The prevalence of chronic infections of the nasal sinuses and the lung (chronic sinopulmonary disease) was investigated in 33 Chinese patients with obstructive azoospermia who were compared with 32 patients with azoospermia due to failure of the germinal epithelium. Ten out of the group of 33 patients with obstructive azoospermia had congenital absence of the vas and/or epididymis and were excluded from that group. The patients with obstructive azoospermia had normal testis size, normal levels of serum FSH and LH, lower seminal fluid fructose, and a higher incidence of serum sperm agglutinating and immobilizing antibodies when compared with the group with damage to the germinal epithelium. The number of patients with symptoms of chronic sinopulmonary infections were similar in all groups. One patient with obstructive azoospermia had bronchiectasis. All other patients had normal chest x-ray studies. About 40% of the patients in all three groups had abnormal sinus X-rays. However, the nonsmoking patients with obstructive azoospermia had a statistically significant (P less than 0.05) lower mid-expiratory flow rate than the nonsmoking patients with nonobstructive azoospermia. Only three additional patients with obstructive azoospermia had both abnormal sinus x-ray and a reduced mid-expiratory flow rate, suggestive of Young's syndrome. It was concluded that Young's syndrome (sinopulmonary infections associated with acquired obstructive azoospermia) is much less common in Chinese men (four out of 23, 17%) and their sinopulmonary problems are less severe than in Caucasians.

Adult↗

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Diagnostic value of sperm function tests and routine semen analyses in fertile and infertile men.

The results of routine semen analyses, the zona-free hamster oocyte penetration test, the hypoosmotic swelling test, and semen adenosine triphosphate levels were studied in 66 fertile and 130 infertile men. Multivariate discriminant analysis demonstrated that routine semen parameters including semen volume, sperm count, percent sperm motility, and percent normal spermatozoa in combination could predict the fertility of these patients with 70.4% accuracy. Of the three sperm function tests evaluated, the zona-free hamster oocyte penetration test and the hypoosmotic swelling test were selected by the multivariate discriminant analysis as variables capable of providing significant information on the fertility status of the patients. However, the addition of the results of these two tests to the routine semen analysis did not significantly improve the predictability of fertility. The overall correct prediction rate was 77.6% after incorporation of the results of these two sperm function tests. In this group of subjects, the presently available sperm function tests did not predict the fertility status of a patient with a high degree of accuracy.

Diagnostic Tests, Routine↗

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Evaluation of computerized analysis of sperm movement characteristics and differential sperm tail swelling patterns in predicting human sperm in vitro fertilizing capacity.

Multivariate discriminant analysis was used to evaluate the usefulness of computer image analysis of sperm movement characteristics and differential patterns of sperm tail swelling after hypoosmotic treatment for predicting the human sperm in vitro fertilizing capacity assessed by the zona-free hamster egg penetration assay. Fifty-five semen samples, mostly normospermic, from untreated infertility clinic patients were analyzed. The % normal sperm morphology, linearity of seminal sperm movement, seminal sperm head beat frequency, mean and maximum amplitudes of lateral head displacement, and hypoosmotic sperm tail swelling patterns c, d and f were selected by multivariate discriminant analysis to be capable of discriminating the samples exhibiting the presence or the absence of sperm in vitro fertilizing capacity. The % total sperm tail swelling did not give additional information about in vitro fertilizing capacity. These preliminary data suggest that computer image analysis of sperm movement characteristics and differential evaluation of hypoosmotic sperm tail swelling might be useful for the prediction of human sperm fertility. Further prospective studies are necessary to validate their predictive functions.

Evaluation Studies as Topic↗

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Impairment of spermatogenesis in transgenic mice with selective overexpression of Bcl-2 in the somatic cells of the testis.

To explore the functional role of Bcl-2 in germ cell development, transgenic mice carrying 6 kilobases of the inhibin-alpha promoter were generated to express human bcl-2 gene product in the gonads. Although female transgenic mice demonstrated decreased follicle apoptosis, enhanced folliculogenesis, and increased germ cell tumorigenesis, the adult males exhibited variable impairment of spermatogenesis. The degree of damage ranged from tubules with intraepithelial vacuoles of varying sizes to near atrophied tubules consisting of Sertoli cells and a few spermatogonia. Although there was no significant change in body weight, an approximately 34% decrease in testicular weights was noted in transgenic animals compared with wild-type mice. Gamete maturation, assessed by determining the percentage of tubules with advanced (steps 13-16) spermatids, was decreased to 44.4% of the values measured in the wild-type animals. The incidence of germ cell apoptosis increased 3.8-fold in the transgenic animals and was associated with a marked loss of germ cells. Electron microscopy of the testes further revealed large vacuoles in the Sertoli cell cytoplasm and dilations of the intracellular spaces between adjacent Sertoli cells, spermatid malformations, and increased germ cell apoptosis in the transgenic animals. There was no evidence of Sertoli cell death either by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay or electron microscopy. Leydig cell ultrastructure, cell size and numbers, and plasma levels of testosterone were not different between normal and the transgenic animals. Collectively, these results support the critical role of Bcl-2 in male germ cell development and are consistent with the gender-specific role of the Bcl-2 family members in reproduction.

Animals↗

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Uptake of mangafodipir trisodium in liver metastases from endocrine tumors.

The purpose of the study was to investigate retrospectively whether mangafodipir trisodium (MnDPDP) can enhance the liver metastases from endocrine tumors. Thirteen patients with endocrine tumors and liver metastases underwent T1-weighted spin-echo (SE) and turbo gradient-echo (GRE) MRI conducted before and 20 to 60 minutes after i.v. infusion of MnDPDP. Additional 24-hour-delay scans were performed in 8 of 13 patients. MR signal intensity (SI) was measured in liver parenchyma and metastases, which was then related to that of paraspinal muscle. A total of 30 lesions on precontrast and postcontrast images and 18 lesions on 24-hour-delay images were measured. An enhancement by 49% in SE and 40% in GRE images (P = .0001) was observed in tumor tissues after MnDPDP infusion. In 24-hour-delay images, the SI of the lesions remained relatively high, but in liver parenchyma, it decreased significantly, and the tumor-liver tissue contrast was reduced.

Adult↗

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Cancer-specific worry interference in women attending a breast and ovarian cancer risk evaluation program: impact on emotional distress and health functioning.

Intrusive thoughts about cancer, often identified as 'cancer-specific worries' or 'cancer-specific distress', have been postulated to be associated with dysfunction in women at increased risk of developing breast or ovarian cancer. The current study discusses the development and validation of a measure designed to assess women's perceptions of the interference such worries create in their daily functioning. Analyses revealed that approximately two-thirds of a high-risk breast cancer clinic sample perceived worries about breast cancer as interfering with their functioning across a variety of life domains. Multiple regression analyses indicated that worry interference scores predicted Profile of Mood States (POMS) Anxiety and Confusion, and Short Form-36 (SF-36) Role-Emotional and Mental Health scores after the effects of other variables such as frequency of worry about breast cancer, and having a family history of cancer had been considered. Women who perceived their worries as interfering with their functioning reported higher levels of anxiety and confusion, and diminished mental health and role functioning. The results add to the expanding area of anxiety/distress in at-risk populations by providing (1) a direct measure of the perceived interference associated with breast cancer-specific thoughts, (2) a validation of the measure via its associations with standard measures of emotional distress and health functioning, and (3) evidence of the measure's incremental predictive value in explaining distress and quality of life, after consideration of background variables, such as having a family history of cancer.

Activities of Daily Living↗

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CT appearance of ectopic pancreas: a case report.

The appearance of ectopic pancreas on computed tomography (CT) is described in a 47-year-old man with bowel obstruction. The enhancement pattern of ectopic pancreas after intravenous iodine contrast administration is the same as that of leiomyoma or carcinoid. This CT finding has not been reported previously to our knowledge.

Choristoma↗

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Androgens and aging in men.

Androgen levels decrease with aging in men. Androgen deficiency in elderly men may lead to asthenia, decrease in muscle mass, osteoporosis, decrease in sexual activity, and, in some cases, changes in mood and cognitive function. Combination of these factors may result in impaired quality of life in the elderly male. Androgen replacement therapy may increase bone and muscle mass, enhance muscle and cardiovascular function, and improve sexual function and general well-being. These potential benefits of androgens have to be weighed against the possible adverse effects on prostate and cardiovascular diseases. Careful long-term studies will be required to assess the risk-to-reward ratios of androgen or other hormone replacement therapy before the development of treatment strategies similar to estrogen and progestagen substitution therapy for the postmenopausal female.

Aged↗

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Electroshock- and pentylenetetrazol-induced seizures in genetically epilepsy-prone rats (GEPRs): differences in threshold and pattern.

Using facial and forelimb (F&F) clonus (a proposed forebrain marker) and running-bouncing (R/B) clonus and tonus (proposed brain-stem markers), the responsiveness of forebrain and brain-stem to electroshock or pentylenetetrazol seizures was assessed in GEPRs. The most striking finding was the failure of GEPR-9s to display F&F clonus in response to transcorneal electroshock at any stimulus intensity. Indeed, GEPR-9s displayed only R/B clonus or tonus indicative of brain-stem seizure discharge. GEPR-3s and normal rats, on the other hand, displayed F&F clonus in response to the least effective electroshock stimulus, and R/B clonus and tonus at higher stimulus intensities. After treatment with phenytoin (50 mg/kg) to inhibit the tonic seizure, the least effective electroshock stimulus also produced F&F clonus in GEPR-9s. These findings suggest that the threshold for triggering brain-stem seizure discharge by electroshock is lower than that for triggering forebrain seizure discharge in GEPR-9s, whereas the reverse relationship is true in normal rats and GEPR-3s. The rank ordering of the electroshock thresholds was: normals greater than GEPR-3s greater than GEPR-9s. Both GEPR-3s and GEPR-9s were found to be hyper-responsive to pentylenetetrazol as evidenced by shorter latency for the tonic seizure and a greater seizure severity than normal rats. The rank ordering of seizure severity in response to pentylenetetrazol was: GEPR-9 greater than GEPR-3 greater than normal rats.

Animals↗

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Direct and computed tomography thickness measurements of the human, lumbar vertebral shell and endplate.

Although the trabecular bone of the human vertebral body has been well characterized, the thin "cortical" shell and endplate that surround the trabecular centrum have not. In addition, the accuracy of estimating the thickness of the shell and endplate using computed tomography (CT) has not been evaluated directly. To address these issues, we measured the thickness of the vertebral shell and endplate in the mid sagittal plane of 16 human L1 vertebral bodies using direct and CT based methods. Specimens were assigned to four equal sized groups based on age (middle-aged, mean age = 49 years; old, mean age = 84) and gender. We investigated the dependence of the shell and endplate thicknesses on age, gender, and anatomic region. Our findings indicate that the shell and endplate in vertebrae over age 45 are porous and often irregular, with an average thickness of approximately 0.35 mm. However, when measured from CT images, the vertebral shell and endplate appear significantly thicker, indicating that measurements based on clinical CT scans overestimate the thickness by a factor of at least two. In addition, our data indicated that, in the midsagittal plane, the anterior shell is thicker than the posterior shell or either endplate. Although these data indicated that thickness did not depend on age or gender, these particular findings are inconclusive given the small and heterogeneous sample we examined. We conclude that the so-called cortical shell and endplate of the vertebral body are thin (less than one-half of a millimeter) and porous, and perhaps are better thought of as thin membranes of fused trabeculae than as true cortices.

Adult↗

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