Sexual maturation of the Mongolian gerbil (Meriones unguiculatus): a histological, hormonal and spermatic evaluation
Maria Etelvina Pinto-Fochi A B , Ana Carolina Negrin A B , Wellerson Rodrigo Scarano C , Sebastião Roberto Taboga A B and Rejane Maira Góes A B DA Department of Biology, Institute of Biosciences, Letters and Exact Sciences, São Paulo State University – IBILCE/UNESP, Rua Cristóvão Colombo, 2265, CEP 15054-000, São José do Rio Preto, São Paulo, Brazil.
B Department of Structural and Functional Biology, Institute of Biology, University of Campinas – UNICAMP, Box 6109, CEP 13083-970, Campinas, São Paulo, Brazil.
C Department of Morphology, Institute of Biosciences, São Paulo State University – IB/UNESP, Box 510, 18618-000, Botucatu, São Paulo, Brazil.
D Corresponding author. Email: remagoes@ibilce.unesp.br
Reproduction, Fertility and Development 28(6) 815-823 https://doi.org/10.1071/RD14074
Submitted: 24 February 2014 Accepted: 9 October 2014 Published: 3 December 2014
Abstract
This study determined the phases of sexual development of the male Mongolian gerbil (Meriones unguiculatus) based on an integrative analysis of testicular morphology, hormonal data and sperm parameters. Male gerbils were analysed at 1, 7, 14, 21, 28, 35, 42, 50, 60, 70, 90, 100 and 120 days of age. Body, testicular and epididymal weights increased up to Day 70, 60 and 90, respectively. The impuberal phase, characterised by the presence of gonocytes, extended until Day 14. The prepubertal period lasted until Day 42, when puberty was achieved and a drastic increase in serum testosterone levels, mature adult Leydig cells and elongated spermatids was observed. Gerbils at 60 days of age showed a remarkable number of spermatozoa in the testis, epididymidis caput/corpus and cauda, and at Day 70 the maximum daily sperm production was reached. However, the gerbil may be considered sexually mature only from Day 90 onward, when sperm reserves become stable. The total transit time of spermatozoa along the epididymis of sexually mature gerbils was 11 days, with 1 day in the caput/corpus and 10 days in the cauda. These data cover a lacuna regarding the reproductive parameters of this rodent and provide foundations for its use in testicular toxicology studies.
Additional keywords: daily sperm production, epididymal sperm transit time, puberty, sperm motility.
References
Amann, R. P. (1970). Sperm production rates. In ‘The Testis – Development, Anatomy and Physiology’. (Eds A. D. Johnson, W. R. Gomes and N. L. Van Demark.) pp. 433–482. (Academic Press: New York.)Amann, R. P. (2008). The cycle of the seminiferous epithelium in humans: a need to revisit? J. Androl. 29, 469–487.
| The cycle of the seminiferous epithelium in humans: a need to revisit?Crossref | GoogleScholarGoogle Scholar |
Amann, R. P., Johnson, L., Thompson, D. L., and Pickett, B. W. (1976). Daily spermatozoal production, epididymal spermatozoal reserves and transit time of spermatozoa along the epididymis of the rhesus monkey. Biol. Reprod. 15, 586–592.
| Daily spermatozoal production, epididymal spermatozoal reserves and transit time of spermatozoa along the epididymis of the rhesus monkey.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaE2s%2FmsFyrsA%3D%3D&md5=3b496a4bec650b99365d486477a213b1CAS | 826287PubMed |
Amann, R. P., Hammerstedt, R. H., and Veeramachaneni, D. N. (1993). The epididymis and sperm maturation: a perspective. Reprod. Fertil. Dev. 5, 361–381.
| The epididymis and sperm maturation: a perspective.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2c3gsVarug%3D%3D&md5=10d262af44e842e85f060333630170e6CAS | 8153387PubMed |
Blottner, S., Franz, C., Rohleder, M., Zinke, O., and Stuermer, I. W. (2000). Higher testicular activity in laboratory gerbils compared to wild Mongolian gerbils (Meriones unguiculatus). J. Zool. 250, 461–466.
| Higher testicular activity in laboratory gerbils compared to wild Mongolian gerbils (Meriones unguiculatus).Crossref | GoogleScholarGoogle Scholar |
Bonde, J. P., Ernst, E., Jensen, T. K., Hjollund, N. H., Kolstad, H., Henriksen, T. B., Scheike, T., Giwercman, A., Olsen, J., and Skakkebaek, N. E. (1998). Relation between semen quality and fertility: a population-based study of 430 first-pregnancy planners. Lancet 352, 1172–1177.
| Relation between semen quality and fertility: a population-based study of 430 first-pregnancy planners.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1cvkvFalsQ%3D%3D&md5=c84e96bd522782bfc1a7c0a6f4584372CAS | 9777833PubMed |
Cao, D., Li, M., Xue, R., Zheng, W., Liu, Z., and Wang, X. (2005). Chronic administration of ethyl docosahexaenoate decreases mortality and cerebral oedema in ischemic gerbils. Life Sci. 78, 74–81.
| Chronic administration of ethyl docosahexaenoate decreases mortality and cerebral oedema in ischemic gerbils.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD2MXhtFKmsL3P&md5=598dafb426484c3cfd036cc1ae3532fcCAS | 16214179PubMed |
Chamindrani Mendis-Handagama, S. M., and Ariyaratne, H. B. (2001). Differentiation of the adult Leydig cell population in the postnatal testis. Biol. Reprod. 65, 660–671.
| Differentiation of the adult Leydig cell population in the postnatal testis.Crossref | GoogleScholarGoogle Scholar |
Clermont, Y., Leblond, C. P., and Messier, B. (1959). Duration of the cycle of the seminal epithelium of the rat. Arch. Anat. Microsc. Morphol. Exp. 48, 37–55.
| 1:CAS:528:DyaF3cXltFWqtg%3D%3D&md5=97e7ecb9ffaae3af88a5f5d274f98dbcCAS | 13810668PubMed |
Cordeiro-Júnior, D. A., Costa, G. M. J., Talamoni, S. A., and França, L. R. (2010). Spermatogenic efficiency in the spiny rat, Trinomys moojeni (Rodentia: Echimyidae). Anim. Reprod. Sci. 119, 97–105.
| 20018466PubMed |
Corradi, L. S., Goes, R. M., Carvalho, H. F., and Taboga, S. R. (2004). Inhibition of 5-alpha-reductase activity induces stromal remodelling and smooth muscle de-differentiation in adult gerbil ventral prostate. Differentiation 72, 198–208.
| Inhibition of 5-alpha-reductase activity induces stromal remodelling and smooth muscle de-differentiation in adult gerbil ventral prostate.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD2cXnslKmu7g%3D&md5=df3c4ace9d3e5f41ae5e818f5fbdb3b9CAS | 15270776PubMed |
Costa, G. M. J., Leal, M. C., Ferreira, A. C. S., Guimarães, D. A., and França, L. R. (2010). Duration of spermatogenesis and spermatogenic efficiency in two large neotropical rodent species: the agouti (Dasyprocta leporina) and paca (Agouti paca). J. Androl. 31, 489–499.
| Duration of spermatogenesis and spermatogenic efficiency in two large neotropical rodent species: the agouti (Dasyprocta leporina) and paca (Agouti paca).Crossref | GoogleScholarGoogle Scholar |
Courot, M., Reviers, M. T. H., and Ortavant, R. (1970). Spermatogenesis. In ‘The Testis – Development, Anatomy and Physiology’. (Eds A. D. Johnson, W. R. Gomes and N. L. VanDemark.) pp. 339–432. (Academic Press: New York.)
Domeniconi, R. F., Orsi, A. M., Silva, M. D. P., Beu, C. C., and Viegas, K. S. A. (2006). Histochemical localisation of some hydrolases in the epididymis of the gerbil. Braz. J. Vet. Res. Anim. Sci. 43, 107–116.
Domeniconi, R. F., Orsi, A. M., Beu, C. C., and Felisbino, S. L. (2007). Morphological features of the epididymal epithelium of gerbil, Meriones unguiculatus. Tissue Cell 39, 47–57.
| Morphological features of the epididymal epithelium of gerbil, Meriones unguiculatus.Crossref | GoogleScholarGoogle Scholar | 17320128PubMed |
dos Santos, F. C., Carvalho, H. F., Goes, R. M., and Taboga, S. R. (2003). Structure, histochemistry and ultrastructure of the epithelium and stroma in the gerbil (Meriones unguiculatus) female prostate. Tissue Cell 35, 447–457.
| Structure, histochemistry and ultrastructure of the epithelium and stroma in the gerbil (Meriones unguiculatus) female prostate.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3srgsVKltQ%3D%3D&md5=c05631d0f7dd48ad52861c79558dcca7CAS | 14580358PubMed |
Eckstein, B., Borut, A., and Cohen, S. (1987). Metabolic pathways for androstanediol formation in immature rat testis microsomes. Biochim. Biophys. Acta 924, 1–6.
| Metabolic pathways for androstanediol formation in immature rat testis microsomes.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DyaL2sXitVOqs70%3D&md5=f7edc84bb78ef1276f9cc654fbe657e4CAS | 3828389PubMed |
Fernandes, G. S., Arena, A. C., Fernandez, C. D., Mercadante, A., Barbisan, L. F., and Kempinas, W. G. (2007). Reproductive effects in male rats exposed to diuron. Reprod. Toxicol. 23, 106–112.
| Reproductive effects in male rats exposed to diuron.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD2sXisValsA%3D%3D&md5=33f7b4c2bd021e937acf2b6d3d723643CAS | 17070669PubMed |
Fernandez, C. D., Bellentani, F. F., Fernandes, G. S., Perobelli, J. E., Favareto, A. P., Nascimento, A. F., Cicogna, A. C., and Kempinas, W. D. (2011). Diet-induced obesity in rats leads to a decrease in sperm motility. Reprod. Biol. Endocrinol. 9, 32.
| Diet-induced obesity in rats leads to a decrease in sperm motility.Crossref | GoogleScholarGoogle Scholar | 21396114PubMed |
Fochi, R. A., Santos, F. C., Goes, R. M., and Taboga, S. R. (2013). Progesterone as a morphological regulatory factor of the male and female gerbil prostate. Int. J. Exp. Pathol. 94, 373–386.
| Progesterone as a morphological regulatory factor of the male and female gerbil prostate.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXhslKnsrnF&md5=94bc8b7db3a75b2028e03e4cb2fa1ec6CAS | 24205795PubMed |
França, L. R. (1992). Daily sperm production in piau boar estimated from Sertoli population and Sertoli cell index. In ‘ Proceedings of the 12th International Congress on Animal Reproduction (ICAR), The Netherlands’. (Ed(s) International Congress on Animal Reproduction.) pp. 1716–1718. (ICAR: The Hague.)
França, L. R., Avelar, G. F., and Almeida, F. F. (2005). Spermatogenesis and sperm transit through the epididymis in mammals with emphasis on pigs. Theriogenology 63, 300–318.
| Spermatogenesis and sperm transit through the epididymis in mammals with emphasis on pigs.Crossref | GoogleScholarGoogle Scholar | 15626401PubMed |
Góes, R. M., Zanetoni, C., Tomiosso, T. C., Ribeiro, D. L., and Taboga, S. R. (2007). Surgical and chemical castration induce differential histological response in prostate lobes of Mongolian gerbil. Micron 38, 231–236.
| Surgical and chemical castration induce differential histological response in prostate lobes of Mongolian gerbil.Crossref | GoogleScholarGoogle Scholar | 16919465PubMed |
Hermo, L., and Robaire, B. (2002). Epididymal cell types and their functions. In ‘The Epididymis – From Molecules to Clinical Practice’. (Eds B. Robaire and B. T. Hinton.) pp. 81–102. (KA/PP: New York.)
Jeffers, G. W., Klei, T. R., and Enright, F. M. (1984). Activation of jird (Meriones unguiculatus) macrophages by the filarial parasite Brugia pahangi. Infect. Immun. 43, 43–48.
| 1:STN:280:DyaL2c%2Fos1ymtg%3D%3D&md5=e1a29f6cd3b6dd35a124d9656166ea7fCAS | 6690414PubMed |
Juana, L., Barbara, V. G., Martin, M. T., Agustin, C., Guillermo, R. B., and Guadalupe, O. (2010). Neither testosterone levels nor aggression decrease when the male Mongolian gerbil (Meriones unguiculatus) displays paternal behaviour. Horm. Behav. 57, 271–275.
| Neither testosterone levels nor aggression decrease when the male Mongolian gerbil (Meriones unguiculatus) displays paternal behaviour.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3cXivFaltLg%3D&md5=2759cd195a466d1171bc6b80bd148bd6CAS | 20036242PubMed |
Kilborn, S. H., Trudel, G., and Uhthoff, H. (2002). Review of growth plate closure compared with age at sexual maturity and lifespan in laboratory animals. Contemp. Top. Lab. Anim. Sci. 41, 21–26.
| 1:CAS:528:DC%2BD38XnsVGgsbs%3D&md5=13f84a69193806bea51ea3d98bb4c1d0CAS | 12213043PubMed |
Leblond, C. P., and Clermont, Y. (1952). Definition of the stages of the cycle of the seminiferous epithelium in the rat. Ann. N. Y. Acad. Sci. 55, 548–573.
| Definition of the stages of the cycle of the seminiferous epithelium in the rat.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaG2c%2FlvFSgtg%3D%3D&md5=135a779232ca406e51d93d362048708eCAS | 13139144PubMed |
Moller, M., Nielsen, J. T., and van Veen, T. (1979). Effect of superior cervical ganglionectomy on monoamine content in the epithalamic area of the Mongolian gerbil (Meriones unguiculatus): a fluorescence histochemical study. Cell Tissue Res. 201, 1–9.
| Effect of superior cervical ganglionectomy on monoamine content in the epithalamic area of the Mongolian gerbil (Meriones unguiculatus): a fluorescence histochemical study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL3c7htFWitg%3D%3D&md5=9c9b312ab46be8f997c7315df41fad0fCAS | 527008PubMed |
Moritomo, T., Saito, H., Watanabe, T., and Mochizuki, K. (1991). Tissue culture study on Mongolian gerbil’s (Meriones unguiculatus) malignant melanoma. Jikken Dobutsu 40, 385–388.
| 1:STN:280:DyaK38%2FgvVartA%3D%3D&md5=80a85d7423f1d2afa9389076ed762f83CAS | 1915606PubMed |
Nawa, Y., Horii, Y., Okada, M., and Arizono, N. (1994). Histochemical and cytological characterisations of mucosal and connective tissue mast cells of Mongolian gerbils (Meriones unguiculatus). Int. Arch. Allergy Immunol. 104, 249–254.
| Histochemical and cytological characterisations of mucosal and connective tissue mast cells of Mongolian gerbils (Meriones unguiculatus).Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2czgsFektw%3D%3D&md5=184f1cf6886ebb6fcde7d81f82f5f687CAS | 8032236PubMed |
Ninomiya, H., and Nakamura, T. (1987). Postnatal development of the testis in the Mongolian gerbil, Meriones unguiculatus. Jikken Dobutsu 36, 65–72.
| 1:STN:280:DyaL2s7jtl2rtg%3D%3D&md5=c8e0f894951321f7b1dd1aafe05e5054CAS | 3816990PubMed |
Oakberg, E. F. (1956). Duration of spermatogenesis in the mouse and timing of stages of the cycle of the seminiferous epithelium. Am. J. Anat. 99, 507–516.
| Duration of spermatogenesis in the mouse and timing of stages of the cycle of the seminiferous epithelium.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaG2s%2FkvV2luw%3D%3D&md5=68f874ca35e818cedd7efcfad5198ff5CAS | 13402729PubMed |
O’Shaughnessy, P. J., Baker, P. J., and Johnston, H. (2006). The foetal Leydig cell – differentiation, function and regulation. Int. J. Androl. 29, 90–95, discussion 105–108.
| The foetal Leydig cell – differentiation, function and regulation.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD28XjslWitr8%3D&md5=514285020822738363b935d106e53af8CAS | 16466528PubMed |
Paula, T. A., Chiarini-Garcia, H., and França, L. R. (1999). Seminiferous epithelium cycle and its duration in capybaras. Tissue Cell 31, 327–334.
| Seminiferous epithelium cycle and its duration in capybaras.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1MvhtV2iug%3D%3D&md5=693cf2b9a5c51ee8afe7aa96ea26242dCAS | 10481304PubMed |
Petrunkina, A. M., and Harrison, R. A. (2011). Cytometric solutions in veterinary andrology: developments, advantages and limitations. Cytometry A 79A, 338–348.
| Cytometric solutions in veterinary andrology: developments, advantages and limitations.Crossref | GoogleScholarGoogle Scholar |
Petrunkina, A. M., Waberski, D., Günzel-Apel, A. R., and Töpfer-Petersen, E. (2007). Determinants of sperm quality and fertility in domestic species. Reproduction 134, 3–17.
| Determinants of sperm quality and fertility in domestic species.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD2sXpvFGisrs%3D&md5=be54e8aea7195333ef0e6e2026bed4b2CAS | 17641084PubMed |
Pinto, M. E., Botta, L. S., Taboga, S. R., and Goes, R. M. (2010a). Neonatal gonocyte differentiation in Mongolian gerbil Meriones unguiculatus involves asynchronous maturation of seminiferous cords and rapid formation of transitional cell stage. Anat. Rec. (Hoboken) 293, 310–419.
| Neonatal gonocyte differentiation in Mongolian gerbil Meriones unguiculatus involves asynchronous maturation of seminiferous cords and rapid formation of transitional cell stage.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3cXis1aisbw%3D&md5=749b1337ea4492117dcc8bb8fca1d9f0CAS | 20027643PubMed |
Pinto, M. E., Egydio, F. de M., Taboga, S. R., Mendis-Handagama, S. M., and Goes, R. M. (2010b). Differentiation of Leydig cells in the Mongolian gerbil. Microsc. Res. Tech. 73, 119–127.
| 1:CAS:528:DC%2BC3cXitlaltbY%3D&md5=8ca46fb1b32cdd7a742adb42b35bc059CAS | 19697434PubMed |
Rich, S. T. (1968). The Mongolian gerbil (Meriones unguiculatus) in research. Lab. Anim. Care 18, 235–243.
| 4233357PubMed |
Robb, G. W., Amann, R. P., and Killian, G. J. (1978). Daily sperm production and epididymal sperm reserves of pubertal and adult rats. J. Reprod. Fertil. 54, 103–107.
| Daily sperm production and epididymal sperm reserves of pubertal and adult rats.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaE1M%2FltVegtg%3D%3D&md5=b21d5568351b720a1bf59f4ecc2ff08fCAS | 712697PubMed |
Rochel, S. S., Bruni-Cardoso, A., Taboga, S. R., Vilamaior, P. S., and Goes, R. M. (2007). Lobe identity in the Mongolian gerbil prostatic complex: a new rodent model for prostate study. Anat. Rec. (Hoboken) 290, 1233–1247.
| Lobe identity in the Mongolian gerbil prostatic complex: a new rodent model for prostate study.Crossref | GoogleScholarGoogle Scholar | 17724712PubMed |
Santos, F. C., Leite, R. P., Custodio, A. M., Carvalho, K. P., Monteiro-Leal, L. H., Santos, A. B., Goes, R. M., Carvalho, H. F., and Taboga, S. R. (2006). Testosterone stimulates growth and secretory activity of the female prostate in the adult gerbil (Meriones unguiculatus). Biol. Reprod. 75, 370–379.
| Testosterone stimulates growth and secretory activity of the female prostate in the adult gerbil (Meriones unguiculatus).Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD28XovVWmtbg%3D&md5=53a9ddead5d7ab5042f6e6791d6b8e5cCAS | 16707769PubMed |
Schwentker, V. (1963). The gerbil – a new laboratory animal. Veterinarian 6, 5–9.
Segatelli, T. M., Almedia, C. C., Pinheiro, P. F., Martinez, M., Padovani, C. R., and Martinez, F. E. (2000). Ultrastructural study of acrosome formation in Mongolian gerbil (Meriones unguiculatus). Tissue Cell 32, 508–517.
| Ultrastructural study of acrosome formation in Mongolian gerbil (Meriones unguiculatus).Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M7kslSguw%3D%3D&md5=4ae840123162c3064e44fe535b7c5a38CAS | 11197233PubMed |
Segatelli, T. M., Almeida, C. C., Pinheiro, P. F., Martinez, M., Padovani, C. R., and Martinez, F. E. (2002). Kinetics of spermatogenesis in the Mongolian gerbil (Meriones unguiculatus). Tissue Cell 34, 7–13.
| Kinetics of spermatogenesis in the Mongolian gerbil (Meriones unguiculatus).Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD383ltVKgtg%3D%3D&md5=681275f20c87420a9ee23c0f7653915eCAS | 11989971PubMed |
Segatelli, T. M., Franca, L. R., Pinheiro, P. F., Alemida, C. C., Martinez, M., and Martinez, F. E. (2004). Spermatogenic cycle length and spermatogenic efficiency in the gerbil (Meriones unguiculatus). J. Androl. 25, 872–880.
| 15477358PubMed |
Siegford, J. M., Hadi Mansouri, S., and Ulibarri, C. (2003). Normal ontogeny of perineal muscles and testosterone levels in Mongolian gerbils; response to testosterone in developing females. Anat. Rec. A Discov. Mol. Cell. Evol. Biol. 275A, 997–1008.
| Normal ontogeny of perineal muscles and testosterone levels in Mongolian gerbils; response to testosterone in developing females.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD3sXps1ejsL8%3D&md5=82fd2cb9cc5d54332e77e2874315da0aCAS |
Taboga, S. R., Vilamaior, P. S., and Goes, R. M. (2009). Androgenic and oestrogenic modulation in the prostate: an approach in rodent experimental models with emphasis on structural biology. Arq. Bras. Endocrinol. Metabol. 53, 946–955.
| 20126846PubMed |
Verma, R. J. (2001). Sperm quiescence in cauda epididymidis: a mini-review. Asian J. Androl. 3, 181–183.
| 1:STN:280:DC%2BD3Mrltlahtg%3D%3D&md5=b41100c0a29e9379ae46e11f5cfd11c1CAS | 11561187PubMed |
Wiedemann, T., Loell, E., Mueller, S., Stoeckelhuber, M., Stolte, M., Haas, R., and Rieder, G. (2009). Helicobacter pylori cag-pathogenicity island-dependent early immunological response triggers later precancerous gastric changes in Mongolian gerbils. PLoS ONE 4, e4754.
| Helicobacter pylori cag-pathogenicity island-dependent early immunological response triggers later precancerous gastric changes in Mongolian gerbils.Crossref | GoogleScholarGoogle Scholar | 19270747PubMed |
Winkle, T., Rosenbusch, B., Gagsteiger, F., Paiss, T., and Zoller, N. (2009). The correlation between male age, sperm quality and sperm DNA fragmentation in 320 men attending a fertility centre. J. Assist. Reprod. Genet. 26, 41–46.
| The correlation between male age, sperm quality and sperm DNA fragmentation in 320 men attending a fertility centre.Crossref | GoogleScholarGoogle Scholar | 19030983PubMed |