Tested Research Articles

Activation of liver X receptors ameliorates alterations in testicular function in rats exposed to electromagnetic radiation

ABSTRACT Introduction: Cell phones are essential for modern life and their usage becomes prevalent. Worries have increased concerning the harmful effects of their radio-frequency electromagnetic radiation. Liver X receptors (LXRs) are ligand-dependent transcription factors that have important roles in lipid metabolism and inflammation, plus several recently emerging roles. Whether it is useful to overcome the hazardous effects of cell phone radiation needs to be clarified. So, this study aimed to investigate the effect of LXRs activation on testicular changes in rats exposed to electromagnetic radiation. Methods: Thirty adult male Wistar rats were subdivided into control group, experimental group: exposed to cell phone electromagnetic radiation, and treated group: as experimental group and received LXRs agonist T0901317. Serum testosterone (T), Follicle-Stimulating Hormone (FSH), and Luteinizing Hormone (LH), testicular tissue malondialdehyde (MDA) and superoxide dismutase (SOD), and gene expressions of inflammatory and apoptotic markers were assessed. Seminal analysis and testicular histological examination were performed. Results: LXRs activation in rats exposed to cell phone radiation improved the decreased testicular and gonadotrophic hormones, semen quality parameters, tissue SOD, and anti-apoptotic gene expression as well as the elevated tissue MDA, apoptotic and inflammatory gene expressions, and the testicular histological changes induced by exposure to electromagnetic radiation. Conclusion: Exposure to cell phone radiation leads to harmful effects on spermatogenesis and LXRs activation could improve these effects via antioxidant, anti-inflammatory properties in addition to its endocrinal action.

LOW COST IC TESTER USING PSEUDO-RANDOM APPROACH

Lowcost IC testing is now a burning issue in semiconductor technology. Conventional IC tester, ATE (automatic test equipment), cannot cope with the today’s continuously increasing complexities in IC technology. Deterministic algorithm, which is an idea of 1960’s, is adopted in the ATE. Recently pseudo random testing approach has been emerged as an economically viable alternative to the expensive deterministic testing. This paper introduces a SOC implementing pseudo-random test technique for lowcost IC testing with reliable performance. It is capable of testing combinational circuits as well as sequential circuits with scan-path facilities efficiently. It can also be used for testing PCB interconnection faults.

Efficacy of Ginger on Male Reproductive Traits and Oxidative Stress Indices in White Pekin Ducks Intoxicated with Arsenic

Arsenic (As) exerts adverse effects on reproduction and oxidative stress in monogastric animals. But in poultry birds this fact is not yet verified. Ginger has both androgenic and antioxidant property. Thus, in this experiment, the protective effect of ginger against As toxicity induced by sodium arsenite was investigated in White Pekin ducks. For this, 300 number of ducks were randomly allocated into 5 groups with 6 replicates (10 ducklings in each replicate). The control group (CON) was fed only basal diet along with normal water. The toxicity group (TOX) was fed sodium meta-arsenite @ 28 ppm in drinking water along with basal feed. Along with sodium meta-arsenite @ 28 ppm in drinking water, the dried ginger powder was fed in increasing doses @ 100, 300 and 1000 mg per kg basal feed in ameliorative groups LDG, MDG and HDG respectively. Duration of experiment was 6 months. The oxidative damage caused by As was restored by supplementation of ginger. Ginger also enhanced the antioxidant activities of testis tissue of birds by suppressing reactive oxygen species (ROSs). Suppressed reproductive performance of male duck due to inorganic As toxicity were impaired by ginger through enhanced testicular size, semen volume, spermatozoa concentrations, live spermatozoa percentage and testosterone level. Histopathological examination of testis of As intoxicated birds showed significant changes which were restored by supplementation of ginger. In conclusion, adverse effects of As on reproductive performance of male duck was corrected by dried ginger supplementation.

The effects of ozone and melatonin on busulfan-induced testicular damage in mice.

Objective:Busulfan is one of the most common chemotherapeutic drugs and has the ability to induce apoptosis in testicular germ cells, which leads to infertility. In this study, the effects of ozone therapy and melatonin were evaluated on testicular disorders induced by busulfan.Methods:In this study, we divided 24 male mice into four groups: control group, groups treated with busulfan, busulfan/melatonin, and busulfan/ozone. At the end of a 35-day period, blood samples were taken from the mice and their testosterone levels were measured. Both of the mice’s testes were removed and weighed, afterwards, each one of them was used for evaluation of morphology by Johnson’s score, as well as for measuring the diameter and thickness of seminiferous tubules. The other testis was homogenized for measuring Malondialdehyde (MDA) and antioxidant status using Catalase (CAT), Super Oxide Dismutase (SOD), and Total Antioxidant Capacity (TAC) levels. Epididymis spermatozoa were also used to evaluate motility, morphology, and sperm count.Results:Busulfan significantly reduced the testis quality (weight, sperm parameters, testosterone, CAT, SOD, and TAC levels) and increased MDA and destruction of seminiferous tubules compared to the control group. Ozone and melatonin treatments significantly increased testis quality, sperm parameters, MDA, and antioxidant status, but they did not affect the TAC level.Conclusions:This study showed that similar to melatonin, ozone can reduce the effect of busulfan toxicity on mice testis. However, further studies are needed to understand the precise mechanism of ozone function on testis.

SRY-Positive 46-XX Testicular Disorder of Sex Development as a Rare Cause of Male Hypergonadotropic Hypogonadism: A Case Report

SRY-Positive 46-XX Testicular Disorder of Sex Development as a Rare Cause of Male Hypergonadotropic Hypogonadism: A Case Report

Nonylphenol Induces Apoptosis through ROS/JNK Signaling in a Spermatogonia Cell Line.

Nonylphenol (NP) is an endocrine-disruptor chemical that negatively affects reproductive health. Testes exposure to NP results in testicular structure disruption and a reduction in testicular size and testosterone levels. However, the effects of NP on spermatogonia in testes have not been fully elucidated. In this study, the molecular mechanisms of NP in GC-1 spermatogonia (spg) cells were investigated. We found that cell viability significantly decreased and apoptosis increased in a dose-dependent manner when GC-1 spg cells were exposed to NP. Furthermore, the expression levels of the pro-apoptotic proteins increased, whereas anti-apoptosis markers decreased in NP-exposed GC-1 spg cells. We also found that NP increased reactive oxygen species (ROS) generation, suggesting that ROS-induced activation of the MAPK signaling pathway is the molecular mechanism of NP-induced apoptosis in GC-1 spg cells. Thus, NP could induce c-Jun phosphorylation; dose-dependent expression of JNK, MKK4, p53, and p38; and the subsequent inhibition of ERK1/2 and MEK1/2 phosphorylation. The genes involved in apoptosis and JNK signaling were also upregulated in GC-1 spg cells treated with NP compared to those in the controls. Our findings suggest that NP induces apoptosis through ROS/JNK signaling in GC-1 spg cells.

Circulating inhibin and testosterone during sexual maturation and reproductive seasonality of captive male killer whales (Orcinus orca)

The present study aimed to investigate the reproductive biology of male killer whales. Changes in the concentrations of two circulating testicular hormones, inhibin and testosterone, were monitored during sexual maturation of two male Type 1 Eastern Northern Atlantic killer whales over a period of 20 years. The two killer whales grew rapidly at the pubertal stage and reached a plateau at the age of 23 and 20 years, respectively, after which growth slowed down. In the younger male, circulating inhibin was higher in the juvenile than in the pubertal and mature stages; whereas circulating testosterone exhibited the opposite trend. The pubertal period was estimated to last approximately 5 years, from 12 to 17 years of age. In the elder male, circulating testosterone was high from the onset of this study (12 years of age), when the animal also sired successfully for the first time. This finding shows that the male killer whale is possible to sire even if it is not socially matured, if there is opportunity for copulation. During the mature stage, both animals exhibited significantly higher circulating testosterone concentrations in spring compared to autumn and winter; whereas no seasonal change was observed for circulating inhibin. These results clearly demonstrate that the male killer whale is a seasonal breeder, even though it is fertile throughout the year. This is the first study to elucidate the inhibin concentration and secretory source in the male killer whale.

Efficacy of Azadirachta indica (Neem) leaf extract and hypertonic saline solution as intratesticular chemical sterilizing agents in dogs

Castration refers to induced sterility via physical, chemical, or hormonal methods. Chemical castration is an efficient and reliable technique in contrast to other sterilization procedures as it is less painful to physical methods and cost‑effective to hormonal methods. Azadirachta indica (neem), is a charismatic plant as its leaves possess anti-inflammatory, anti‑microbial, and anti-androgenic chattels. To abate the escalating human population in South Asia, neem oil and neem leaf extract have been effectively used as a contraceptive agent. The key determinant of the current study was to evaluate Neem as a chemical sterilizing agent, (either necrotic or apoptotic), in dogs injected intratesticular in comparison to a hypertonic saline solution. Pre- and post-injection testicular width size and blood samples for serum testosterone levels were collected on alternative days. Results disclosed substantial changes in testicular width size, histopathological profile, and serum testosterone level. A non-significant (P > 0.05) pre-injection testicular width readings in contrast to a significant increase (P < 0.05) three days post-injection was noted in all the competitive groups. The mean values recorded for testicular width size at the end of the trial study via neem leaf extract, 30% HSS and, control groups were 27.7362 ± 2.3315mm, 30.9594 ± 4.6861mm, and 24.5023 ± 2.5387mm, respectively. A declining trend, regarding serum testosterone level being statistically significant (P < 0.05) was recorded in treated groups (A, B) in contrast to the control group (C) as the values were 1.5357 ± 0.7819ng, 1.2669 ± 0.9095ng, and 2.4517 ± 0.1827ng in groups A, B, and C, respectively. Histopathological findings advocated the presence of apoptotic bodies in the neem treated group whereas the presence of degenerated interstitial cells, necrosed seminiferous tubules, damaged germinal epithelium, and ceased spermatogenesis was also studied in both competitive groups. Thus, the apoptotic effect and anti-inflammatory property of neem leaf extract resulted in less painful castration and verified Azadirachta indica as a better substitute for chemical castration in contrast to hypertonic saline solution.

Protective effect of Feijoa sellowianan fruit on testicular toxicity-induced by cadmium chloride.

The purpose of the present study was to investigate the protective potential of Feijoa fruit extract on cadmium chloride (CdCl2 )-induced testicular injury and pituitary-gonadal axis. Adult male Wistar rats were randomly divided into four groups: (a) control (normal saline, orally), (b) cadmium chloride (0.1mg/kg, single dose, intraperitoneally), (c) Feijoa fruit extract (400mg/kg, orally for 30 consecutive days) and (d) CdCl2 +Feijoa fruit extract. One day after receiving the last medicine, the LH, FSH, prolactin and testosterone concentration were assayed. Also, sperm parameters and tissue structure of the testis were evaluated. Administration of Feijoa fruit extract after CdCl2 injection in rats ameliorated sperm parameters such as sperm count, morphology, motility and sperm viability, increased levels of LH, FSH, prolactin and testosterone and improved testicular histology. According to the results of this study, it was shown that Feijoa can reduce the destructive side effects of CdCl2 on testicular tissue and sex hormones of the pituitary-gonadal pathway.

Estimation of Sexual Maturity Based on Morphometrics of Genital Organs in Male Northern Fur Seals, Callorhinus ursinus

It's not always possible to obtain samples from dead male pinnipeds that are fresh enough to determine the histological characteristics of spermatogenesis and their stage of sexual maturity. We propose that the morphometrics of genital organs of northern fur seals, Callorhinus ursinus, can be used as a new indicator of sexual maturity. We analyzed data from collected records of male fur seals around Hokkaido during 2011–2017 to examine morphometrics of genital organs and their stage in histological characteristics of spermatogenesis. First, we investigated ontogenetic and seasonal variation in three genital organs: testes, epididymides, and bacula. Second, we classified the stages of histological characteristics of spermatogenesis into three groups (Stage A–C) using non-linear discriminant analysis, based on the stage in histological characteristics of spermatogenesis determined by histological observation of seminiferous tubules. Testicular size, testicular mass, and epididymal mass showed seasonal variation associated with spermatogenesis. From our analysis, the stage in histological characteristics of spermatogenesis could be estimated using testicular mass with high accuracy of predicting spermatogenesis. And measurement of baculum was suggested to be an indicator of predicting sexual maturity. We conclude that this simple estimation may be used to determine sexual maturity based on individual growth patterns.

Artemisia judaica L. diminishes diabetes-induced reproductive dysfunction in male rats via activation of Nrf2/HO-1-mediated antioxidant responses.

Diabetes mellitus is a well-known danger element for the progression of male reproductive dysfunctions. Available evidence supports oxidative stress to be the underlying mechanism for the manifestation of testicular dysfunctions during diabetes, and this relation represents an attractive target to antagonize these complications. Artemisia judaica L. is known to have antidiabetic and antioxidant characteristics. The possible protective effect of Artemisia judaica against diabetes-induced testicular disorders was not explored. In this investigation, we planned to estimate the possible protective effect of Artemisia judaica extract against diabetes-induced testicular disorders in male rats. The blood levels of insulin, glucose, glycosylated hemoglobin, testosterone, luteinizing hormone and follicle stimulating hormone were evaluated in rats after 12weeks of Artemisia judaica treatment. Further, oxidative stress markers were determined in their testicular tissue. Epididymal fluid and testicular histological changes were also assessed. Expression of proliferating cell nuclear antigen has been evaluated in testis. Testicular mRNA expression of nuclear factor erythroid 2-related factor 2 and heme oxygenase-1 as the significant transcription factors in controlling antioxidant system were evaluated by real-time polymerase chain reaction. Artemisia judaica extracts have the ability to ameliorate the elevation in the serum glucose and blood glycosylated hemoglobin and the reduction in insulin, testosterone, follicle stimulating hormone and luteinizing hormone caused by streptozotocin-induced diabetes. It induced a significant recovery of the testicular oxidative stress markers, sperm characteristics and improved histopathological findings of the testes. Treatment with Artemisia judaica extracts led to an increase in proliferating cell nuclear antigen protein expression. Reduction of testicular oxidative stress potential in streptozotocin-treated groups was confirmed by upregulation of nuclear factor erythroid 2-related factor 2 and heme oxygenase-1.

ESR1 gene polymorphism (rs827421) as a potential genetic marker for constitutional delay of growth and puberty in Egyptian adolescents

Constitutional delay of growth and puberty (CDGP) is a variant of normal pubertal timing and progress. It is the most common form of delayed puberty in both genders. The genetic director of CDGP is ill-understood despite the positive family history result noted in those patients. The current study aimed at assessing the role of estrogen receptor 1 (ESR1) gene variant (rs827421) in Egyptian adolescents with CDGP. A cross-sectional study with follow-up part was carried out on 6760 children aged 4 to15 years. The study focused generally on children aged 13–15 years in order to evaluate the prevalence of delayed puberty in relation to all ages in general and to their peers in specific. Assessment of serum TSH, FSH, and LH was conducted on all participants, along with the measurement of serum-free testosterone for males and estradiol for females. Genotyping of ESR1 (rs827421) was done to all subjects through the use of TaqMan discrimination assay by real-time PCR. ESR1 (rs827421) GG genotype and G allele were significantly dominant among CDGP adolescents in comparison with controls (OR = 25.67 and 6.90). As regards follow-up of testicular size, AA genotype was significantly associated with increased size in the right and left testis compared to other genotypes (P = 0.021 and 0.006, respectively). Moreover, AA genotype showed significantly higher Tanner stage in both males and females in comparison with other genotypes. Serum estradiol level was significantly higher in AA genotype group than other genotypes groups. ESR1 gene polymorphism can be considered a potential genetic marker for CDGP in both sexes in a sample of Egyptian adolescents.

FSH-R Human Early Male Genital Tract, Testicular Tumors and Sperm: Its Involvement in Testicular Disorders.

The follicle-stimulating hormone receptor (FSH-R) expression was always considered human gonad-specific. The receptor has also been newly detected in extragonadal tissues. In this finding, we evaluated FSH-R expression in the human male early genital tract, in testicular tumors, and in sperm from healthy and varicocele patients. In sperm, we also studied the mechanism of FSH-R action. Immunohystochemistry and Western blot analysis showed FSH-R presence in the first pathways of the human genital tract, in embryonal carcinoma, and in sperm, but it was absent in seminoma and in lower varicocele. In sperm, FSH/FSH-R activity is mediated by G proteins activating the PKA pathway, as we observed by using the H89. It emerged that increasing FSH treatments induced motility, survival, capacitation, and acrosome reaction in both sperm samples. The different FSH-R expression in tumor testicular tissues may be discriminate by tumor histological type. In spermatozoa, FSH-R indicates a direct action of FSH in these cells, which could be beneficial during semen preparation for in vitro fertilization procedures. For instance, FSH positive effects could be relevant in idiopathic infertility and in the clinic surgery of varicocele. In conclusion, FSH-R expression may be considered a molecular marker of testicular disorders.

Male infertility due to testicular disorders.

Male infertility is defined as the inability to conceive following 1 year of regular unprotected intercourse. It is the causative factor in 50% of couples and a leading indication for assisted reproductive techniques (ART). Testicular failure is the most common cause of male infertility, yet the least studied to date. The review is an evidence-based summary of male infertility due to testicular failure with a focus on etiology, clinical assessment, and current management approaches. PubMed-searched articles and relevant clinical guidelines were reviewed in detail. Spermatogenesis is under multiple levels of regulation and novel molecular diagnostic tests of sperm function (reactive oxidative species and DNA fragmentation) have since been developed, and albeit currently remain as research tools. Several genetic, environmental, and lifestyle factors provoking testicular failure have been elucidated during the last decade; nevertheless, 40% of cases are idiopathic, with novel monogenic genes linked in the etiopathogenesis. Microsurgical testicular sperm extraction (micro-TESE) and hormonal stimulation with gonadotropins, selective estrogen receptor modulators, and aromatase inhibitors are recently developed therapeutic approaches for men with the most severe form of testicular failure, nonobstructive azoospermia. However, high-quality clinical trials data is currently lacking. Male infertility due to testicular failure has traditionally been viewed as unmodifiable. In the absence of effective pharmacological therapies, delivery of lifestyle advice is a potentially important treatment option. Future research efforts are needed to determine unidentified factors causative in "idiopathic" male infertility and long-term follow-up studies of babies conceived through ART.

Modification of exhaled air nitric oxide in patients with asthma - cortisone monotherapy or dual inhalation therapy?

Asthma, a chronic lung disease, is a major health challenge worldwide with increased addressability to health services. There are different asthma phenotypes, which have different evolution and can be specifically tracked. The measurement of fractional expired nitric oxide (FeNo) with different devices reflects the eosinophilic inflammation of the airways, and can be used to evaluate the allergic phenotype and predict the treatment responses. The new GINA (Global Initiative for Asthma) guideline recommends FeNO monitoring to assess adherence to cortisone treatment in high doses before prescribing biological treatment, and as a means of monitoring the decrease in oral corticosteroid treatment. The aim of the study is to analyze the applicability of FeNO in monitoring response to therapy. An observational study was carried out on 129 subjects with a previously established diagnosis of asthma. The research was based on the determination of FeNO with NObreath. Those with intermediate FeNO received a low dose of inhaled corticosteroids in mono/dual therapy, those with increased FeNO received medium ICS mono/dual therapy. FeNO testing, its values and doses of ICS were below the the ATS / ERS guidelines. FeNO reduction is strictly dependent on the cortisone dose. Applying the dual therapy from the beginning does not bring additional benefits in comparison with cortisone in monotherapy, in terms of FeNO value. Recommendations that include FeNO testing can help monitor response to treatment.

Effect of orally administrated letrozole on reproduction performance and gene expression of FOXJ1, LPR2 and PVRL3 in reproductive tract in aged roosters

letrozole is an aromatase inhibitor that stops the production of estrogen through interrupting the entrance of hormone androgen into a small amount of estrogen. Therefore, the current study was developed to estimate orally administrated Letrozole on the reproductive performance and relative abundance of Foxj1, PVRL3, and LPR2 mRNA in aged roosters. Fifty-five-week old ROSS 308 breeder roosters (n = 18) were orally treated using letrozole. Primarily, the body weight of the animals was recorded, and they were randomly classified into three groups (n = 6 birds/group) receiving different doses of Letrozole, including 0, 0.015, and 0.03 mg/kg body weight/day for three weeks. At the end of the trial, seminal traits, plasma, testicular hormone levels (testosterone, estradiol, and FSH), histopathological studies, in vitro fertility, and relative abundance of testis PVRL3, epidydimal Foxj1, and LPR2 mRNA were evaluated. Based on the results, the sperm quality variables were statistically higher in the 0.03 group compared to the controls. Greater histologic parameters, such as diameter of seminiferous tubules, thickness of seminiferous epithelium, categorized epididymal region, and in vitro fertility rates were estimated for the treated groups(p < 0.001). Plasma and testicular testosterone, estradiol concentrations, and plasma FSH levels were significantly influenced by letrozll treatment (p < 0.001). Relative mRNA transcript abundance increased for PVRL3 and decreased for Foxj1 and LPR2 in treated groups. Overall, aromatase inhibitors can enhance the reproductive performance of aged commercial broiler breeder roosters. However, it can impact endocytosis and ciliogenesis events via reducing estradiol.

Analytical post-heating behavior of concrete-filled steel tubular columns containing tire rubber

This research focused on analyzing the post-fire behavior of high-performance concrete-filled steel tube (CFST) columns, with the concrete containing tire rubber and steel fibers, under axial compressive loading. The finite element (FE) modeling of such heated columns containing recycled aggregate is a branch of this field which has not received the proper attention of researchers. Better understanding the post-fire behavior of these columns by measuring their residual strength and deformation is critical for achieving the minimum repair level required for structures damaged in the fire. Therefore, to develop this model, 19 groups of confined and unconfined specimens with the variables including the volume ratio of steel fibers, tire rubber content, diameter-to-thickness (D/t) ratio of the steel tube, and exposure temperature were considered. The ABAQUS software was employed to model the tested specimens so that the accurate behavior of the FE-modeled specimens could be examined under test conditions. To achieve desirable results for the modeling of the specimens, in addition to the novel procedure described in this research, the modified versions of models presented by previous researchers were also utilized. After the completion of modeling, the load-axial strain and load-lateral strain relationships, ultimate strength, and failure mode of the modeled CFST specimens were evaluated against the test data, through which the satisfactory accuracy of this modeling procedure was established. Afterward, using a parametric study, the effect of factors such as the concrete core strength at different temperatures and the D/t ratio on the behavior of the CFST columns was explored. Finally, the compressive strength values obtained from the FE model were compared with the corresponding values predicted by various codes, the results of which indicated that most codes were conservative in terms of these predictions.

The Effect of Sulfobetaine on the Activity of Strobilurins and Benzimidazole Fungicides

Surfactants (adjuvants) are the substances often added to the spray tank, besides the pesticide formulation, whose role is to improve the performance of the pesticide or the physical properties of the spray mixture, or both. Adjuvants are not often used as fungicides themselves, however, it is interesting to investigate if they can improve the fungistatic activity of the system they are included in. Therefore the main aim of this work was to determine the effect of the addition of a newly obtained, never investigated before, sulfobetaine type surfactant to the fungicides on their final properties. In the in vitro experiment fungistatic activity of the surfactant and the system of surfactant with strobilurins and benzimidazole fungicides were evaluated. The tested surfactants were added to the liquid medium of Potato Dextrose Agar (PDA) at concentrations: 1, 10, 50, and 100 ppm. The organisms of Fusarium culmorum, Rhizoctonia solani, Microdochium nivale, and Alternaria brassicas were used as indicators. The experiments have shown that the addition of the new surfactant studied to the medium resulted in inhibition of mycelium growth of all the tested fungi. The system with the surfactant and the fungicide was much more effective against the tested fungi than individual fungicides.

Clinical efficacy of two-staged Fowler-Stephens laparoscopic orchidopexy in the treatment of children with high cryptorchidism

Objective: To Evaluate the clinic effect of two-staged laparoscopic Fowler-Stephens orchiopexy in the treatment of high cryptorchidism, and compare it with laparoscopic orchiopexy treatment without disconnecting spermatic vessels. Methods: A retrospective analysis was conducted on 20 cases of children with high cryptorchidism who were treated with two-staged Fowler-Stephens orchiopexy from January 2015 to April 2019 (F-S group). All the children in this group had unilateral cryptorchidism, age 6 to 18 months. The average age was 13.5 months. Seven cases were on the left side, and 13 cases were on the right side. There were 20 control children in the same age group who were treated with testicular fixation without disconnecting spermatic vessels, age 6 to 18 months. The average age was 12.5 months. Six cases were on the left side, and 14 cases were on the right side. Testicular ultrasonography and sex hormone examination were conducted before operation. F-S group met the indications for Fowler-Stephens surgical. In the first stage, the testicular vessels were doubly clipped at a site away from the testis in laparoscopic, and the second stage was scheduled about 6 months after the first stage. The children in the control group were treated with laparoscopic orchiopexy without disconnect spermatic vessels. The two groups were followed up to 6 months after the operation, and the testicular volume and sex hormone indexes of the two groups were measured. The testicular volume and sex hormones before and after the operation of the F-S group and the control group were respectively subjected to a self-control study, and a hormone comparison study was carried out between the two groups of children. Results: Both the F-S group and the control group successfully fixed the testes in the scrotum without tension during the operation. In both groups, 20 cases of testicular positions were reexamined 6 months after the operation without retraction. All the patients had a viable testis in scrotum after operation. Two of F-S group had an atrophic testis in the scrotum, and the others had a good vascularization detected on echo color doppler ultrasound. The average testicular volume of F-S group was (0.34±0.16) ml before operation and the postoperative one was (0.38±0.13) ml, P=0.089, P>0.05. In control group, the preoperative average testicular volume was (0.40±0.14) ml, and postoperative one was (0.40±0.15) ml, P=0.933, P>0.05. The testicular volume of two group had no significant difference. Sex hormone reexamination: Testosterone (T), estradiol (E2) and luteinizing hormone (LH) did not change after operation. Prolactin (PRL) in F-S group was 13.44 μg/L before operation and 12.3 μg/L after operation, PRL in control group was from 15.45 μg/L to 10.34 μg/L, P=0.732, the change of prolactin (PRL) has no significant difference. The median preoperative follicle stimulating hormone (FSH) in the F-S group was 1.18 U/L preoperatively and 1.61 U/L postoperatively; the median FSH of the control group was 1.21 U/L preoperatively and 1.1 U/L postoperatively. Compared between the two groups, the postoperative increase in the FS group was higher than that before the operation, P=0.032, P<0.05, the difference was statistically significant. The median of progesterone (PROG) in the F-S group was 0.25 nmol/L before operation and 0.17 nmol/L after operation; the median PROG of the control group was 0.56 nmol/L before operation and 0.24 nmol/L after operation. It was lower after the operation than before the operation, P=0.034, P<0.05, the difference was statistically significant. Conclusions: (1) Laparoscopic Fowler-stephens staging operation is an effective method for the treatment of patients with high cryptorchidism, and it is worthy of further promotion. (2) Disruption of spermatic cord vessels does have an impact on hormones changes. The choice of this surgical procedure should be carefully and fully evaluated.

Idiopathic central precocious puberty in a Klinefelter patient: highlights on gonadotropin levels and pathophysiology

BackgroundIdiopathic central precocious puberty (ICPP) is supposed to be non-existent in a context of testicular destruction that is typically present in Klinefelter syndrome (KS). Herein, we describe a rare case of ICPP in a Klinefelter patient (47,XXY) with 2 maternal X chromosomes. Moreover, we highlight the differences in gonadotropin levels in comparison to males with ICPP and a normal karyotype.Case presentationAn 8 years old boy with a history of cryptorchidism was evaluated for precocious puberty (Tanner staging: P2/G3). Both testes measured 25x35mm. His hormonal profile confirmed a central origin of precocious puberty with high serum testosterone (4.3 ng/ml), luteinizing hormone [LH (3.5 UI/l)] and follicle stimulating hormone [FSH (7.7 UI/l)] levels. Luteinizing hormone-releasing hormone (LHRH) test amplified LH and FSH secretion to 24 and 14 UI/l respectively. Brain magnetic resonance imaging (MRI) was normal. No MKRN3 mutation was detected. He was treated for ICPP for two years. During puberty, he suffered from hypergonadotropic hypogonadism leading to the diagnosis of KS (47,XXY karyotype). Chromosomal analysis by fluorescent multiplex polymerase chain reaction (PCR) using X chromosome microsatellite markers identified 2 maternal X chromosomes.Analysing 8 cases of KS developing ICPP (our reported case and 7 other published cases) revealed that these KS patients with ICPP have higher LH and FSH levels during ICPP episode than in ICPP patients with a normal karyotype (ICPP with KS vs ICPP with a normal karyotype: LH levels 9.4 ± 12 vs 1.1 ± 0.6 UI/l; FSH levels 23.1 ± 38.5 vs 2.7 ± 1.5 UI/l). Furthermore, their response to gonadotropin-releasing hormone (GnRH) stimulation is characterized by excessive LH and FSH secretion (LH levels post-GnRH: 58 ± 48 vs 15.5 ± 0.8 UI/l; FSH levels post-GnRH: 49.1 ± 62.1 vs 5.7 ± 3.9 UI/l).ConclusionsICPP in boys is extremely rare. The pathophysiology of ICPP in KS is unknown. However, maternal X supplementary chromosome and early testicular destruction may play a significant role in the initiation of ICPP, in part explaining the relative “overrepresentation of ICPP in KS. Thus, karyotype analysis could be considered for boys suffering from ICPP, especially if testicular size is smaller or gonadotropins are significantly elevated.