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Biomedical subjects

F Comhaire

Publications and source records attributed to F Comhaire.

At least 73 records · Page 4Linked to original sources

Adenosine triphosphate in human semen: a quantitative estimate of fertilizing potential.

The concentration of adenosine triphosphate (ATP) per milliliter of ejaculate was found to be significantly correlated with the following parameters: sperm concentration, number of motile spermatozoa per milliliter, capacity of spermatozoa to migrate against gravity, and in vitro potential to penetrate zona-free hamster ova. The ATP concentration was significantly lower in the semen of infertile men with normal sperm concentration and motility, compared with matched fertile donors. The ATP concentration of deep-frozen donor semen was significantly correlated with its fertilizing potential as estimated from the pregnancy per cycle index in an artificial insemination by donor semen program. These qualities suggest that measurement of semen ATP may be a possible biochemical method for the quantitation of the actual fertilizing potential of the ejaculate.

Adenosine Triphosphate↗

Testicular arterial perfusion in varicocele: the role of rapid sequence scintigraphy with technetium in varicocele evaluation.

Rapid sequence scintigraphy was used to study testicular arterial perfusion and venous stasis in 53 patients with varicocele-associated infertility, 17 with idiopathic testicular failure and 9 treated for varicocele. Arterial blood supply to the diseased testicle was decreased in 63 per cent of the patients with subclinical or low grade varicocele compared to 18 per cent with idiopathic testicular failure. In the majority of cases the disturbance of perfusion disappeared immediately after interruption of retrograde blood flow in the internal spermatic vein by transcatheter embolization, whereas persistently impaired perfusion was found in a few cases with no improvement of semen quality after treatment. Venous stasis was found in only 18 per cent of the patients with low grade varicocele compared to 88 per cent with large varicoceles. It is suggested that impaired arterial blood supply rather than venous stasis is the pathogenic factor in epididymo-testicular dysfunction associated with low grade varicocele.

Humans↗

Effect of high dose oral Kallikrein treatment in men with idiopathic subfertility: evaluation by means of in vitro penetration test of zona free hamster ova.

High dose oral Kallikrein treatment (600 U Padutine per day) was given to 10 infertile men with poor semen quality. After 3 months of this treatment no pregnancies occurred, and no significant changes in routine semen characteristics were observed. Moreover, the capacity of the spermatozoa to migrate in vitro and to penetrate zona free hamster ova remained unchanged after Kallikrein ingestion. It is concluded that Kallikrein treatment was ineffective in these men.

Animals↗

Radiological anatomy of the internal spermatic vein(s) in 200 retrograde venograms.

The radiological anatomy of the internal spermatic vein(s) was studied in 200 retrograde venograms performed as part of presurgical evaluation in patients with variocele. A large range of anatomical variations was found at the left side. Bilateral reflux occurs in one out of four patients with unilateral varicocele at palpation. Bilateral treatment is therefore necessary in as much as one fourth of cases with "unilateral' left side varicocele. In right side varicocele the spermatic vein generally enters the right renal vein. Varicocele ligation should be performed near the internal inguinal ring in order to interrupt reflux most securely. Non-surgical treatment of varicocele by means of sclerosis or embolization of the internal spermatic vein, will remain restricted to those cases in which reflux passes through only one spermatic vein. Insufficient knowledge of the anatomy of the internal spermatic vein(s), and the resulting incomplete interruption of reflux in this (or these) vessel(s) may be the cause of poor treatment results reported by some authors.

False Negative Reactions↗

Diagnosis of accessory gland infection and its possible role in male infertility.

The diagnosis of male adnexitis is difficult and the influence of this condition on fertility is still a matter of debate. With the intention to define diagnostic criteria a comprehensive study of biochemical and morphological features of semen, plus culture for microorganisms, was performed in patients who were assessed for infertility during a four year period. The following parameters were considered of diagnostic value: a) history of urogenital infection and/or abnormal rectal palpation. b) significant alterations in the expressed prostatic fluid and/or urinary sediment after prostatic massage. c) 1. Uniform growth of more than 10(3) pathogenic bacteria, or more than 10(4) non-pathogenic bacteria per ml, in culture of diluted seminal plasma. c) 2. Presence of more than 10(6) (peroxidase positive) leucocytes per ml of ejaculate. c) 3. Signs of disturbed secretory function of the prostate or seminal vesicles. The diagnosis of infection is accepted if either of the following combinations if found: a + b, a + c (1 or 2 or 3), b + c (1 or 2 or 3), c1 + c2, c1 + c3, c2 + c3.

Acid Phosphatase↗

Hormonal effects of an antiestrogen, tamoxifen, in normal and oligospermic men.

The administration of tamoxifen, 20 mg/day for 10 days, to normal males produced a moderate increase in luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, and estradiol levels, comparable to the effect of 150 mg of clomiphene citrate (Clomid). However, whereas Clomid produced a decrease in the LH response to LH-releasing hormone (LHRH), no such effect was seen after the administration of tamoxifen. In fact, prolonged treatment (6 weeks) with tamoxifen significantly increased the LH response to LHRL. Treatment of patients with "idiopathic" oligospermia for 6 to 9 months resulted in a significant increase in gonadotropin, testosterone, and estradiol levels. A significant increase in sperm density was observed only in subjects with oligospermia below 20 X 10(6)/ml and normal basal FSH levels. When basal FSH levels were increased or oligospermia was moderate (greater than 20 X 10(6)/ml); no effect on sperm density was seen. As sperm density increased, FSH levels decreased, suggesting an inhibin effect. Sperm motility was not improved by tamoxifen treatment. In five boys with delayed puberty, tamoxifen treatment appeared to activate the pituitary-gonadal axis and pubertal development.

Adult↗

The thermographic characteristics of varicocele: an analysis of 65 positive registrations.

Sixty-five positive thermograms in patients suspected of subclinical varicocele or presenting with clinically palpable varicocele have been analysed. Two distinct patterns of varicocele associated thermograms could be distinguished, herperthermia always exceeding 1 degrees C. A correlation was found between the clinical grade of varicocele and both the extension and the degree of hyperthermia.

Diagnostic Errors↗

[Clinical, hormonal and spermiologic evaluation in 25 crytorchids patients (author's transl)].

To obtain as many informations as possible about the degree of their fertility, 25 patients treated with gonadotropin or surgically for unilateral or bilateral cryptorchidism, were submitted to clinical examination, to evaluation of the endocrine testicular function, and to detailed sperm analysis. With respect to the serum gonadotropin levels, it is possible to distinguish three groups of patients : some with normal FSH and LH, some with increased FSH and normal LH, and some with increased FSH and LH. It appears that the tubular cells exerce a feed-back control on the FSH level, probably through a substance called "inhibin". The possibility is suggested that some feed-back control on the LH level is equally exerced from the tubular cells.

Adult↗

The value of scrotal thermography as compared with selective retrograde venography of the internal spermatic vein for the diagnosis of "subclinical" varicocele.

The accuracy of scrotal thermography as a diagnostic method to confirm or detect spermatic venous reflux in patients with palpable and subclinical varicocele, respectively, was evaluated. In all, 118 scrotal thermograms were performed in 110 patients, and the results were compared with the findings by selective retrograde venography of the internal spermatic vein whenever required. Normal thermograms were recorded in 23 oligospermic men without varicocele. Of 39 patients with palpable varicocele, 37 had abnormal thermograms; normal recordings occurred in 2 patients with associated unilateral testicular atrophy. Among 36 men suspected of having subclinical varicocele, 19 had abnormal thermograms and 16 presented reflux on the venogram. Venography was performed in 5 of the remaining 17 men with normal thermograms; only 1 had reflux. Screening for varicocele by means of scrotal thermography thus revealed reflux in 16 of 36 patients with unexplained infertility. Postoperative thermograms were disturbed in 6 of 20 cases, 5 of which presented reflux. Only 1 of 14 postoperative patients with normal thermograms underwent venography, and no reflux was demonstrable. Both the difference in temperature between the affected and contralateral hemiscrotum and the area of hyperthermia were significantly greater in patients with grades II and III varicocele, compared with those with subclinical and grade I varicocele. It is concluded that scrotal thermography is a valuable screening method for the detection of spermatic venous reflux. The technique allows selection of patients to be subjected to retrograde venography.

Adult↗

Selective retrograde venography of the internal spermatic vein: a conclusive approach to the diagnosis of varicocele.

Selective retrograde catheterisation of the left internal spermatic vein at its orifice in the renal vein was carried out in 25 patients suspected of varicocele. When contrast medium is injected, the patients with varicocele, standing in the erect position, present a retrograde filling of the varicose spermatic vein, in contrast to the absence of such reflux in normal men. The venography is indicated for diagnostic and therapeutic purposes and it is the only available, non-surgical technique to prove the existence of a disturbed venous flow in the testicular region.

Adult↗

Plasma testosterone in patients with varicocele and sexual inadequacy.

Plasma testosterone concentration was decreased in 10 patients combining varicocele with sexual inadequacy (mean 346.2 ng/100 ml) against normal concentration observed in 23 men with varicocele without sexual disturbances (mean 567.8 ng/100 ml) and in 31 patients with pure psychogenic impotence (mean 581.6 ng/100 ml). There was a significant inverse linear correlation between age and plasma testosterone concentration in the varicocele patients (r= minus 0.56, P smaller than 0.01) in contrast to the absence of such correlation in normal men or in patients with psychogenic impotence of the same age range. The secretion products of the secondary sex glands were more often in the lower range in the ejaculates of men combining varicocele with sexual disturbance (P smaller than 0.02), proving the decreased testosterone level to induce a deficient function of these glands. Plasma testosterone levels normalized after surgical correction in varicocele patients with a low preoperative concentration. Since adequate surgical or hormonal treatment resulted in complete recovery of sexual potency in the majority of patients with varicocele and sexual inadequacy, it is suggested that the decreased testosterone production might have contributed to the impairment of sexual function.

Acid Phosphatase↗