[Show abstract][Hide abstract] ABSTRACT: A rat varicocele model using partial occlusion of the left renal vein has previously been described; reproducibility in creation of this model has met with varied success. Alternate routes of testicular venous drainage may negate the effect of partial renal vein occlusion on varicocele creation. We hypothesized that varicocele induction would be more effective if microsurgical ligation of the gonadal venous drainage to the common iliac vein was combined with partial occlusion of the left renal vein.
Thirty-six rats were randomly assigned to 3 groups: sham surgery (SS), partial renal vein occlusion alone (classic technique, CT), and microsurgical ligation (ML). Half of each group was evaluated at 5 and 12 weeks. We evaluated internal gonadal vein diameter, spermatic cord diameter, testicular weight, cauda epididymal sperm concentration and motility, testicular histology using the Johnsen score, and serum and intratesticular testosterone and dihydrotestosterone levels.
Five weeks after varicocele creation, the ML group had larger spermatic cord diameter than the CT and SS animals, as well as lower Johnsen scores. After 12 weeks, the ML group had larger spermatic cord diameter, lower cauda epididymal sperm concentration, lower sperm motility, and worse histology compared to the CT and SS groups. There were no differences in serum androgen levels outcomes, but the ML group had lower intratesticular androgens levels.
The addition of microsurgical ligation of testicular vein collaterals in the pelvis to partial renal vein occlusion appears to improve the effectiveness in creation of a rat varicocele model.
The Journal of urology 08/2013; 191(2). DOI:10.1016/j.juro.2013.08.011 · 4.47 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Purpose:
In the United States more men are diagnosed with cancer than women. We quantified the differential mortality rates of nonsex specific cancers between the sexes and compared cancer stage distributions.
Materials and methods:
In this descriptive epidemiological study we obtained the incidence of new cancer cases, cancer deaths and stage distributions for the last 10 years in the United States from SEER (Surveillance, Epidemiology and End Results) program results. Sex specific cancers were excluded from study. We compared male-to-female relative mortality rate for all cancers as well as the average male-to-female relative mortality rate weighted by cancer incidence in the last 10 years. Sex specific stage distributions were also compared with the Kendall τ-c test.
The male-to-female relative mortality rate for any cancer was 1.060 (95% CI 1.055-1.065). The average male-to-female relative mortality rate for the same cancer was 1.126 (95% CI 1.086-1.168). The discrepancy in incidence and mortality rates was stable for the last 10 years. Of the top 10 most common cancers men had an unfavorable stage distribution in all except colorectal, bladder and brain cancers.
Men are more likely to have nonsex specific cancer than women and more likely to die of the cancer even after controlling for the incidence. This discrepancy has been stable for the last decade. For 7 of the 10 most commonly occurring nonsex specific cancers, representing 78% of all incident cancers, men are more likely to be diagnosed with advanced stage.
The Journal of urology 11/2012; 189(4). DOI:10.1016/j.juro.2012.11.153 · 4.47 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Although microdissection testicular sperm extraction has become first line therapy for sperm retrieval in men with nonobstructive azoospermia, there are challenges to the procedure, including difficulty differentiating between seminiferous tubules with normal and abnormal spermatogenesis. Multiphoton microscopy illuminates tissue with a near infrared laser to elicit autofluorescence, which enables real-time imaging of unprocessed tissue without labels. We hypothesized that we could accurately characterize seminiferous tubular histology in humans using multiphoton microscopy.
Seven men with normal or abnormal spermatogenesis underwent testicular biopsies, which were imaged by multiphoton microscopy. We assessed these images in blinded fashion. The diagnosis rendered with multiphoton microscopy was then correlated with that of hematoxylin and eosin stained tissue. We evaluated the ability of multiphoton microscopy to differentiate normal from abnormal seminiferous tubules by examining autofluorescence characteristics and diameters, as imaged by multiphoton microscopy. Assessment was repeated with stained slides and results were compared.
The overall concordance rate between multiphoton microscopy and stained slides was 86%. The seminiferous tubules of patients with nonobstructive azoospermia were smaller than those of controls when measured by multiphoton microscopy and staining (p <0.05). The proportion of normal tubules and the diameters obtained with multiphoton microscopy were not different from those obtained with hematoxylin and eosin (p >0.05).
Multiphoton microscopy can be used to differentiate normal from abnormal spermatogenesis. Its characterization of seminiferous tubular architecture is similar to that provided by hematoxylin and eosin staining. Further investigation of the clinical applications of multiphoton microscopy may improve surgical sperm retrieval outcomes for patients with nonobstructive azoospermia.
The Journal of urology 06/2012; 188(2):538-43. DOI:10.1016/j.juro.2012.03.124 · 4.47 Impact Factor