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H Chemes

Publications and source records attributed to H Chemes.

At least 19 recordsLinked to original sources
PubMed2001

Intermittent hyperaldosteronism in a child due to an adrenal adenoma.

UNLABELLED: Aldosterone producing adenoma (APA) is a rare but potentially curable form of paediatric hypertension. We report a case of APA in a 9-year-old boy, suspected due to persistent hypokalaemia. Neither BP nor initial laboratory investigations disclosed the diagnosis and the presence of an APA was suggested by functional tests and radiological findings. Histologically, a cortical tumour was found associated with a marked medullary hyperplasia of both chromaffin and ganglion cells. CONCLUSION: This case reinforces the need for further investigations in patients with misleading clinical and laboratory data.

Adenoma↗
PubMed2001

Sertoli cell proliferations of the infantile testis: an intratubular form of Sertoli cell tumor?

We report on six boys with intratubular Sertoli cell proliferations (ISCPs), studied by routine histologic methods, electron microscopy, and immunohistochemistry of anti-müllerian hormone (AMH), inhibin alpha-subunit, 3beta-hydroxysteroid dehydrogenase (3beta-HSD), proliferative cellular nuclear antigen, and p53, and carefully followed for extended periods with periodic clinical examinations, testicular ultrasonographies, and determinations of serum levels of AMH and inhibin B. Peutz-Jeghers syndrome was found in four of six patients, and gynecomastia occurred in five of six patients. One boy had isosexual pseudoprecocity. ISCPs were observed as multiple foci of seminiferous tubules with large and proliferated Sertoli cells replacing germ cells and limited by the basement membrane. Mitotic figures, atypia, and/or interstitial invasion were not observed. Bilateral ISCPs were the only pathologic finding in three patients (patient nos. 1-3) and were associated with a microscopic tumor that resembled a large-cell calcifying Sertoli cell tumor (LCCSCT) in a fourth patient (patient no. 4). In the two remaining patients (patient nos. 5 and 6) ISCPs and LCCSCT were found in both testes. Ultrastructural examination showed large Sertoli cells, with round nuclei, sparse organelles, and some glycogen. Inhibin alpha-subunit immunolocalization was positive in the five patients in whom it was determined (patient nos. 2-6), AMH was positive in those ISCPs associated with tumors (patient nos. 4-6) and negative in isolated ISCPs (patient nos. 2 and 3); 3beta-HSD and PCNA were variable, and p53 was negative in all ISCPs. Patient nos. 1-4 have been followed for 2-19 years. One of them is currently entering puberty, the other two have already completed puberty and have testes of normal size, and the remaining one is an adult with clinically normal testes and sperm production. None of these patients had evidence of tumor development during follow-up as shown by serial ultrasonographies and serum levels of AMH and inhibin B. Patient nos. 5 and 6 who had bilateral ISCPs and LCCSCT were orchidectomized and evolved for 2-10 years after surgery without tumor recurrence. The prognostic significance of ISCPs, particularly when they are the only pathologic finding in a testicular biopsy, is a matter of controversy. Based on the long normal evolution, we recommend a conservative approach to therapy. The bilateral and multicentric character of ISCPs and their association with Sertoli tumors and Peutz-Jeghers syndrome suggest that they represent either proliferative lesions with tumorigenic potential or the intraepithelial stage in the evolution of some testicular Sertoli cell tumors.

3-Hydroxysteroid Dehydrogenases↗
PubMed2000

Endometrial dating and determination of the window of implantation in healthy fertile women.

OBJECTIVE: To reassess endometrial morphological criteria of normality identifying the best morphological and molecular "implantation window" indicators in normal women. DESIGN: Prospective clinical study. SETTING: Assisted reproductive unit. PATIENT(S): Fourteen healthy volunteers. INTERVENTION(S): Blood sampling for LH, E(2), and progesterone (P4) determinations. Daily vaginal ultrasounds. Two endometrial biopsies per volunteer, 7 days apart, during luteal phase. MAIN OUTCOME MEASURE(S): Endometrial dating, pinopodes formation, immunohistochemical determination of integrins (alphavbeta3, alpha4beta1), leukemia inhibitory factor (LIF), interleukin-1 receptor type I (IL-1R tI), mouse ascites Golgi (MAG), the transmembrane mucin (MUC-1), and P4 receptor expression. RESULT(S): In 26 of 28 biopsies observers agreed; in two biopsies there was a discrepancy (difference of 72 hours). With use of LH peak, 24 of 26 samples were in phase, and 2 were 3 days behind. Pinopodes appeared on days 20-21 and persisted through day 28 in small groups or larger areas. beta3 Integrin was highly expressed in luminal and glandular epithelium from day 22 through 28; 48 hours thereafter pinopodes appeared. alpha4 Subunit exhibited luminal epithelium reaction positivity on days 22-23 and glands on days 18-23. LIF and IL-1R tI showed weak, erratic expression. MAG antibodies showed luminal epithelium expression up to day 22 and glands up to day 25. MUC-1 showed positivity during the whole luteal phase. P4 receptors were positive through day 20 and at the end of the luteal phase. CONCLUSION(S): The three most cited markers that frame the window of implantation do not correlate in our material. Pinopodes are present from day 20 on; beta3 and alpha4 integrin subunits indicate a window opening on days 22-23.

Adult↗
PubMed2000

Anti-Müllerian hormone is a specific marker of sertoli- and granulosa-cell origin in gonadal tumors.

Sex cord stromal tumors are gonadal neoplasms containing Sertoli, granulosa, Leydig, or thecal cells, which originate from cells derived from either the sex cords (Sertoli and granulosa cell tumors) or the specific mesenchymal stroma (Leydig and thecal cell tumors) of the embryonic gonad. Only granulosa and Sertoli cells produce anti-Müllerian hormone (AMH). Our purpose was to investigate whether AMH can be used as a specific marker of human granulosa or Sertoli cell origin in gonadal tumors, to distinguish them from other primary or metastatic neoplasms, using immunohistochemistry. We studied 7 juvenile and 6 adult-type granulosa cell tumors of ovarian localization and 3 extraovarian metastases, 20 other ovarian tumors, 6 testicular Sertoli cell tumors, 2 gonadoblastomas, and 13 extragonadal tumors. Granulosa cell tumors, both juvenile- and adult-type of either ovarian or metastatic localization, showed an heterogeneous pattern of AMH immunoreactivity: Areas containing intensely or weakly AMH-positive cells were intermingled with AMH-negative areas. Although in most cases AMH-positive areas represented a minor proportion of tumor cells, we found a positive reaction in all the cases examined. In testes, although normal prepubertal Sertoli cells were intensely positive, testicular Sertoli cell tumors showed large areas of negative reaction, with few positive cells scattered throughout the tumor. AMH was also reactive in most of the cells of sex-cord origin in gonadoblastomas. No AMH immunoreaction was observed in other gonadal and extragonadal tumors. We conclude that AMH expression is conserved in only a small proportion of tumor cells of granulosa or Sertoli cell origin; however, a positive reaction in a few cells helps to distinguish between granulosa or Sertoli cell tumors or gonadoblastomas and other gonadal tumors of different origin.

Adrenal Cortex Neoplasms↗
PubMed2000

Serum inhibin B concentration in a prepubertal boy with gynecomastia and Peutz-Jeghers syndrome.

Gynecomastia in boys with Peutz-Jeghers syndrome and Sertoli cell tumors of gonadal origin results from increased estrogen production due to increased aromatase activity within the testicular tumor. We present a prepubertal boy with Peutz-Jeghers syndrome, gynecomastia and bilateral neoplastic Sertoli cell proliferation in whom the only abnormal hormonal profile was increased concentration of inhibin B and Pro-alpha C in serum.

Biopsy↗
PubMed1998

Regulation of follicular luteinization by a gonadotropin-releasing hormone agonist: relationship between steroidogenesis and apoptosis.

The purpose of this study was to evaluate the effects of GnRH-analog (Leuprolide acetate, LA) administration on follicular luteinization in equine chorionic gonadotropin plus human chorionic gonadotropin (eCG + hCG)-superovulated prepubertal treated rats. Results indicate that LA treatment decreases circulating levels of progesterone (P) and P accumulation in collagenase-dispersed ovarian cell cultures, though estradiol (E2) production is increased. These data suggest that cells from the LA group may be less luteinized following gonadotropin treatment. Studies performed on histological ovarian sections after different times of eCG administration showed that LA injections produce lower amounts of corpora lutea and antral follicles, and a greater number of atretic and preantral follicles. The basal and LH-stimulated P and progestagen accumulations are decreased in incubations of corpora lutea isolated from the LA group. In addition, the mitochondrial cholesterol side-chain cleavage (P450SCC) levels in corpora lutea from LA-treated rats are reduced, indicating that the decrease in P production observed is due in part to an alteration in the steroidogenic luteal capability. Immunocytochemical localization of nuclei exhibiting DNA fragmentation by the technique of terminal deoxynucleotidyl transferase end-labeling showed that LA treatment causes an increase in the number of apoptotic cells in preantral and antral follicles at all times studied (1, 2, 4, or 7 days of LA administration). A similar effect, though less pronounced, was observed in corpora lutea. It is concluded that LA treatment produces a failure in the steroidogenic luteal capability and an increase of apoptotic mechanisms in the ovary, producing as a consequence an interference in the follicular recruitment, growth, and luteinization induced by gonadotropins.

Animals↗
PubMed1996

Functional adrenal cortical tumors in pediatric patients: a clinicopathologic and immunohistochemical study of a long term follow-up series.

BACKGROUND: Controversy exists as to which variable is a reliable predictor of clinical outcome of adrenal cortical tumors in children. METHODS: Twenty patients with adrenal cortical tumors were studied. Tumor weight, histologic features, and percentage of proliferating cell nuclear antigen (PCNA/cyclin) in tumor cells were analyzed to determine the best predictor of clinical outcome. RESULTS: Eleven patients had Cushing's syndrome with virilization and 9 had virilization without Cushing's syndrome. The mean age at diagnosis was 7.1 +/- 5.2 years (range, 0.4-15.6 years). Sixteen patients, with good outcomes have been followed for 10.7 +/- 7.8 years (range, 3-23 years). All but two patients had a tumor weight of less than 100 g (185 g and 800 g, respectively) (mean 47.7 g +/- 46.4 g). Two patients with large tumors (weighing 1000 g and 780 g, respectively) had poor outcomes; 1 died 3 months after surgery with metastasis and the other presented with lung metastasis 18 months after surgery. Histologic features did not correlate with clinical outcome. Overall, PCNA stained cells were 6.96 +/- 8.2% (range, 0-32.5%). PCNA values were significantly lower in tumors of patients with good outcomes (P < 0.002). Within all tumors, we found a weak correlation between tumor weight and PCNA (r = 0.51; P < 0.02), but a better correlation was found between tumor weight and PCNA in patients with Cushing's syndrome (r = 0.70; P < 0.01). Patients with Cushing's syndrome had higher PCNA values than those with virilization syndrome (10.3 +/- 9.6% vs. 2.8 +/- 3.3%; P < 0.03). CONCLUSIONS: Our data show that small tumors (less than 100 g) are associated with good outcome; the two patients with the poorest prognosis had Cushing's syndrome and large tumors (more than 100 g). Histologic features are not adequate predictors of outcome and PCNA may be useful in tumors of patients with Cushing's syndrome, but this parameter should not be used alone. Two patients had virilization syndrome, large tumors (185 g and 800 g, respectively), and good outcomes, which contradicts with the concept that these tumors are usually associated with poor prognosis.

Adolescent↗
PubMed1996

Morphometric study of the testicular interstitial tissue of the monkey Cebus apella during postnatal development.

The purpose of this study was to evaluate the developmental changes of the Leydig cells and their precursors during postnatal development in the monkey Cebus apella. Four groups of monkeys were studied: neonatal, infantile, early pubertal and late pubertal. Light microscopy, immunocytochemistry, electron microscopy and stereological studies were performed to determine cytologic and cytochemical characteristics, volume density, absolute volume and cell counts of Leydig cells. In the interstitial tissue two components were recognized: specific interstitium comprising mature and immature Leydig cells and differentiating Leydig cell precursors, and non-specific interstitium including connective tissue and blood vessels. Mature Leydig cells were polygonal with a round, euchromatic nucleus and abundant cytoplasm. Immature Leydig cells were more elongated and the nucleus showed more heterochromatin. Mature and immature Leydig cells showed either a pale- or a dark-stained cytoplasm. Pale Leydig cells showed abundant smooth endoplasmic reticulum (SER), mitochondria with tubular cristae and glycogen granules. The SER of dark Leydig cells consisted of abundant flat cisternae, only few glycogen inclusions and abundant lipid droplets. All Leydig cells were intensely reactive for 3beta-hydrohysteroid dehydrogenase (3beta-HSD). Some peritubular cells acquired nuclear and cytoplasmic characteristics that indicated that they were differentiating to Leydig cells, as evidenced by the strong 3beta-HSD positivity found in scattered elongated cells of the peritubular tissue. Absolute interstitial volume increased from birth to the end of puberty due to an increment in Leydig cells numbers and size. The mature and immature Leydig cell populations showed a different evolution during postnatal development. While immature Leydig cells increased 7-fold from the neonatal to the early pubertal period and increased at a lower rate during puberty, mature Leydig cells remained stable until early puberty and increased significantly during late pubertal development.

Animals↗
PubMed1995

Testicular steroidogenesis in the Cebus monkey throughout postnatal development.

There is scant information on testicular steroidogenesis during postnatal development in monkeys, particularly in New World species. Our purpose was to study the in vitro steroidogenic capacity of the Cebus monkey testis from birth to advanced puberty. Fresh testicular tissue was incubated in Medium 199 with or without hCG (10 IU/ml); and levels of pregnenolone (P5), dehydroepiandrosterone (DHA), progesterone (P4), androstenedione (A), testosterone (T), dihydrotestosterone (DHT), and 3 alpha-androstanediol (3 alpha-DIOL) were measured in tissue and incubation media by RIA. To determine the predominant steroidogenic pathway, the ratio between the concentrations of the 5-ene and the 4-ene T precursors was determined, and the relative conversion of 3H-P5 and 14C-P4 to T was calculated. The number of Leydig cells per testis was determined in all experimental groups. The testes of the Cebus monkeys could produce T in vitro without the addition of gonadotropins at all ages. T and the 5-ene precursors (P5 and DHA) were the main steroids found within testicular tissue throughout postnatal development. T content per Leydig cell increased continuously with age, but testicular T concentration reached maximal levels at early puberty and did not change thereafter. The ratios between 5-ene and 4-ene T precursors ranged between 2.8 and 13.2, which suggested a predominance of the delta-5 pathway. This was confirmed by the finding that 3H-P5 was more efficiently converted to T than was 14C-P4. The T production relative to that of its d-ene precursors progressively increased to reach maximal values in late puberty.(ABSTRACT TRUNCATED AT 250 WORDS)

Androstenedione↗
PubMed1994

Steroidogenic and morphogenic characteristics of human peritubular cells in culture.

We have explored the morphogenic and functional characteristics of human peritubular cells originating from seminiferous tubule (ST) fragments isolated from the testes of two prepubertal patients with the androgen insensitivity syndrome. These ST were cultured in Dulbecco's Modified Eagle's Medium-Ham's F-12 supplemented with antibiotics, transferrin, hydrocortisone, vitamin E, and 3% fetal bovine serum. A centrifugal growth of elongated fibroblast-like cells peripheral to the ST explants was observed. Muscle-specific actin and 3 beta-hydroxysteroid dehydrogenase were evident in the peritubular area and in the elongated cells growing from the tubules. Histochemistry was negative in the tubules themselves, revealing the mixed nature of these cultures. The ST fragments were lost after subculturing, leaving a homogeneous monolayer of fibroblast-like cells. The steroidogenic potential of these cells was demonstrated by the secretion of testosterone (T) to the culture medium. T secretion was stimulated by hCG in a time-dependent fashion (patient 1: Day 11, 84% and Day 15, 200%; patient 2: Day 8, 73% and Day 11, 32% over basal). FSH also stimulated T secretion (patient 1: Day 5, 136% and Day 8, 89%; patient 2: Day 8, 117% and Day 11, 129% over basal). Furthermore, T secretion by these cultures was 100% higher than that observed in mesenchymal cells obtained from the testicular intertubular space in the same patient. Spontaneous T secretion and hormone responses declined progressively to cease by 25 days in culture. These results suggested the involvement of Sertoli cell (SC)-secreted factor(s) in the regulation of T secretion by peritubular cells. In order to further explore possible paracrine interactions between peritubular and Sertoli cells, we carried out heterologous cocultures with rat SC. After 72 h a striking redistribution of both cell types was observed with the formation of cord-like structures. Ultrastructural examination of these cords showed the formation of a basement membrane between epithelial (Sertoli) and mesenchymal cells of peritubular origin. No resumption of T secretion was observed, but an increase in androgen-binding protein (ABP) production by rat SC under basal (37%) and FSH-stimulated (52%) conditions was evident. Our results show that in the human peritubular compartment, cells exist that can alternatively express steroidogenic functions, associate with SC in a specific mesenchymal-epithelial interaction, and exert regulatory influences on ABP secretion by SC. In addition they indicate that communicating events in the testis are preserved throughout evolution.

3-Hydroxysteroid Dehydrogenases↗
PubMed1992

Isolation of human Leydig cell mesenchymal precursors from patients with the androgen insensitivity syndrome: testosterone production and response to human chorionic gonadotropin stimulation in culture.

Mature Leydig cells, the main source of testicular testosterone in mammals, arise from immature mesenchymal precursors through an LH-dependent differentiation process. In order to study the steroidogenic potential of these precursors, undifferentiated mesenchymal cells were obtained from the testicular interstitium of two patients with androgen insensitivity syndrome. After double digestion with collagenase and separation of the suspensions in a Percoll density gradient, the cells were cultured in Ham's F12 medium: Dulbecco's Modified Eagle Medium (1:1) supplemented with antibiotics, transferrin, insulin, hydrocortisone, and vitamin E with or without 1 IU of hCG/ml. At 11 days in culture, samples were removed for morphological characterization and determination of 3 beta-hydroxysteroid dehydrogenase activity (3 beta-HSD). Testosterone concentration was determined by RIA in the culture medium at different intervals. Cultured cells were mesenchymal in appearance, elongated in shape, with numerous processes running in different directions. No mature Leydig cells were present. In basal conditions, the percentages of 3 beta-HSD-positive cells at 11 days on patients 1 and 2 were 33% and 28%, respectively, and the testosterone concentrations in the culture media were 4.8 and 8.4 ng.10(6) cells.24 h, respectively. In cultures stimulated with hCG, there was an increase of histochemical reactivity (47% and 42% in patients 1 and 2, respectively) and in the amount of testosterone secreted (10.2 and 12.0 ng.10(6) cells, respectively). Electron microscopic studies of cultures grown in the absence of hCG demonstrated a homogenous population of poorly differentiated, fibroblastic-type mesenchymal cells.(ABSTRACT TRUNCATED AT 250 WORDS)

3-Hydroxysteroid Dehydrogenases↗
PubMed1988

Spermatogenic onset. II. FSH modulates mitotic activity of germ and Sertoli cells in immature rats.

By using high doses of testosterone propionate (TP) endogenous FSH was lowered to non-detectable levels in immature rats of different ages. Combined administration of TP and human menopausal gonadotrophin (hMG) or purified human FSH (hFSH) restored circulating FSH to normal or supranormal levels. This experimental model was used to investigate the influences of hormones on the proliferation of Sertoli and germ cells. Mitoses in seminiferous tubules were counted after being blocked by administration of colchicine. The mitotic index so determined showed a reduction with FSH withdrawal and a significant increase when the hormone levels were restored. Testicular DNA content was determined in testicular homogenates and showed similar changes. Autoradiographs were prepared and 3H-thymidine incorporation into germ and Sertoli cells was quantified. It was found that hFSH induced a significant increase in the labelling indices of gonocytes, type A-spermatogonia and Sertoli cells. All of these changes were effective in rats younger than 10 days but no modifications in any of the parameters under study were observed after 20 days. It is concluded that FSH exerts a stimulatory effect on the proliferation of spermatogonia, Sertoli cells and testicular DNA content during the first 10 days of life.

Animals↗
PubMed1986

Paratesticular rhabdomyosarcoma in children.

The clinicopathological features of 10 children with paratesticular rhabdomyosarcoma treated between 1965 and 1984 are reviewed. Of the patients 9 had embryonal rhabdomyosarcoma and 1 was pleomorphic. Median age was 4 years (range 2 to 11 years). Staging was based on clinical findings, chest x-ray, lymphoangiography, computerized tomography and histological studies. The disease was stage I in 5 patients, stage II in 2 and stage IV in 3. Treatment included radical orchiectomy in all patients, chemotherapy in 8 and lumboaortic radiotherapy in 5. No retroperitoneal node lymphadenectomy was performed. Of the 10 children 7 are free of disease after 2 to 19 years (median 7 years) of followup, including all of those with stages I and II disease.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

The phagocytic function of Sertoli cells: a morphological, biochemical, and endocrinological study of lysosomes and acid phosphatase localization in the rat testis.

The lysosomal population of the seminiferous tubules of the rat was studied by conventional electron microscopy and electron microscopic histochemistry. Biochemical determinations of acid phosphatase were carried out in whole cell suspensions of seminiferous tubular cells or in different cell populations purified by sedimentation in albumin gradients. Lysosomes were rarely found in spermatogonia and primary spermatocytes. Young spermatids showed up to six lysosomes per section, and this number increased as spermatid maturation proceeded. Residual bodies had a very heterogeneous lysosomal content. Sertoli cells showed cyclical variations in their lysosomes. These were present in small numbers from stages I-IV of the cycle of the seminiferous epithelium and progressively increased to be numerous in Sertoli cells at stages VI-VIII. After spermiation, their rapidly decreased. Acid phosphatase contents were (nanomoles of nitrophenol formed per mg protein/min): whole cell suspension, 67.5 +/- 7.8; pachytene spermatocytes (72% purity), 76.5 +/- 10.6; round spermatids (73% purity), 95.0 +/- 2.8; residual bodies (88% purity), 96.0 +/- 14.2; and Sertoli cell-enriched fraction, 278.5 +/- 75.7. In a group of rats, endogenous LH and testosterone were lowered by administration of anti-LH antibodies. There was an intense degeneration of meiotic spermatocytes, which were phagocytized and digested by these immature testosterone-depleted Sertoli cells. It is concluded that lysosomes of the seminiferous epithelium show cyclical variations, with an increase toward the time of spermiation and a decrease after the residual bodies have been digested; the acid phosphatase and lysosomal contents of Sertoli cells are higher than those of germ cells, residual body disposal is probably initiated by autophagy and completed by Sertoli cell phagocytosis; and the phagocytic function of Sertoli cells is not hormone (testosterone) dependent.

Acid Phosphatase↗
PubMed1983

Evaluation of testicular function following long-term treatment for acute lymphoblastic leukemia.

A study of reproductive function was carried out in 31 patients following long-term treatment of acute lymphoblastic leukemia (mean: 4 1/12 years); 17 prepubertal; nine pubertal, and five adults. Spontaneous clinical pubertal development was observed in 4 of 17 prepubertal patients. Serum testosterone response to hCG was normal or increased in the nine prepubertal patients studied. Intratesticular testosterone concentration was normal in 11 out of 12 patients. Only two of 14 prepubertal patients had a reduced number of germ cells. Normal progress of spermatogenesis was seen in six out of seven pubertal patients and only moderate hypospermatogenesis with focal hyalinosis was found in the five adults. Two of them had normal sperm count and one fathered two children. In six out of 14 prepubertal patients unexpected early signs of pubertal stimulation were found. Serum gonadotrophins response to LH-RH was normal in most patients. Testicular infiltration of blastic cells was found in four of 26 biopsies, but only one of 23 patients was without clinical signs of testicular relapse. Computerized axial tomography was normal in 10 out of 13 patients. Bone age was significantly below chronological age in four out of 15 patients. This study suggests that the gonad is moderately injured by long-term antileukemic therapy. In addition, microscopic testicular infiltration is not frequent in subjects without testicular enlargement.

Adolescent↗
PubMed1981

Testicular testosterone levels during puberty in cryptorchidism.

Serum and testicular concentrations of testosterone were determined by radioimmunoassay in four prepubertal patients (Tanner's genital stage G1) with unilateral cryptorchidism and in ten pubertal patients with different degrees of genital development (stages G2-G5), five with unilateral and five with bilateral cryptorchidism. In every case, testicular testosterone concentration was determined in the cryptorchid gonad. Two prepubertal autopsy cases were also studied. Results were compared with scrotal testes of adult subjects. Pubertal development resulted in a gradual increase in tubule diameter on microscopic examination notwithstanding the abnormal position of the gonad. As expected, serum testosterone also increased gradually throughout sexual development. Testicular testosterone concentration however increased to adult levels at early stages of puberty. Mean concentrations and ranges were: G1, 26 ng/g (range 7-49, n = 6); G2 + G3, 660 (range 37-1357, n = 6); G4 + G5, 438 (range 272-702, n = 4) and adults 520 (range 356-663, n = 4). This resulted in similar testicular: serum testosterone ratios in G1, G4 + G5 and adults but a high ratio in G2 + G3. Patients of groups G2 + G3 did not have elevation of serum gonadotrophins and did not show Leydig cell hyperplasia. Therefore, in early puberty, when peripheral tissues are exposed to low testosterone levels, seminiferous tubules of cryptorchid gonads might already receive high androgen stimulation.

Child↗