OBJECTIVE: To analyze the clinical characteristics, surgical management decisions, and outcomes of Neonatal testicular torsion (NTT) in order to offer guidance for future clinical practice.
METHODS: Retrospectively analyzed the clinical data of patients with NTT who were admitted and underwent surgery from January 2008 to October 2023.
RESULTS: A total of 24 neonates were enrolled in this study, all of whom were unilateral cases. Age of onset was 0 d (IQR: 0-1.8), while the median duration of symptoms was 73 h (IQR: 26-199). Clinical manifestation included enlarged scrotum (75 %), changes in scrotal color (79 %), and crying upon palpation (17 %). All patients underwent urgent bilateral exploration and performed by orchiectomy and contralateral orchiopexy.
CONCLUSIONS: NTT primarily occurs prenatally with insidious manifestations, often leading to omission or misdiagnosis. The testicular salvage rate is extremely low. Physicians need to attach importance to neonatal testicular examination, improve the vigilance of NTT. Early bilateral exploration does not necessarily save the affected testes, but it is more important to prevent damage to the contralateral one.

It is highly uncommon for solid tumours to metastasise to the testis. Here, we report a case of metachronous testicular metastasis from clear cell renal cell cancer (RCC) in a male patient 3 years after left radical nephrectomy. Ultrasound of the scrotum showed a 3.5 cm × 4 cm left testicular mass with normal serum tumour markers. The patient underwent left high inguinal orchidectomy, which revealed metastatic renal cell carcinoma. CT of the chest, abdomen and pelvis showed multiple liver secondaries. Cabozantinib was started for metastatic RCC, and the patient showed no evidence of disease progression in a follow-up of 1 year.

Behavioral pain scales have been helpful for standardized swine pain assessment. However, it is still unknown if observers\' experience influences the scale score. We conducted a pilot study to investigate how three different levels of swine experience influenced how observers scored castration pain in piglets using Unesp-Botucatu Pig Composite Acute Pain Scale (UPAPS). We used a database from UPAPS scores from pigs undergoing surgical castration in a previous study. Scores were attributed by six observers with Little to no experience (n = 2), Some experience (n = 2) and Extensive experience (n = 2). Reliability was estimated using the intraclass correlation coefficient, agreement was investigated by Bland-Altman analysis, predictive capacity was estimated using the area under the curve (AUC), and statistical differences were tested using a regression model. We found that intra-experience levels reliability were satisfactory (Little to no: 0.72, Some: 0.81, Extensive: 0.84), but inter-experience reliability was lower (0.42). Little to no experience observers had poor agreement with other observers, with a bias toward underscoring UPAPS (bias of 0.94 vs. Some, 1.17 vs. Extensive). Predictive capacity was similar between all observers (AUC, Little to no: 71.94%, Some: 76.10%, Extensive: 79.09%, p > 0.05). Regression model confirmed underscoring of Little to no experience observers (mean ± standard error; Little to no: 1.09 ± 0.14; Some: 2.02 ± 0.23; Extensive: 2.25 ± 0.22; p < 0.05). We concluded that minimal experience, as Some experience observers have in the swine industry, is sufficient for them to score UPAPS in a similar way than more experienced observers. The present pilot study supports the enhancement and implementation of UPAPS on farm and laboratory settings by minimally qualified observers, improving swine welfare in the short and long term.

Acute scrotum in a child is common, and the main underlying conditions are torsion of intrascrotal appendages, epididymitis, testicular torsion and idiopathic scrotal edema. The main diagnostic aim is to confirm or rule out testicular torsion, since this may lead to irreversible ischemia within hours. The diagnostics can be difficult, especially in prepubertal boys, but consist of a thorough history and clinical examination, the use of a clinical prediction score, and sometimes ultrasound with doppler. However, none of these tools can with completely accuracy rule out a testicular torsion, and uncertainty should prompt an acute scrotal exploration. The treatment of a testicular torsion is detorsion and bilateral orchidopexy, or unilateral orchidectomy in case of a completely necrotic testicle. Treatment of the other underlying conditions is often only symptomatic, and follow-up is often not required.

Low or insufficient testosterone levels caused by caponization promote fat deposition in animals. However, the molecular mechanism of fat deposition in caponized animals remains unclear. This study aimed to investigate the metabolomics and transcriptomic profiles of adipose tissues and study the effect of testosterone and leptin on the proliferation of adipocytes. We observed a significant enlargement in the areas of adipocytes in the abdominal fat tissues in capon, as well as increased luciferase activity of the serum leptin and a sharp decrease in the serum testosterone in caponized gander. Metabolomics and transcriptomic results revealed differentially expressed genes and differentially expressed metabolites with enhanced PARR signal pathway. The mRNA levels of peroxisome proliferators-activated receptor γ, fatty acid synthase, and suppressor of cytokine signaling 3 in goose primary pre-adipocytes were significantly upregulated with high leptin treatment and decreased significantly with increasing testosterone dose. Hence, reduced testosterone and increased leptin levels after caponization possibly promoted adipocytes proliferation and abdominal fat deposition by altering the expression of PPAR pathway related genes in caponized ganders. This study provides a new direction for the mechanism through which testosterone regulates the biological function of leptin and fat deposition in male animals.

BACKGROUND: Testicular ischemia requires timely diagnosis and definitive management to avoid serious consequences such as orchiectomy. It is almost always caused by testicular torsion; however, there are other causes to be aware of.
METHODS: A 32-year-old man developed testicular ischemia following a laparoscopic robotic-assisted inguinal hernia repair with preperitoneal mesh. The ischemia progressed to a fully infarcted testicle with no evidence of torsion on subsequent surgical exploration. He ultimately did require an orchiectomy. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: While extremely rare, testicular ischemia or infarct must be considered in patients presenting with testicular pain shortly after inguinal hernia repair. Emergent surgical evaluation and loosening of the hernia mesh may be required to salvage the testicle.

OBJECTIVE: Vitamin D supplementation in aging subjects manifests a positive effect on various health-related parameters. We performed a functionally-histological analysis of the adrenal cortex regarding the factors of vitamin D activity and corticosterone output after vitamin D3 application in a rat model of the andropause.
METHODS: Middle-aged Wistar rats were divided into sham operated (SO; n=8), orchidectomized (Orx; n=8) and vitamin D3-treated orchidectomized (Orx+vit. D; n=8) groups. Vitamin D3 (5 μg/kg b.m.) was administered subcutaneously for three weeks, while the SO and Orx groups received the vehicle alone. Set objectives were achieved using histochemistry/immunohistochemistry, stereology, ultrastructural and biochemical analyses.
RESULTS: Orchidectomy (Orx) decreased the adrenal cortex-related volume densities of vascular (p<0,0001), vitamin D receptor (VDR; p<0,0166), cytochrome P450 oxidase 2R1 (CYP 2R1; p<0,0001) and cytochrome P450 oxidase 24 (CYP 24; p<0,0001) depots, but increased the volume density of cytochrome P450 27B1 (CYP 27B1; p<0,0001) depots. In Orx+vit. D rats, increase of the adrenal cortex-related volume densities of collagen (p<0,0001), VDR (p<0,0001) and CYP 2R1 (p<0,0001) depots as well as the lipid-droplet diameter (p<0,0001) in adrenocortical outer zona fasciculata cells was observed, while a decrease of volume densities of the vascular (p<0,0001), CYP 27B1 (p<0,0001) and CYP 24 (p<0,0001) depots was registered, all versus Orx group. Plasma level of ACTH was decreased (p=0,0155) and serum concentrations of 25-hydroxyvitamin D3 and corticosterone were increased (p<0,0001 and p=0,0187, respectively), all after the same treatment.
CONCLUSIONS: Increased corticosterone output after vitamin D3 application to andropausal rats appears not to be related to increased availability of 25-hydroxyvitamin D3 and decreased degradation of 1,25-dihydroxyvitamin D3 in adrenal tissue, but rather involves the central regulatory mechanisms.

Spermatic cord malignancies are a scarce modality and liposarcoma of spermatic cord is even a rarer condition encountered. Liposarcoma is usually a slowly progressive, non-tender, well circumscribed mass of variable shapes owing to conformity to fascial compartments. We are reporting a case of 65-year-old male, with a two-month history of initially tender and later non-tender mass in the scrotum, above the testis. Ultrasonography showed a right mid inguinal mass measuring 6x3x3 cm at the superior pole of the right testis and small fluid around the right testis. Fine needle aspiration cytology (FNAC) of the right inguinal mass revealed a spindle cell neoplasm. The patient underwent right inguinal radical orchiectomy with local wide excision of the sarcoma of the spermatic cord origin. Final histopathology confirmed dedifferentiated liposarcoma. No adjuvant treatment was offered and the patient was put on surveillance. Follow-up of more than 10 months has not revealed any local recurrence, regional or non-regional lymph nodes, or systemic metastasis.

The present study describes the morphological and immunohistochemical characteristics of a case of diffuse seminoma in a 16-year-old male mixed-breed horse. According to the owner, the animal\'s left testicle had been gradually increasing in size over a period of 2 months. On palpation, the testicle had a firm consistency, with no sensitivity to digital pressure, was adhered to the scrotum and measuring 16 cm × 8 cm. In the ultrasound examination, it presented a heterogeneous texture and areas of hypoechogenic echogenicity without visualization of the mediastinum. Therefore, the bilateral orchiectomy was performed. After the surgical procedure, it was found that the affected testicle presented a firm mass measuring 9 cm × 7 cm × 3.5 cm. Histologically, a multilobulated, non-encapsulated and invasive tumour mass was found, which replaced the seminiferous tubules, consisting of polygonal cells arranged in a mantle that varied from cohesive to loosely cohesive, supported by a scarce fibrous stroma. In the immunohistochemical examination, the neoplastic cells showed positive immunolabelling for OCT4 and C-KIT. In this report, the physical examination combined with the ultrasonographic examination were fundamental to the therapeutic management of the case, and the final diagnosis was made after histopathological and immunohistochemical tests.

OBJECTIVE: Microglial cells are integral to the pathogenesis of Alzheimer\'s disease (AD). The observed sex disparity in AD prevalence, with a notable predominance in women, implies a potential influence of sex hormones, such as androgens, on disease mechanisms. Despite this, the specific effects of androgens on microglia remain unclear. This study is designed to delineate the interplay between androgens and the survival and inflammatory profile of microglial cells, as well as to explore their contribution to the progression of AD.
RESULTS: To create a chronic androgen deficiency model, 3-month-old wild-type (WT) mice and APP/PS1 mice underwent bilateral orchiectomy (ORX), with age-matched sham-operated controls. Cognitive and memory were evaluated at 5 and 12 months, paralleled by assessments of amyloid-beta (Aβ) and microglial morphology in hippocampal and cortical areas. The ORX treatment in mice resulted in diminished microglial populations and morphological alterations, alongside an increase in Aβ plaques and a concomitant decline in cognitive performance that exacerbated over time. In vitro, dihydrotestosterone (DHT) was found to stimulate microglial proliferation and ameliorate Aβ1-42-induced apoptosis.
CONCLUSIONS: These findings suggested that androgens may exert a protective role, maintaining the normal proliferation and functionality of microglial cells. This preservation could potentially slow the progression of AD. As a result, our study provided a conceptual framework for the development of novel therapeutic strategies for AD.