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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty rabbits were submitted to orthostatic collapse, divided into 9 groups and sacrificed 6, 12, 24, and 48 hours, 4, 7, 15, 30 and 45 days following collapse. Ten animals were used as controls. The testis and epididymis were submitted to microscopic examination. The most striking change was necrosis of seminiferous cells which was most severe in the 24-hour group. The most susceptible cell to necrosis was the primary spermatocyte whilst spermatogonia, Sertoli cells and Leydig cells were not damaged. Other frequent changes included hypertrophic spermatocytes, hypertrophic early spermatids, nonelongated late spermatids, nonelongated multinucleated late spermatids, multinucleated and binucleated early spermatids. A quantitative study done by counting tubular cross-sections with presence of the changes described showed a significant increase of frequency in the rabbits submitted to orthostatic collapse. The histological changes can be related primarily to the circulatory disturbance leading to oligaemia and consequently to anoxia and are strikingly similar to those following experimental ischemia of testis.
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PMID:Effects on rabbit spermatogenesis following orthostatic collapse. Light microscope qualitative and quantitative studies. 73 82

32 boys with symptoms of an acute scrotum had testicular sonography with color flow imaging (CFI). Patients ranged in age from 4-15 years (avg = 11 yrs). Symptoms were present from 12 h to 5 days (avg = 42 hrs). CFI correctly predicted presence or absence of testicular perfusion in 11 boys who had surgical exploration of the scrotum. 8 of these 11 patients had hemorrhagic infarction of the testicle, 1 had torsion of the appendix epididymis, 1 had epididymitis, and 1 had bilateral incomplete torsions with normal testicular perfusion. The remaining 21 patients did not have an operation. At least a 1 year follow-up of all patients has shown no clinical evidence of testicular atrophy to suggest a missed diagnosis of torsion. Absence or markedly decreased testicular flow was easily identified and indicates testicular ischemia/infarction. Conversely, hyperemia of the testis and/or epididymis is usually associated with trauma or infection. However, incomplete torsion or spontaneous detorsion may demonstrate normal testicular flow on CFI. Only close correlation of clinical symptomatology and gray scale findings with CFI can identify these patients, who remain at high risk for subsequent complete torsion and infarction.
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PMID:Color flow imaging in children with clinically suspected testicular torsion. 140 49

Mobile epididymis plays an important role in the genesis of male infertility. It constituted 9 percent of a consecutive series of idiopathic infertility. Of 200 patients examined (100 fertile and 100 infertile), mobile epididymis was detected in 9 infertile patients. The clinical picture is characteristic. Epididymis is widely separated from testicle and moves freely from side to side. Its body and tail are ill formed and the epididymovasal angle is obtuse. Azoospermia was persistent in 3 patients and intermittent in 6 patients. Testicular biopsy showed tubular dilatation. Epididymopexy was performed in the 9 patients to fix the epididymis to testicle: 3 patients showed improvement in semen quality with two resultant pregnancies. Failures were due to advanced testicular damage. Infertility in mobile epididymis appears to result from obstruction of efferent ductules, testicular ischemia, and/or interference with sperm maturation, transport, or delivery.
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PMID:Mobile epididymis. A new clinicopathologic entity in genesis of male infertility and its treatment by epididymopexy. 199 85

The author reports the case of a patient presenting with a recurrent right hydrocele after tapping, associated with an infectious syndrome resulting in a swollen and painful right compartment of the scrotum, which failed to respond to antibiotic treatment. A right scrotal incision revealed a vaginal empyema and a swollen and enflamed testicle and epididymis. After a right ochiectomy, an anatomopathological examination showed a severe ischemia of the testicle and epididymis associated with arteriosclerotic stenosis of the testicular artery.
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PMID:[Spontaneous orchi-epididymitis due to necrosis of ischemic vascular origin]. 652 90

During the course of acute bacterial epididymitis of nonvenereal origin, severe epididymal inflammation and edema can produce compression of adjacent branches of the spermatic vessels, which can compromise the testicular vascular system. Scrotal fixation over the involved testicle heralds this event and indicates actual or impending epididymal suppuration. At this crucial moment either surgical decompression of the epididymis or epididymectomy is indicated to prevent ischemia of the testis and subsequent development of gangrenous epididymo-orchitis with testicular slough. Between 1956 and 1980, 14 epididymotomies were done, which resulted in salvage of 12 testicles (86 per cent). During the same period 10 patients with acute epididymitis had progression of the disease to gangrenous epididymo-orchitis, which necessitated orchiectomy. Epididymotomy can prevent progression of acute epididymitis to gangrenous epididymo-orchitis in many instances and is believed to have a role in the management of this troublesome affliction.
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PMID:The surgical management of acute bacterial epididymitis with emphasis on epididymotomy. 714 92

Unilateral anorchidism, or monorchidism, refers to the absence of one testis. It is defined as the unilateral or bilateral partial or complete absence of testicular tissue, with or without rudimentary epididymal and spermatic cord remnants, in the presence of internal Wolffian duct development and normal external genitalia. In the case of monorchidism with derivatives of the Wolffian duct an ipsilateral testis must be present at least up to the 16th week of gestation to induce the formation of an epididymal structure. Few studies have been devoted to the etiology of monorchidism or to management of the contralateral solitary testis. With the aid of a personal series of 36 cases and a review of the literature the etiopathology of monorchidism is discussed; the long-term fate of the contralateral testis is considered, and an answer to the question of whether protection of the solitary contralateral testis by orchidopexy is really indicated, as stated by most authors, is offered. Ischemia due to intrauterine torsion is thought to be the cause of monorchidism; it is thus a syndrome of testicular regression. The histopathological findings are characteristic, if not specific, for atrophy secondary to ischemia. Vas deferens, epididymis, calcification or hemosiderin pigmentation is noted in almost 90% of cases. In the absence of these remnants, clinical and surgical findings and the presence of a richly vascular stroma support the diagnosis. According to the author's experience, exploration and fixation of the contralateral testis is neither necessary nor desirable.
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PMID:Monorchidism or unilateral anorchidism. 791 Sep 27

Clinical assessment of the testicular torsion and epididymoorchitis is inherently difficult. Inadequate clinical information may prevent differentiation testicular torsion from non-surgical condition. We reported 3 cases with symptoms of acute scrotal condition who had received color Doppler sonography. One man had epididymoorchitis and color Doppler sonography showed profusely increased blood flow in the region of epididymis and testis. Symptoms subsided with one week of medical treatment. Sonography correctly detected absence of testicular perfusion in 2 boys who had sugical exploration of the scrotum. Testicular torsions were confirmed by surgical findings. Absence or markedly decreased testicular blood flow which indicated testicular ischemia or infarction was easily identified. Conversely, hyperemia of the testis and/or epididymis is usually associated with inflammation However, incomplete torsion or detorsion may demonstrate normal testicular flow on color Doppler sonography. Color Doppler sonography provides early diagnosis of acute testicular torsion, and prevents unnecessary scrotal exploration.
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PMID:Color Doppler sonogrphy in differentiation between testicular torsion and epididymoorchitis: report of three cases. 893 82

The cytoplasmic granules of mammalian neutrophils contain several antimicrobial peptides. Some, like defensins, are fully processed before storage, whereas others are stored as precursors that require additional processing. Cathelicidins are bipartite molecules with an N-terminal cathelin domain and an antimicrobial C-terminal domain. Humans apparently have only one cathelicidin gene. Its product, hCAP-18, is present in the secondary (specific) granules of neutrophils, and its C-terminal antimicrobial peptide, LL-37, is liberated by proteinase 3 coincident with degranulation and secretion. Many nonmyeloid tissues also express hCAP-18, including epididymis, spermatids, keratinocytes, epithelial cells, and various lymphocytes. LL-37 stimulates chemotaxis, acting via the formyl peptide-like receptor-1. The structurally diverse cathelicidin-derived antimicrobial peptides of animals provide interesting models for pharmaceutical development. PR-39, a proline-rich porcine cathelicidin, has shown efficacy in limiting myocardial damage after experimental ischemia in rodent models. Porcine protegrins are in stage III clinical trials to prevent oral mucositis caused by radiation or chemo-therapy.
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PMID:Cathelicidins: a family of endogenous antimicrobial peptides. 1175 73

Hypoxia-inducible factor 1 (HIF-1) is a transcription factor composed of alpha and beta subunits. Stabilized from proteasome degradation and activated by hypoxia, HIF-1 stimulates expression of hypoxia-sensitive genes that mediate oxygen homeostasis in many tissues. Our hypothesis is that HIF-1 is involved in the cellular response to hypoxia in the ischemic testis. Goals of this study were to determine if HIF-1alpha mRNA is expressed in the testis, epididymis, and accessory sex glands of adult Sprague-Dawley rats and to determine if HIF-1alpha mRNA and protein expression in the testis is affected by experimentally induced ischemia. Total RNA from reproductive organs of adult rats was analyzed by relative reverse transcription-polymerase chain reaction (RT-PCR) analysis. HIF-1alpha mRNA showed equal expression in testis, all segments of epididymis, ductus deferens, accessory sex glands, and penis. To examine the effects of ischemia on HIF-1alpha mRNA and protein expression in the testis, rats were subjected to unilateral testicular ischemia by placing a ligature around spermatic artery or ischemia-inducing experimental torsion and reperfusion. RT-PCR revealed that HIF-1alpha mRNA expression at all times of ischemic treatment and reperfusion was unchanged compared with normoxic controls. HIF-1alpha protein was detected by immunoblot analysis of nuclear protein extracts from normoxic testes. Steady-state levels of HIF-1alpha protein were stimulated by 15 min of ischemia and showed a 2-fold increase at 30 min and 1, 3, and 6 h. HIF-1alpha protein was also elevated by experimental torsion and reperfusion compared with normoxic controls. These results support the hypothesis that HIF-1 may play a role in the cellular response to hypoxia in the ischemic testis.
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PMID:Stimulation of hypoxia-inducible factor-1 alpha (HIF-1alpha) protein in the adult rat testis following ischemic injury occurs without an increase in HIF-1alpha messenger RNA expression. 1219 13

The epididymal epithelium contributes to formation of a luminal fluid that is essential for the protection of spermatozoa from a variety of insults including changes in oxygen tension. A key regulator of the response to oxygen debt in many cells is hypoxia-inducible factor-1 (HIF-1). A transcription factor composed of alpha and beta subunits, HIF-1 activates genes that mediate oxygen homeostasis and cell survival pathways or trigger cell death responses. Previously we have shown that HIF-1alpha mRNA is expressed in the adult rat epididymis. Goals of this study were to determine whether HIF-1alpha protein is activated by ischemia in the rat epididymis, to determine whether epididymal HIF-1alpha mRNA expression is androgen dependent, and to identify epididymal cell types expressing HIF-1alpha and beta. Immunoblot analysis revealed that HIF-1alpha protein is primarily present in corpus and cauda of the normoxic epididymis and unaffected by ischemia, whereas HIF-1beta was detected equally in all regions and also unaffected by ischemia. HIF-1alpha mRNA expression in all regions was not affected by 15 days bilateral orchiectomy. Principal cells stained positive for HIF-1alpha by immunocytochemistry, with the epithelium of initial segment and caput epididymidis staining less intensely than corpus and cauda. HIF-1beta immunoreactivity was equally present in principal cells in all regions. Clear, narrow, and basal cells were unreactive for HIF-1alpha and beta. The presence of HIF-1 in normoxic epididymis and the regional distribution of HIF-1alpha suggests fundamental differences in how proximal and distal regions of the epididymis maintain oxygen homeostasis to protect the epithelium and spermatozoa from hypoxia.
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PMID:Expression and localization of hypoxia-inducible factor-1 subunits in the adult rat epididymis. 1466 8


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