The Norplant system: an effective, long term contraceptive of the 20th century.
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Biomedical subjects
Publications and source records attributed to E S Hafez.
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Multidisciplinary andrology deals with clinical application and modern technology for the evaluation and differential diagnosis of male infertility with emphasis on morphological, anatomical, biochemical, immunological, hereditary, and microbiological parameters. Little is known about the effects of diet, disease, stress, environmental, and drugs on male-related unexplained infertility of couples. Regional, national, and international centers of multidisciplinary andrology should provide (1) extensive and unique clinical services; (2) a computerized "patient referral center," (3) self-learning packages (slides/tape programs) for patients; and (4) a computer link to the National Library of Medicine and the Drug Information Center. Specialized laboratories and clinics can be served by expert consultants, visiting professors, bilingual and well-trained clinicians, nurses, laboratory technologists, computer operators, and related allied health personnel. Patient education pamphlets, updated every few years, can be distributed during training workshops when an extensive network of remote teleprinters can be utilized. Qualified client location may install a printer to allow on-site printing of reports in the shortest possible time. Special mailing containers are provided to clients who wish to mail their laboratory specimens. Other clinical services may include the following: 1. Central source of communication and information in andrology; 2. International roster of multidisciplinary andrology centers; 3. Patient referral to centers and consultations for developing countries; 4. Screening of husbands and wives for in vitro fertilization/embryo transfer (IVF/ET); 5. Screening of couples with unexplained infertility for sexually transmitted diseases (STDs) including AIDS; 6. Exchange of research material and methodology; 7. Coordination of multicenter research; 8. Organizing training workshops for clinicians, nurses, and laboratory technicians; 9. Establishing a repository of films, video tapes, slides, catalogs, instrumentation, books, SEM photos, and atlases; 10. Publication and editorial assistance; 11. Consultation for the appropriate selection, purchase, and quality control of instrumentation (all on one computer system); 12. Evaluation of new diagnostic tools for idiopathic infertility and fertility regulation; 13.(ABSTRACT TRUNCATED AT 400 WORDS)
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The zona-free hamster egg penetration test was performed on semen samples from 21 fertile donors, 57 infertile patients with normal semen parameters, and 63 infertile patients with subnormal spermiogram, as well as on 19 frozen semen samples. In the donor group 100% of the samples gave a positive range of penetration (PRP) of 20-96% with a mean penetration rate (MPR) of 53%, while 84% of the frozen samples showed a PRP of 18-44% and an MPR of 31%. Although 74% of the samples from infertile patients with normal spermiograms gave a PRP of 11-92% and an MPR of 34%, only 46% of the semen samples from the infertile patients with subnormal spermiogram showed a PRP of 21-100% but an MRP of 43%.
This work studied the effect of variations in the different parameters of routine semen analysis on the penetration rate of the spermatozoa into the zona-free hamster eggs, using semen samples from 21 fertile donors, 57 infertile patients with normal spermiograms, 63 infertile patients with subnormal spermiograms, and 19 frozen semen samples. The results of the hamster test do not correlate with the percentage of motile spermatozoa, the percentage of live spermatozoa, or the percentage of spermatozoa with normal morphology in the semen samples. A positive correlation was found between the results of the hamster test and three other parameters of the semen analysis: the sperm concentration, the progressive type of motility, and a pH range of 7.2-7.7, but these positive correlations were statistically insignificant.
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The state of the art of scanning electron microscopy in the field of human reproduction and the clinical significance of SEM techniques is described on the basis of 272 articles in which the SEM was a substantial instrument for research. The first section deals with reproductive cell biology, the various cell types and function in relation to cell surface microstructure. The second section outlines briefly various types of cell and tissue preparation, and advantages and pitfalls. The following sections describe the female reproductive system (including vulva, vaginal and ectocervical squamous epithelium, metaplastic epithelium of the transformation zone, endocervix and cervical mucus, endometrium, IUDs, tube, ovary, and mammary gland), the male reproductive system (male sex organs, spermatozoa) and the conceptus (placenta, embryogenesis). It is indicated where SEM has revealed deeper insights in the structure and function of reproductive cells and tissues and where SEM has a potential for clinical application. The following areas seem promising: the placenta (description of various classes of pathological conditions), the oviduct (description of two types of hydrosalpinges with different prognostic significance), cervical and ascites cytology (SEM's capacity for (early) discrimination of malignant cells) and spermatozoa (prognostic significance of classification with the use of X-ray micro-analysis). In many instances the same results can be obtained by routine LM and TEM. Because SEM does have potentially large diagnostic and prognostic powers further research is essential in order to establish the future role of SEM in the field of human reproduction.
Thryotropin-releasing hormone (TRH) was intravenously administered to eight normal control infants and ten infants with kwashiorkor. Stimulation caused by TRH was measured at various time intervals. The basal total protein mean value +/- SE was 6.9 +/- 0.3 and 4.0 +/- 0.3 g/dl for the control and kwashiorkor groups, respectively. Serum total thyroxine was 7.7 +/- 0.6 and 4.8 +/- 0.8 micrograms/dl for the control and kwashiorkor groups, respectively. Serum levels of thyroid-stimulating hormone (TSH) were 3.2, 13.5, 9.0, 7.4, and 8.0 microU/ml for the controls before stimulation and 20, 60, 90, and 120 min after stimulation, respectively. The corresponding values for the infants with kwashiorkor were 5.7, 13.9, 14.9, 15.2, and 15.3 microU/ml, respectively. The delayed TSH response to TRH stimulation in the infants with kwashiorkor was attributed to disturbance in the hypothalamic-pituitary-thyroid axis.
Seventy-five diabetic male and female children and 75 matched controls were classified according to pubertal staging. Blood samples were assayed for gonadotropins and gonadal hormones. The ultimate adult height in diabetic patients was 5 cm less than that of controls. Almost all diabetic children had a retarded bone age. Levels of serum gonadotropins and gonadal hormones did not differ markedly between diabetic and healthy children. The delay in growth and maturation was not due to hormonal failure, but probably to chronic undernutrition of body cells and failure to utilize the amino acids for protein anabolism related to relative insulin deficiency.
Serum testosterone (T) concentration and urinary 17-ketosteroid (17-KS) excretion were measured under basal conditions and after stimulation with human chorionic gonadotropin (hCG) in 36 prepubertal males (10 normal children and 26 cryptorchid patients). As a function of hCG stimulation, the increase in serum T level was evident in both groups, although the magnitude of the rise was higher in the control group than in cryptorchid boys. No significant differences in serum T or urinary 17-KS were observed between patients with unilateral and bilateral undescended testis, either before or after hCG stimulation. In spite of the wide individual variations in testicular response in all subjects, the test is valuable in assessing Leydig-cell function and in prognosis for virilization at puberty.
One hundred seventy-five males aged 9-20 years were selected. The subjects comprised two groups; controls and patients infected with urinary bilharziasis not associated with any other parasite. Pubertal development was assessed. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, and progesterone were determined by radioimmunoassay procedure. Delay in pubertal development was evident in the normal control group as indicated by higher chronological age mean values at the various stages as compared to other world norms. Urinary bilharziasis exaggerated the delay in pubertal development as compared to that in the control group. In relation to the control group, the group with urinary bilharziasis had higher levels of serum FSH and LH, which were significant only at stages III and IV. No significant difference was noted between the two groups for serum testosterone and progesterone levels, except for the high progesterone mean value at stage V in the group with urinary bilharziasis.