How to Reverse Testicular Atrophy

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Assessment of Testicular Function

Hormone analysis involves measurement of plasma FSH, LH and sex steroids (Table 14.5). In prepubertal children, however, this is an unreliable predictor of gonadal damage, since the prepubertal hypothalamic pituitary-testicular axis is quiescent. In post-pubertal boys, elevated LH and diminished testosterone levels are indicative of Leydig cell dysfunction, while elevated FSH and diminished inhibin B suggest germ cell failure. HCG may be given to confirm the diagnosis of end organ failure as a cause of hypogonadism. An abnormal response to HCG is suggestive of disturbed Leydig cell function. Patients with hypogonadotrophic hypogonadism should have a brisk response, while those with decreased Leydig cell function will have little or no response. GnRH may be administered to determine whether the primary defect is in the hypothalamus or in the pituitary. If it's in the hypothalamus, the pituitary and testicles themselves should respond normally to exogenous GnRH. Alternatively, if the...

Clinical evaluation

Ear Notching Mice

Normal mouse feces are about the size and shape of a rice grain, firm to hard in consistency, and dark brown in color. Perianal matting of feces or light yellow colored feces might indicate the phenotype of inflammatory bowel disease or the presence of any number of intestinal infections.10 Several commonly used inbred strains of mice may have perianal swelling, giving the appearance of extra testicles (3 or 4) due to cysts of the bulbourethral glands.11

Mechanism of action and conversions

The testis has a dual function spermatogenesis and the production of T. The latter takes places in the Leydig cells. The daily production of T in adulthood is about 5-7 mg. T diffuses passively into cells of the target organs of androgens. To exert its biologic action, it must bind to the androgen receptor, though there are also a number of biologic actions of T that do not require receptor activation. For some of its biologic actions T is a prohormone. After diffusion into the cell, T may be converted to 5 a-dihydrotestosterone (DHT) or estradiol. There are two types of 5 a-reductase enzymes that convert T to DHT. 5a reduc-tase type 1 is predominantly located in skin, liver, and brain whereas 5a reductase type 2 is almost exclusively distributed in the classical androgen-dependent organs such as prostate,seminal vesicles, and testicles. DHT and T bind to the same androgen receptor, although DHT has an approximately tenfold greater affinity for the receptor and its dissociation is...

Physiological Functions of Growth Hormone

All the major anterior pituitary hormones, except for growth hormone, exert their principal effects by stimulating target glands, including thyroid gland, adrenal cortex, ovaries, testicles, and mammary glands. The functions of each of these pituitary hormones are so intimately concerned with the functions of the respective target glands that, except for growth hormone, their functions are discussed in subsequent chapters along with the target glands. Growth hormone, in

Reproduction through development

If male, cell divisions in the testicles will give sperm cells. Finally, the sperm and egg cells are brought together and fuse to produce the fertilised egg for the next generation, closing the cycle. The life cycle involves alternation between a single-cell phase, the fertilised egg, and a complex multicellular adult phase. The two are linked by numerous cell divisions and an occasional sexual fusion.

What are the symptoms and complications of gonorrhea

When initially infected, about 50 of men have some signs or symptoms. Symptoms and signs include a burning sensation when urinating and a yellowish white discharge from the penis. Sometimes men with gonorrhea get painful or swollen testicles. In men, gonorrhea can cause epididymitis, a painful condition of the testicles that can sometimes lead to infertility if left untreated. Without prompt treatment, gonorrhea can also affect the prostate and can lead to scarring inside the urethra, making urination difficult.

Consequences of Telomerase Loss In Vivo The Telomerase Knockout Mouse

Work from a number of laboratories has shown that the mouse is an excellent system for studying telomere biology (reviewed in Chang et al. 2001, Goytisolo and Blasco 2002). The telomerase-deficient mouse lacks the critical RNA subunit mTerc, is viable, fertile, and has no significant morphological abnormalities (Blasco et al. 1997). Telomere length measurements revealed that, as in yeast and human cells lacking telomerase, telomeres shortened by approximately 120 bp per cell division. Given the long telomeres in mice, successive generations of telomerase-deficient mice were produced to achieve sufficient telomere attrition. By the sixth generation (G6), defects were revealed in multiple tissue compartments with high proliferative histories, including hematopoietic and reproductive systems. Defects in the hematopoietic system were manifested by a marked decline in hematopoietic precursor cell numbers, reduced proliferation of T and B lymphocytes upon mitogenic stimulation, and splenic...

Cirrhosis In Liver Disease

The liver has immense reserve and regenerative powers. It is estimated that at least 75 of normal hepatic function must be absent for any changes in standard hepatic function tests to occur. Thus, taking an accurate history is important. Careful attention should be given to factors such as alcohol ingestion, state of nutrition, previous history of hepatitis, jaundice, or anorexia, and protean manifestations such fatigue and loss of stamina. A carefully directed physical examination includes a search for petechiae, rhinophyma, Dupuytren's contracture, telangiectasia in the upper trunk, ascites, asterixis, palmar erythema, and testicular atrophy. In our opinion, the classic live function tests, especially of synthetic function, give as good a measurement of hepatic reserve as other more sophisticated tests, such as galactose elimination, urea

Effects of Chemotherapy

Nitrosoureas, used in the treatment of brain tumors in childhood, may also cause gonadal damage in boys 1,47,71 . In nine children treated for medul-loblastoma with craniospinal radiation and a nitro-sourea (carmustine or lomustine, plus vincristine in four boys and procarbazine in three), there was clinical and biochemical evidence of gonadal damage. Specifically, these children presented with elevated serum FSH and small testes for the stage of pubertal development, compared with eight children similarly treated but without chemotherapy. The authors concluded that nitrosoureas were responsible for the gonadal damage, with procarbazine also contributing in the three children who received this drug. Heyn and colleagues described the late effects of therapy on testicular function in patients between the ages of 10 months and 19 years afflicted with paratesticular rhabdomyosarcoma as a result of cyclophosphamide, radiation and retroperitoneal lymph node dissection. Tanner staging was...

CSF1 Antisense Treatment Suppresses Growth of Human Embryonic and Colon Carcinoma Xenografts in Mice

Severe combined immunodeficient (SCID) mice bearing established human embryonic tumors were treated systemically with CSF-1 antisense oligodeoxyri-bonucleotides (ODNs), scrambled ODN or Ringer's solution. Antisense ODN treatment was well tolerated. Local inflammatory reactions were not observed and no significant changes in the complete blood count (CBC) of treated mice were seen. Treatment with CSF-1 antisense ODN significantly downregulated tissue CSF-1 mRNA and protein levels and suppressed the growth of embryonic tumors to dormant levels. Marked differences were found in the testicular weight between SCID mice with embryonic tumors treated with CSF-1 ODN for 2 wk

Myotonic Dystrophy

In males, testicular atrophy, Leydig cell hyperplasia, and slightly reduced serum testosterone is common. In females, no consistent ovarian problems have been documented, but the spontaneous abortion rate is high. Fertility in both sexes seems to be reduced to about 75 percent of normal. Finally, in the ocular system, cataracts with characteristic multicolored crystalline subcapsular opacities have been documented since the recognition of DM as an entity. Retinal degeneration, low intraocular pressure, and saccadic eye movement defects have been reported. d

Fragile X

Because it is an X-linked disorder, fragile X affects males and females differently. In boys, fragile X is associated with variable presentations of mental retardation, difficulties with visuospatial and memory functioning, gaze avoidance, stereotypic behaviors, hyperactivity, and abnormal speech patterns, including echolalia, high-pitched speech, poor articulation, and dysfluency. Aggression and self-injurious behaviors are prominent in some individuals. Persons with fragile X commonly have a characteristic appearance that includes an elongated face, a large protruding jaw, large ears, enlarged testicles, and accentuated secondary sexual characteristics. In girls who are heterozygous for the fragile X full mutation, the syndrome is associated with a normal physical appearance, variable cognitive functioning that ranges from normal to mildly mentally retarded, and difficulties with mathematics, attention, social communication, and the regulation of anxiety (Reiss et al., 2000a)....

Age years

Reverse Testicular Atrophy

In girls, the first signs of puberty are a growth spurt and breast development (palpable breast buds or thelarche), followed by pubic hair growth and, after about 2 years, by menar-che. In boys, the first sign of puberty is testicular enlargement (testes length 2.5 cm), followed by penile and pubic hair growth, followed by a growth spurt. In most studies of normal children, pubertal milestones are attained at ages that are normally distributed, with a standard deviation (SD) of approximately lyear 69 . Children entering puberty more than 2 SDs earlier or later than average should be considered for endocrine evaluation. The average age that girls experience thelarche is 10 years, and the average age they experience menarche is 12.8 years the average age when boys experience testicular growth is 11

The Fertility Factor

Richard Spark's review of the male fertility literature suggests that for global sperm count the persistent trend is unquestionably downward. 14 With such a wide variety of risk factors, it's not surprising that men's fertility has become increasingly compromised. For example, some diseases lead to male infertility these include cystic fibrosis, sickle cell anemia, and some sexually transmitted diseases. Environmental factors such as pesticides and herbicides (including estrogen-like chemicals), hydrocarbons (found in products like asphalt, crude oil, and roofing tar), heavy metals (used in some batteries, pigments, and plastics), and aromatic solvents (used in paint, varnish, stain, glue, and metal de-greasers) have all been suspected of lowering sperm counts and damaging morphology.15 Furthermore, men and boys may lower their sperm count through tobacco exposure, whether chewing or smoking,16 and prenatal exposure to tobacco has been shown to lower sperm counts in male offspring.17...

The Role Of Learning

Finally (but not exhaustively), handedness has been related (frequently if not convincingly) not only to physical features connected with, for example, the nose, (Sutton, 1963), testicles (Chang et al., 1960), and handprints and fingerprints (Newman, 1934), but also to behavioral phenomena such as eye dominance (McManus et al., 1999 Annett, 1999b, 2000) and laterality of jaw movements (Koch, 1933), which are difficult to reconcile with an effect of learning. The fact that anatomical brain asymmetry has been related to a familial as well as a personal history of left-handedness (Steinmetz et al., 1991) is particularly problematic for a learning account.

Effects of Radiation

These results are supported by other reports. In a study of 17 males treated for Hodgkin's disease who received 6-70 cGy of scatter dose to the testes, FSH levels remained normal in patients who received 20 cGy had a dose-dependent increase in serum FSH levels, with a maximum difference seen at six months following radiation. In all patients,the FSH normalized within 12-24 months. Eight patients had normal pretreatment sperm counts. Most of the patients continued to have high sperm counts following irradiation, although two developed transient oligospermia with complete recovery of sperm count by 18 months. Four patients who had received 23 cGy or less went on to father children. Ortin et al. reported on children treated for Hodgkin's disease 57 . Seven boys received pelvic radiation as part of their treatment without any chemotherapy. Three of them fathered children. Three had azoospermia 10-15 years after irradiation, and one had testicular atrophy diagnosed by biopsy a year after...

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