Caesarean section under epidural analgesia.
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Biomedical subjects
Publications and source records attributed to H Morgan.
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The behaviour of sperms has been investigated in preovulatory cervical mucus in 44 infertile couples. In 22 couples, immobilising and agglutinating autoantibodies were detected in the husband's sera in high titres. In 10 couples, antisperm antibodies were detected in the husbands by indirect immunofluorescent testing. In 12 couples, no evidence of antisperm antibodies was found in either husbands or wives. The results obtained with husband and wife were compared with the behaviour of the husband's sperms in cervical mucus from fertile donors, and with the behaviour of sperms from fertile donors in the wives' mucus. This crossed hostility test indicated that high tires of immobilising and agglutinating antisperm antibodies in the husband effectively prevented the sperms from penetrating the cervical mucus, even though the sperms appeared normal on seminal analysis. Antibodies detected by indirect immunofluorescence did not have this effect. Poor penetration was also observed with low sperm motility or poor cervical mucus. It is concluded that this test, taken with the postcoital test, could provide a useful screen for immunological causes of infertility and an accurate test for the clinical relevance of antisperm antibody tests.
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Sera from 591 men attending Fertility Clinics have been tested for agglutinating, immobilising and immunofluorescent antisperm antibodies. There was good correlation between the presence of high titres (more than 1/32) of agglutinating and immobilising antibodies which were found in 50 patients (8.5%). 27 of these men had normal sperm counts, but crossed hostility testing showed that in 21 of 22 couples the sperms were unable to penetrate the cervical mucus, apparently because of the antibodies. 17 patients were treated with prednisone for an average of 6 months and 1 pregnancy was produced. 17 patients were treated with methylprednisolone for 7 days and 1 pregnancy resulted. No correlation was found between the present of immunofluorescent antibodies and the other antibodies of impaired sperm penetration of cervical mucus.
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Seventeen cases of cerebellar abscesses are reviewed. The incidence was 18% of all brain abscesses. Thirteen were males, and four were females. Headache was the most common presenting symptom. These abscesses have a better prognosis for survival and neurological function than supratentorial abscesses. They are less likely to be encapsulated. Continued neurological decline in the face of adequate surgical treatment of a single abscess should alert the physcian to the possibility of a second abscess.
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