockage by administration of capsaicin on apoptotic changes in the contralateral testis in rats undergoing ipsilateral testicular torsion. MATERIALS AND METHODS: Twenty male albino rats were randomly divided into four groups. In groups 1 and 2, rats underwent a sham operation and testicular torsion, respectively, after the intraperitoneal administration of 0.9% NaCl. Similarly, in groups 3 and 4 the rats underwent a sham operation and testicular torsion, respectively, after an intraperitoneal capsaicin injection. The testes were untwisted 24 h later and the contralateral testes harvested. Apoptosis was assessed in paraffin-embedded sections stained for nuclear DNA fragmentation. Fifteen cells were counted in each seminiferous tubule and the apoptotic cells recorded. A score was calculated for each group and the results compared using the Kruskal-Wallis analysis of variance and Mann Whitney U-tests, with P<0.05 considered to be significant. RESULTS: The mean apoptotic score of group 2 was significantly higher than that of the other groups. There was no difference between the apoptotic scores of groups 1 and 3, 1 and 4, and 3 and 4. CONCLUSION: Capsaicin effectively prevented apoptosis in the contralateral testes of rats that had undergone testicular torsion.     

Infertility in rats subjected to genitofemoral nerve section is not associated with testicular damage

This work was aimed at assessing the relationship between testicular ascent and infertility induced by genitofemoral nerve (GFN) section in rats. Eighteen male rats were assigned to three experimental groups as follows: (i) Group SGFN was subjected to surgical section of genitofemoral nerve; (ii) Group Sham; (iii) Control group. The GFN was cut at puberty (28D), and the contralateral testis removed at 90D, with fertility tests at 120D. At 150D, maturity index, epithelial area and histopathological index of seminiferous tubules of all rats were determined and statistically compared between superior and inferior testicle poles, and between groups. There were no differences in testicular parameters, sperm morphology or sperm concentrations (P > 0.05). Section of NGF interfered with fertility (58.3 ± 15.4 in SGFN versus 83.3 ± 10.5 in Sham) and litter size (6.2 ± 1.1 in SGFN versus 10.7 ± 1.4 in Sham). Cremaster of SGFN group showed early neuropathy. The GFN section induced partial testicular ascent and diminished fertility without damage on testicular morphology or spermatic parameters, because, cremaster could affect the contractibility and ejaculation mechanisms in which it participates. The study of the damage on cremaster induced by an injury on GFN could have an overview of the mechanisms inherent in the testicular ascent induced by this iatrogenic alteration and their potential risks on fertility.     

Spermatic cord torsion. Contralateral testicular degeneration at various ages in the rat

Unilateral spermatic cord torsion causes damage to the contralateral testis in humans and animals models. It is now known, however, at what age an animal's reproductive capacity is most susceptible to this type of trauma. To determine if the animal's age is a factor in its susceptibility to reproductive damage, rats at 30 to 70 days of age were subjected to unilateral spermatic cord torsion. Rats of the same ages underwent sham surgery and served as controls. The animals were allowed to recover from the surgery and to attain puberty before a period of fertility testing. Fertility, serum testosterone, organ weight, and testicular histologic data were obtained after the breeding period. Our data indicate that animals undergoing torsion at the youngest (30 days) and oldest (70 days) ages exhibited no change in the parameters studied. Animals between the ages of 35 and 50 days are highly susceptible to reproductive damage due to unilateral spermatic cord torsion, and the 35-day-old animals exhibit the most susceptibility. The stages of testicular development occurring during this period are such that damage to one testicle will result in degeneration of both organs. However, once the animal is older than 50 days, its reproductive capacity is not affected by spermatic cord torsion. The specific period of susceptibility in the development of human testes is yet to be defined.     

大鼠单侧睾丸扭转复位后对对侧睾丸的影响

目的研究大鼠单侧睾丸扭转复位后对对侧睾丸的影响。方法16只成年健康SD雄性大鼠随机分为实验组(n=8)和对照组(n=8)；建立单侧睾丸扭转复位模型。术后30d取扭转对侧睾丸,采用原位缺口末端标记法(TUNEL)检测生殖细胞凋亡,光镜下计数精子数。结果与对照组相比,实验组对侧的睾丸重量和日产精子量都有显著性差异(P＜0.05),实验组生殖细胞凋亡显著增多(P＜0.01)。结论大鼠单侧睾丸扭转后,对侧睾丸生殖细胞凋亡增多可能是导致不育的原因之一。     

Androgen and estrogen receptor expression in the spinal segments of the genitofemoral nerve during testicular descent

Aim

During testicular descent (TD), the genitofemoral nerve (GFN) is masculinized by androgen. This study aimed to test whether androgen receptor (AR), estrogen receptorα (ERA), or estrogen receptor β (ERB) are expressed during TD in the GFN spinal segments and dorsal root ganglia (DRG) in normal and flutamide-treated rats.

Methods

Time-mated Sprague-Dawley dams were injected with flutamide (75 mg/kg, subcutaneously (S/C) in sunflower oil) on embryonic (E) days 16 to 19. Embryonic and postnatal (P) male L1-2 spinal cord segments were collected (E16, E17, E19, P0, P2, and P4) in control and flutamide-treated groups (n = 5-10). Samples were fixed in 4% paraformaldehyde. Five-micrometer-thick sections were prepared immunohistochemically for AR, ERA, and ERB.

Results

During TD, ERB was expressed in L1-2 DRG. Surprisingly, AR was not expressed in prenatal DRG, only after P2. There was no ERA expression. Flutamide had no effect on AR, ERB, or ERA expression in the L1-2 DRG during TD.

Conclusion

During the E window of androgen sensitivity, the GFN is not directly masculinized, with little AR expression and no change with flutamide over this period. Estrogen receptor β is expressed in the DRG during TD. However, its relevance is yet to be determined.     

高压氧对睾丸扭转/复位后生精细胞凋亡的作用

目的 探讨单侧睾丸扭转/复位后睾丸细胞凋亡状况和高压氧(HBO)的干预作用。方法 32只青春期 Wistar大鼠随机等分为 4组,1组为对照组,2～4组制成单侧睾丸扭转/复位模型(扭转 720°、2 h后复位),3组、4组分别于睾丸复位前和复位后立即予以 60 min HBO治疗。术后48 h获取双侧睾丸,原位缺口末端标记法(TUNEL)观察细胞凋亡,常规染色观察病理学改变。结果 与1组比较,2组扭转侧睾丸生精细胞凋亡增加(P<0.01)、病理损害明显;对侧睾丸生精细胞凋亡增加(P<0.01)。3～4组尤其是4组扭转侧睾丸生精细胞凋亡较2组明显减少(P<0.01)、病理损害减轻;对侧睾丸细胞凋亡较1组无明显变化(P>0.05)。结论 单侧睾丸扭转复位后,双侧睾丸生精细胞凋亡增加,复位前和复位后早期HBO治疗能明显减少细胞凋亡的发生。     

Reperfusion injury following testicular torsion and detorsion in prepubertal rats

Summary Acute testicular torsion is a surgical emergency which requires immediate intervention. Although damage to the gonad has been well documented, it remains unknown whether the majority of injury occurs during the period of torsion (ischemia) or following detorsion (reperfusion). The aims of this study were to determine: (1) whether damage following testicular torsion-detorsion has a reperfusion component similar to that described in other tissues, and (2) whether iron-catalyzed oxygen radical formation or altered calcium homeostasis plays a role in this injury. To study this, anesthetized prepubertal rats underwent 720° intravaginal testicular torsion and were divided into groups of torsion only (ischemia) and torsion with reperfusion (ischemia/reperfusion). Reperfusion groups were treated prior to detorsion with either deferoxamine (iron chelator), diltiazem (calcium channel blocker), or saline vehicle. The results indicated that detorsion produces a qualitatively distinct reperfusion injury from that of non-reperfused testicles; however, such damage was not ameliorated by deferoxamine or dilitiazem. Thus, testicular torsion-detorsion appears to have a significant reperfusion component that appears to not be mediated by iron-catalyzed oxygen radical formation or calcium injury.     

Upper limb sympathetic blockade following intercostal nerve blocks

A case of transient sympathetic block of the arm following percutaneous intercostal nerve injections is described and the possible aetiology discussed.     

Unilateral spermatic cord torsion without ipsilateral spermatogenetic material: effects on testicular blood flow and fertility potential

This experiment was planned to answer the question of how the elimination of ipsilateral spermatogenetic material, which is necessary for contralateral testicular damage caused by an autoimmune response, affects contralateral testicular blood flow and fertility potential in unilateral spermatic cord torsion (USCT). Thirty-four male and 68 female adult albino rats were divided into three groups. Group 1 rats underwent a control operation, group 2 rats underwent subepididymal orchiectomy to eliminate spermatogenetic material, and group 3 rats underwent USCT after subepididymal orchiectomy. Testicular blood flows of the rats were measured by ¹³³Xe clearance technique. Additionally, to determine fertility potential, each male rat was housed with two female rats. Numbers of impregnated and delivered rats were recorded. Both mean testicular blood flow and fecundity of group 3 were significantly lower than those of groups 1 and 2. When compared with groups 1 and 2, fertility and mean number of the impregnated rats of group 3 were lower but the differences were not significant. These findings suggest that absence of spermatogenetic material in USCT reduces contralateral blood flow and fertility potential. Therefore, contralateral testicular damage originating from blood flow alterations rather than autoimmune mechanism should be considered to explain fertility problems encountered following USCT.     

Effects of epidural anesthesia on sympathetic nerve discharge to the skin

Direct intraneural recordings of skin sympathetic activity (SSA) were performed to determine the magnitude of blockade of sympathetic fibers to the lower extremities during epidural anesthesia. Lumbar epidural catheters were inserted in nine volunteers. Multiunit postganglionic sympathetic activity was recorded in a skin fascicle of the peroneal nerve before and after injection of 4 ml of mepivacaine 2% epidurally, followed by an additional 12-16 ml after 5 min. Arousal stimuli such as sudden loud noises and noxious electrical skin stimulation were used to elicit transient sympathetic activation. Epidural anesthesia with upper level of sensory blockade at T4-T8 (n = 7) completely blocked spontaneous SSA and no detectable skin sympathetic activity could be provoked by arousal stimuli later than 14 min after the test dose. Sympathetic blockade was accompanied by marked increases in foot skin blood flow and loss of skin resistance responses to arousal. Epidural anesthesia with sensory blockade up to T10-11 (n = 2) only produced a partial sympathetic blockade. The result shows that epidural anesthesia with sensory blockade at T8 or above is equally as effective as injections of local anesthetics directly at postganglionic nerve fibers or ganglionic blockade in producing a complete sympathetic blockade of intraneurally recorded SSA. This neural blockade was paralleled by skin vasodilatation and a loss of sudomotor responses in the foot.