Platelet-derived growth factor ligand and receptor subunit mRNA in the Sertoli and Leydig cells of the rat testis.

The expression of mRNAs encoding the platelet-derived growth factor (PDGF) subunits (PDGF A and PDGF B) and the PDGF receptor subunits (PDGF-R alpha and PDGF-R beta) was studied in cells of the rat testis. Leydig cells, primary spermatocytes, round spermatids, and cytoplasts were isolated from adult animals, and enriched preparations of Sertoli cells were obtained from 20-day-old animals. RNA from these cells was examined using Northern blots. Messenger RNA encoding both the PDGF-R alpha and PDGF-R beta subunits was observed in Leydig and Sertoli cell preparations but not in any of the germ cell samples. The Leydig cells contained predominantly mRNA encoding PDGF B subunits, while the Sertoli cells contained abundant mRNAs encoding both ligand subunits. Neither PDGF subunit mRNA was detected in the germ cells. This paper has not examined the expression of protein corresponding to the mRNAs detected but the data suggest that both paracrine and autocrine roles for PDGF are likely in the testis, and that PDGF may mediate communication between the interstitial compartment and the seminiferous epithelium.

Y chromosome analysis of infertile men and their sons conceived through intracytoplasmic sperm injection: vertical transmission of deletions and rarity of de novo deletions.

OBJECTIVE: To determine the prevalence and type of Yq microdeletions in 86 consecutive men that fathered 99 sons by intracytoplasmic sperm injection (ICSI) and to determine the incidence of vertical transmission and de novo deletions in these boys. DESIGN: Prospective clinical observational study. SETTING: Genetics laboratory associated with a university IVF unit. PATIENT(S): Eighty-six consecutive infertile men presenting to an IVF clinic and their 99 ICSI-conceived sons. Fifty of the 86 men (58%) had idiopathic seminiferous tubule failure (STF); the remainder had a variety of other clinical indications for ICSI. INTERVENTION(S): Collection of peripheral and cord blood samples. MAIN OUTCOME MEASURE(S): The Yq genetic status of fathers who underwent ICSI and of their sons by the presence or absence of 22 Y-specific markers covering the four azoospermia factor (AZF) subregions. RESULT(S): Yq deletions of the AZFd/c region were detected in two (6.9%) of 29 azoo- or severely oligospermic men with STF. Identical deletions were found in their respective sons. No de novo deletions were detected in the remaining 97 sons conceived by men without deletions. CONCLUSION(S): The detection of Yq deletions only in men with severe STF is consistent with previous studies, with the AZFd/c region being most commonly affected. This study demonstrates the vertical transmission of these Yq deletions through the use of ICSI and supports the notion that, in most cases, Yq deletions will be inherited by male offspring. The absence of de novo Yq deletions in the male offspring indicates that these events are rare following ICSI in men with both STF and other common male factor indications.

Renal medullary carcinoma: sonographic, computed tomography, magnetic resonance and angiographic findings.

Renal medullary carcinoma is a recently described, highly aggressive tumour, occurring predominantly in young patients of African descent with sickle cell trait (SCT). All have been metastatic at surgery. Surgery, radiotherapy and chemotherapy do not appear to alter the course of the disease. The survival time is very short. Presentation is usually with haematuria, abdominal pain and weight loss. Forty-nine patients have been reported from the USA, of these 47 were African/Americans. The reports have mostly appeared in pathology journals. On review of the imaging findings reported in the radiological journals, it becomes apparent that it is possible for a radiologist to suggest a specific diagnosis in the appropriate demographic and clinical setting. Here the first British patient of Afro-Caribbean decent in whom a pre-operative diagnosis was suggested on the imaging findings of a centrally located renal pelvic tumour, encasing the pelvis on a background of SCT in a 28-year-old is described. It is expected that a high index of suspicion in the appropriate clinical setting may lead to earlier diagnosis, treatment and survival of patients. The patient is alive and reasonably well 9 months after surgery. The full range of imaging findings in renal medullary carcinoma are described.

The management of male subfertility by in vitro fertilisation techniques.

Although IVF was developed for the treatment of tubal infertility, it is clear that it has a significant application in treatment of couples where the problem is one of male subfertility. This is particularly relevant because, despite the developments in reproductive medicine, in most males there is no identifiable cause for the poor semen quality. Therefore, for these men there is no efficacious method of treatment. Varicocele ligation and the use of agents such as clomiphene citrate, mesterolone empirical antibiotic therapy, and anabolic steroids have not been show to be beneficial when subject to controlled trials. The concept of improving the chance of fertilisation by taking the oocytes to the sperm in vitro is therefore the first feasible therapeutic option available to these subfertile couples. However, these possibilities should not obviate the need for a thorough assessment of the subfertile male and continuing research into the basis of male infertility. During the past decade new methods of sperm preparation, modified methods of insemination, and the use of microinjection have been developed. IVF is now a realistic option for couples if the male is subfertile. It has been suggested by some critics of these techniques that the brunt of the discomfort and risk has to be borne by the women where the problem appears to be solely with the male partner. Nevertheless, as having children is a 'couple' decision, prospective couples need to consider whether such procedures are acceptable to them.(ABSTRACT TRUNCATED AT 250 WORDS)

Sonographic features of mucinous biliary papillomatosis: case report and review of imaging findings.

Because of its indolent course, high recurrence rate, and risk of malignant transformation, mucinous biliary papillomatosis is an important consideration in the differential diagnosis of bile duct obstruction. We report a case of mucinous biliary papillomatosis and review the sonographic and other imaging findings previously reported in the literature. On sonography, these tumors appear as nonshadowing intrabiliary masses that are clearly defined and associated with proximal biliary dilatation. They may be multiple and associated with mucoid sludge. The imaging findings reflect the macroscopic appearance of a doughy papilliferous tumor of a bile duct. Associated findings include cholelithiasis, choledocholithiasis, and gallbladder dysplasia.

Pituitary response to LHRH during the puerperium in women.

Five breast-feeding women received 100 mug synthetic LHRH at between 19 and 58 days post-partum. One subject was treated twice. LH and FSH responses were monitored using radioimmunoassay. In four women treated at 19,21,29 and 51 days post-partum, the FSH response was greater than the LH response which was absent altogether in three of these women. In two women who were treated at 52 and 58 days both LH and FSH levels was elevated with the LH response being greater than the FSH response. This change in the pattern of pituitary response is considered in relation to the post-partum anovulatory condition.

Expression of stem cell factor in the postnatal rat testis.

The expression of stem cell factor (SCF) mRNA and protein was examined in the postnatal rat testis. Northern blot analysis of total RNA from 1-4 days postpartum (dpp) testes showed none or barely detectable levels of the approximately 6.5 kb SCF transcript. At 5 dpp, there was a striking elevation in this mRNA, a timing that coincides with the onset of spermatogonial proliferation. Immunohistochemical staining of testes showed that SCF protein was readily detected within Sertoli cells at 1-7 dpp and in the adult. Immunoreactive material was also detected within gonocytes and within Leydig cells at 1-7 dpp and in Leydig cells in the adult. Given the intense staining of Leydig cells by two different antibodies to SCF, the potential synthesis of SCF mRNA by these cells was investigated. Northern blot and reverse transcription/polymerase chain reaction analysis indicated that adult Leydig cells do not synthesize SCF mRNA, and Sertoli cells do. The significance of these findings is discussed in the context of germ cell-Sertoli cell interactions and Leydig cell function.

Plasma gonadotrophin levels in ovulatory and anovulatory patients.

Although episodes of FSH values were similar in subjects with secondary amenorrhoea and oligomenorrhoea, but patients with oligomenorrhoea had significantly higher plasma LH secretion in four normal, fourteen anovulatory and one postmenopausal woman were confirmed by samples taken every 15 minutes for three hours, single plasma samples invariably provided a valid estimate of the current mean plasma FSH level, and of the current mean plasma LH level during the follicular phase of the ovulatory menstrual cycle and in anovulatory women with a mean plasma LH value of less than 0-8 mIU/ml. If the mean plasma LH value in anovulatory women exceeded 0-8 mIU/ml, the maximum difference between single and mean values was 28-3+/-4-7 per cent for four patients with oligomenorrhoea and 43-4+/-5-2 per cent for five patients with secondary amenorrhoea. Single plasma samples were collected from 26 patients with primary amenorrhoea, 95 patients with secondary amenorrhoea, 51 patients with oligomenorrhoea and 33 postmenopausal patients not on replacement therapy. In each group there were subjects with plasma FSH values in the postmenopausal range and they were unlikely to respond to ovulation induction. Those patients aside, plasma FSH values were similar in subjects with secondary amenorrhoea and oligomenorrhoea, but patients with oligomenorrhoea had significantly higher plasma LH values (p less than 0-001); mean levels of neither FSH nor LH showed a significant correlation with response to treatment with clomiphene but in patients with secondary amenorrhoea an ovulatory response to clomiphene did not occur unless the individual's plasma FSH value was in excess of 1-4 mIU/ml. In patients with oligomenorrhoea, plasma LH levels below 0-8 mIU/ml precluded successful treatment with clomiphene.