Antenatal sonographic diagnosis of testicular torsion.
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Antenatal testicular torsion is a well-established condition diagnosed and treated after birth. This report describes the antenatal diagnosis of testicular torsion with surgical and pathological confirmation. Antenatal and postnatal sonographic findings included enlarged testis and epipdidymis surrounded by hemorrhagic fluid organized in two concentric compartments ('double ring hemorrhage' image). A contralateral hydrocele with bulging of the scrotal septum towards the unaffected side were also present. Pathological examination demonstrated a recent extravaginal torsion, which is the predominant mechanism for testicular torsion in the fetus and neonate. Recognition of this phenomenon and the ultrasonographic images associated with it may enable the diagnosis of antenatal testicular torsion to be made on prenatal sonography of the fetus. (+info)
Bilateral groove sign with penoscrotal elephantiasis.
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Lymphogranuloma venereum (LGV) is a sexually transmitted disease of the lymph channels caused by Chlamydia trachomatis. Esthiomene, a rare late manifestation of LGV, is a primary infection affecting the lymphatics of scrotum, penis, or vulva. The male genitalia are affected less commonly by esthiomene, but we report a male patient who presented with inguinal syndrome, penoscrotal elephantiasis, along with enlargement of femoral lymph nodes. (+info)
Scrotal pain in the absence of torsion; need for vigilance.
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Epididymitis is a common presentation of acute testicular pain seen in the emergency department, the differential diagnosis being testicular torsion. The vast majority of young men with epididymitis have an infective aetiology and this settle with antibiotic treatment. The clinical course of a patient who presented with testicular pain is described. At ultrasonography, the patient was found to have the uncommon condition of testicular microlithiasis, a condition that has been linked to malignant disease. Emergency doctors should be aware of the potential consequences of returning scrotal pain consistent with epididymitis to the community on antibiotic treatment alone. All patients with probable epididymitis should have either a scrotal ultrasound or specialist follow up. (+info)
Genetic relationships between scrotal circumference and female reproductive traits.
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Records for yearling scrotal circumference (SC; n = 7,580), age at puberty in heifers (AP; n = 5,292), age at first calving (AFC; n = 4,835), and pregnancy, calving, or weaning status following the first breeding season (PR1, CR1, or WR1, respectively; n = 7,003) from 12 Bos taurus breeds collected at the Meat Animal Research Center (USDA) between 1978 and 1991 were used to estimate genetic parameters. Age at puberty (AP) was defined as age in days at first detected ovulatory estrus. Pregnancy (calving or weaning) status was scored as one for females conceiving (calving or weaning) given exposure during the breeding season and as zero otherwise. The final model for SC included fixed effects of age of dam at breeding (AD), year of breeding (Y), and breed (B) and age in days at measurement as a covariate. Fixed effects in models for AP and AFC were AD, Y, B, and month of birth. Fixed effects in models for PR1, CR1, and WR1 included AD, Y, and B. For all traits, random effects in the model were direct genetic, maternal genetic, maternal permanent environmental, and residual. Analyses for a three-trait animal model were carried out with SC, AP, and a third trait (the third trait was AFC, PR1, CR1, or WR1). A derivative-free restricted maximum likelihood algorithm was used to estimate the (co)variance components. Direct and maternal heritability estimates were 0.41 and 0.05 for SC; 0.16 and 0.03 for AP; 0.08 and 0.00 for AFC; 0.14 and 0.02 for PR1; 0.14 and 0.03 for CR1; and 0.12 and 0.01 for WR1. Genetic correlations between direct and maternal genetic effects within trait were -0.26, -0.63, -0.91, -0.79, -0.66, and -0.85 for SC, AP, AFC, PR1, CR1, and WR1, respectively. Direct genetic correlations between SC and AP and between those traits and AFC, PR1, CR1, and WR1 ranged from -0.15 (between SC and AP) to 0.23 (between AP and WR1). Estimates of heritability indicate that yearling SC should respond to direct selection better than AP, AFC, PR1, CR1, and WR1. Variation due to maternal genetic effects was small for all traits. No strong genetic correlations were detected between SC and female reproductive traits or between AP and the other female traits. These results suggest that genetic response in female reproductive traits through sire selection on yearling SC is not expected to be effective. (+info)
Intratunical bupivacaine and methylprednisolone instillation for scrotal pain after testicular sperm retrieval procedures.
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AIM: To investigate the effect of intratunical instillation of bupivacaine and methylprednisolone for scrotal pain, swelling and peritesticular fibrosis due to testicular sperm retrieval procedures. METHODS: A total of 65 patients were randomly divided into two groups. In the instillation group (GI), 34 patients were administered 2.5 mL of 0.5 % bupivacaine combined with 10 mg/ml methylprednisolone before closure of the tunica vaginalis. In the control group (GC), 31 patients only received analgesics postoperatively by intramuscular route. The pain (by visual analogue scale, VAS) and duration of pain-free period after surgery between the two groups were evaluated at 2 and 4 h and at days 2 and 7 postoperatively. RESULTS: The mean pain scores were significantly lower in the GI than in the GC group at 2 and 4 h after surgery (P<0.05 and P<0.01, respectively). The mean duration of pain free interval after the procedure was 47.8 +/-16.9 (12-72) h in GI, which was significantly longer than that in GC [(9.9 +/-3.6; 4-20) h]. Besides, in the GI, 29 % of patients were completely free from pain and 67 % had no scrotal swelling, but in the GC, all the patients required additional NSAID injection due to pain and only 3 % had no scrotal swelling. CONCLUSION: This study confirms that direct intratunical instillation of bupivacaine and methylprednisolone around the testis reduces the postoperative pain, scrotal swelling and peritesticular fibrosis. (+info)
Primary transcrotal excision for paratesticular rhabdomyosarcoma: is hemiscrotectomy really mandatory?
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BACKGROUND: To evaluate the role of primary reexcision (PRE) with scrotal resection in patients with paratesticular rhabdomyosarcoma enrolled in the German-Italian Cooperative Studies. The authors compared patients who underwent this procedure, according to the protocol guidelines, with those who did not. METHODS: In 32 of 198 patients with localized disease, the primary surgery was performed through a noncorrect scrotal approach. Twenty-four patients underwent PRE as recommended by the protocol guidelines (Group A) and 8 did not receive this treatment (Group B). The Group B patients were treated with the same chemotherapeutic regimens as the Group A patients and no radiotherapy was given to either group. RESULTS: After PRE, residual tumor was not detected in 21 of the 24 Group A patients. Twenty patients are alive in first complete remission 26-250 months after diagnosis (median, 40 months), 2 are alive in second complete remission at 3 and 9 months from diagnosis of lymph node and lung recurrence, and 2 died of disease after lymph node and distant metastases at 16 and 13 months from diagnosis. Three-fourths of these patients were older than 10 years old and the tumor was larger than 5 cm. The eight Group B patients are all alive in first complete remission 24-250 months since diagnosis. CONCLUSIONS: The data on the eight patients who obtained local control without PRE or radiotherapy warrant further investigation. Because of the supposed high risk of contamination with subsequent microscopic residual tumor after a transcrotal approach, we emphasize the utility of PRE with hemiscrotectomy. (+info)
Primary effusion lymphoma of the left scrotum.
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A 51-year-old man without human immunodeficiency virus, hepatitis B virus or hepatitis C virus was admitted with left scrotum swelling and hydrocele. The cytological finding of fluid in the left scrotum revealed malignant lymphoma, and the immunophenotypic analysis and monoclonal rearrangement of immunoglobulin heavy chain demonstrated B-cell lymphoma. However, no solid tumor of lymphoma was identified in the specimen following a left orchiectomy, or in any other body site and genomic human herpes virus-8 and Epstein-Barr virus were not detected in the lymphoma cells. So we interpreted this as a primary effusion lymphoma without any ethological viral infection. Subsequently, he underwent chemo-radiation therapy and has remained in remission. (+info)
MRL/lpr lupus-prone mice show exaggerated ICAM-1-dependent leucocyte adhesion and transendothelial migration in response to TNF-alpha.
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OBJECTIVE: Endothelial activation and dysfunctional leucocyte-endothelial interactions are thought to play key roles in the pathogenesis of systemic lupus erythematosus (SLE). The object of this study was to investigate directly the effect of increased endothelial adhesion molecule expression on leucocyte-endothelial cell interactions, using the MRL/lpr mouse model. METHODS: Leucocyte rolling, arrest and transendothelial migration were quantified in the cremaster muscle microcirculation of 20-week-old MRL/lpr mice, using intravital microscopy. Endothelial adhesion molecule expression was quantified using intravenously injected radiolabelled monoclonal antibodies. RESULTS: Basal expression of intercellular adhesion molecule 1 (ICAM-1) by cremaster endothelium was 2-fold greater in MRL/lpr than in MRL/++ mice (P<0.05). There was a 1.6-fold increase in expression of vascular adhesion molecule 1 (VCAM-1), but no increase in E-selectin or P-selectin expression. Following intrascrotal injection of saline, no difference was detected in leucocyte-endothelial interactions between MRL/lpr and control MRL/++ mice. In contrast, intrascrotal injection of tumour necrosis factor alpha (TNF-alpha) (2 h test period) led to significantly increased numbers of adherent and extravasated leucocytes in MRL/lpr (5.98+/-0.71 and 5.45+/-0.34 leucocytes per 100 micro m vessel segment respectively) compared with MRL/++ mice (3.63+/-0.26 and 2.97+/-0.24 respectively, each P<0.05). Treatment of TNF-alpha-stimulated mice with anti-ICAM-1 F(ab')2 (YN1) abolished the difference between MRL/lpr and MRL/++ mice, whereas a negative control anti-DNP F(ab')2 had no effect. CONCLUSIONS: MRL/lpr lupus-prone mice show exaggerated ICAM-1-dependent leucocyte-endothelial interactions in response to TNF-alpha. Increased leucocyte-endothelial interactions due to endothelial priming could contribute to the clinical link between infection and flares of lupus disease activity. (+info)