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OBJECTIVE This study aimed to investigate the application value of shear wave elastography in examining normal testes and inflammatory epididymal tail masses. METHODS We examined 110 healthy male volunteers (with a total of 220 testes) and 25 patients with epididymitis via conventional scrotal ultrasonography and shear wave elastography. The mean (Emean), minimal (Emin), maximal (Emax), and standard deviation (ESD) values of elasticity were acquired. The inflammatory masses were assessed at initial diagnosis, at weeks 1 and 2 of standard anti-inflammatory treatment, upon remission, and at 2 weeks after remission. RESULTS The Emean values of different regions in testes varied in the following order: center region (3.14 ± 0.35 kPa) < upper- or lower-pole capsule (upper, 3.94 ± 0.90 kPa; lower, 3.94 ± 0.97 kPa) < posterior capsule (5.96 ± 1.46 kPa) < anterior capsule (6.27 ± 1.58 kPa). The Emean value of the center of the testicular parenchyma in the short axis was significantly larger than that in the long axis (3.47 ± 0.32 vs 3.14 ± 0.35 kPa; P < 0.05). There were significant differences in the Emean value between inflammatory epididymal tail masses at initial diagnosis, at 1 and 2 weeks after treatment, upon remission, and at 2 weeks after remission (P < 0.05). CONCLUSIONS Shear wave elastography can be used to reflect the relative hardness of normal testes and inflammatory epididymal tail masses.

This study aimed to assess if Ecotext, a new software for evaluation of testicular echotexture, is a good method for diagnosis of stallions with testicular dysfunction (TD). Relationships between Ecotext parameters and sperm motility and production, testicular volume, and testicular blood flow were also studied. Ecotext provides a total of six echotexture parameters: Ecotext 1 (black pixels), 2 (white pixels) and 3 (grey pixels), and another 3 parameters related to hypoechogenic areas: Ecotext tubular density (ETD), Ecotext tubular diameter (ETd), and Ecotext tubular area (ETA). Stallions (n = 33) were assessed using proven diagnostic techniques (spermiogram, B-mode and Pulse Doppler ultrasound), and subsequent analysis with Ecotext. Animals were classified as “control stallions” (n:21, acceptable semen quality), and “stallions with TD” (n:12, poor semen quality (TM < 60%, PM < 45% and total nº of sperm with PM < 2000 × 106 spz), that were subdivided into “induced TD group” (immunized, anti-GnRH vaccine) and “acquired TD group”. The acquired TD group showed differences in all Ecotext parameters in relation to controls (Ecotext 1:0.11 ± 0.17 vs 2.82 ± 2.52, Ecotext 2:1584.0 ± 575.8 vs 388 ± 368.2, Ecotext 3:134.2 ± 9.26; ETA: 2.14 ± 0.59 vs 5.40 ± 1.90; ETd: 65.66 ± 6.27 vs 86.93 ± 10.65 and ETD: 92.35 ± 11.24 vs 132.10 ± 16.35, p ≤ 0.001). Results suggest acquired TD stallions were suffering testicular degeneration with loss of architecture and function as all Ecotext parameters were altered in relation to controls. Induced TD horses only showed a reduction in ETD (116.2 ± 8.59 vs 132.10 ± 16.35, p ≤ 0.001), despite all sperm parameters being worse. These findings suggested immunized stallions probably only experience an acute loss of testicular functionality and parenchyma architecture is likely not affected since differences in Ecotext parameters with control stallions were not detected. ETD was the best parameter to identify animals with TD (AUC: 0.84, optimal cut-off value of 124.3 seminiferous tubules/cm2). Correlations were found between ETD and Doppler indices (PI: 0.60; RI: 0.47 p ≤ 0.001), total testicular volume (r: 0.48; p ≤ 0.05) and sperm motility (TM:0.51; and PM:0.54; p ≤ 0.001) and production (r:0.51; p ≤ 0.001). In summary, Ecotext could identify changes in testicular echotexture of stallions with TD. Results open the possibility for new research focused on establishing the relationship between Ecotext parameters and histomorphometry features in stallion testes.

The aim was to determine the proton MR (1H-MR) spectra of normal adult testes and variations with age. Forty-one MR spectra of normal testes, including 16 testes from men aged 20–39 years (group I) and 25 testes from men aged 40–69 years (group II), were analyzed. A single-voxel point-resolved spectroscopy sequence (PRESS), with TR/TE: 2000/25 ms was used. The volume of interest was placed to include the majority of normal testicular parenchyma. Association between normalized metabolite concentrations, defined as ratios of the calculated metabolite concentrations relative to creatine concentration, and age was assessed. Quantified metabolites of the spectra were choline (Cho), creatine (Cr), myo-inositol (mI), scyllo-inositol, taurine, lactate, GLx compound, glucose, lipids, and macromolecules resonating at 0.9 ppm (LM09), around 20 ppm (LM20), and at 13 ppm (LM13). Most prominent peaks were Cho, Cr, mI, and lipids. A weak negative correlation between mI and age (P = 0.015) was observed. Higher normalized concentrations of Cho (P = 0.03), mI (P = 0.08), and LM13 (P = 0.05) were found in group I than in group II. 1H-MR spectra of a normal adult testis showed several metabolite peaks. A decrease of levels of Cho, mI, and LM13 was observed with advancing age. • Single-voxel PRESS MRS of a normal testis is feasible. • 1H-MR spectra of a normal testis showed several metabolite peaks. • Most prominent peaks were Cho, Cr, mI, and lipids. • A decrease of Cho, mI, and LM13 was seen with advancing age.

Purpose The aim of this study was to evaluate the testicular parenchyma in pediatric patients with testicular microlithiasis by shear wave elastography (SWE) and compare the values with normal control subjects. Methods Twenty-three patients previously diagnosed with testicular microlithiasis under follow-up for 20 ± 11 months were included in the study group. In the control group, 31 patients with no medical history that could affect testicular tissue were prospectively included. Forty-six testes in the study group and 62 testes in the control group were evaluated with gray-scale ultrasound and SWE. Results There were no differences in age and testes volume between the study and control groups. The mean SWE values of all testes based on elasticity and speed parameters in the study group were 8.84 ± 2.86 kPa and 1.66 ± 0.26 m/s, respectively. In the control group, mean SWE values were 5.26 ± 1.17 kPa and 1.31 ± 0.14 m/s, respectively. Elasticity values were significantly higher in testes with microlithiasis as compared with the control group (p Conclusions SWE evaluation demonstrates the effects of ultrastructural changes in elasticity that are not detected on gray-scale ultrasound. SWE is a more reliable method in follow-up examinations for pediatric testicular microlithiasis.

The usefulness of diffusion-weighted magnetic resonance imaging (DWI) in the evaluation of scrotal pathology has recently been reported. A standard reference of normal testicular apparent diffusion coefficient (ADC) values and their variations with age is necessary when interpreting normal testicular anatomy and pathology. We evaluated 147 normal testes using DWI, including 71 testes from 53 men aged 20-39 years (group 1), 67 testes from 42 men aged 40-69 years (group 2) and nine testes from six men older than 70 years (group 3). DWI was performed along the axial plane, using a single shot, multislice spin-echo planar diffusion pulse sequence and b-values of 0 and 900 s mm−2 . The mean and standard deviation of the ADC values of normal testicular parenchyma were calculated for each age group separately. Analysis of variance (ANOVA) followed by post hoc analysis (Dunnett T3) was used for statistical purposes. The ADC values (× 10−3 mm 2 s−1 ) of normal testicular tissue were different among age groups (group 1: 1.08 ± 0.13; group 2: 1.15 ± 0.15 and group 3: 1.31 ± 0.22). ANOVA revealed differences in mean ADC among age groups (F = 11.391, P < 0.001). Post hoc analysis showed differences between groups 1 and 2 (P = 0.008) and between groups 1 and 3 (P = 0.043), but not between groups 2 and 3 (P = 0.197). Our findings suggest that ADC values of normal testicular tissue increase with advancing age.

Summary Intratesticular varicocele is an uncommon condition with variable sonographic appearence and identified as dilated intratesticular veins lying from the mediastinum through testicular parenchyma. We present a case of a 20-year-old male, married and unable to conceive for 2 years. Routine scrotal sonography disclosed extratesticular varicocele which was associated with ipsilateral intratesticular varicocele. Colour Doppler ultrasonography should be the first choice modality of imaging to confirm the diagnosis. Detection of intratesticular varicocele is essential because it is one of the most common recoverable reasons of male infertility.

Ovotesticular syndrome (OTS) belongs to the group of disorders of sex development (DSD). We present a case of a patient with OTS presenting with acute labioscrotal pain. A surgical exploration was indicated, and hemorrhage was identified. A gonadectomy was performed and the final pathology report revealed an ovotestis with a bleeding follicle, normal ovarian parenchyma and atrophic testicular parenchyma. After reviewing the literature there is scarce information on this complex topic, but conservative management could be an option if the risk of a gonadal malignancy is low.

Summary The objective of the research was to evaluate the efficiency of the spermatogenesis through the morphology of the testicular parenchyma in bulls of different zebu breeds. We used testicular fragments from bull of the breeds Nelore (n = 10), Polled Nelore (n = 6), Gyr (n = 5), Guzerat (n = 5) and Tabapua (n = 5). The tissue was perfused with Karnovsky solution, included in glycol methacrylate and stained with toluidine blue–sodium borate 1%. Animals of the Nelore breed presented higher population of primary spermatocyte in pre-leptotene/leptotene (38.30) and in pachytene (38.14) and round spermatids (113.30), higher yield of spermatogonia mitosis (21.2) and higher daily spermatic production per gram of testicular parenchyma (32.8 × 106) than those from breeds Gyr, Guzerat and Tabapua and higher general yield of spermatogenesis (62.4) than breeds Gyr and Tabapua. There was no significant difference in any of the evaluated parameters between breeds Nelore and Polled Nelore. The rate of Sertoli cells did not vary between the studied breeds. Apparently, the genetic selection applied to the breeds has been improving the yield in the spermatogenic process by decreasing cellular loss, although it did not increase the support capacity of the Sertoli cells.

Kaposiform haemangioendothelioma is a very rare vascular tumour of intermediate (borderline) malignancy, typically occurring in the skin and soft tissues of the extremities in infants and children. We report two morphologically and immunophenotypically classical cases occurring in the testicular parenchyma of old adults, review the literature on vascular tumours of the testis and discuss the differential diagnosis of these unusual cases.

The effect of chloroform extracts from seeds of the papaya plant (Carica papaya) on the spermatic characteristics of dogs was evaluated at doses of 50, 100 and 150 mg/kg, Groups 1, 2, and 3, respectively. Structural and ultrastructural changes in sperm cells and testicular parenchyma were also evaluated, and possible side effects were noted. Significant reductions in sperm concentration and motility were observed starting from Days 60 and 75, respectively, in all treated groups (P0.05), but no azoospermia was noted. A mild osmotic diarrhea occurred in dogs from Group 3 (150 mg/kg), although blood variables were within the normal range of a clinically healthy dog. Arrested spermatogenesis was observed in the seminiferous tubules of all treated groups, and vacuolization and signs of Sertoli cell degeneration were detected in all treated groups, particularly in Group 3 (150 mg/kg). Selective damage to Sertoli cells induced by the extract occurred in all treated groups independently of the extract concentration. Alteration of the epididymal environment may reduce the motility of sperm cells, considering that their structure was normal. Sperm characteristics in treated animals were considered to be similar to those of sub-fertile dogs. However, these effects may be temporary, and dogs may recover normal sperm characteristics when the extract is withdrawn.

Despite its extensive use for evaluation of spermatogenesis and assisted reproduction, the safety and consequences of fine (FNA) and large needle aspiration (LNA) to the testicular parenchyma and its normal function have not been established. This study was performed in order to accurately assess, by serial in vitro ultrasonographic, bacteriologic, gross anatomic and histological examinations, the type and extent of the effect of FNA or LNA on the dog's testis. Twenty three sexually mature, 1 to 2 years old, healthy laboratory Beagles were randomly assigned to 2 groups: (1) 5 dogs without testicular aspiration (control group) and (2) 18 dogs in which one of their testes was aspirated using a 23 G butterfly needle and the other using a 19 G butterfly needle (experimental group). Two dogs at a time were castrated 10 minutes, 60 minutes, 2, 14, 29, 63, 76, 90 or 180 days post-aspiration. The control group was also castrated 2, 29, 63, 90 or 180 days after the beginning of the experiment. Following castration, in vitro ultrasonographic, gross anatomic, cytological examinations of epididymal sperm, bacteriologic and histological examinations of the testes were performed. Following testicular FNA and LNA bacteriologic, gross anatomic, histologic, epididymal sperm findings and the in vitro ultrasonographic appearance of the testis were normal, except of intratesticular haemorrhage, detected the first days post-aspiration, and degeneration of less than 1.5% of the seminiferous tubules. Within the parameters of this experiment, testicular FNA and LNA have no ill effect on the canine testis and therefore, both FNA and LNA should be considered safe.

There is a close correlation between the angioarchitecture of the human testis and its inner subdivision into testicular lobules. Serial sections from paraffin and epon-embedded testicular tissue were used to examine the angioarchitecture of the human testis, and computer-aided 3-D-reconstruction was used to demonstrate the correlation between blood vessels and tissue organization. The recurrent arteries arise from the centripetal arteries, and run in the central axis of the testicular lobule. At regular intervals of on average, 300 microns the segmental arteries arise from the recurrent artery, which supplies segments of the testicular parenchyma perpendicular to the long axis of the testicular lobules. Within such a segment, the segmental artery supplies the microvasculature, which is partly surrounded by Leydig cells and partly stands in close contact with the wall of the seminiferous tubules. The venous drainage occurs through the intralobular veins, which run to the periphery of the lobule (towards the septum). These veins lead into the septum and there they join the collecting veins. A lobule can have several segments depending on its size. The base of such a tissue segment is directed towards the septum whereas the top is directed towards the centre of the lobule. Sections of several seminiferous tubules can be found in such a segment. The flow of blood from the arterial to the venous side of the testicular circulation occurs radially from the centre of the lobule to the septum.

We present ultrasonographic and magnetic resonance imaging findings of intratesticular adrenal rests in a 16-year-old patient with congenital adrenal hyperplasia. Scrotal ultrasonography showed bilateral well-delineated homogenous hypoechoic lesions located around the mediastinum testis, which were highly vascularized on power Doppler ultrasonography. Relative to normal testicular parenchyma the lesions were iso- or hyperintense on T1-weighted and hypointense on T2-weighted images. T2-weighted images also showed a target-like appearance caused by a more hypointense peripheral halo around the lesions. The lesions enhanced remarkably on post-contrast images. This case suggests that radiological evaluation of testes, even in the presence of normal physical examination findings, should be included in periodical follow-up of patients with congenital adrenal hyperplasia. Magnetic resonance (MR) imaging is useful in demonstrating the lesions, because the contrast resolution better than with ultrasonography.

Pediatric testicular tumors are well suited for testicular sparing surgery due to the high incidence of non-malignant lesions in this population and the observed low incidence of recurrence or complication. Bilateral pediatric testicular tumors have been rarely reported; however, testicular sparing surgery, if possible, is an attractive alternative to radical orchiectomy in an effort to preserve testicular parenchyma and function. To our knowledge, we present the first reported case of successful bilateral testicular sparing surgery.

Summary The existence of a physiological integration between the immune and endocrine systems has long been recognized. In spite of the abundant literature data on the presence of cells of the immune system in the testis, mast cells and eosinophil leukocytes have received little attention. We have studied the presence, distribution and numbers of mast cells and eosinophils in the testes of 12 mammalian species. Mast cells were frequently found in equine (stallion, ass and mule) and human testis, whereas eosinophils were nearly absent. On the contrary, eosinophils were abundant in the hare testis, while mast cells were lacking. Both cells types were present in high numbers in swine (wild and domestic boar) testis. Otherwise, mast cells and eosinophils were absent from the testicular parenchyma of several species (rat, dog, cat, bull and deer), although they were present, in most cases, around blood vessels in the tunica albuginea. The presence of high numbers of mast cells and/or eosinophil leukocytes in the testicular parenchyma of some species suggest a role for these cells in local regulatory pathways.

A 13-year-old-boy with suspected left testicular torsion was referred to our institute. During preparation, a significant decrease of signals on the left testis was found, however, slight blood flow was detected by the ultrasound examination enhanced by Levovist. As a result of the examination we left the testis intact, although the color of the testicular parenchyma remained black. One year after the surgery, an ultrasound examination was done again and good vascurality was observed.

Haemangioma of the testis is a rare condition. This benign vascular neoplasm may arise either within the testicular parenchyma (intratesticular) as in this case or from adnexal structures of the testis (extratesticular). Intratesticular haemangioma is rarer than extratesticular form. Intratesticular vascular neoplasms are extremely rare tumours and mostly seen in children or young adults. There are 21 reported testicular haemangioma cases in the literature1–3 as indexed in PubMed. Since 2007, only 19 cases of cavernous haemangioma have been reported in the literature4 in PubMed and other indexed sites. We report a case of cavernous haemangioma of the testis to attract attention to testicular haemangioma and also to prevent invasive surgery of the testis.

A 49-year-old male presented with a painful mass in the left scrotum. An inguinal orchiectomy was performed. Pathological examination revealed a well-differentiated leiomyosarcoma completely located inside the testicular parenchyma. We report this unusual case because primary leiomyosarcoma of the testis proper is extremely rare; our patient being the 19th case recorded thus far in the medical literature. It can lead to significant clinical and diagnostic difficulty due to its wide differential diagnosis and extreme rarity.

We performed a prospective study to investigate whether the sonographic appearance of the testicular parenchyma changes during maturation of the testis. One hundred forty-three boys ranging in age from 6 months to 16 years, and 11 volunteers aged about 30 years, were included in the study. The echogenicity of each of the 308 normal testes were determined by measuring the average brightness of a histogram over a defined testicular area. To avoid divergent results due to different settings of the device in individual cases, the average brightness of a histogram of a standard ultrasound phantom was measured immediately after the examination of each testicle. From these 2 measurements, testicular echogenicity could be calculated independently of individual equipment settings. All testes had a homogeneous echotexture. The echogenicity of the prepubertal testis was markedly reduced compared to the medium-level echogenicity of the mature testis (p0.001). Testicular echogenicity increases during puberty. We conclude that testicular echogenicity increases with maturation. Knowledge of this fact may improve the diagnostic performance of scrotal ultrasound especially in children.

The present study examined the courses of testicular efferent lymphatics in the rabbit, by injections of India ink directly into testicular parenchyma. In 58% of the testes examined, testicular efferent lymphatics were observed to course along the testicular artery to the lumbar trunk. In other testes, efferent lymphatics were found along the testicular artery as well as along either the ductus deferens (26%) or cremasteric muscle (8%). In the remaining 8% of the testes, efferent lymphatics were found along the testicular artery, ductus deferens, and cremasteric muscle. These findings demonstrate that testicular efferent lymphatics in the rabbit course not only along the testicular artery, but also along the ductus deferens and/or cremasteric artery in about 40% of the testes.

The study investigated live weight related changes in testicular histomorphmery of White Fulani (WF) bulls of live weight range 171-320 kg under the traditional extensive system of management in Ibadan, Nigeria. Fifty-two WF bulls were randomly selected from local Fulani herds around Ibadan and placed in Giant Star grass paddocks with water available free choice for one week prior to slaughter. Morhpometric measurements were taken on the scrotum before and on the testes immediately after slaughter. Histometric measurements were taken on the testicular parenchyma tissue after histological processes. From their weight at slaughter, the bulls were grouped into four live weight groups of 171-200, 201-230, 231-260 and 261-320 kg for group I, II, III and IV, respectively. Mean values of group IV bulls were significantly (p0.05) higher in all scrotal and testicular morphometric measurements than all other groups, which did not differ significantly (p0.05) from one another. The gonadal index (relative weight of testes to live weight) did not differ (p0.05) between groups except that group IV value was significantly (p0.05) higher than all other groups. The relative proportion of paired epididymal weight to live weight did not differ between groups, while the relative proportion of tunica albuginea to the testes weight decreased insignificantly from group I to IV. The seminiferous tubule diameter did not significantly (p0.05) differ between groups, while the stages in the cycle of the seminiferous epithelium also appeared stable between the different live weight groups. The volume proportion of the lumen in the semiferuos epithelium was significantly higher in group I bulls than group IV bulls while none of the testicular elements differed significantly (p0.05) between groups in volume proportions. However, absolute weights of all the testicular elements were significantly higher in the group IV bulls than all the other groups, which did not differ significantly (p0.05) from one another. It was concluded that the live weight range 171-320 kg corresponds to a physiologically stable state in White Fulani bulls extensively managed in Ibadan, a humid tropical environment in Nigeria.

Testicular microlithiasis (TM) is an unusual ultrasonographic manifestation in testicular parenchyma. Limited information is available about TM in Taiwanese men. We performed a retrospective analysis to investigate the characteristics of TM and its association with testicular cancer and infertility in Taiwan. Male patients who had received scrotal ultrasonography because of scrotal symptoms or infertility between January 2000 and December 2003 were recruited. The incidence of TM was 7.6%. Both testicular microlithiasis and testicular cancer occurred chiefly in the third decade. Patients with TM exhibit a higher chance of testicular cancer (6% vs. 0.9%). No local field effect between TM and testicular cancer was observed. Testicular microlithiasis severity is not positively correlated with sperm quality and sterility. Forty-eight patients (32%) were available at follow-up. No patient developed a testicular tumor or elevated tumor markers (AFP, beta-hCG) during follow-up. We suggest monthly self-examination, annual scrotal ultrasonography and tumor markers screening between the age of 20 and 30 years of patients with TM.

In children with nonpalpable undescended testes, preoperative localization is very helpful prior to surgical investigation both to reduce the time required for complete exploration and to plan the correct surgical procedure. Magnetic resonance imaging (MRI) was accomplished in 23 patients with a clinical diagnosis of cryptorchidism after ultrasonographic studies were inconclusive in identifying the undescended testis. An abdominal testis was correctly located in 16 cases. No structures resembling testicular parenchyma were detected in 4 instances. The surgical findings confirmed the absence of testes in 2 patients but showed 2 abdominal testes not seen by MRI. The movements of 5 patients caused inadequate MRI examinations, so these patients were not considered in the results. In our experience MRI proved to be effective in locating undescended abdominal testes with a diagnostic accuracy of 90%. Therefore MRI should be performed before any invasive diagnostic procedure. Lack of cooperation in young patients could reduce the accuracy of the procedure, so we think that sedation should be performed in children under 6 years of age.

Testicular microlithiasis is a relatively uncommon condition in children. It is characterized by the presence of microcalcifications within the testicular parenchyma. Although it is a benign finding, underlying diseases and other conditions must be ruled out because testicular microlithiasis has been found in association with both benign and malignant lesions in the testes and other tissues. We present two brothers with testicular microlithiasis, and highlight the prevalence, natural history, associated malignant conditions and follow-up recommendations of children diagnosed with testicular microlithiasis.

A case of unilateral seminoma with visceral metastases in a Mallard duck (Anas platyrhynchos) is reported. The right testis was markedly enlarged. The liver surface showed multifocal to coalescent regular circular umbilicated greyish-white spots. In addition, multiple rough whitish nodules were evident on the pancreas and the visceral peritoneum lining the intestine. Histologically, the right testicular parenchyma was diffusely affected and replaced by neoplastic growth, consisting of sheets of large round to polyhedral cells with conspicuous vesicular nuclei having distinctly granular chromatin and prominent nucleoli. Sheets of cells with similar features were observed also in the other affected organs. Multiple lung metastases were detected on histology. This is the first known report of seminoma with hepatic, pancreatic, pulmonary and peritoneal metastases in a Mallard duck.

We present a case of testicular dermoid cyst that was treated with transinguinal excision of the testicular cyst with preservation of the healthy testicular parenchyma. We have reviewed the literature for clinical features and therapeutic approach in benign cystic tumors in the pre-pubertal testis.

Adenomatoid tumors are benign mesothelial tumors most commonly found in the paratesticular structures, especially the epididymis. Herein, we report a case of adenomatoid tumor originating in the tunica albuginea and mimicking an intratesticular neoplasm. We review the ultrasonographic presentation and literature regarding adenomatoid tumors originating in the tunica albuginea and testicular parenchyma.

A dermoid cyst is a particular form of a cystic teratoma. In the testis, it is very rare, with only a few cases reported in world literature. A 19-year-old patient come to our attention with a 7-year history of an intratesticular cystic mass. Sonography showed a large hypoechoic solid mass. The tumour markers α-fetoprotein, β-human chorionic gondatotrophin, and lactate dehydrogenase were negative. Chest X-ray was negative. He underwent surgical exploration of the right testis and enucleation of the mass with testis preservation. At 14 month of follow-up, the patient had no complications and no recurrence of the lesion. Surgical enucleation is the treatment of choice in consideration of hormonal, psychological, and reproductive aspects. Orchiectomy should have been the treatment of choice, if the mass had substituted all testicular parenchyma and if there had been some malignant transformations.

A 28-year-old phenotypic woman with a 46, XY karyotype underwent endoscopic gonadectomy for definitive treatment of complete androgen insensitivity syndrome. Computed tomography helped to locate and identify gonadal tissue before surgery. The histologic findings were classified according to predominant cell types. Hamartomas are frequent findings in these patients. Hamartomatous nodules almost totally replaced normal testicular parenchyma in this woman.

The objective of this study was to determine the contribution of the scrotum, testes, and the testicular artery to scrotal/testicular thermoregulation in bulls at two ambient temperatures. Crossbred beef bulls, 1.5 years of age, were placed in controlled environment chambers at ambient temperatures of 15 degrees C (n = 5) or 25 degrees C (n = 6). The distal lateral aspects and entire ventral part of the scrotum was incised under caudal epidural anaesthesia (xylazine, 0.07 mg kg-1. Both testes were withdrawn from the scrotum and then replaced and maintained by clamping the scrotal incisions with towel clamps. One testis was randomly chosen to be the exposed testis and was withdrawn prior to temperature measurements. Surface and internal temperature were measured with infrared thermography and needle thermocouples, respectively. Temperature gradients (degree C; difference in temperature from top to bottom at 15 and at 25 degrees C) were: scrotal surface (with testis), 1.5 and 1.3; scrotal surface (without testis), 2.1 and 1.6; surface of exposed testis, -0.6 and 0.0; sub-tunic of exposed testis, -2.2 and -0.6; intratesticular (covered testis), 0.0 and 0.4; and intratesticular (exposed testis), -1.3 and 0.4. The scrotum markedly affects testicular temperature but the testes have limited influence on scrotal surface temperature. The bovine scrotum and testes have opposing temperature gradients that complement one another, resulting in a relatively uniform intratesticular temperature. These temperature gradients are attributed in part to the testicular artery, which goes from the top of the testis to the bottom, divides into several branches and ramifies dorsally and laterally before entering the testicular parenchyma. Intra-arterial temperatures (measured with needle thermocouples) were lower (P < 0.05) where the artery entered the testis than at both the bottom and top of the testis for both the covered (31.7, 33.4 and 34.3 degrees C) and exposed testis (29.6, 32.0 and 32.5 degrees C) at an ambient temperature of 15 degrees C. Temperature differences were similar, but less pronounced, at 25 degrees C (covered testis, 34.8, 36.3 and 36.5 degrees C; exposed testis, 32.4, 33.5, 33.9 degrees C). Results supported the hypothesis that blood within the testicular artery has a similar temperature at the top of the testis (just ventral to the testicular vascular cone) compared with the bottom, but subsequently cools before entering the testicular parenchyma.

Serial cross sections were evaluated to determine the architectural arrangement of stages among men with varied spermatogenic efficiencies. Using autopsy specimens, glutaraldehyde-perfused testes from men with low or high daily sperm production per g parenchyma were compared. Lobes of testicular parenchyma were teased from connective tissue septa, further fixed in osmium, and embedded such that the straight portions of tubules could be sectioned perpendicularly. Unstained 22 microns serial sections were sectioned optically with Nomarski optics. Paired photomicrographs of each tubular cross section were taken under a 40 x objective, and stages of the spermatogenic cycle were mapped by two observers using Clermont's criteria (Clermont, 1963). For comparison, numbers (1-6) were assigned randomly to the stages, the stages were plotted in two dimensions (length and circumference of tubule) as if the tubule were cut down its length and laid flat, and geometric centers were plotted for each stage. Geometric centers consecutive and/or non-consecutive stages appeared to form an angle down the length of the tubule. When considering helical patterns along the tubule, men with neither low nor high spermatogenic efficiency had a complete wave composed of all six consecutive stages. The helical pattern of geometric centers indicated only 2-4 consecutive stages when the actual values of stages were used or when random numbers were substituted for actual numerical value of stages. The number of consecutive stages in tubules from these men was not different from consecutiveness found when stages were assigned random numbers. Given that no complete wave was found, regardless of spermatogenic efficiency, and that the degree of consecutiveness of stages down a helical pattern in human seminiferous tubules could be generated from random numbers, the arrangement of stages in human seminiferous tubules may simply be a random occurrence.

The vascular anatomic features of the testis were studied with color Doppler ultrasound to determine the prevalence and anatomic relationships of transmediastinal arteries.Fifty testes in 26 men were prospectively examined to identify and analyze transmediastinal arteries by means of color Doppler equipment optimized for detection of slow blood flow.Transmediastinal arteries were present in 26 testes (52%). In the 24 men in whom both testes were evaluated, transmediastinal arteries were unilateral in 12 men (50%), bilateral in six men (25%), and absent in six men (25%). In four testes, transmediastinal arteries were multiple; in the rest, they were single. In most testes, they occurred in the superior half of the testis. Only three transmediastinal arteries (6%) branched within the testicular parenchyma. Seventeen transmediastinal veins were seen in 13 testes (26%). Ten of these 17 veins (59%) were paired with transmediastinal arteries; the seven others (41%) were isolated.Transmediastinal arteries occur in approximately one-half of normal testes and should be considered normal.

SUMMARY Greasy wool production, body weight, behaviour and fertility of male, fine wool Merino sheep were studied from 10 to 21 months of age to assess their suitability for wool production. The males were either castrated (wethers), or were hemi-castrated with a vasectomy and reduction (either partially or in full) of the parenchyma of the retained testicle, or the testicles pushed up into the ingulnal canal and the scrotum shortened (induced cryptorchids). There were significant differences among all groups in body weight, with increases being associated with the larger amounts of testicular tissue present. Fertility was low in the induced cryptorchids at 19 months of age. The hemi-castrates with reduced testicular parenchyma were infertile. The hemi-castrates with reduced testicular parenchyma had significantly heavier greasy fleece weights than the wethers and induced cryptorchids, which had similar fleece weights. The wether group suffered a higher prevalence of posthitis in spring and autumn than the hemi-castrate or induced cryptorchid groups. Those hemi-castrates with the largest amount of testicular parenchyma retained and the induced cryptorchids exhibited masculine behaviour patterns and had an increased incidence of fly strike to the head. The principle of hemi-castration and reduction of the testicular parenchyma is shown to be applicable in wool producing flocks with the potential to increase greasy wool production while minimising the management and marketing limitations previously associated with induced cryptorchids.

In five newborn patients with spermatic cord torsion, sonography demonstrated an enlarged and globular testis, hydrocele, and skin thickening. In four of these patients the testicular parenchyma was heterogeneous. Peripheral hypoechoic areas were seen in two of the four patients; the other two had a central hypoechoic region and a peripheral echogenic rim. The testis in the fifth patient was diffusely hyperechoic. Duplex Doppler sonography performed in two patients failed to demonstrate any signal in the spermatic cord in either the abnormal or contralateral hemiscrotum. Scintigraphic findings were positive for testicular torsion in two patients and equivocal in three patients. Surgery was performed 2-12 days after sonography and established the diagnosis of spermatic cord torsion. Pathologic examination demonstrated hemorrhagic infarction of the entire testis as well as scattered calcifications. The authors conclude that a solid globular testicular mass seen during the neonatal period is suggestive of intrauterine spermatic cord torsion.

Summary— A histological review of testicular biopsies of the contralateral testis, obtained at the time of surgical intervention for testicular torsion, was performed in 20 post-pubertal men. Contralateral histological abnormalities were found in 12 specimens. The duration of torsion correlated well with the viability of the involved testis but not with the presence of contralateral abnormalities. The high incidence of contralateral histological abnormalities and their nature suggest that they existed prior to the torsion since they would be unlikely to appear at such an early stage. We believe that some patients who suffer testicular torsion probably have congenital anomalies of both testes. These abnormalities involve testicular parenchyma as well as the suspension system.

A 40-year-old man presented with a 1-month history of a large, painless, rapidly growing right scrotal mass. Examination, ultrasonography, and intraoperative inspection did not exclude an intratesticular tumor, and a radical orchiectomy was performed. Histology was typical for adenomatoid tumor, but gross and microscopic inspection revealed bundles of tumor extending from the tunica albuginea into the testicular parenchyma. In this case the rapid growth, large size, and the inability to exclude an intratesticular origin directed suspicion toward a malignant neoplasm. In hindsight, the tumor's unique pattern of extension into the adjacent testicular parenchyma confounded the preoperative diagnosis.

Three patients with neonatal testicular torsion and infarction (two bilateral, one unilateral) are presented with a distinctive sonographic appearance. All five testes appeared inhomogeneously hypoechoic and each was surrounded by a brightly echogenic rim. Whereas surgical exploration was required in the past to establish the diagnosis of testicular infarction in the neonate, sonographic demonstration of the abnormality in the appearance of the testicular parenchyma permits nonoperative diagnosis. Because surgical salvage of the testis in the setting of neonatal extravaginal torsion is thought to be quite rare, the necessity of removing the testis is less clear when the diagnosis is established preoperatively.

Enumeration of homogenization-resistant spermatids in testicular homogenates provided a rapid and precise means of characterizing human spermatogenesis in quantitative terms. This technique was applied to simulated biopsy specimens as small as 10 mg of testicular parenchyma and yielded values for daily sperm production per gram of testicular parenchyma (DSP/gm) that were highly correlated with over-all DSP/gm values for paired testes (r = +0.86) and DSP/pair of testes (r = +0.93). In 12 autopsy cases representing a 100-fold range of sperm production rates, the average difference between DSP/gm values obtained from simulated biopsy specimens and from entire testes was not significantly different from zero (P < 0.05). The small amount of testicular parenchyma required for this determination indicated that both DSP data and routine histologic observations can be collected from the material included in a conventional testicular biopsy. Various measurements related to testicular size were positively but weakly correlated with DSP/testis (values for r ranged from +0.45 to +0.66). Hence, testicular size was a relatively poor index of sperm production in this study.

Age-related changes in daily sperm production (DSP) and testicular weights were investigated in paired testes from 89 men aged 21-50 years and 43 men aged 51-80 years. For both DSP/testis and DSP/g parenchyma, remarkably large standard deviations exceeded 50% of mean values. However, DSP/g and DSP/testis for both right and left testes were approximately 30% higher in the younger than in the older group (P less than 0.01) and were negatively correlated with age (P less than 0.01) when data from both groups were pooled. Weights of whole testes and of testicular parenchyma were similar in both age groups and were not significantly correlated with age. However, testicular tunic weights were 29% higher in the older group (P less than 0.001) and were positively correlated with age (P less than 0.001). Both testicular tunic weight and the % of total testis occupied by tunic were negatively correlated with DSP/g (P less than 0.01); these correlations were weakened by removing the effect of age. Although total testicular weight and testicular parenchymal weight did not change with age, these values were about 10% lower on the left than on the right (P less than 0.001). In addition to its increase with age, testicular tunic weight was about 8% greater for right than for left testes in all men (P less than 0.001). Although the average size of the testis varied from right to left, DSP/g was similar in paired testes (P = 0.15), and the correlation between right and left DSP/g was high (rho = +0.89, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Rats were considered to be pubertal at 50 days of age when spermatozoa were first found in the tail of the epididymis. Sperm production/g testis increased up to 75 days of age and testicular weight increased until 100 days of age. Sperm reserves in the tail of the epididymis were not maximal until 100 days of age. Therefore, Wistar rats are not sexually mature until 100 days. Sexually mature rats had testes weighing 3.7 g, produced 86 x 10(6) spermatozoa or 24 x 10(6) spermatozoa/g testicular parenchyma daily, and their paired epididymides contained 295 x 10(6) spermatozoa in the head + body and 440 x 10(6) spermatozoa in the tail.

Experiments were performed to establish the daily level of testicular production of spermatozoa, the distribution of spermatozoa within the epididymis, and the time required for transport of spermatozoa through the epididymis in 8 sexually rested rhesus monkeys (Macaca mulatta) of at least 6 years of age. The daily production of spermatozoa was similar among all animals, averaging a production rate of 23 times 10 (6) sperm/gm of testicular parenchyma per day. However, the weight of testicular parenchyma ranged from 15 to 32 gm. Per testis , the average daily spermatozoal production was found to be 547 plus or minus 69 tomes 10(6). Consequently, the normal average production of spermatozda for the rhesus monkey per day during the breeding seasson is about 1.1 times 10(9). The number of sperm in the caput, corpus, and cauda epididymis was found to be .6 plus or minus .1, 2.1 plus or minus .3, and 2.9 plus or minus .3 times 10(9), respectively. 1 plus or minus .1 times 10(9) sperm were found in the proximal 49-70 mm of the ductus deferens. The mean transport times of sperm through the caput, corpus, and cauda epididymis were approximately 1.1, 3.8, and 5.6 days, respectively. The rate of transport of sperm through the epididymis was virtually the same between 2-5.5 days, even though a 265-fold difference in epididymal reserves was found. The results indicate that sperm matures within the epididymis of this species within 5 days.

Two experiments established the relationships among total scrotal width (TSW), daily spermatozoal production (DSP), daily spermatozoal output (DSO) and extragonadal spermatozoal reserves (EGR) of dogs ejaculated daily. In Experiment 1, 11 dogs (14 to 36 kg) were ejaculated daily for two 10-day periods and in Experiment 2, seven dogs (15 to 47 kg) were ejaculated daily for two 20-day periods. Approximately six daily ejaculations were required for stabilizing DSO. After the second period of daily ejaculations, dogs were castrated or killed and the testes were weighed and DSP and EGR were determined. In Experiments 1 and 2, DSP averaged 11.7 +/- 0.5 and 16.7 +/- 1.4 X 10(6) per gram of testicular parenchyma, respectively, or 369 and 594 X 10(6) per dog. DSP per gram of testicular parenchyma was not significantly correlated with parenchymal weight for the same testis in either experiment (r = 0.04 and 0.26). Mean (+/- SEM) EGR of dogs in Experiment 1 were 4024 +/- 368 X 10(6) and 4791 +/- 767 X 10(6) in Experiment 2. Approximately 63% of the EGR were contained in the caput and corpus epididymidis, 36% in the cauda epididymidis and 1% in the ductus deferens. DSO averaged 79 and 82% of DSP for the 2 groups of dogs. Based on combined data for all 18 dogs, TSW was correlated with testicular weight (r = 0.95; P less than 0.01), DSP (r = 0.82; P less than 0.01) and DSO (r = 0.75; P less than 0.01). Thus, measurement of TSW is a useful predictor of a dog's ability to produce and ejaculate spermatozoa.

Treatment with an iron-chelating substance (α, α’-dipyridyle) provokes alterations in the seminiferous tubules and interstitial tissue of rat testicular parenchyma. The action of the drug seems to be dependent neither on the dose nor on the duration of the treatment. The effects of the drug appear in the testicular parenchyma according to a centripetal course either in the whole gonad or in the tubule. Because the alterations of the testicular parenchyma occur at the first treatments the reaction of the tissue cannot be ascribed to an intoxication effect of the drug. The interstitial cells of the testicular parenchyma show greater resistance to the action of dipyridyle than the seminal epithelial cells.

By using the immune electrophoresis method, analysis was made on Wassermann's reagin refined from the sera of syphilitic patients at different stages. Investigation was also made on changes in the time process of antibody distribution. The results obtained are summarized as follows.1) In Ig-G, Wassermann's reagin had an activity in all stages of syphilis. In Ig-M, however, an activity on syphilis was observed only in the early stage. From then on and after the third stage, all sera were inactive. It should be noted that activity was recognized also in Ig-A from the early stage, and that it was absent only in the fourth stage of syphilis.2) By inoculating the Nichols strain of Treponema pallidum into the testicular parenchyma, syphilis was established experimentally in adult rabbits. Then the VDRL test, Wassermann Ogata method, and RPCF and FTA tests were performed on these rabbits. All the tests were compared with regard to the appearance-time of reaction. As a result, the FTA test brought about positive results four days after the inoculation. The RPCF test gave rise to a positive reaction six to eight days after the inoculation. The positive reaction to the VDRL test and Ogata method occurred eight to ten days after the inoculation.3) The FTA titer was resorbed by VDRL-antigen, but it did not decrease. In conclusion, FTA and RPCF antibodies were considered to be entirely different from each other.

Patients with testicular cancer were treated by semicastratio and in some cases by retroperitoneal surgery. The diminution of testicular parenchyma to about 50% results to a low serum level of testosterone, but elevated serum level of LH and FSH. 3 years after surgery and irradiation this is not a pathological finding but appears to be a typical pattern. As it is difficult to differentiate embryonal carcinomas and choriocarcinomas from pure embryonal carcinomas an estimation of serum level of LH and FSH may be of use by the diagnosis.

Eleven cases of unilateral anorchism are presented. The patients, aged two to thirty-nine years, were explored for cryptorchism but, though ducts could be identified operatively in most cases, there was doubt regarding the presence of the testis. These tissues, including the putative testes, were excised and pathologically the excurrent ducts, consisting of vas deferens with or without epididymis, were seen in all cases. No tunica albuginea or testicular parenchyma was identified and the structures, submitted as possibly testicular, were nonencapsulated, well-circumscribed, subserosal foci of highly vascularized fibrous tissue with few small nerves and smooth muscle bundles. Dystrophic calcific deposits were seen in 2 cases and microfoci of poorly developed Leydig cells in 2 cases. A vascular hypothesis is proposed for the etiology and pathogenesis of unilateral anorchism.

Fifty-two Holstein bulls were castrated at 12, 16, 20, 24, 28 or 32 weeks to (1) determine whether testicular development is influenced by season of birth (April or October) and (2) examine quantitatively the establishment of spermatogenesis. Season of birth (spring or fall) did not influence (P less than .05) either testis weight at castration or the establishment of spermatogenesis. With age held constant, scrotal circumference and testis weight were correlated (.79; p less than .05). Testis weight increased from 9 +/- 1 g at 12 weeks to 117 +/- 10 g at 32 weeks of age. Seminiferous tubules occupied 44% of the testicular parenchyma at 12 weeks and 81% at 32 weeks. Differentiation of basal indifferent supporting cells to Sertoli cells started at 20 weeks, and formation of Sertoli cells was completed near 28 weeks. Gonocytes predominated at 12 weeks, but by 20 weeks most had been replaced by prespermatogonia and A-spermatogonia. Thus, transformation from a prepubertal testis to a pubertal testis containing Sertoli cells and A-spermatogonia occurred between 16 and 24 weeks (testis weight = 18 to 42 g). Preleptotene to diplotene spermatocytes appeared sequentially between 16 and 28 weeks and their numbers increased through 32 weeks. Significant numbers of pachytene spermatocytes and spermatids were not present before 28 and 32 weeks, respectively. Establishment of spermatogenesis was completed by 32 weeks (testis weight less than 80 g). Testes weighing less than 80 g were producing few if any sperm. Thus, the establishment of spermatogenesis was progressive, associated with more than a fourfold increase in testis weight, and occurred over a period of about 16 weeks.

A temporary pinching off of the spermatic cord was carried out in 100 male Wistar rats in order to evaluate the effect of a limited period of ischaemia on the testicular parenchyma. The animals were divided into four groups of equal number, and a certain period of ischaemia was chosen (15, 30, 45 and 60 min). The histological investigation of the testicle parenchyma was performed 2 months after the operation, the contralateral testicle serving as control. Already an ischaemia of 15 min leads to a statistically significant, irreversible damage of 53.5% of the seminiferous tubulus (p = 0.001). The degree of the damage does not increase up to an ischaemic period of 1 h. Since rat testicles have proven to be a model for the judgement of human fertility, operations on testicles which are combined with a temporary ischaemia of this organ, should be ended within a few minutes.

A papillary adenocarcinoma of the rete testis in a 67-year-old man is presented. The tumor was localized in the rete testis, showing no involvement of the adjacent testicular parenchyma or the epididymis. The tumor cells manifested a transition to the normal epithelial cells of the rete testis. The electron microscopic features of this tumor are compared with those of the normal epithelial cells of the rete testis.

It has been reported that patients with history of testicular torsion experienced diminished fertility. This study was instituted to evaluate the effect of unilateral testicular torsion on contralateral testicular histology. Mature Sprague Dawley rats were divided into 10 experimental groups, 2 of which (10 animals each) were used for experimental controls. Group 1 underwent a sham procedure consisting of a right hemi-scrotal incision. Group 2 underwent a sham operation in which the right hemi-scrotum was opened and 2 sutures were placed through the testicular parenchyma. Group 3 animals underwent right testicular torsion with fixation to the scrotal wall. Ten days later contralateral testicles were examined. Testicular torsion was demonstrated to cause contralateral testicular damage. The sham animals had no contralateral changes. The effect of therapy (detorsion vs. orchiectomy) was then studied. Group 4 animals underwent torsion followed by detorsion at 24 hours. Group 5 animals underwent torsi...