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Biomedical subjects

A Mansat

Publications and source records attributed to A Mansat.

At least 37 records · Page 2Linked to original sources

[Bilateral testicular Leydig cell tumor. Procedure to follow].

The authors report one case of a bilateral testicular Leydig cell tumor in a man of 29 years old. There are few cases of such tumors reported in the literature. Gynecomastia force the patient to consult his doctor. His hormonal profile is practically normal; however, the serum estradiol is at the limit superior of normal range, and serum testosterone at the limit inferior. Testicular palpation is normal. It is the scrotal ultrasonography which confirms the diagnosis of testicular tumor. The scrotal ultrasonography has to be performed in every patient with unexplained gynecomastia. There is no metastasis. Before the treatment, the sperm conservation is performed (his sperm is normal). Our surgical sequence for this man without children was the next one: 1. inguinal orchiectomy was performed at the side of bigger tumor. Histological diagnosis was the benign Leydig cell tumor; 2. one month later, an inguinal orchidotomy at the other side was performed and the tumor palpable of 9 mm was removed. The extemporaneous biopsy confirmed the same diagnosis as at the other side; 3. one year later, there is no metastasis and the woman of our patient becomes pregnant.

Adult↗

Evidence for the activation of phospholipases during acrosome reaction of human sperm elicited by calcium ionophore A23187.

Incubation of washed human sperm with [3H]- or [14C]arachidonic acid allowed a major incorporation of the label into phospholipids, provided that the final concentration of the fatty acid did not exceed 20 microM. A further challenge with calcium ionophore A23187 of spermatozoa suspended in a calcium-containing medium led to phospholipid hydrolysis, which could account for 10-12% of total cell radioactivity. Degradation products were identified as free, unconverted arachidonic acid, occurring with some diacylglycerol. Phospholipid hydrolysis was significant after 15 min of incubation and became maximal after 120 min. It was found to be calcium dependent, diacylglycerol and free arachidonate production occurring maximally at 2 mM and 5 mM CaCl2, respectively. Phosphatidylcholine and phosphatidylinositol were the most significantly degraded phospholipids after 60 min of incubation. Similar incubations conducted with 32P-labeled sperm confirmed the selective hydrolysis of phosphatidylcholine and revealed an increase production of phosphatidic acid probably due to a phosphorylation of diacylglycerol. Under the same conditions, one third of the cells remained motile and electron microscopy revealed that acrosome reaction was completed in 40% of the cells and displayed an intermediary state in 40-50% of the spermatozoa. Furthermore, a good parallelism was observed between the extent of the acrosome reaction and the extent of phospholipid hydrolysis promoted by increasing concentrations of A23187. It is concluded that calcium entry into the cells activates both a phospholipase A2 and a phospholipase C, leading to the production of substances, like lysophospholipid, diacylglycerol or phosphatidic acid, which may or may not be involved in acrosome reaction.

Acrosome↗

Association of scrotal hyperthermia with impaired spermatogenesis in infertile men.

Scrotal temperatures, testicular volumes, and sperm characteristics were studied in 150 infertile, nonazoospermic men and in 37 fertile men, used as a control group. The mean scrotal temperature values of the infertile men were significantly greater than those observed in the fertile men (+0.4 degrees C for the right; +0.5 degrees C for the left). In the infertile men, it was found that the higher the scrotal temperature, the more alterated the sperm characteristics. The only clinical element that seemed to be linked to the existence of scrotal hyperthermia in the infertile men was testicular hypotrophy. Although the scrotal temperatures of the infertile men with varicocele were significantly higher than those of the fertile men, they did not significantly differ from those of the infertile men without varicocele. No other specific pathologic factor, infectious or surgical urogenital history was found to be responsible for the scrotal hyperthermia observed in the infertile men.

Body Temperature↗

Hyperthermia and human spermatogenesis: enhancement of the inhibitory effect obtained by 'artificial cryptorchidism'.

Decreased sperm count and motility were observed in men after induction of local testicular hyperthermia by raising the testicles into the inguinal canal during the day in adult volunteers. A similar technique in which the testicles were better maintained in the inguinal canal resulted in more marked suppression of spermatogenesis. As assessed by the total motile sperm count, the mean inhibitory effect of hyperthermia was at least 97% after 2 months using this technique. This effect of 'artificial cryptorchidism' may be of practical interest in the manipulation of male fertility.

Adult↗

[Chromosome anomalies and male infertility. A study of 1,444 subjects].

Chromosomal anomaly was detected in 7.6% of a cytogenetic survey of 1,444 infertile male azoospermia or oligozoospermia with a sperm count below 20 million/ml. Anomalies are especially of the sex-chromosome and of autosomal robertsonian translocation type. Distribution of these subjects on account of the sperm count has pointed out an increase of chromosomal anomalies in inverse ratio to the sperm count.

Chromosome Aberrations↗

Effects of artificial cryptorchidism on sperm morphology.

In a diurnal artificial cryptorchidism (AC) experiment intended to provide a male contraceptive method, oligoasthenozoospermia was found as early as the fourth month, accompanied by an increase in the mean percentage of abnormally shaped spermatozoa. A detailed morphologic study concerning 19 volunteers exposed for 6 to 24 months demonstrated that the overall increase of the mean percentage of abnormally shaped spermatozoa resulted from the percentage increase of elongated, thin, and irregular heads and of bent tails. This increase is probably caused by the rise in environmental testicular temperature induced by AC. A return to baseline values was observed within 12 months after the end of the experiment.

Adult↗

[Varicocelectomy for infertility is more effective in cases of sperm count less than 5 million/ml. Apropos of 70 cases].

70 patients, out of a total of 664 infertile subjects with a varicocele, presenting a sperm count of less than 5 X 10(6)/ml, were operated and followed for a mean period of 8 months. 80% of the 70 varicoceles were voluminous, compared with 23% in the general population. There was a statistically significant difference between the presence of a large varicocele and the presence of testicular hypotrophy or a sperm count of less than 5 X 10(6)/ml. Histological examination of 80 testes revealed a defect of maturation in 36% of cases (T2), corresponding to reversible histological lesions. The histological lesions predominantly involved the tube (66%) followed by the basement membrane (52%) and the interstitium (42%). The difference between the pre- and post-operative sperm counts was statistically significant (p less than 0.001). We obtained a 36% paternity rate after a mean post-operative delay of 8 months. The authors consider that the larger the varicocele, the more severe the histological lesions (maturation defect = T2). These cases have a very good chance of post-operative improvement as a result of restoration of spermatogenesis. This improvement is more marked when the lesions of the basement membrane and interstitial lesions are less severe. This concept of a "large pathogenic varicocele" which responds well to surgical cure raises doubts about the concept of sub-clinical pathogenic reflux detected by Doppler examination or by phlebography resulting, far too often at the present time, in an embolisation procedure.

Humans↗

[Epididymal prognostic factor in epididymo-deferential anastomosis].

Results of a 1981 study are complemented and analyzed with respect to epididymal histology in 94 patients undergoing uni- or bilateral epididymo-deferential anastomosis. Testicular histology was normal in all patients. Epididymal histology could be differentiated into two main groups: one with normal or only slightly altered epididymis, the other with major epididymal lesions. Repermeabilization was more frequent and of better quality (10 X 10(6) sperm/ml or more) in the first group, in which there were also all the pregnancies. Previous genital infection or injury is of poor prognosis due to the severe epididymal lesions present.

Epididymis↗

Inhibiting effect of artificial cryptorchidism on spermatogenesis.

In order to provide a contraceptive method in man, an attempt at inhibition of spermatogenesis was made by means of thermogenesis induced by artificial cryptorchidism. This experimental protocol consists of pushing up the testicles into the inguinal canal and keeping them there, each day during waking hours, by means of an adapted athletic supporter. Fourteen men volunteered for this protocol during a 6- to 12-month period. They all had a normal semen analysis before starting the experiment. The total sperm count, the sperm count per milliliter, the motility, the motile sperm count per milliliter, and the total motile sperm count dropped significantly after the first or second month; they reached their lowest values after the sixth month and remained stable during the next 6 months. At that time the average values reached were a total sperm count of 12 to 34 X 10(6)/ejaculate, a sperm count of 3 to 10 X 10(6)/ml, a motility of 21% to 34%, a motile sperm count of 1 to 3 X 10(6)/ml, and a total motile sperm count of 4 to 12 X 10(6)/ejaculate.

Adult↗

[The place of urinary cytology in the diagnosis of urothelial tumors].

A cytologic study was done in three groups of patients, either for screening purposes or for the follow up of vesical tumors already treated by transurethral resection or cystectomy. The reliability of urinary cytology is closely related to the degree of tumor anaplasia (81,8% positive cytology in grade III tumors). When a cytologic and cystoscopic follow-up is done, the results of these two methods are in agreement in 60% of the cases. In the follow up of patients already treated for vesical tumors, the association of cystoscopy and cytology increases the discovery of recurrences by 40%. The persistence of isolated positive cytologies is indicative of highly malignant lesions (grade III). In cystectomized patients, a close correlation exists between the histologic grade and the positivity of the cytologic survey. A cytologic follow up after cystectomy helps to discover a greater number of urethral recurrences.

Carcinoma in Situ↗

Varicocelectomy.

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Adult↗

[Cryptorchism and sterility].

The authors report their observations on the association of sterility with antecedent cryptorchidism. In 1 190 sterile men, 88 had history of cryptorchidism (bilateral in 55 cases and unilateral in 33 cases). All had testicles in normal position in the scrotum at the time of their clinical examination, whether or not they had had an operation. Of 73 cases operated, 46 had been followed, and amongst these, 12 had had an operation for varicocele. The majority of these patients had had treatment with clomiphene or androgens. In these patients the earlier the operation had been done, the better the chances for testicles of normal volume. Of 20 patients with azoospermia, 16 had had bilateral cryptorchidism. Only 9 of the whole group had a normal sperm analysis, while all the other had oligospermia, teratospermia and altered motility. One third the subjects had elevation of FSH and hypotestosteronemia, and in 13 with hypotestosteronemia, 10 had had bilateral cryptorchidism. Treatment resulted in 10 pregnancies. Since the majority of the patients had been treated late for their cryptorchidism, the authors advise bringing the testicles down before the age of 4. Hormonal treatment and varicocele ligature can improve fertility in sterile men having cryptorchidism in their past.

Adolescent↗

[Varicocele and hypofertility. Results of 220 cases. Postoperative results].

Having studied 220 varicocelectomies which were performed by a method already described, we have been able to correlate the degree of varicocele present with testicular atrophy, with a rise in the plasma LH and with the severity of the histological lesions found. In 52.3% of cases there was a higher concentration of sperms present. Above all if the motility was less than 30% beforehand it improved most. 120 patients were reviewed. 43 (35%) became fertile. These was no difference in the improvement in the spermograms between those who were operated on who stayed infertile and those that become fertile. Thermography is not a reliable test: there were 35 poor correlations out of 107 patients. These was no correlation between the size of the varicocele, the gradient of the temperature and the biological abnormalities as against the concentration, the mobility and teratospermia.

Adult↗

[A summary of the results of microsurgical exploration and treatment. 40 cases of male sterility (author's transl)].

The authors report their statistical results of 40 subjects that were explored and where double epididymo-deferens anastomoses were achieved. They found that there were associated conditions which worsened the prognosis, namely: stenosis of the genital tracts and broncho-pulmonary infections. On the other hand stenosis of the genital tracts associated with varicocoele gave a better prognosis. Permeability was achieved in 40 p. 100 of cases. Six pregnancies occured from 33 patients who were followed up with post-operative spermograms. The following treatments are useful if added to the surgical treatment: gonadotrophins, corticoids and antibiotics. They point out that surgical cure is much more likely when varicocoele is associated.

Bronchiectasis↗

[The results of two years of artificial insemination (author's transl)].

Artificial insemination donor (AID) is the solution for the sterility of many couples where the man is irreversibly sterile. We present the results of AID using frozen sperm in the two first years of work at the Centre d'Etudes et de Conservation du Sperme (C.E.C.O.S.), which is situated in the Midi-Pyrénées region of France. The results that have been obtained are satisfactory and prove the value of this method, but the means at present at the disposal of the Center do not always meet the demands made on it.

Adult↗

[Analysis of 830 case histories of male sterility of which 282 are usable. Results of our diagnostic investigations and therapeutic procedures].

Overall results are given of the investigation and treatment of 282 cases of male sterility: 245 cases of secretory and 37 of excretory sterility; 126 cases in which treatment produced no change, 110 cases showing biological improvement and 45 cases in which pregnancy occurred; 128 of the 282 men had varicoceles. There were three groups of patients; 1) Those with azoospermia: 59 cases, predominantly with excretory problems, bilateral atrophy and chromosomal anomalies: of these, eight showed an improvement, of which two resulted in pregnancy; 2) Those with oligo-asthenospermia: 110 cases, with predominantly solitary varicoceles, intoxications and unknown causes: 66 per 100 showed improvement, and in 23 of these cases pregnancy resulted; 3) Those with varicoceles associated with another cause, predominantly unilateral atrophy and intoxications: 62.8 percent showed biological improvement, and 12 of these cases resulted in pregnancy. Also mentioned is the group of patients with solitary asthenospermia; solitary oligospermia and hyperzoospermia of more than 200 million per ml. Varicocele is the predominant pathology in these three groups.

Adult↗