Toxicity evaluation of Dolichandrone serrulata flower extract on vital and reproductive organs in adult male rats

Abstract Although Dolichandrone serrulata flower (DSF) aqueous extract has been shown to possess pharmacological properties, its systemic toxicity has still to be evaluated. The present study aimed to investigate the sub-chronic toxicity effect of DSF extract on biochemical parameters and histological structures of liver, kidney, testis, and epididymis plus vas deferens. Adult male rats were administered DSF at 100, 300, and 600 mg/kgBW via oral gavage for 48 consecutive days while control rats received distilled water. At the end of the experiment, blood, liver, kidney, testis, and epididymis plus vas deferens samples were collected to determine any changes to serum biochemical components including ALT, ALP, and creatinine levels and histological structures. The results revealed no significant difference in body weight and food or water consumption between control and the DSF-treated groups. It was found that DSF significantly increases the weight of epididymis plus vas deferens, while the kidney and liver showed a decrease in the high dose group (P value 0.05). Histological changes in these vital and reproductive tissues including fibrosis were not observed after administration but ALT, ALP, and creatinine levels were significantly altered in the treated groups (P value 0.05). These altered levels, however, were still within normal ranges. In conclusion, these findings demonstrated that D. serrulata flower extract had no sub-chronic toxicity on vital and reproductive structures but slightly altered some liver and kidney functions.

Resumo Como o extrato aquoso da flor de Dolichandrone serrulata (DSF) demonstrou ter algumas propriedades farmacológicas, sua toxicidade sistêmica ainda não foi avaliada. Este estudo teve como objetivo investigar o efeito da toxicidade subcrônica do extrato de DSF em parâmetros bioquímicos e estruturas histológicas do fígado, rim, testículo e epidídimo mais os vasos deferentes. Ratos machos adultos foram administrados com DSF em 100, 300 e 600 mg / kg de peso corporal por meio de gavagem oral por 48 dias consecutivos, enquanto os ratos controle receberam água destilada. No final do experimento, amostras de sangue, fígado, rim, testículo e epidídimo mais canais deferentes foram coletados para determinar as alterações dos componentes bioquímicos séricos, incluindo ALT, ALP e níveis de creatinina e estruturas histológicas. Os resultados revelaram que o peso corporal e o consumo de comida ou água do controle e de todos os grupos tratados com DSF não foram significativamente diferentes. Verificou-se que o DSF aumentou significativamente o peso do epidídimo mais os canais deferentes, mas o rim e o fígado diminuíram no grupo de alta dose (P valor 0,05). As alterações histológicas, incluindo fibrose de tais tecidos vitais e reprodutivos, não foram encontradas após a administração, mas os níveis de ALT, ALP e creatinina foram significativamente alterados nos grupos tratados (valor P 0,05). No entanto, seus níveis alterados ainda estavam em intervalos normais. Em conclusão, esses achados demonstraram que o extrato da flor de D. serrulata não apresentou toxicidade subcrônica nas estruturas vitais e reprodutivas, mas alterou ligeiramente algumas funções hepáticas e renais.

The effect of diagnosis delay in testis cancer on tumor size, tumor stage and tumor markers.

INTRODUCTION: In testicular cancer, the positive effect of early diagnosis on survival has been known for many years. In this study, we aimed to determine the diagnostic features of testicular cancer patients, to examine the effect of duration of diagnosis delay (DD) on tumor size, tumor stage, and serum tumor markers, and to reveal the possible benefits of early diagnosis. METHODS: A total of 71 patients who underwent inguinal orchiectomy due to suspicion of testicular cancer and whose pathology was found to be the germ cell tumor were included in the study. The relationship between the duration of diagnosis delay and tumor size, level of tumor markers, TNM stage, presence of LAP, and presence of metastasis were examined. RESULTS: Seminoma was detected in 39 (54.9%) patients and non-seminoma tumor was detected in 32 (45.1%) patients. In the correlation analysis between the markers, a significant and positive correlation was found between DD and radiological tumor size, pathological tumor size, retroperitoneal LAP detection rate, LDH and AFP levels, and N stage (respectively; r=0.345 p=0.003, r=0.324 p=0.006, r=0.244 p=0.041, r=0.286 p=0.015, r=0.244 p=0.040, r=0.238 p=0.046). It was determined that a 1-day increase in DD caused an increase of 0.431mm in the pathological size of the tumor. CONCLUSION: Duration of diagnosis delay is an issue that still keeps its importance for testicular tumors. Delay in diagnosis not only leads to an increase in tumor size but also negatively affects tumor stage and prognostic factors.

Clinical and ultrasonographic findings associated with testicular infiltration in pediatric patients with leukemia.

BACKGROUND: Testicular infiltration is infrequent in pediatric patients with leukemia and can be confused with other testicular conditions. OBJECTIVE: To analyze the presence of clinical and radiological features suggestive of testicular disease and its histological association with leukemia infiltration. METHOD: Retrospective and analytical observational study that included patients with diagnosis of leukemia who underwent biopsy for suspected testicular infiltration. The relationship with the variables analyzed were diagnosis, reason for taking the biopsy, ultrasound findings, stage of treatment, induration, increased volume and pain, with testicular infiltration. RESULTS: Eighteen patients were included; 11 of them with microlithiasis, of which one 1 reported infiltration (odds ratio: 0.075; p = 0.026), no association was found between ultrasound findings and the presence of infiltration. Clinical findings were significantly associated with positive biopsies. CONCLUSIONS: No risk association was found with the ultrasound findings such as microlithiasis and hypoechoic imaging. The clinically evident testicular disease (testicular enlargement and testicular induration) has a significant statistic association with the presence of leukemia infiltration.

ANTECEDENTES: La infiltración testicular en pacientes pediátricos con leucemia es infrecuente y puede ser confundida con otros padecimientos testiculares. OBJETIVO: Analizar la presencia de características clínicas y radiológicas sugestivas de enfermedad testicular y su asociación histológica con infiltración por leucemia. MÉTODO: Estudio observacional retrospectivo y analítico que incluyó a los pacientes con diagnóstico de leucemia sometidos a biopsia por sospecha de infiltración testicular. Se analizó la relación con las variables diagnóstico de base, motivo de toma de biopsia, hallazgos ultrasonográficos, etapa del tratamiento, induración, aumento de volumen y dolor, con infiltración a testículo. RESULTADOS: Se incluyeron 18 pacientes; de ellos, 11 con microlitiasis, de los cuales solo uno reportado con infiltración (odds ratio: 0.075; p = 0.026). No se encontró una asociación entre los hallazgos ultrasonográficos y la presencia de infiltración. Los hallazgos clínicos se asociaron significativamente con biopsias positivas. CONCLUSIONES: No se encontró una asociación de riesgo con los hallazgos por ultrasonido, como microlitiasis e imágenes hipoecogénicas. La enfermedad testicular clínicamente evidente (incremento de volumen e induración testicular) tiene una asociación estadísticamente significativa con la presencia de infiltración por leucemia.

The Effects of White Tea (Camellia Sinensis) and Infliximab Against Cisplatin- Induced Testicular Damage via Oxidative Stress and Apoptosis / Efectos del Té Blanco (Camellia Sinensis) e Infliximab Contra el Daño Testicular Inducido por Cisplatino a Través del Estrés Oxidativo y la Apoptosis

SUMMARY: Cisplatin (Cis) is an important chemotherapeutic agent used in cancer treatment. Males exposed to Cis were reported to exhibit testicular toxicity. Cis-induced testicular toxicity is mediated by oxidative stress, inflammation, testosterone inhibition and apoptosis. Accordingly, this study was conducted to evaluate the potential protective roles of infliximab (IFX), which is an anti- TNF-a agent, and of white tea (Camellia sinensis), which is known to possess antioxidant, anti-apoptotic, and anti-inflammatory effects, against Cis-induced testicular toxicity in rats. Rats were randomly assigned into five groups as follows: control group, Cisplatin (7 mg/kg) treatment group, Cisplatin (7 mg/kg) + infliximab (7 mg/kg) treatment group, cisplatin + white tea (WT) treatment group, and Cisplatin+ WT+IFX combined treatment group. In the present study, Cis exposure reduced the sperm count. It also increased testicular oxidative stress as well as the levels of inflammatory and apoptotic markers. Histopathological assays supported the biochemical findings. Treatment with IFX and/or WT restored testicular histology, preserved spermatogenesis, suppressed oxidative stress and apoptosis, and significantly ameliorated Cis-induced damage. It was concluded that white tea and infliximab could potentially serve as therapeutic options for the protection of testicular tissue against the harmful effects of Cis.

El cisplatino (Cis) es un importante agente quimioterapéutico utilizado en el tratamiento del cáncer. Se informó que los hombres expuestos a Cis exhibieron toxicidad testicular. La toxicidad testicular inducida por Cis está mediada por el estrés oxidativo, la inflamación, la inhibición de la testosterona y la apoptosis. En consecuencia, este estudio se realizó para evaluar las posibles funciones protectoras de infliximab (IFX), un agente anti-TNF-α, y del té blanco (Camellia sinensis), conocido por sus propiedades antioxidantes, antiapoptóticas y anti-TNF-α -efectos inflamatorios, contra la toxicidad testicular inducida por Cis en ratas. Cinco grupos de ratas se asignaron al azar de la siguiente manera: grupo control, grupo de tratamiento con cisplatino (7 mg/ kg), grupo de tratamiento con cisplatino (7 mg/kg) + infliximab (7 mg/kg), grupo de tratamiento con cisplatino + té blanco (WT), y grupo de tratamiento combinado Cisplatino+ WT+IFX. En el presente estudio, la exposición a Cis redujo el conteo de espermatozoides. También aumentó el estrés oxidativo testicular, así como los niveles de marcadores inflamatorios y apoptóticos. Los ensayos histopatológicos respaldaron los hallazgos bioquímicos. El tratamiento con IFX y/o WT restauró la histología testicular, preservó la espermatogénesis, suprimió el estrés oxidativo y la apoptosis, y mejoró significativamente el daño inducido por Cis. Se concluyó que el té blanco y el infliximab podrían potencialmente servir como opciones terapéuticas para la protección del tejido testicular contra los efectos nocivos de Cis.

Transiluminación negativa en patología testicular / Negative transillumination in testicular pathology

Los tumores testiculares representan el 1-2% de las neoplasias masculinas, siendo el más frecuente el seminoma. En pacientes con aparición de una masa o dolor testicular subagudo, es importante hacer una anamnesis exhaustiva y una exploración física. Hemos de apoyarnos en dos técnicas exploratorias para poder hacer un diagnóstico diferencial adecuado y detectar patología testicular urgente: transiluminación y ecografía testicular. El tratamiento incluye una orquiectomía y, según el estadio tumoral, quimioterapia.(AU)

Testicular tumors account for 1% to 2% of male neoplasms, the most common being seminoma. In patients who consult due to the presence of a mass or subacute testicular pain, it is important to undertake a thorough history and physical examination. We must rely on two exploratory techniques to be able to perform a suitable differential diagnosis and detect urgent testicular pathology: transillumination and testicular ultrasound. Treatment includes performing an orchiectomy and depends on tumor stage and chemotherapy.(AU)

Estadios de Tanner y orquidometría de Prader en varones adolescentes. Estudio descriptivo transversal / Tanner stages and Prader orchidometry in male adolescents. A descriptive, cross-sectional study

Introducción. La escala de Tanner y el orquidómetro de Prader son los instrumentos más utilizados para evaluar el desarrollo puberal en los niños. La evaluación de la pubertad en la clínica solo es útil si se dispone de datos de referencia recientes y confiables de la misma población para comparar. Objetivo: evaluar la correlación entre los estadios de Tanner y el volumen testicular (VT) en adolescentes argentinos. Población y métodos. Diseño descriptivo transversal, realizado con varones saludables de 9 a 20 años de edad. Se excluyeron varones con patología urogenital y enfermedades que afectan el crecimiento testicular. La correlación entre estadios de Tanner y VT fue evaluada con pruebas no paramétricas. Resultados. Se evaluaron 367 varones con una edad de 13,8 ± 2,5 años. El VT aumentó en correlación a los estadios de Tanner (Spearman 0,943; p <0,001) con volúmenes significativamente diferentes, salvo en los estadios iniciales genital 1-2 (p 0,343) y vello púbico 1-2 (p 0,447). El 16 % (intervalo de confianza del 95 % 9,6-24,4 %; n = 17/106) de los varones peripuberales fue clasificado erróneamente basado en los estadios de Tanner. Conclusiones. Durante la pubertad masculina, el VT aumentó en correlación con los estadios de Tanner, pero no presentó diferencias significativas entre los estadios 1 y 2 de Tanner. Es fundamental el uso del orquidómetro de Prader para detectar el inicio puberal en varones.

Introduction. The Tanner scale and the Prader orchidometer are the instruments most commonly used to assess pubertal development in children. The assessment of puberty in the clinic is only useful if recent and reliable references in the same population are available for comparison. Objective: to assess the correlation between Tanner stages and testicular volume (TV) in Argentine adolescents. Population and methods. Study with a descriptive, cross-sectional design conducted in healthy boys aged 9­20 years. Male children and adolescents with urogenital conditions and disorders affecting testicular growth were excluded. The correlation between Tanner stages and TV was assessed using non-parametric tests. Results. A total of 367 male adolescents with an average age of 13.8 ± 2.5 years were assessed. TV increased in correlation to Tanner stages (Spearman: 0.943, p < 0.001) with significantly different volumes, except in the early genital 1-2 stages (p 0.343) and pubic hair 1-2 stages (p 0.447). Among peripubertal boys, 16% (95% confidence interval: 9.6­24.4%, n = 17/106) were wrongly classified based on Tanner stages. Conclusions. During male puberty, TV increased in correlation to Tanner stages, but no significant differences were observed between Tanner stages 1 and 2. Using the Prader orchidometer is critical to establish the onset of puberty in boys

Unilateral testicular torsion in a neonate / Torsão testicular unilateral em neonato

A male neonate born at gestational age of 40 weeks was found to have an enlarged and darkened right hemiscrotum after birth. Left testicle was descended and normal. No clinical signs of distress were evident. A color Doppler ultrasound showed an absence of testicular blood flow, consistent with perinatal testicular torsion. The patient underwent a bilateral scrotal exploration through an inguinal incision and a necrotic right testicle was found. A right orchiectomy and left orchiopexy were performed. Perinatal testicular torsion is a rare but severe condition. A high clinical suspicion is required since most of perinatal testicular torsion are intrauterine and can often be asymptomatic, only with localized findings of the affected testis. The management of perinatal testicular torsion is still controversial; however, the most consensual approach is a prompt testicle exploration with orchiectomy of the necrotic testicle and contralateral orchiopexy

Recém-nascido do sexo masculino com idade gestacional de 40 semanas, com edema e escurecimento cutâneo do hemiescroto direito constatados após o nascimento. O testículo esquerdo era palpável na bolsa escrotal e não apresentava alterações. A ecografia escrotal com Doppler revelou ausência de fluxo vascular no testículo direito, achado compatível com torção testicular perinatal. O doente foi submetido a exploração escrotal bilateral através de abordagem por via inguinal, tendo sido confirmada a necrose do testículo direito. Foi realizada orquidectomia direita e orquidopexia esquerda. A torção testicular perinatal corresponde a uma patologia rara, mas com possíveis consequências graves. O seu diagnóstico requer elevada suspeição clínica, uma vez que a maioria dos casos ocorre no período pré-natal, podendo ser assintomáticos após o nascimento e manifestar-se com alterações localizadas ao testículo afetado. A abordagem da torção testicular perinatal é ainda controversa, sendo mais consensual uma exploração escrotal célere com orquidectomia do testículo necrosado e orquidopexia contralateral

Características clínico-ecográficas pre y postquirúrgicas de niños intervenidos por criptorquidia en el Hospital Sabogal, Perú

Objetivo: Determinar las características clínicoecográficas pre y postquirùrgicas de niños intervenidos por criptorquidia. Material y métodos: Estudio descriptivo y longitudinal, los datos recolectados de historias clínicas del Hospital Sabogal, las variables fueron edad del diagnóstico, tiempo de espera de orquidopexia, testículo afectado, ubicación del testículo y volumen testicular. Resultados: Se incluyeron 34 niños menores de 14 años con criptorquidia, la edad del diagnóstico fue 44 meses y de la orquidopexia 49 meses. El tiempo de espera para la orquidopexia fue 4,72 meses, el testículo más afectado fue el derecho (58,82%). Se incluyeron 39 testículos, la ubicación primaria canalicular (71,79 %), la ubicación final escrotal (50,0%), la técnica operatoria fue inguinal (91,18%). El incremento de volumen testicular fue de 0,39 cm3, p = 0,0006, IC 95% (-0,62, -0,17). Conclusiones: La edad de la orquidopexia fue 49 meses y el volumen testicular aumentó en 0,39 cm3 después de la orquidopexia.

Objective: To determine the preand post-surgical clinical-ultrasound characteristics of children operated on for cryptorchidism. Material and methods: Descriptive and longitudinal study, data collected from medical records of the Hospital Sabogal, the variables were age at diagnosis, waiting time for orchidopexy, affected testicle, location of the testicle and testicular volume. Results: We included 34 children under 14 years with cryptorchidism, the age of diagnosis was 44 months and orchidopexy 49 months. The waiting time for orchidopexy was 4.72 months, the most affected testicle was the right (58.82%). 39 testicles were included, the primary canalith location (71.79 %), the final scrotal location (50.0%), the operative technique was inguinal (91.18%). The increase in testicular volume was 0.39 cm3, p = 0.0006, 95% CI (-0.62, -0.17). Conclusions: The age of orchidopexy was 49 months and testicular volume increased by 0.39 cm3 after orchidopexy.

Satisfaction with testicular prosthesis: a Portuguese questionnaire-based study in testicular cancer survivors.

Radical orchiectomy in testicular cancer patients can have a negative impact on body image and self-esteem. Reconstructive surgery with testicular prosthesis might mitigate this burden. We conducted a questionnaire-based study aiming to evaluate our patients' satisfaction with testicular prosthesis. Overall satisfaction was rated as excellent or good in 97.7%. The main complaints were related to the prosthesis' inappropriate texture (45.5%), size (18.1%) or position (15.9%). Among men interviewed, 59% considered that having a normal looking scrotum was either extremely important or important for their self-esteem. The majority (88.2%) stated they would make the same decision again, and nearly all patients would recommend it to other men with testicular cancer. We believe testicular implants should always be offered, leaving the final decision to the patient.

Satisfaction with testicular prosthesis: a Portuguese questionnaire-based study in testicular cancer survivors / Satisfacción con las prótesis testiculares: estudio portugués basado en cuestionario de los supervivientes de cáncer de testículo

Radical orchiectomy in testicular cancer patients can have a negative impact on body image and self-esteem. Reconstructive surgery with testicular prosthesis might mitigate this burden. We conducted a questionnaire-based study aiming to evaluate our patients’ satisfaction with testicular prosthesis. Overall satisfaction was rated as excellent or good in 97.7%. The main complaints were related to the prosthesis’ inappropriate texture (45.5%), size (18.1%) or position (15.9%). Among men interviewed, 59% considered that having a normal looking scrotum was either extremely important or important for their self-esteem. The majority (88.2%) stated they would make the same decision again, and nearly all patients would recommend it to other men with testicular cancer. We believe testicular implants should always be offered, leaving the final decision to the patient (AU)

La orquiectomía radical en los pacientes de cáncer de testículo puede tener un impacto negativo en su imagen corporal y autoestima. La cirugía reconstructora con prótesis testiculares podría mitigar esta carga. Realizamos un estudio basado en el uso de un cuestionario con el objetivo de evaluar la satisfacción de nuestros pacientes con las prótesis testiculares. La satisfacción general fue calificada como excelente o buena en el 97,7% de los casos. Las principales quejas guardaron relación con la textura inadecuada de las prótesis (45,5%), el tamaño (18,1%) o su posición (15,9%). Entre los varones entrevistados, el 59% consideró que tener un escroto con aspecto normal era extremadamente importante, o importante para su autoestima. La mayoría (88,2%) afirmó que volverían a tomar la misma decisión de nuevo, y casi todos los pacientes lo recomendarían a otros varones con cáncer de testículo. Consideramos que siempre deberían ofrecerse los implantes testiculares, dejando que el paciente tome siempre la decisión final. (AU)

[Biomarkers in testicular cancer.] / Biomarcadores en cáncer de testículo.

OBJECTIVE: To review the current situationof biomarkers used in the diagnosis, prognosis,treatment response and relapse of testicular cancer. METHODS: A non systematic review was performedof clinical guidelines and articles published within thelast years regarding biomarkers in testicular cancer. RESULTS: The most commonly used biomarkersare alphafetoprotein (AFP) and beta human corionicgonadotropin (ß-HCG).The enzyme lactate dehydrogenase (LDH) is presentin multiple tissues and is elevated in advancedgerminal tumors. A few micro molecules of RNA (micro-RNA) have demonstrated to be specifically elevatedin testicular germinal tumors. However, its clincalbenefit, as well as its standardization is currently underinvestigation. CONCLUSIONS: Classic biomarkers AFP, ß-HCG,and LDH are of some utility confirming the diagnosisif they are elevated. However, its limited sensibility isnot enough to rely the diagnosis on themselves. Thereare promising results with Micro-RNA but its daily usedoes not seem imminent.

OBJETIVO: .-Revisar la situación actualde los biomarcadores utilizados en el diagnóstico, pronóstico,monitorización de la respuesta al tratamiento,y detección de la recidiva del cáncer de testículo.MÉTODOS:.- Realizamos una revisión no sistemáticatanto de guías de práctica clínica como de artículospublicados en los últimos años sobre los biomarcadoresen cáncer de testículo, en conjunto, y cadauno en particular. RESULTADOS: .- Los dos marcadores más extendidosy utilizados son la alfafetoproteína (AFP), y la Betagonadotropina coriónica humana (ß-HCG).La lactato deshidrogenasa (LDH) es una enzimapresente en diversos tejidos y que se encuentra elevadaen algunos tumores germinales, especialmenteen estados más avanzados. Algunas moléculas pequeñasde ácido ribonucleico circulante en sangre (Micro-RNA) han demostrado estar elevadas de maneramás constante y específica en los tumores germinalestesticulares. Sin embargo su utilidad práctica aún estáen evaluación, así como su sistematización para facilitarla extensión de su uso. CONCLUSIONES: .- Los marcadores clásicos AFP,ß-HCG, y LDH son de cierta utilidad confirmatoria encaso de estar elevados. Pero su limitada sensibilidadno permite fundamentar en ellos el diagnóstico. Losresultados obtenidos con los Micro-RNA son muchomás prometedores, sin embargo su incorporación a lapráctica diaria no parece inminente.

Biomarcadores en cáncer de testículo / Biomarkers in testicular cáncer

OBJETIVO: Revisar la situación actualde los biomarcadores utilizados en el diagnóstico, pronóstico, monitorización de la respuesta al tratamiento,y detección de la recidiva del cáncer de testículo.MÉTODOS:.- Realizamos una revisión no sistemática tanto de guías de práctica clínica como de artículos publicados en los últimos años sobre los biomarcadores en cáncer de testículo, en conjunto, y cadauno en particular.RESULTADOS:.- Los dos marcadores más extendidos y utilizados son la alfafetoproteína (AFP), y la Betagonadotropina coriónica humana (β-HCG).La lactato deshidrogenasa (LDH) es una enzimapresente en diversos tejidos y que se encuentra elevada en algunos tumores germinales, especialmenteen estados más avanzados. Algunas moléculas pequeñas de ácido ribonucleico circulante en sangre (Micro-RNA) han demostrado estar elevadas de maneramás constante y específica en los tumores germinalestesticulares. Sin embargo su utilidad práctica aún estáen evaluación, así como su sistematización para facilitar la extensión de su uso.CONCLUSIONES:.- Los marcadores clásicos AFP,β-HCG, y LDH son de cierta utilidad confirmatoria encaso de estar elevados. Pero su limitada sensibilidadno permite fundamentar en ellos el diagnóstico. Losresultados obtenidos con los Micro-RNA son muchomás prometedores, sin embargo su incorporación a lapráctica diaria no parece inminente. (AU)

OBJECTIVE: To review the current situation of biomarkers used in the diagnosis, prognosis, treatment response and relapse of testicular cancer.METHODS: A non systematic review was performedof clinical guidelines and articles published within thelast years regarding biomarkers in testicular cancer.RESULTS: The most commonly used biomarkersare alphafetoprotein (AFP) and beta human corionicgonadotropin (β-HCG).The enzyme lactate dehydrogenase (LDH) is present in multiple tissues and is elevated in advancedgerminal tumors. A few micro molecules of RNA (micro-RNA) have demonstrated to be specifically elevated in testicular germinal tumors. However, its clincalbenefit, as well as its standardization is currently under investigation.CONCLUSIONS: Classic biomarkers AFP, β-HCG,and LDH are of some utility confirming the diagnosisif they are elevated. However, its limited sensibility isnot enough to rely the diagnosis on themselves. Thereare promising results with Micro-RNA but its daily usedoes not seem imminent. (AU)

Effect of sunitinib on testicular oxidative and proinflammatory damage induced by ischemia-reperfusion in rats.

INTRODUCTION: This study aimed to biochemically and histopathologically investigate the effect of sunitinib on oxidative testicular damage induced by ischemia/reperfusion in rats. MATERIAL-METHOD: Experimental animals were divided into three groups of six rats each: testicular torsion-detorsion (TTD), sunitinib+testicular torsion-detorsion (STD), and sham control (SC). Sunitinib (25mg/kg) was administered orally to the STD group by gavage. Normal saline (0.9% NaCl) was administered orally to the TTD and control groups as the solvent. One hour after administration of sunitinib and 0.9% NaCl, all animal groups were done torsion-detorsion. Then, all the rats were killed by high-dose anesthesia, and their testicles were removed. Biochemical and histopathological examinations were performed on the removed testicular tissues. RESULTS: Malondialdehyde; it was observed that the results in the STD group were close to those of the SC group and statistically significant lower compared to the TTD group (p=0.001). The glutathione values were statistically significantly higher in the STD group compared to the TTD group (p<0.001). Nuclear factor kappa B values, revealing a statistically significant difference between the TTD and STD groups (p<0.001). The TNF-α levels were measured and indicating that the results of the STD group were statistically significantly lower than those of the TTD group (p<0.001). Histopathologically, animal tissues given sunitinib were observed to resemble normal tissues. CONCLUSION: Sunitinib was shown to prevent histopathological changes in testicular tissue against ischemia/reperfusion damage.

Volumen testicular en pacientes adultos operadosde criptorquidia en edad infantil y su efectosobre la paternidad / Testicular volume in adult patients undergoing cryptorchidism surgery in childhood, and impact on paternity

Objetivos: Determinar el efecto de la orquidopexia sobre el volu-men testicular. Determinar si la edad de intervención afecta el volumentesticular. Determinar si la paternidad se asocia al volumen testicular.Métodos: Pacientes nacidos entre los años 1961 y 1985, interveni-dos de criptorquidia por el Servicio de Cirugía Pediátrica del HospitalUniversitario Miguel Servet, tomando datos de la localización del testey aspecto macroscópico. Se realizan ecografías testiculares de controly encuestas de paternidad. Realizamos un estudio inicial descriptivo yposteriormente inferencial.Resultados: La ecografía se realizó con una media de 14,9 añospostoperatorios en 216 unidades testiculares y la encuesta de paternidadcon una media de 41,9 años postoperatorios a 157 participantes. Existendiferencias significativas (p = 0,0038) en la distribución del volumentesticular según disyunción del epidídimo. Hay correlación lineal entremayor edad de tratamiento quirúrgico y menor volumen testicular, sinllegar a significancia estadística. Se observan diferencias significativas(p = <0,0001) en el volumen testicular según grupos de operados y nooperados, como también entre los unilaterales y los bilaterales. No seobservan diferencias en índices de paternidad según volumen testicular.Conclusión: El teste intervenido presenta un volumen testicularmenor que el teste de descenso normal. Una mayor edad de tratamientoquirúrgico puede contribuir a un menor volumen final del teste. Lostestículos con disyunción epidídimo testicular completa tienen menorvolumen total. No observamos relación entre el volumen testicular eíndices de paternidad. Más estudios a largo plazo son necesarios.

Objective: To determine the impact of orchiopexy on testicularvolume. To determine whether age at surgery impacts testicular volume.To determine whether paternity is associated with testicular volume.Methods: Patients born between 1961 and 1985 who had under-gone cryptorchidism surgery at the Pediatric Surgery Department ofMiguel Servet University Hospital were included. Testis location andmacroscopic appearance data were collected. Control testicular ultra-sonographies and paternity surveys were carried out. Initially, the studywas descriptive, and subsequently, inferential.Results: Ultrasonography was performed in 216 testicular units amean of 14.9 years following surgery, whereas the paternity survey wasconducted among 157 respondents a mean of 41.9 years following sur-gery. There were significant differences (p = 0.0038) in testicular volumedistribution according to epididymal dissociation. There was a linearcorrelation between older age at surgery and lower testicular volume,but without statistical significance. Significant differences (p = <0.0001)in testicular volume according to groups –operated and non-operated–,as well as between unilateral and bilateral cases, were found. No dif-ferences in paternity rates according to testicular volume were noted.Conclusion: Operated testes have lower volumes than normallydescended testes. Older age at surgery may contribute to lower finalvolumes. Testes with full epididymal-testicular dissociation have lowertotal volumes. No relation between testicular volume and paternity rateswas found. Further long-term studies are required.

Gamma-amino butyric acid immunoreactivity in the testis tissue of Wistar and genetic absence epilepsy rats / Inmunorreactividad del ácido gamma-amino butírico en el tejido testicular de ratas Wistar con epilepsia de ausencia genética

SUMMARY: Studies have shown the adverse effects of epileptic seizures on reproductive health. The aim of the present study was to investigate morphological changes, apoptosis and GABA localization in the testis tissue of genetic absence epilepsy rats. Testis tissues of GAERS and Wistar rats were processed for paraffin embedding and electron microscopy. Sections were stained with hematoxylin and eosin, Masson's trichrome and periodic acid-Schiff reaction. GABA immunohistochemistry was applied for determining the alterations in GABA levels. GABA immunoreactivity was observed in the seminiferous tubules and interstitial areas of both GAERS and Wistar rats. GABA immunoreactivity was found to be decreased in GAERS compared to Wistar group. Electron microscopic observations showed that GABA was present in manchette microtubules, sperm tail and neck at different phases of spermiogenesis. Qualitative observations revealed that testis tissues of GAERS showed reduced sperm in the seminiferous tubules compared to the Wistar controls. In conclusion, we demonstrated GABAergic system in the seminiferous tubules of control and GAERS rats, in parallel with the previous studies; and there were alterations in this system in GAERS. We suggest that these alterations in absence epilepsy may also affect the gonadal system, resulting in decreased sperm production.

RESUMEN: Los estudios han demostrado los efectos adversos de las convulsiones epilépticas sobre la salud reproductiva. El objetivo del presente estudio fue investigar los cambios morfológicos, la apoptosis y la localización de GABA en el tejido testicular de ratas con epilepsia de ausencia genética. Se procesaron tejidos testiculares de ratas GAERS y Wistar para inclusión en parafina y microscopía electrónica. Las secciones se tiñeron con hematoxilina y eosina, tricrómico de Masson y reacción de ácido peryódico de Schiff. Se aplicó inmunohistoquímica de GABA para determinar las alteraciones en los niveles de GABA. Se observó inmunorreactividad de GABA en los túbulos seminíferos y las áreas intersticiales de las ratas GAERS y Wistar. Se encontró que la inmunorreactividad de GABA estaba disminuida en GAERS en comparación con el grupo Wistar. Las observaciones microscópicas electrónicas mostraron que GABA estaba presente en los microtúbulos, la cola y el cuello del espermatozoide en diferentes fases de la espermiogénesis. Las observaciones cualitativas revelaron que los tejidos testiculares de GAERS mostraron una reducción de los espermatozoides en los túbulos seminíferos en comparación con los controles Wistar. En conclusión, demostramos el sistema GABAérgico en los túbulos seminíferos de ratas control y GAERS, en paralelo con estudios previos; y además se observaron alteraciones en este sistema en GAERS. Sugerimos que estas alteraciones en epilepisa de ausencia genética también pueden afectar el sistema gonadal, resultando en una disminución de la producción de semen.

Explorando un seminoma, encontrado en una ruptura testicular: reporte de caso

Dentro de los traumas testiculares, el cerrado representa la mayoría de los casos, y por lo general afecta a hombres de 15 a 40 años de edad. Presentamos un hallazgo de seminoma clásico luego de un trauma incidental con posterior exploración quirúrgica y orquiectomía radical de testículo izquierdo. Se resalta la dificultad de las herramientas de investigación como la ecografía testicular para apoyo del médico. Los seminomas suelen ser masas homogéneamente hipoecoicas. Las imágenes por resonancia magnética pueden ayudar a confirmar que una masa es intratesticular y proporcionar datos para la estadificación local. La tomografía computarizada proporciona información valiosa para la estadificación, incluida la presencia y el tamaño de los ganglios linfáticos retroperitoneales. El manejo es limitado. Sin embargo, el seminoma testicular se trata con orquiectomía inguinal radical y es altamente curable incluso en etapas avanzadas de la enfermedad. La mayoría de los médicos eligen la orquiectomía seguida de vigilancia para pacientes con enfermedad seminomatosa en estadio I y quimioterapia o radiación, seguida de una cirugía para el manejo de masas residuales, para pacientes con enfermedad en estadio II y superior. Destacamos la importancia de la sospecha clínica en estos tipos de pacientes jóvenes y tener una búsqueda activa ante estos traumas triviales.   (provisto por Infomedic International)

Among testicular traumas, blunt testicular trauma represents the majority of cases and usually affects men between 15 and 40 years of age. We present a finding of classic seminoma after an incidental trauma with subsequent surgical exploration and radical orchiectomy of the left testicle. The difficulty of research tools such as testicular ultrasound for physician support is highlighted. Seminomas are usually homogeneously hypoechoic masses. Magnetic resonance imaging can help confirm that a mass is intratesticular and provide data for local staging. Computed tomography provides valuable information for staging, including the presence and size of retroperitoneal lymph nodes. Management is limited. However, testicular seminoma is treated with radical inguinal orchiectomy and is highly curable even in advanced stages of the disease. Most physicians choose orchiectomy followed by surveillance for patients with stage I seminomatous disease and chemotherapy or radiation, followed by surgery for management of residual masses, for patients with stage II and higher disease. We stress the importance of clinical suspicion in these types of young patients and having an active search for these trivial traumas. (provided by Infomedic International)

Spermatic vein thrombosis. first clinical case reported in colombia

ABSTRACT Introduction: Spermatic vein thrombosis (SVT) is a very rare event with no specific epidemiological data. Its presentation is predominantly on the left, and in most cases, its cause is unknown. Its diagnosis is usually made by exclusion when studying acute scrotum pain. The following is the first case of SVT reported in Colombia and one of the few cases of right laterality in the world. Case presentation. A 21-year-old male patient consulted the emergency department of a tertiary care institution in Bogotá, Colombia, due to pain in the right inguinoscrotal region for a week that progressively increased in intensity and was accompanied by unquantified fever, without other associated symptoms. The patient reported only a medical history of a mild cranioencephalic trauma without sequelae at the age of 20 years. A testicular Doppler ultrasound was performed, revealing right spermatic cord thrombosis. He started antibiotic therapy, low molecular weight heparins and coumarin, which resulted in an adequate response and resolution of the condition. Conclusion: SVT poses a diagnostic challenge that requires a high clinical suspicion, which is achieved by having knowledge of this condition and establishing it as a differential diagnosis of acute scrotum pain. Once suspected, Doppler ultrasound becomes a useful tool for diagnosis because, in addition to being cost-efficient, it allows the initiation of a timely, safe and effective conservative treatment, thus avoiding unfavorable outcomes for the patient.

RESUMEN Introducción. La trombosis de la vena espermática (TVE) es una entidad muy poco frecuente de la cual no se tienen datos epidemiológicos específicos. Su presentación es de predominio izquierdo, en la mayoría de los casos su causa es desconocida y su diagnóstico suele realizarse por exclusión en el estudio del escroto agudo. A continuación, se presenta el primer caso documentado de TVE en Colombia y uno de los pocos de lateralidad derecha en el mundo. Presentación del caso. Hombre de 21 años quien consultó al servicio de urgencias de una institución de tercer nivel de atención de Bogotá, Colombia, por un cuadro clínico de una semana de evolución consistente en dolor en región inguinoescrotal derecha que aumentó progresivamente de intensidad y estuvo acompañado de un pico febril no cuantificado; el paciente indicó como único antecedente médico un trauma craneoencefálico leve sin secuelas a los 20 años. Se realizó estudio con ecografía Doppler testicular en donde se observó trombosis del cordón espermático derecho. Se inició manejó con antibioticoterapia, heparinas de bajo peso molecular y cumarínicos, con lo cual se obtuvo una adecuada respuesta y la resolución del cuadro. Conclusión. La TVE representa un reto diagnóstico, por lo que se requiere de una alta sospecha clínica, la cual se genera teniendo conocimiento de la entidad e incluyéndola en el diagnóstico diferencial del escroto agudo. La ecografía Doppler es una herramienta fundamental para diagnosticar TVE, además permite iniciar un tratamiento conservador oportuno, seguro y eficaz que evite desenlaces desfavorables para el paciente, lo que resulta ser costo-efectivo.

Antecedentes de neoplasias urológicas previos al trasplante renal. Resultados oncológicos a largo plazo / History of urological malignancies before kidney transplantation, oncological outcome on the long term

Introducción: Nuestro objetivo ha sido informar de los resultados oncológicos de pacientes con ERET y antecedentes de neoplasias urológicas que fueron sometidos posteriormente a un trasplante renal (TR).Material y métodoEstudio retrospectivo llevado a cabo en el registro de la Fundación Puigvert (Barcelona) con 1.200 TR realizados entre 1988 y 2018. Se identificaron 85 neoplasias urológicas que recibieron tratamiento previo al TR en 81 pacientes: 15 (18%) cánceres de próstata, 49 (58%) carcinoma de células renales (CCR), 19 (22%) carcinomas uroteliales y 2 (2%) cánceres de testículo. Se registraron datos de las características basales, la estadificación del cáncer, el tratamiento y el seguimiento, y sobre la cronología del inicio de diálisis, la inscripción en la lista de espera y el TR. Los criterios de valoración fueron la recidiva del cáncer, la progresión metastásica, la muerte específica por cáncer y la supervivencia global.ResultadosEn una mediana de seguimiento de 13,1 años (2,2-32), se registraron 16/85 (19%) recidivas del cáncer, con 3 (4%) progresiones a metástasis y muerte por cáncer. La mediana de supervivencia global tras el tratamiento del cáncer fue de 25,3 años y la supervivencia por cáncer específica fue del 95% a los 25 años.La mediana de tiempo desde el tratamiento del cáncer hasta el trasplante de riñón fue de 4,8 años: 3,7 años en el cáncer de próstata, 3,9 años en el CCR y 8,8 años en el cáncer vesical. La mediana de tiempo desde el inicio de diálisis hasta el TR fue de 1,8 años en los pacientes con antecedentes de neoplasia urológica, frente a 0,5 años en la cohorte total de 1.200 trasplantes renales durante el mismo periodo. (AU)

Introduction: We aimed to report the oncological outcomes of ESRD patients with histories of urological malignancies who were subsequently submitted to kidney transplantation (KT).Material and methodRetrospective study lead in the Puigvert Foundation (Barcelona) registry of 1,200 KT performed from 1988 to 2018. Eighty-five urological malignancies that were treated before KT in 81 patients were identified: 15 (18%) prostate cancers, 49 (58%) RCC, 19 (22%) urothelial carcinomas and 2 (2%) testicular cancers. Baseline characteristics, cancer staging, treatment and follow-up were registered as well as the chronology of the start of dialysis, inscription on the waiting list and kidney transplantation. Endpoints included were cancer recurrence, metastatic progression, cancer-specific death and overall survival.ResultsIn a median follow-up of 13.1 years (2.2-32), 16/85 (19%) cancer recurrences were reported, with 3 (4%) who progressed to metastasis and died of cancer. Median overall survival after cancer treatment was 25.3 years and cancer-specific survival was 95% at 25 years.Median time from cancer treatment to kidney transplantation was 4.8 years: 3.7 years in prostate cancer, 3.9 years in RCC and 8.8 years in bladder cancer. The median time from start of dialysis to kidney transplantation was 1.8 years in patients with histories of urological malignancy versus 0.5 year in the total cohort of 1,200 renal transplanted over the same period. (AU)

History of urological malignancies before kidney transplantation, oncological outcome on the long term.

INTRODUCTION: We aimed to report the oncological outcomes of ESRD patients with histories of urological malignancies who were subsequently submitted to kidney transplantation (KT). MATERIAL AND METHOD: Retrospective study lead in the Puigvert Foundation (Barcelona) registry of 1,200 KT performed from 1988 to 2018. Eighty-five urological malignancies that were treated before KT in 81 patients were identified: 15 (18%) prostate cancers, 49 (58%) RCC, 19 (22%) urothelial carcinomas and 2 (2%) testicular cancers. Baseline characteristics, cancer staging, treatment and follow-up were registered as well as the chronology of the start of dialysis, inscription on the waiting list and kidney transplantation. Endpoints included were cancer recurrence, metastatic progression, cancer-specific death and overall survival. RESULTS: In a median follow-up of 13.1 years (2.2-32), 16/85 (19%) cancer recurrences were reported, with 3 (4%) who progressed to metastasis and died of cancer. Median overall survival after cancer treatment was 25.3 years and cancer-specific survival was 95% at 25 years. Median time from cancer treatment to kidney transplantation was 4.8 years: 3.7 years in prostate cancer, 3.9 years in RCC and 8.8 years in bladder cancer. The median time from start of dialysis to kidney transplantation was 1.8 years in patients with histories of urological malignancy versus 0.5 year in the total cohort of 1,200 renal transplanted over the same period. CONCLUSIONS: Well-selected patients with histories of urological malignancies greatly benefit from kidney transplantation with infrequent and late cancer recurrence. Waiting time could be optimized in low-risk prostate cancer and RCC, but more robust data are needed.

Fusión esplenogonadal asociada a síndrome de Moebius y Poland: primer caso reportado / Splenogonadal fusion associated with Moebius and Poland syndromes: first case reported

Introducción: La fusión esplenogonadal es una anomalía congénitarara, de etiología desconocida, causada por la fusión anormal entre eltejido esplénico y gonadal. Caso clínico: Paciente de dos años, con parálisis del 6°, 7° y 9°nervio craneal, boca en tienda, paladar hendido, hipoplasia del músculopectoral mayor derecho y defecto disruptivo de la extremidad superior derecha, masa visible en región inguinal izquierda. Al realizar laherniorrafia inguinal encontramos un conducto peritoneo vaginal concontenido no reductible y a la apertura del saco herniario observamosun segmento de tejido esplénico que desciende y se fusiona con elpolo superior del testículo izquierdo. El paciente fue diagnosticado confusión esplenogonadal. El tejido esplénico fusionado al polo superiordel testículo es resecado y el resto del tejido esplénico se reduce haciala cavidad abdominal. Comentarios: La fusión esplenogonadal es una patología de difícildiagnóstico y su conocimiento puede evitar orquiectomías innecesarias.(AU)

Introduction: Splenogonadal fusion is a rare congenital anomalyof unknown etiology caused by an abnormal fusion of the splenic tissueand the gonadal tissue. Clinical case: 2-year-old patient with paralysis of the 6 th , 7 th , and9th cranial nerves, tent-shaped mouth, cleft palate, right pectoralis majorhypoplasia, disruptive defect of the right upper limb, and a mass locatedat the left inguinal region. At inguinal hernia repair surgery, a processusvaginalis with non-reducible content was observed. When opening thehernia sac, a descending segment of splenic tissue merging with theupper pole of the left testis was found. The patient was diagnosed withsplenogonadal fusion. The splenic tissue merging with the testis uppe pole was resected, and the remaining splenic tissue was reduced towardsthe abdominal cavity. Discussion: Splenogonadal fusion is difficult to diagnose. Beingfamiliar with it allows unnecessary orchiectomies to be prevented.(AU)