How to Reverse Testicular Atrophy
Bulbospinal muscular atrophy (BSMA), a slowly progressive disease of adult males, is an x-linked recessive disorder caused by trinucleotide repeat expansion. The androgen receptor (AR) gene on chromosome 22 contains trinucleotide CAG repeats that normally expand from 14 to 32 but, in BSMA, from 40 to 62. The disease presents with progressive bulbar palsy, weakness and atrophy of the limb muscles, gynecomastia, and testicular atrophy.
Growth hormone (somatrem, somatropin) and corticotrophin use may be combined with that of anabolic steroids. Chorionic gonadotrophin may be taken to stimulate testosterone production (and prevent testicular atrophy). Similarly, tamoxifen (antioestrogen) may be used to attenuate some of the effects of anabolic steroids.
As you examine him, his emesis becomes darker and malodorous. On exam, he has high-pitched increased bowel sounds and has voluntary guarding and rebound. His testicles are descended bilaterally, and his right testicle seems tender and enlarged. Auscultating it, you also hear bowel sounds. What diagnosis is most likely the cause of his pain
Our preliminary experience seems promising and suggests that allogeneic nonmyeloablative stem-cell transplantation may result in complete elimination of malignant or genetically abnormal host cells with no or minimal procedure-related toxicity and mortality 84 . For young patients, in contrast to myeloab-lative allogeneic BMT, allogeneic nonmyeloablative stem-cell transplantation may reduce the incidence of growth retardation and infertility which stems from the unique sensitivity to chemoradiotherapy of the growth centers in the bones, the gonads and testicles. For elderly individuals with a matched donor available, who were denied alloBMT until recently, nonmyeloablative stem-cell transplantation may offer an option for cure with no upper age limit. It remains to be seen whether a similar therapeutic approach can be developed for patients with matched unrelated donors and for patients with no matched donors, as well as for malignancies other than those originating in hematopoietic...
Multiple gender differences in the mean levels and functions of hormone secretions are evident during the period of pubertal development. In females, the function of LH and FSH is to initiate follicular development in the ovaries, which stimulates them to produce estrogen. Estrogen sensitive tissues, such as the breasts and uterus, then respond to the increase (Fechner, 2003). In males, increased LH stimulates the testes to secrete testosterone, resulting in an increase in testicular size, and FSH stimulates spermatogenesis. LH levels increase in both girls and boys at puberty, while FSH is higher in girls than boys during the prepubertal and pubertal years. Increased FSH levels simulate the ovaries to produce estrogen. Whereas LH and FSH levels in both sexes are regulated by the negative feedback of the gonadal steroids and by the hormone inhibin, girls have a second control mechanism associated with their menstrual cycles which is under positive feedback and is cyclic. When...
Other drugs may be used by body builders (93), including tamoxifen to reduce or prevent gynecomastia diuretics to counteract the fluid retention caused by anabolic steroids thyroxine to increase the rate of metabolism, which might theoretically increase the ability of anabolic steroids to boost physical strength (94) and P human chorionic gonadotrophin to alleviate testicular atrophy (95). Nalbuphine (Nubain) is an opioid agonist antagonist analgesic used for the treat
Testicular tumors most commonly present as a firm to hard painless mass. Occasionally, scrotal swelling and acute pain (10 ) may be present. The presence of acute pain increases the likelihood of infection, trauma, torsion, and infarction, but does not rule out tumor or tumor in addition to another diagnosis. A history of trauma is present in 30 of cases. Carcinoma in situ most commonly presents in patients being evaluated for infertility. Germ-cell tumors present more commonly in patients with a history of cryptorchidism and testicular atrophy. Patients with either condition should have both testicles carefully evaluated periodically. Carcinoma in situ occurs in 5 of testes corrected for non-descent and in 5 of the contra-lateral testes in patients with a primary testicular germ-cell tumor. In children, up to 20 of cases are associated with hernia or hydrocele. Tran-sillumination will assist with diagnosis of the hydrocele, but does not rule out the co-existence of tumor.
The male reproductive organs are the testes (or testicles). The testes are two egg-shaped organs located in a pouch called the scrotum outside the body. In the scrotum, the temperature is a few degrees cooler than body temperature. The testes develop in the abdominal cavity before birth, and then descend to the scrotum.
The effects of cancer therapy on testicular architecture vary with the patient's age and pubertal status. It was initially thought that the testicles of pre- and peri-pubertal males were less vulnerable to toxic effects induced by treatment. However, it is now clear that these patients experience as much testicular structure damage following chemo radiotherapy as adults.13
It is clear that the use of anabolic steroids produces adverse effects on the liver and reproductive and cardiovascular systems. Effects on the liver include peliosis hepatitis (blood-filled cysts), impaired excretory function (jaundice), and liver tumors ACSM, 1984 . Cardiovascular effects include an increase in blood pressure, abnormal alterations in cardiac tissue, and abnormal lipoprotein-lipid profiles Hurley et al., 1984b . Males can experience a significant reduction in sperm production, testicular size, and testosterone and gonadotrophin production, and females often experience a deepening of voice, male pattern baldness, enlargement of the clitoris, a reduction in breast size, a disruption in their menstrual cycle, and an increase in facial hair. Most of these effects are irreversible even after the drugs are discontinued. There are also many psychological effects including an increase in aggressive behavior, an increase in anger and hostility, large deviations in mood, and...
Testosterone levels decline with aging and may affect both libido and sexual function. Erection becomes more dependent on tactile stimulation and less responsive to erotic cues. Pubic hair may decrease and become gray. The penis decreases in size and the testicles drop lower in the scrotum. Although the testes often decrease in size with protracted illnesses, they do not necessarily change size with aging per se.
While the drug is being taken, there is a significant reduction in testosterone production by the testes so that sperm output and quality are decreased, and a return to normal can take many months after drug use is stopped. The effect on sex drive is variable, but overall it seems that the sex drive increases at the beginning of a steroid-using cycle, and then decreases to below normal after several weeks of use. Drive may remain below normal levels even after the drug is stopped, until such time as the testes start producing testosterone again. There may also be a reduction in size of the testicles (87).
Sexual function has been studied extensively in survivors. During treatment and soon thereafter, approximately one-third of survivors report sexual dysfunction and or dissatisfaction with level of sexual activity. However, this effect does not seem to be permanent in the majority of cases and studies indicate the level of dysfunction returns to baseline by 3 years after completion of therapy. The sexual dysfunction of some patients at the time of diagnosis, due to testicular atrophy and to the presence of disease, must be taken into account. The complications of RPLND and ejaculation have been well documented and have decreased with improved surgical techniques.
Germ cell tumors can be either benign or malignant. Benign tumors include benign germ cell tumors and benign teratoma or dermoid cyst. The malignant germ cell tumors are much rarer than benign ones. The malignant germ cell tumors may be seminomanous or nonseminomanous. Patients with seminomanous malignant germ cell tumors must undergo ultrasound of the testicles even if physical examination is negative since there may be a nonpalpable focus of tumor still there with the mediastinal component being a metastasis rather than a primary tumor. Seminomanous tumors have low levels of beta HCG and alpha-fetopro-tein unlike its nonseminomanous germ cell counterpart.
SYMPTOMS Some symptoms of leukemia are fever, chills, and other flulike symptoms weakness and fatigue frequent infections loss of appetite and or weight swollen or tender lymph nodes, liver, or spleen easy bleeding or bruising tiny red spots under the skin swollen or bleeding gums sweating, especially at night and or bone or joint pain. Leukemia metastasizing to the brain may cause headaches, vomiting, confusion, loss of muscle control, and seizures. Leukemia cells can also colonize the testicles, where they cause pain and swelling the skin and eyes, where they produce sores and many other organs and tissues of the body.
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