title: [Ultrasonographic appearance of experimental testicular ischemia and protective effect of allopurinol].
abstract: OBJECTIVE
  To investigate the correlation of the ultrasonographic appearance of different degrees of experimentally induced acute unilateral testicular ischemia with the protective effect of allopurinol.
  
  
  METHODS
  Forty-two male white rabbits were equally randomized into 7 groups: sham-operation control, ischemic A, B and C, and treatment D, E and F. Models of different degrees of unilateral testicular ischemia were established in the ischemic and treatment groups under the dynamic observation by color Doppler ultrasound. The ischemic testes showed slightly decreased homogeneous echoes and flow signals in groups A and D, obviously decreased heterogeneous echoes and flow signals in groups B and E, and radial or fragmental low-echo areas and disappearance of flow signals in groups C and F. The ischemic groups received reperfusion after the appearance of the above ultrasonographic changes, while the treatment groups following the intraperitoneal injection of allopurinol at 200 mg/kg. Contrast-enhanced ultrasonography (CEUS) was performed on the bilateral testes before and 3 days after the reperfusion. After 3 days of breeding, the histological changes and malondialdehyde (MDA) contents of the ischemic testes were observed, and the correlation was analyzed between the protective effect of allopurinol and the ultrasonographic appearance of different degrees of acute unilateral testicular ischemia.
  
  
  RESULTS
  CEUS showed fast wash-in and fast wash-out in the sham-operation control group, slow wash-in and slow wash-out in groups A and B and extensive central filling defect in group C before the reperfusion. Fast wash-in and slow wash-out were observed in all the ischemic groups 3 days after the reperfusion, most obviously in group C. Groups D, E and F exhibited the same CEUS appearance as A, B and C before and 3 days after the reperfusion. Johnsen's scores were significantly increased in groups D (9.10 +/- 0.23) and E (7.03 +/- 0.20) in comparison with A (8.53 +/- 0.22) and B (5.82 +/- 0.33) (P < 0.05), but with no significant differences between C (2.30 +/- 0.53) and F (2.45 +/- 0.33) (P > 0.05). The rates of apoptosis were significantly decreased in groups D ([1.68 +/- 0.43]%) and E ([12.53 +/- 0.59]%) compared with A ([7.12 +/- 0.84]%) and B ([20.87 +/- 1.59]%) (P < 0.05), but with no significant differences between C ([52.93 +/- 2.62 ]%) and F ([51.23 +/- 2.53 ]%) (P > 0.05). Significant decreases of MDA contents in the ischemic testes were observed in groups D ([0.64 +/- 0.05] nmol/mg prot), E ([1.59 +/- 0.06] nmol/mg prot) and F ([3.10 +/- 0.17] nmol/mg prot) in comparison with A ([1.38 +/- 0.07] nmol/mg prot), B ([2.11 +/- 0.08] nmol/mg prot) and C ([3.25 +/- 0.14] nmol/mg prot) (P < 0.05).
  
  
  CONCLUSIONS
  Allopurinol contributes to the recovery of spermatogenesis when testicular ischemia is sonographically shown to be mild or moderate, but produces no significant effect when it is shown to be severe. Ultrasonography helps to choose the right therapy of testicular torsion and predict spermatogenesis of ischemic testes after reperfusion.
authors.affiliation: Fujian Provincial Institute of Ultrasonic Medicine/Department of Ultrasound, Union Hospital of Fujian Medical University, Fuzhou, Fujian 350001, China. fineliny@126.com
authors.forename: Ying
authors.initials: Y
authors.lastname: Lin
authors.forename: En-Sheng
authors.initials: ES
authors.lastname: Xue
authors.forename: Rong-Xi
authors.initials: RX
authors.lastname: Liang
authors.forename: Wei-Qin
authors.initials: WQ
authors.lastname: Huang
authors.forename: Liang
authors.initials: L
authors.lastname: Yu
authors.forename: Shun
authors.initials: S
authors.lastname: Chen
authors.forename: Li-Yun
authors.initials: LY
authors.lastname: Yu
authors.forename: Li-Wu
authors.initials: LW
authors.lastname: Lin
mesh_terms: D000493:Allopurinol / Q000494:pharmacology*; D000818:Animals; D004195:Disease Models, Animal; D007511:Ischemia / Q000000981:diagnostic imaging; D008297:Male; D011817:Rabbits; D015427:Reperfusion Injury / Q000000981:diagnostic imaging*; D013733:Testicular Diseases / Q000000981:diagnostic imaging*; D013737:Testis / Q000000981:diagnostic imaging*; D014463:Ultrasonography
chemical_list: D000493:Allopurinol