Balkan endemic nephropathy (BEN) is a form of interstitial nephritis causing kidney failure. It was first identified in the 1920s among several small, discrete communities along the Danube River and its major tributaries, in the modern countries of Croatia, Bosnia and Herzegovina, Serbia, Romania, and Bulgaria. It is caused by small long-term doses of aristolochic acid in the diet. The disease primarily affects people 30 to 60 years of age. Doses of the toxin are usually low and people moving to endemic areas typically develop the condition only when they have lived there for 10–20 years. People taking higher doses of aristolochic acid (as Chinese herbal supplements) have developed kidney failure after shorter durations of exposure. Signs and symptoms
The patients are distinguished from those suffering from other causes of end-stage renal disease by showing an absence of high blood pressure, xanthochromia of palms and soles (Tanchevs sign), early hypochromic anemia, absence of proteinuria, and slow progression of kidney failure. There is no specific therapy; BEN causes end-stage renal disease, for which the only effective treatments are dialysis or a kidney transplant. In endemic areas BEN is responsible for up to 70% of end-stage renal disease. At least 25,000 individuals are known to have this form of the disease.Patients with BEN have a greatly increased rate of transitional cell carcinoma of the upper urothelial tract, (the renal pelvis and ureters). (In populations without BEN, most urothelial cancer occurs in the bladder. )
An ovotestis is a gonad with both testicular and ovarian aspects. In humans, ovotestes are an infrequent anatomical variation associated with gonadal dysgenesis. The only mammals where ovotestes are not symptomatic of an intersex variation are moles, wherein females possess ovotestes along with a masculinized clitoris. These ovotestes in nonpregnant female moles secrete eight times as much testosterone as the ovotestes of pregnant moles. In invertebrates that are normally hermaphroditic, such as most gastropods (snails and slugs) in the clade Eupulmonata, an ovotestis is a common feature of the reproductive anatomy. In mice, ovotestes are structured such that the central region is testicular tissue while the poles both contain ovarian tissue. Experiments involving the SOX9 gene, which is initiated by the SRY region of the Y chromosome, have shown the gene’s requirement for testicular differentiation from the presence of ovotestis formation within XX Sox9 trangenic mice. (6)  Ovotestis within B6-XYPOS mice allow for gonadal development research within the same tissue to take place in ways previously unavailable. In gastropods
An ovotestis or hermaphroditic gland (Latin: glandula hermaphroditica), is found as normal anatomical feature in the reproductive system of some gastropods including such species as the land snail Cornu aspersum. People with Ovotestis
Anton Krzyzanowski

See also
Intersex
True hermaphroditism


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