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Microsurgery Techniques in Andrology *
Published in Waldemar L. Olszewski, CRC Handbook of Microsurgery, 2019
To visualize the scale range of the subject under discussion let us be reminded that the diameter of the main vessel, the internal spermatic artery, is 0.5 mm;3 the internal lumen of the vas deferens is also 0.5 mm but in its epididymal region it may be as small as 0.2 mm. Therefore, the interest is focused essentially upon the vascular system of the testis and on the seminal tract of the male reproductive system. One has to emphasize, however, that the surgeon must approach vascular surgery in a manner quite different from the surgery of the seminal tract. One of the reasons for this is the different thickness of vessel walls; on the other hand, fluids which pass through these vessels have different physiological properties. As regards the blood vessels, the surgeon is aided greatly by the coagulative properties of blood. As far as the seminal tract is concerned (nonvascular surgery), in semen there is no such support of the tightening factor. The risk of leakage of the seminal fluid is even increased by the fact that the process of ejaculation is extremely dynamic, semen is being transported through the vas deferens under a relatively high pressure exerted in pulses. Another relevant point is that the receptor set present on the sperm membrane is recognized as allogenic by the patient’s immunological system. A frequent consequence of this leakage is sperm granuloma. Therefore, the secret of success in this respect is preservation of patency of the seminal tract without the slightest leakage of sperm.
Reproductive System and Mammary Gland
Published in Pritam S. Sahota, James A. Popp, Jerry F. Hardisty, Chirukandath Gopinath, Page R. Bouchard, Toxicologic Pathology, 2018
Justin D. Vidal, Charles E. Wood, Karyn Colman, Katharine M. Whitney, Dianne M. Creasy
Sperm granulomas can occur as an incidental background lesion or as a drug or chemical exposure. Ligation or obstruction of the vas deferens will result in almost 100% incidence of sperm granulomas in the epididymis (Flickinger and Howard 2002). In most cases, induced sperm granulomas appear to be region-specific. 2-methyl imidazole-induced sperm granulomas occurred in the proximal caput and efferent ducts (Tani et al. 2005), while methyl chloride produced them in the cauda (Chapin et al. 1984). With guanethidine, sperm granulomas occurred at the junction of the cauda epididymis and vas deferens and are thought to be due to inhibition of adrenergic receptors in the smooth muscle of the vas deferens (Evans et al. 1977). High doses of L-cysteine produced sperm granulomas mostly in the corpus and cauda (Sawamoto et al. 2003). In most cases, the mechanism is unknown, but often initial formation of the sperm granuloma appears to be due to damage to the epididymal epithelium resulting in rupture of the ductal lining and leakage of sperm into the interstitium.
Urology
Published in Janesh K Gupta, Core Clinical Cases in Surgery and Surgical Specialties, 2014
A3: What additional features would you seek to support a particular diagnosis? History of an undescended testis is an important risk factor.Sperm granulomas with a painful lump in the cord may be present after a vasectomy.Hydrocoele is a globular swelling in the scrotum that is not painful.A cough impulse is commonly present with a hernia.Metastatic disease from testicular cancer may present with shortness of breath, back pain and nipple tenderness.
Vasectomy reversal: a review on outcomes using a loupe-assisted vasovasostomy approach
Published in The Aging Male, 2020
Manoj Ravindraanandan, Chea Tze Ong, Mohammed Elhadi, Wasim Mahmalji, Mehmood Akhtar
Under a general anaesthetic, patients were positioned in the supine position. The operating field is prepared by using chlorhexidine wash, followed by sterile draping of the surrounding fields. A midline raphe incision is made, allowing access to both sides of the scrotum. The layers of the scrotum are subsequently dissected until the testis is delivered outside. The epididymis is examined and any sperm granuloma is dissected away. Loupes magnified by seven-fold were then used throughout the remaining procedure. The proximal and distal ends of the vas deferens are isolated and any scar tissue is resected away. Intravasal fluid from the vas is then expressed and the patency of the vas is checked with a 24G cannula catheterised into the lumen of the proximal and distal ends, with 3 ml of saline injected into each.
Immune response induced in rodents by anti-CoVid19 plasmid DNA vaccine via pyro-drive jet injector inoculation
Published in Immunological Medicine, 2022
Tomoyuki Nishikawa, Chin Yang Chang, Jiayu A. Tai, Hiroki Hayashi, Jiao Sun, Shiho Torii, Chikako Ono, Yoshiharu Matsuura, Ryoko Ide, Junichi Mineno, Miwa Sasai, Masahiro Yamamoto, Hironori Nakagami, Kunihiko Yamashita
In the safety test, no animals died at the time of necropsy, and there were no significant variations in the body weight, food consumption, urinalysis, organ weight, or hematology between the PBS- and pVAX1-SARS-CoV2-co-injected groups. As demonstrated in Table 5, the blood biochemistry revealed significantly lower levels of triglycerides and β-globulin in the 400 µg group than in the PBS group. However, the historical data suggests these changes were within normal variation patterns among animals. These results suggest a pVAX1-SARS-CoV2-co injection at all doses tested did not cause systemic toxicity in rats. Scab formulation was observed in the injected region, and the duration between injection and scab formation decreased with each vaccination. In addition, the duration of scab in the high-dose group was shorter than the low-dose group (Table 5). These results suggest that scab formation is related to the immune response caused by the pVAX1-SARS-CoV2-co injection. However, all scabs disappeared within 14 d of injection. However, in the high dose group, slight to mild hyperplasia of the follicular or plasma cells was observed in the inguinal lymph nodes of five of the six animals and the axillary lymph nodes of one in six animals. Conversely, slight to mild hyperplasia occurred in the inguinal lymph nodes of one in six animals in the low-dose group (Table 6). The immune response in the high-dose group was stronger than in the low-dose group. Thus, hyperplasia is thought to be an immune response against antigen invasion, which is non-toxic. Sperm reduction in the epididymis, interstitial inflammation of the prostate, and sperm granuloma were observed in all groups, including the PBS-injected group. These observations did not indicate any signs of toxicity.