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The Journey of the Porcine Spermatozoa from Its Origin to the Fertilization Site: The Road In Vivo vs. In Vitro
Published in Juan Carlos Gardón, Katy Satué, Biotechnologies Applied to Animal Reproduction, 2020
Cristina Soriano-Úbeda, Francisco Alberto García-Vázquez, Carmen Matás
The spermatozoa originate in the germinal epithelium of the seminiferous tubules of the testis during spermatogenesis in which the male produces spermatozoa from spermatogonial stem cells by consecutive mitotic and meiotic divisions. The immature spermatozoa leave the rete testis by passing through the efferent ducts, they enter a unique tubule, the epididymis, in which the final stages of spermatozoa differentiation occur (Joseph et al., 2009).
The Infertile Male
Published in Arianna D'Angelo, Nazar N. Amso, Ultrasound in Assisted Reproduction and Early Pregnancy, 2020
Thoraya Ammar, C. Jason Wilkins, Dean C.Y. Huang, Paul S. Sidhu
On ultrasound examination of the normal testis, the testis has a homogeneous echotexture with the head of the epididymis related to the upper pole of the testis measuring 5–12 mm and the body of the epididymis running along the posterior aspect of the testis measuring 2–4 mm in depth. The epididymis is slightly hyperechoic in relation to the testis. The rete testis when seen runs in the mediastinum testis and is hypoechoic compared to the rest of the testis.
Testicular cancer
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
The TNM system is used for staging (Table 18.1; Figure 18.12) of testicular cancer (9–12). There is a slight difference between the American Joint Committee on Cancer (AJCC) eighth TNM version (11) and the Union Internationale Contre le Cancer (UICC) 8th edition (12), and the AJCC version has addressed some of the issues with the seventh TNM version. For seminoma, T1 has been subdivided into pT1a and 1b for tumours less than 3 cm versus tumours 3 cm or greater, respectively. Soft tissue and epididymal invasion have been redefined as pT2. Rete testis invasion remains as T1 disease. The UICC has not adopted these changes, and this may lead to some confusion in prospective staging. At present, the AJCC provides a better staging method and has been endorsed by the International Society of Urological Pathology (13).
Balancing efficacy with long-term side-effects: can we safely de-escalate therapy for germ cell tumors?
Published in Expert Review of Anticancer Therapy, 2023
Patients with stage 1 disease now form most cases. The risk factors for recurrence of testicular cancer (including lymphovascular invasion, size, and involvement of the rete testis) as well as the relative benefits of chemotherapy are well established. Efforts to de-escalate treatment while preserving efficacy have been successful in this disease setting. One cycle of BEP is considered the standard adjuvant chemotherapy in high-risk stage I non-seminoma, following a series of randomized clinical trials, the most recent being the 111 study [8]. One course of carboplatin AUC7 is considered standard adjuvant chemotherapy in stage I seminoma [9]. In patients at low risk of recurrence, chemotherapy can still be offered, but patient autonomy must be taken into account following the provision of thorough information regarding the relative benefits and disadvantages of alternative management strategies. We focus predominantly on patients with metastatic germ cell tumors by virtue of cumulative toxicity. Any discussion focused on Stage 1 disease will be explicitly highlighted.
Genetic Analysis Reveals Complete Androgen Insensitivity Syndrome in Female Children Surgically Treated for Inguinal Hernia
Published in Journal of Investigative Surgery, 2021
Nurin A. Listyasari, Gorjana Robevska, Ardy Santosa, Aurore Bouty, AZ Juniarto, Jocelyn van den Bergen, Katie L. Ayers, Andrew H. Sinclair, Sultana MH Faradz
A 29-year-old married female (F3.III:8) was referred to our hospital with primary amenorrhea. There was a history of prior medical consultation with no clear diagnosis. She had a history of inguinal hernia repair in childhood, but without pathology analysis and no further evaluation. A swelling was palpated during the procedure, presumed to be a bowel structure, and placed back into the abdomen through the inguinal canal that was then closed. Subsequently, the patient sought medical consultation again when she reached pubertal age because of primary amenorrhea. Ultrasound revealed the absence of female internal organs and an unidentified ovary-like structure. When she was 28-year old, she was admitted to the emergency department complaining of abdominal pain in the right region which came on suddenly during morning physical exercise. The clinician diagnosed her with right cyst torsion. Subsequently, emergency surgery had been performed and the specimen which was suspected of being the cyst torsion structure was taken for histology. Pathology examination identified a rete testis structure.
Current pharmacotherapy for testicular germ cell cancer
Published in Expert Opinion on Pharmacotherapy, 2019
Winfried Alsdorf, Christoph Seidel, Carsten Bokemeyer, Christoph Oing
Proposed risk factors for relapse are tumor size as a continuous variable and invasion of the rete testis. In a large Danish retrospective study, tumor size as a continuous variable was the strongest predictor of relapse, questioning the former established cut-off of 4 cm to identify patients at higher risk of relapse. The same study also identified epididymal invasion and vascular invasion as predictors of recurrence with either of the factors being significant when the other one was excluded from a multivariate model [18]. Vascular invasion, therefore, needs independent evaluation before being considered for clinical decision-making. A current meta-analysis further questioned the routine clinical use of these proposed risk factors [20] as they have not been validated prospectively [21]. If both established risk factors (tumor size <4 cm, no rete testis invasion) were absent, only about 5% of patients relapsed [22,23]. Current treatment guidelines recommend active surveillance (AS) as the standard of care after orchiectomy for all stage I seminoma patients.