[Intervention effect of Modified Dahuang Zhechong Granule on epididymal morphological changes in experimental varicocele rats].

OBJECTIVE: To explore the effect of Modified Dahuang Zhechong Granule (MDZG) on the development and maturation of epididymal sperm in experimental varicocele (VC) rats. METHODS: Sixty SD male rats were randomly divided into six groups of equal number, sham operation, VC model, Aescuven forte, and low-, medium- and high-dose MDZG. The model of left VC was made by the Turner method in all the rats except those of the sham operation group, followed by treatment with 0.9% normal saline for the animals in the sham operation and VC model groups, Aescuven forte tablets at 54 mg per kg of the body weight for those in the Aescuven forte group, and MDZG at 0.6, 1.2 and 2.4 g/ml for those in the low-, medium- and high-dose MDZG groups, all administered intragastrically qd for 8 successive weeks. Then, all the rats were sacrificed and their left epididymides harvested for examination of the quality of the epididymal sperm and the local microscopic and ultrastructural changes of the epididymal tissue. RESULTS: The VC model rats showed significant apoptosis of the epididymal sperm cells, interstitial edema, microvascular dilatation, degeneration and degeneration of the epithelial cells, degeneration of some principal cells and basal cell vacuoles, and immature spermatids in the lumen. Sperm motility was significantly increased in the Aescuven forte and low-, medium- and high-dose MDZG groups as compared with the VC models (P <0.01). Both sperm concentration and motility were markedly higher in the high-dose MDZG than in the Aescuven forte group (P <0.05). Remarkable apoptosis of epididymal sperm cells was observed in the microenvironment of sperm development in the VC models, which exhibited no statistically significant difference from that in the rats of the medium- and high-dose MDZG groups. CONCLUSIONS: Experimental varicocele induced local apoptosis of epididymal sperm cells, interstitial edema and microvascular dilatation in the rat epididymis, while Modified Dahuang Zhechong Granule could improve the stability of epididymal sperm maturation and contribute to their development.

Asymmetric dimethyl arginine levels in testicular tissue and blood of rats with induced experimental varicocele / Niveles de dimetilarginina asimétrica en la sangre y el tejido testicular de ratas con varicocele inducido

Introduction. Varicocele is one of the reasons for testicular dysfunction and is frequently known to accompany infertility. The basic pathology of varicocele is the development of endothelial dysfunction. The most important factors in development of endothelial dysfunction are impaired endothelial-linked vasodilatation, increase in free oxygen radicals, reduced synthesis and release of nitric oxide (NO), abnormal vasoconstriction and increased levels of dimethyl arginine. Our aim was to identify and illustrate the relationship between asymmetric dimethyl arginine (ADMA) and NO levels in testicular tissue and plasma of rats with induced experimental varicocele. Materials and methods. Twenty-one adolescent (average 6 weeks) male rats were included in the study and randomly divided into 3 groups. Group 1 (control, n = 6) did not undergo any procedure. Group 2 (sham, n = 6) had the left renal vein circled proximally but ligation was not performed. Group 3 (varicocele-induced, n = 9) had partial ligation of the proximal left renal vein to induce left varicocele. Superoxide dismutase (SOD) enzyme activity and levels of end-products of NO, nitrite and nitrate salts were investigated in testis tissue. Nitrite/nitrate and ADMA levels were investigated in plasma. Histopathological examination was completed with routine hematoxylin-eosine and TUNEL dyes. Results. Tissue SOD and plasma ADMA values were clearly increased in the varicocele group compared to the other groups; tissue and plasma nitrite/nitrate levels were clearly reduced in the varicocele group and this was observed to be statistically significant between the groups. Conclusion. We believe our study has opened an important window on the relationship between infertility observed in varicocele patients and ADMA. We believe that broad-series prospective studies to support this are required (AU)

Introducción. El varicocele es uno de los causantes de la disfunción testicular y comúnmente cursa con infertilidad. La patología de base del varicocele es el desarrollo de la disfunción endotelial. Los factores más importantes para el desarrollo de la disfunción endotelial son la vasodilatación dependiente del endotelio, el aumento de los radicales libres del oxígeno, la reducción en la síntesis y liberación de óxido nítrico (NO), la vasoconstricción anormal y los niveles altos de dimetilarginina. Nuestro objetivo fue identificar e ilustrar la relación existente entre la dimetilarginina asimétrica (ADMA) y los niveles de NO en el tejido testicular y el plasma de ratas con varicocele inducido en laboratorio. Material y métodos. En el estudio se incluyeron veintiuna ratas macho adolescentes (6 semanas de media), que se dividieron en 3 grupos al azar. El Grupo 1 (control, n = 6) no fue sometido a ninguna operación. Al Grupo 2 (grupo quirúrgico de referencia, n = 6) se le rodeó de manera proximal la vena renal izquierda, pero no se realizó la ligadura. En el Grupo 3 (varicocele inducido, n = 9) se realizó una ligadura parcial de la vena renal izquierda para inducir varicocele izquierdo. Se investigaron en el tejido testicular los niveles de actividad de la enzima superóxido dimutasa (SOD) y de productos finales del NO, sales de nitritos y nitratos. Se investigaron los niveles de nitrito/nitrato y de ADMA en el plasma. El análisis histopatológico se completó con tinciones hematoxilina-eosina y TUNEL rutinarias. Resultados. Los valores hísticos de SOD y plasmáticos de ADMA habían sufrido un aumento claro en el grupo de varicocele comparado con los otros grupos; los niveles hísticos y plasmáticos de nitrito/nitrato se habían visto claramente reducidos en el grupo de varicocele, lo cual se entendió como un valor estadístico significativo entre los grupos. Conclusión. Opinamos que nuestra investigación ha abierto una puerta importante a la relación entre la infertilidad en casos de pacientes con varicocele y la ADMA. Para respaldarla, deberían llevarse a cabo amplios estudios prospectivos (AU)

Effects on the ipsilateral testis during progression of experimental varicocele in rat.

BACKGROUND: We used an animal model of experimental varicocele to investigate the effects on the ipsilateral testis during the progression of experimental varicocele in rat. MATERIAL/METHODS: Experimental varicocele was induced by partial ligation of the left renal vein in rats. Rats in each control group were subjected to a sham operation. After different periods of varicocele creation (6, 12, and 18 weeks), each animal's left testis was extirpated, and Johnsen's score, ultrastructure of seminiferous tubules, intratesticular testosterone concentration, and the germ cell apoptotic index of each left testis were compared between the experimental and control groups. RESULTS: Johnsen's score and intratesticular testosterone concentrations in each experimental varicocele group were significantly lower than those in the corresponding control groups (P<0.05) and showed significant declines as the duration of varicocele gradually increased; the apoptotic index showed an opposite tendency. Ultrastructural injury of seminiferous tubules gradually became severe as the duration of varicocele gradually increased. CONCLUSIONS: Experimental varicocele caused progressive impairment of the ipsilateral testis; apoptosis mediated the pathophysiological processes of dyszoospermia.

The health effects of diethylstilbestrol revisited.

Although diethylstilbestrol has not been prescribed commonly for more than 25 years, its effects on the health of exposed persons are still important. In this article, we summarize current information about the major health effects of diethylstilbestrol exposure and delineate implications for nurses. Nurses can help to identify persons at risk from prior diethylstilbestrol exposure, facilitate comprehensive assessments of persons exposed to diethylstilbestrol, and share current information about diethylstilbestrol.

Genital abnormalities and abnormal semen analyses in male patients exposed to diethylstilbestrol in utero.

Urologic examination of 48 male patients exposed in utero to diethylstilbestrol showed genital abnormalities in 29. Only 33 per cent of the patients studied had normal semen analyses by Eliasson scoring. Genital abnormalities demonstrated included varicoceles, epididymal cysts, hypoplastic testes and undescended testes among others. None of the patients had elevations of alpha-fetoprotein or beta-subunit human chorionic gonadotropin. The high incidence of the aforementioned abnormalities suggests that all male patients exposed to diethylstilbestrol should undergo urologic examination and semen analysis. Additionally, a history of diethylstilbestrol exposure should be sought in all patients with apparent idiopathic infertility.

PIP: 48 male patients exposed in utero to diethylstilbestrol (DES) were studied urologically, retrospectively, to determine residual complications. 29 of the 48 males had genital abnormalities when examined. In addition, only 33% of these patients had normal seman analyses (by the Eliasson scoring method). Other parameters measured included levels of alpha-fetoprotein and beta-subunit human chorionic gonadotropin, but none of the subjects had elevations of these compounds. Genital abnormalities discovered on examination included varicoceles, epididymal cysts, hypoplastic testes, and undescended testes. This high incidence of genital abnormalities and semen deficiency suggests that males as well as female patients exposed in utero to DES should be given periodic examinations for genital abnormalities. As an obvious corollary, histories of DES should be solicited from all patients in urology practices.

Follow-up study of male and female offspring of DES-treated mothers a preliminary report.

This is a follow-up study of male and female offspring of mothers who were part of a double-blind placebo controlled investigation during the years 1951-1952, originally aimed at determining the usefulness of DES administration in maintaining pregnancy. So far, 84 DES-exposed females, 43 female controls, 42 DES-exposed males and 37 male controls have been examined. Circumferential ridges of the vagina and cervix were seen in 39% of the DES-exposed females but in none of the controls. Colposcopy revealed vaginal epitheleal changes in 78% of the DES-exposed females 2% of the female controls. Cytology proved to be reliable as a screening test for vaginal epithelial changes in the DES-exposed female. Urine cytology was negative for tumor cells in all patients. The main abnormal finding in the DES-exposed males was that cysts in the epididymis were detected in 10%. No cases of cancer were observed in either the male or female offspring.

PIP: The original study conducted 22 years earlier at the Chicago Lying-in Hospital attempted to determine the value of diethylstilbestrol (DES) in maintaining pregnancy. The number completing the course of therapy was 840 in the DES group; there were 860 in a control group. Increasing doses were given beginning during the 7th week of pregnancy. The present study was to determine the level of risk of cancer and other anomalies in the female and male offspring of mothers who participated in the study. So far, 84 DES-exposed females, 43 female controls, 43 DES-exposed males, and 37 male controls have been examined. No cases of cancer have been found. The average age was 22 years. For female patients the medical history, a general physical examination, a gynecological examination, a colposcopic study, and laboratory tests were made. Laboratory tests consisted of cervical, endocervical, and 4 vaginal wall Pap smears, urine cytology, and follicle stimulating hormone and luteinizing hormone determinations. Biopsies were performed when indicated. Progesterone and total estrogens were determined only in patients with irregular menstrual cycles. In male patients, a general physical examination, urologic studies, and laboratory work-up were done. Medical records of all the newborn infants were surveyed and pediatric records examined. No cases of congenital malformations were recorded. Minor differences in menstrual histories and in ability to conceive were noted. The differences appeared mainly at vaginal examinations. Circumferential ridges in the vagina and cervix were seen in 39% of the exposed females but in none of the controls. Erythroplakia of the cervix was seen in 67% of the exposed and in 53% of the controls. Colposcopic findings in the vagina revealed vaginal epithelial changes in 78% of the DES-exposed females and 2% of female controls. Iodine negative areas in the vagina were noted in 78% of the exposed females compared with 2% of the unexposed females. Iodine negative areas on the cervix were seen in 74% of the exposed and 58% of the unexposed. All dysplastic lesions were confirmed by histology. The cytology was negative in all. In the males abnormal findings were noted mainly in the DES-exposed group. An undersized penis was noted in 2, small testes in 2, varicocele in 1, and epididymal cysts in 4. Urine cy tology and prostatic fluid cytology did not reveal unusual findings. A more detailed analysis of findings will follow when material is larger and older.