Programmed cell death is an important regulatory event in spermatogenesis. However, the molecular events governing apoptosis have not been characterized. Using the Leydig cell-specific toxin ethane dimethanesulfonate (EDS) to withdraw androgen support, we have investigated the relationship between apoptosis and apoptosis-related genes. Adult male Sprague-Dawley rats were injected (i.p.) with 100 mg/kg EDS and killed at times of androgen depletion 2, 5, and 8 days postinjection. A 24-fold increase in the apoptotic index 8 days after EDS administration was demonstrated in tissue sections by in situ end-labeling of fragmented DNA. Leydig cell death and androgen withdrawal were confirmed by the absence of 3beta-hydroxysteroid dehydrogenase in testes from animals treated with EDS for 2 days. After androgen withdrawal, there were no significant changes in the levels of clusterin, Bcl-xl, Bak, and Bad. However, the expression of Bcl-2 and Bax was up-regulated at 8 days after EDS administration. The induction of Bax at this time suggests that it may play a role in germ cell apoptosis following androgen withdrawal. The concomitant elevation in Bcl-2 expression may represent a survival mechanism for the remaining germ cells. There was also a decline in the expression of Fas-L and Fas-R in the pachytene spermatocytes and spermatids. Fas-R was also present in Sertoli cells, although Fas-L staining was minimal. As the colocalization of Fas-L and Fas-R correlates with the germ cell types that die in response to androgen withdrawal, the potential exists for apoptosis in the rat spermatogenic epithelium to be regulated by the Fas pathway.

We have examined the effect of 3 hr of immobilization stress on plasma luteinizing hormone, testosterone, and corticosterone levels, and on the activity of 3Bhydroxysteroid dehydrogenase (38-HSD) in microsomal and mitochondria1 fractions of the testis from adult rats. Immobilization for 3 hr increased plasma corticosterone and reduced plasma testosterone concentrations by 57%. Plasma luteinizing hormone levels were lower, although not significantly (P = 0.093) so, in stressed animals. Immobilization (3 hr) reduced the VmaX values of 3B-HSD in the mitochondria and in the microsomal fraction of the testis by 40% and 34%, respectively, but had no effect on the K, values of 3B-HSD in the two cellular compartments. These results suggest that the inhibition of the activity of 3B-HSD may be partially responsible for the disruption of testicular steroidogenesis during immobilization stress.[P.S.E.B.M. 1993, Vol2041he effects of stress on reproduction and the mechanism governing these effects depend on the type ' To whom requests for reprints should be addressed

The objective of this study was to identify clinical features of acute mastoiditis in children that are indicative of the need for mastoidectomy. We performed a retrospective chart review of 40 children (20 male, 20 female) between 2 months and 12 years 9 months of age with a diagnosis of acute mastoiditis who were managed in our institution between July 1998 and June 2002. All patients received intravenous antibiotics; this was the only treatment in 14 patients (35%). Tympanostomy tubes were inserted in 22 patients, together with postauricular needle aspiration in 12 (30%), and incision and drainage of subperiosteal abscess in 10 (25%). Mastoidectomy was performed in 4 cases (10%), and cholesteatoma was found in 3. One other child was subsequently found to have cholesteatoma. We conclude that children who present with acute mastoiditis should undergo mastoidectomy if cholesteatoma is clinically suspected, or if extratemporal suppurative complications have occurred.

Ethane dimethanesulphonate (EDS) is cytotoxic to Leydig cells in the adult rat.