CAG repeat length of the androgen receptor gene in Japanese males with cryptorchidism

We have analysed the CAG repeat length in exon 1 of the androgen receptor gene in 48 Japanese males with cryptorchidism and 100 fertile Japanese males. The CAG repeat length was 23.4 +/- 0.48 (mean +/- SE) (range 16-32, median 23) in cryptorchid patients and 23.5 +/- 0.29 (range 15-32, median 23) in normal males. There was no significant difference between the two groups. The expansion of the CAG repeats in exon 1 of the androgen receptor gene is unlikely to constitute a major cause of cryptorchidism.

Posterior retroperitoneoscopic partial adrenalectomy using ultrasonic scalpel for aldosterone-producing adenoma

BACKGROUND

Posterior retroperitoneoscopic adrenalectomy has become a standard procedure, but removal of the entire gland is not necessary in all cases.

PATIENTS AND METHODS

We performed 10 posterior retroperitoneoscopic partial adrenalectomies for aldosterone-producing adenoma (APA) using an ultrasonic scalpel to divide the normal adrenal gland and the adenoma.

RESULTS

The mean operation time and blood loss were 154 (110-231) minutes and 11 (5-32) mL, respectively. The mean weight of removed tissue was 5.7 g (2.3-10.2 g). Subcutaneous emphysema occurred in three patients, but there were no serious operative complications.

CONCLUSION

Posterior retroperitoneoscopic partial adrenalectomy using the ultrasonic scalpel may be a valuable treatment for typical solitary APA.

Laparoscopic varicocelectomy in adolescents using an ultrasonically activated scalpel

Ten laparoscopic varicocelectomies were performed using an ultrasonically activated scalpel to divide spermatic vessels in adolescents. The mean operation time was 35 (25-46) min. There were no intraabdominal viscelar or vascular complications, and no postoperative analgesia was required. These findings suggest that laparoscopic varicocelectomy using an ultrasonically activated scalpel may be a valuable treatment in the adolescent.

Retroperitoneoscopic partial adrenalectomy using an endoscopic stapling device in patients with adrenal tumor

We performed 15 retroperitoneoscopic partial adrenalectomies using an endoscopic stapling device to divide the normal adrenal tissue and adenoma. The mean operating time and mean blood loss were 162 (129-210) min and 12 (5-67) ml, respectively. In 1 patient (6.7%), a pneumothorax occurred at the end of the procedure due to injury of the medial crus of the diaphragm. However, the procedure was not subsequently converted to open surgery. These facts suggest that posterior retroperitoneoscopic partial adrenalectomy is a valuable addition to adrenal gland surgery.

Detection of chromosome 15 deletion in Prader-Willi syndrome using fluorescence in situ hybridization

Deletion of chromosome 15 was investigated in 6 patients with Prader-Willi syndrome (PWS) using chromosome and fluorescence in situ hybridization (FISH) analysis. Although chromosome analysis using G-banding methods revealed the deletion of 15q11-q13 in only 3 cases, staining by FISH using D15S11 and/or small nuclear ribonucleoprotein polypeptide N (SNRPN) probes detected chromosome 15 deletion in all cases. It would appear that FISH analysis is an effective diagnostic test for the detection of chromosome 15 deletion in patients with PWS.

Absence of Y chromosome microdeletions involving the DAZ (deleted in azoospermia) and RBM (ribonucleic acid-binding motif) genes in patients with chordee without hypospadias

The presence or absence of 33 DNA loci was investigated with a focus on the long arm of Y chromosome (Yq) interval 6 involving the DAZ and RBM genes, by means of a polymerase chain reaction strategy, in 10 patients with hypospadias. All patients did not show any of the 33 DNA loci. It would appear that chordee without hypospadias does not involve interval 6 of the Y chromosome.

The use of ebastine, a mast cell blocker, for treatment of oligozoospermia

The effect of mast cell blocker (ebastine) on semen quality was evaluated in 15 idiopathic oligozoospermic males. Ten milligrams/day of ebastine was administered orally for 3 months. Nine cases (66.7%) showed definite improvement in the semen quality. The wives of 3 patients (20%) became pregnant within 6 months of the initial treatment. It would appear that mast cell blocker (ebastine) significantly improves semen quality in men with idiopathic oligozoospermia.

Localization of the sex-determining region-Y gene in XX males

Localization of the sex-determining region Y (SRY) was investigated in 2 XX males. Metaphase chromosomes from peripheral lymphocytes were stained by fluorescence in situ hybridization using DXZ1 and SRY probes. An identical hybridization signal with the SRY probe was found on an X chromosome in both cases. The karyotype of the 2 cases was 46,XX, t(X;Y)(p22.3;p11.3). It would appear that XX male is the presence of a Y-chromosome fragment transferred to the X-chromosome short arm by unequal interchange between homologous regions in the short arms of sex chromosomes.

Deletion of Y chromosome involving the DAZ (deleted in azoospermia) gene in XX males

The testicular histology and the presence or absence of 32 Y DNA loci was investigated, with a focus on the long arm of Y chromosome (Yq) interval 6, by means of a polymerase chain reaction strategy in 2 XX males. Seminiferous tubules lined by only Sertoli cells and a slight thickening of tubular walls were observed. The men showed an absence of 32 Y DNA loci. These facts suggest that severe spermatogenic impairment is caused by deletions of Yq interval 6 in XX males.

Pulmonary function after posterior retroperitoneoscopic surgery

Pulmonary function tests were performed in 12 patients who underwent posterior retroperitoneoscopic surgery, before and on the 3rd and 7th days after operation. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FCV, vital capacity (VC), total lung capacity (TLC), residual volume (RV) and functional residual capacity (FRC) were not significantly different between before and after surgery. It is assumed that posterior retroperitoneoscopic surgery could be performed without impairment of pulmonary function after surgery.

Microdeletion of the DAZ (deleted in azoospermia) gene or the YRRM (Y chromosome ribonucleic acid recognition motif) gene does not occur in patients with Klinefelter's syndrome with and without spermatogenesis

OBJECTIVE

To evaluate the occurrence of microdeletions of the Y chromosome involving the DAZ and YRRM genes in patients with Klinefelter's syndrome with and without spermatogenesis.

DESIGN

Controlled clinical study.

SETTING

Yamagata University Hospital, Yamagata, Japan.

PATIENT(S)

Patients with Klinefelter's syndrome with spermatogenesis (n = 1) and without spermatogenesis (n = 20) and a control group of men of proven fertility (n = 10).

INTERVENTION(S)

Blood and semen sampling and testicular biopsy.

MAIN OUTCOME MEASURE(S)

Semen analysis, polymerase chain reaction amplification of 32 DNA loci on the long arm of the Y chromosome involving the DAZ (deleted in azoospermia) and YRRM (Y chromosome ribonucleic acid recognition motif) genes, and measurement of plasma FSH, LH, and testosterone levels.

RESULT(S)

No microdeletions of 32 loci were found in any of the patients with Klinefelter's syndrome, either with or without spermatogenesis. Plasma LH and FSH levels were abnormally high and testosterone levels were reduced in all the patients with Klinefelter's syndrome. American Society for Reproductive Medicine.)

CONCLUSION(S)

Severe impairment of spermatogenesis in patients with Klinefelter's syndrome is not caused by microdeletions of the Y chromosome involving the DAZ and YRRM genes.

Expression of plasminogen-related gene B varies among normal tissues and increases in cancer tissues

We previously found that the promoter activity of plasminogen (PLG)-related gene B (PRGB) was 5-fold that of PLG. We have since examined the transcript levels of PRGB among various normal human tissues, and compared these findings with those of PLG. Reverse transcription-PCR analysis revealed that the PRGB expression varied widely among different tissues, while PLG was expressed only in the liver and kidney. RNA samples obtained from cultured cell lines also demonstrated differing PRGB expression. Furthermore, increased PRGB expression was observed in several fresh samples of cancer tissue obtained from cancer patients when compared with surrounding normal tissues.

Long arm deletion of chromosome 10 in a boy with monorchidism

We report on a boy with long-arm deletion of chromosome 10 and compare this case to 10 previously reported patients. He had right cryptorchidism and absence of the left testis, but the size of his penis was normal. Cytogenetic analysis of the case showed the deficiency of 10q26.1-26.3 and the presence of 10qter. Four of 10 previously reported patients had an intersex phenotype, and all others had combinations of cryptorchidism, micropenis and hypospadias. These facts indicate that the terminal of chromosome 10q is strongly associated with abnormal male development.

Simultaneous induction of pathway-specific potentiation and depression in networks of cortical neurons

Activity-dependent modification of synaptic efficacy is widely recognized as a cellular basis of learning, memory, and developmental plasticity. Little is known, however, of the consequences of such modification on network activity. Using electrode arrays, we examined how a single, localized tetanic stimulus affects the firing of up to 72 neurons recorded simultaneously in cultured networks of cortical neurons, in response to activation through 64 different test stimulus pathways. The same tetanus produced potentiated transmission in some stimulus pathways and depressed transmission in others. Unexpectedly, responses were homogeneous: for any one stimulus pathway, neuronal responses were either all enhanced or all depressed. Cross-correlation of responses with the responses elicited through the tetanized site revealed that both enhanced and depressed responses followed a common principle: activity that was closely correlated before tetanus with spikes elicited through the tetanized pathway was enhanced, whereas activity outside a 40-ms time window of correlation to tetanic pathway spikes was depressed. Response homogeneity could result from pathway-specific recurrently excitatory circuits, whose gain is increased or decreased by the tetanus, according to its cross-correlation with the tetanized pathway response. The results show how spatial responses following localized tetanic stimuli, although complex, can be accounted for by a simple rule for activity-dependent modification.

Assessment of testicular function in experimental varicocele rats by phosphorus-31 magnetic resonance spectroscopy

To assess testicular function in experimental varicocele rats, we used 31P magnetic resonance (MR) spectroscopy and compared MR spectroscopic parameters with flow cytometric DNA analysis. In vivo 31P MR spectroscopy and flow cytometric DNA analysis of testes were performed in 10 sham-operated and 9 induced varicocele rats. Although the testicular phosphomonoester (PM)/ATP ratio did not differ between sham-operated and induced varicocele rats, the phosphodiester (PD)/ATP ratio was significantly reduced and the inorganic phosphate (Pi)/ATP ratio was significantly increased in induced varicocele rats. There was no difference between the right and left sides. DNA flow cytometry showed a decrease in the percentage of haploid cells in induced varicocele rats, regardless of the side. This study indicates that in vivo 31P MR spectroscopy provides valuable information for assessment of testicular function.

Activity-dependent enhancement in the reliability of correlated spike timings in cultured cortical neurons

To study the use-dependent modification of activity in neural networks, we investigated the spike timing by simultaneously recording activity at multiple sites in a network of cultured cortical neurons. We used dynamical analysis to study the temporal structure of spike trains and the activity-dependent changes in the reliability and reproducibility of spike patterns evoked by a stimulus. We also used cross-correlation analysis to evaluate the interactions of neuron pairs. Our main conclusions are that even when no obvious change in spike numbers can be seen, use-dependent modification occurs, either enhancing or reducing in the reliability and reproducibility of spike trains evoked by a stimulus, and the fine temporal structure of stimulus-evoked spike trains and interactions between neurons are also modified by tetanic stimulation.

Round spermatids from hybrid sterile mice can initiate normal embryo development

Fertilization and embryo development following intracytoplasmic injection of round spermatids collected from hybrid sterile mice (BALB/c) were investigated. The rates of oocyte activation, blastocyst formation and development into live offspring were compared with those after intracytoplasmic injection of round spermatids from fertile mice (B6D2F1). The injection of oocytes with round spermatids from hybrid sterile or sterile males resulted in similar rates of normal fertilization and embryo development. The rates of development to term of 2-cell embryos were also similar, regardless of the origin of the round spermatids injected. This finding suggested that round spermatids from hybrid sterile mice have the ability to fertilize normally and to allow normal embryo development.

Circulating levels of inhibin in hemodialysis males

Serum concentrations of LH, FSH, testosterone, and inhibin were measured in 65 hemodialysis male patients and 60 healthy men. In hemodialysis patients, serum levels of LH, FSH, and inhibin were significantly elevated compared to the controls (p < 0.001). However, serum testosterone level was significantly reduced in hemodialysis males (p < 0.01). Neither serum LH nor FSH correlated with inhibin in the control and hemodialysis males. In hemodialysis patients, serum inhibin showed a positive correlation with serum creatinine (p < 0.05). It would appear that an elevated level of serum inhibin is caused by a decreased metabolic clearance rate or testicular dysfunction due to chronic renal failure, and indicates the abnormality of hypothalamic-pituitary-testicular axis leading to hypergonadotropic hypogonadism in hemodialysis males.

Testicular histology in experimental uremic rats

Testicular histology in chronic renal failure was studied using stepwise-nephrectomized and adenine-treated rats. Serum levels of urea nitrogen and creatinine were significantly higher than those in sham-operated and control rats (P < .001). However, the mean tubular diameter was not different among the 4 groups. Numbers of A-spermatogonia, preleptotene and pachytene spermatocytes, and spermatids per 100 Sertoli cells were not different among the 4 groups. It would appear that testicular histology is not influenced by chronic renal failure in rats.

Round spermatids from prepubertal mouse testis can develop into normal offspring

We investigated fertilization and embryo development after intracytoplasmic injection of round spermatids collected from mice before puberty. The rates of normal fertilization, blastocyst formation, and development into live offspring were examined. The injection of oocytes with round spermatids from mature or prepubertal males resulted in similar rates of normal fertilization and embryo development. The rates of the development to term of two-cell embryos were also similar, regardless of the origin of the round spermatids injected. This finding suggests that round spermatids from the prepubertal testis already have the ability to fertilize normally and to allow normal embryo development.

Influence of adenine-induced chronic renal failure on testicular function in the rat

The influence of adenine-induced chronic renal failure on the male reproductive function was investigated using male Wistar rats. Adenine-induced chronic renal failure was performed in 22 rats (adenine-treated) by providing them with an adenine-excessive diet (150 mg adenine per day) for 10 days. An additional 22 rats were fed without adenine-excessive diet and served as a control group. On days 30 and 60 after start of treatment, body weight ratio to the testis, serum levels of creatinine, urea nitrogen, luteinizing hormone (LH), follicle-stimulating hormone (FSH), 17 alpha hydroxyprogesterone (17 alpha-OHP), androstenedione and testosterone were measured. During the experiment, progressive elevation of serum creatinine and urea nitrogen was found in adenine-treated rats. Body weight ratio of the testes and serum level of LH in adenine-treated rats were similar to those in the controls. On day 60, the FSH level in adenine-treated rats was significantly higher than that in the controls (P < 0.001). While serum concentrations of 17 alpha-OHP and androstenedione in adenine-treated rats were considerably elevated compared with those in the controls on day 30 (P < 0.05). These concentrations did not differ between the two groups at day 60. Serum testosterone level was reduced in adenine-treated rats (P < 0.001). This reduction was progressive with time (P < 0.05). These results suggest that adenine itself reduces testosterone synthesis by suppressing 17 beta-hydroxysteroid oxidoreductase at the early stage of adenine-induced chronic renal failure, but that progressive renal insufficiency causes an elevation of FSH, a reduced synthesis of testosterone and its precursors at the late stage of adenine-induced chronic renal failure. Thus, hormonal conditions in the male rat with adenine-induced chronic renal failure change with time after induction.

Experimental uremia in male rats: effect of interval between partial nephrectomies on testicular function

Testicular function in stepwise-nephrectomized rats, with a different interval between the two operations, was studied suing male Wistar rats. Serum levels of urea nitrogen and creatinine in stepwise-nephrectomized rats were significantly elevated compared to those in sham-operated rats (p < 0.001). With a 1-day interval between the two operations, these concentrations were considerably higher (p < 0.001) than those in 7-day interval rats. While serum LH levels were significantly reduced (p < 0.001) in 1-day interval rats, FSH levels in this group were considerably higher (p < 0.001) than in other groups. Serum concentrations of androstenedione in 1-day interval rats were significantly suppressed compared to other groups (p < 0.01). Serum testosterone levels in stepwise-nephrectomized rats were considerably lower (p < 0.001) than in sham-operated rats. It is assumed that testicular function in stepwise-nephrectomized rats is influenced by the interval between the two operations.

[Early steroid withdrawal after kidney transplantation]

BACKGROUND

The side effects of steroid are serious problems in renal transplant patients. However, withdrawal of steroid has been controversial. We evaluated the benefits and risk of early steroid withdrawal after renal transplantation.

PATIENTS AND METHODS

The outcomes of early steroid withdrawal from triple immunosuppressive drug therapy were analyzed in four living related and one cadaveric renal transplant recipients. The dosage of steroid was gradually reduced and the time of steroid withdrawal after transplantation was 5 to 7.5 months.

RESULTS

Four Patients have been able to be free from steroid and maintained stable graft functions and normal urinary findings for 14 to 33 months after withdrawal. The findings of rejection were not observed in the graft specimens obtained by serial biopsies. One patient who received a living related graft developed an increase in serum creatinine level and proteinuria two weeks after discontinuation of steroid. The serum creatinine level returned to that before withdrawal and proteinuria disappeared by steroid readministration. Long term side effects of steroid were not observed in 4 patients with successful steroid withdrawal.

CONCLUSION

These results suggest that steroid withdrawal about 6 months after transplantation can be accomplished without jeopardizing graft function in selected renal transplant recipient and the withdrawal in the early stage is preferred for reducing the side effects. Careful and long-term follow up are required to assess the further risk and benefit of steroid withdrawal on immunosuppressive morbidity.