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Biomedical subjects

J L Marmar

Publications and source records attributed to J L Marmar.

At least 37 records · Page 2Linked to original sources
PubMed1980

A protocol for evaluation of prostatitis.

The traditional office diagnosis of prostatitis has been based on clinical history, rectal palpation of the gland, and a microscopic examination of the expressed prostatic fluid. In light of present day information this appraoch appears to be incomplete. We have examined 41 consecutive patients with complaints of prostatitis along with 17 controls. In each case expressed prostatic fluid was collected under sterile conditions. On each specimen, we performed a bacterial culture, microscopic examination for white blood cells, and assay for zinc. The intent of this protocol was to classify clearly those with bacterial prostatitis from those with nonbacterial prostatitis and prostatodynia. We believe this approach is simple to perform even in the setting of a busy office practice.

Ambulatory Care↗
PubMed1980

Values for zinc in whole semen, fractions of split ejaculate, and expressed prostatic fluid.

Since the prostate gland secretes specific substances, several investigators have suggested that measurement of these products may be useful for the evaluation of prostatitis. In our laboratory we have measured seminal zinc as a marker of prostatic secretion to establish normal values and define the confidence limits for this assay. Zinc assays were performed on whole semen, fractions of the split ejaculate, and expressed prostatic fluid from among a population of 456 men. We hope that these data will be useful when compared with data from patients with prostatic disease.

Ejaculation↗
PubMed1980

Modification of the Friberg microagglutination tray technique for detection of sperm antibodies.

The Friberg microagglutination tray technique for the detection of sperm-agglutinating antibodies in the serum has several advantages over other techniques. Microquantities of a single-donor sperm specimen may be used for several tests and the agglutinates may be examined directly with an inverted lense microscope. However, in its original form, there were a few technical problems. The technique has been modified to eliminate the problems. The donor sperm is filtered through a glass wool filter. The procedure was adapted for Terasaki tissue culture plates. With these modifications the technique seems more practical for clinical usage.

Agglutination Tests↗
PubMed1980

Functional role of spermagglutinating antibodies in men.

The presence of spermagglutinating antibodies in blood and semen has been associated with reduced fertility in men. In this study 203 men were screened for infertility. An antibody measurement was performed on the blood and semen of each patient. Each semen specimen was also examined for spontaneous agglutination. Twelve patients with a positive reaction in the blood underwent a sperm-cervical mucus contact test. We have attempted to correlate the findings in blood with the observed functional results in semen and cervical mucus. We believe that these simple tests should be included in the infertility work-up in order to determine the presence of immune infertility.

Antibodies↗
PubMed1979

An estimate of the fertility potential of the fractions of the split ejaculate in terms of the motile sperm count.

The motile sperm count is a simple index which is equivalent to the product of sperm density (millions of sperm per milliliter) and percentage of motility (motile sperm per 100 sperm x 0.01). Since other studies have demonstrated a positive correlation between this index and the pregnancy rate, it has been hypothesized that the motile sperm count could be useful for expressing the potential fertility of individual semen specimens. Collection of semen by the split ejaculate technique and subsequent artificial insemination homologous (AIH) with the best split fraction has been used for the treatment of oligospermia. We calculated the motile sperm count for whole semen and the first fraction of split ejaculates from 45 men who were studied for infertility. Subsequently, 15 couples agreed to AIH with the first fraction of the split ejaculate. The data indicate that the motile sperm count may be a reasonable index for comparing the potential fertility of the semen specimens and thereby estimating the chances of successful AIH.

Cell Count↗
PubMed1978

Urethrographic manifestations of venereal warts (condyloma acuminata).

Intraurethral spread of venereal warts is a serious complication. Urethral involvement may be extensive and is associated with severe irritative symptoms. Spread to the bladder is possible. Recurrence are frequent and eradication difficult. We describe the urethrographic appearance of intraurethral verrucae and believe it to be strongly suggestive of the diagnosis. Voiding cystourethrography is recommended, and satisfactory visualization may be obtained with either voiding or retrograde urethrography. Voiding urethrography following intravenously administered contrast (excretory voiding cystourethrography) is particularly advantageous since it avoids the need for urethral instrumentation and, therefore, cannot contribute to retrograde spread of these contagious growths.

Condylomata Acuminata↗
PubMed1978

Statisical comparison of the parameters of semen analysis of whole semen versus the fractions of the split ejaculate.

The split ejaculate has proven to be a reliable method for concentrating sperm in a small volume. However, there is some controversy whether the spermatozoa in the most sperm-rich fraction of the split ejaculate has better motility than the spermatozoa in whole semen. In this study, at least two specimens of whole semen and two split ejaculates were obtained from 45 infertile males. The mean values for the parameters of the semen analysis were compared statistically. Our data indicate that increased sperm density is a consistent finding with the split ejaculate, even for severely oligospermic men. However, improved sperm motility with the split ejaculate is more variable. On the other hand, patients with mild oligospermia (10 to 40 million sperm/ml of whole semen) and high semen volumes (greater than 5.0 ml) demonstrated improvement in all parameters in the split ejaculate.

Humans↗
PubMed1977

Postcoital-voiding insemination: technique for patients with retrograde ejaculation and infertility.

Three patients with infertility secondary to retrograde ejaculation demonstrated motile sperm in their urine after coitus. These patients were instructed to alkalinize their urine and void directly into the vagina after intercourse. The technique was called "postcoital-voiding insemination." Three pregnancies have resulted. The technique appears to be a good alternative to bladder catheterization and artificial insemination.

Adult↗
PubMed1975

Preoperative urography in hypotensive patients with severe trauma.

In hypotensive patients with severe trauma including renal injuries, the preoperative urogram is generally of poor quality. In many instances these patients are taken to the operating room with no films at all. We have proposed a protocol for the resuscitation of severely injured patients, following which we performed a carefully monitored high-dosage urogram. We demonstrated in 16 patients that diagnostic films can be obtained even in severely injured patients who were initially in shock.

Abdominal Injuries↗
PubMed1975

Semen zinc levels in infertile and postvasectomy patients and patients with prostatitis.

The semen zinc levels were determined in 18 volunteers, 132 patients postvasectomy, and in 19 patients with prostatitis. The mean values for semen zinc were the same in the volunteers and postvasectomy patients. However, the mean zinc concentration in the volunteers and postvasectomy patients was significantly different from that of the patients with prostatitis. When a group of 12 patients with prostatitis was given supplementary zinc sulfate, the levels of semen zinc rose dramatically and were significantly different from those before treatment. As part of an infertility evaluation, 153 specimens from 72 men who had not fathered a child were examined. A complete semen analysis of each specimen was made, including the semen zinc concentration. The specimens were separated into four arbitrary groups with differing fertility potential. The groups were organized by sperm counts (less than 20 million sperm/ml, 20 to 60 million sperm/ml, 60 to 100 million sperm/ml, and greater than 100 million sperm/ml). There was a trend toward increasing zinc concentrations in the groups with increasing fertility potential. Eleven patients with oligospermia and low semen zinc levels were given supplementary zinc sulfate, 80 mg three times/day for 6 months to 1 year. The parameters of the semen analysis improved in all categories. There were three pregnancies during the period of treatment.

Cell Count↗
PubMedDate not supplied

Clinical experience with an artificial spermatocele.

Artificial spermatoceles were implanted into three patients with congenital absence of the vas. In each case, the testicular biopsy demonstrated normal spermatogenesis, and the dilated epididymal tubule was packed with spermatozoa. The ciliated epididymal mucosa appeared normal despite the tubular dilatation. The spermatoceles were constructed of expanded polytetrafluoroethylene, and they were microsurgically implanted over the cut end of the epididymis. The grafts were aspirated monthly for up to six months, and the aspirates containing spermatozoa were used for artificial insemination. Spermatozoa were consistently retrieved from each patient, but no pregnancies have resulted. The most obvious finding was that the spermatozoa lacked motility. In the discussion, other problems related to artificial spermatoceles are reviewed, including epididymal development and sperm maturation, aspiration techniques, and sperm storage.

Adult↗
PubMedDate not supplied

A modified acrosome induction test.

Many types of acrosome induction tests require special equipment and reagents that are not available to most clinicians; thus, simpler tests seem desirable. A modified acrosome induction test has been developed that uses basic reagents and a light microscope, which are available in most office settings. A hypoosmotic swelling test and a double stain (Bismark brown and rose Bengal) were combined to evaluate the viable acrosome reaction (AR) among 74 infertile men and 42 control men. The study included 34 infertile males without varicoceles, 20 with nonrepaired varicoceles and 20 with repaired varicoceles. On each test day, a specimen from a fertile donor was run as a control. The spontaneous acrosome reaction was recorded in semen before and after capacitation. The final % viable acrosome reaction equaled the capacitated value minus the spontaneous value for whole semen. The mean % viable AR among the control specimens was 16% with no values less than 10%. This mean value for controls was significantly greater than the mean % viable AR in each patient group. There were no overlaps in the 95% confidence intervals. When the study group was stratified according to normal acrosome induction tests or >10% viable AR, 30 patients had a normal test and 44 had abnormal tests. Six patients with varicoceles and an abnormal acrosome induction test had a varicocelectomy, and 2 (33%) converted their acrosome induction test to normal after at least 6 months of follow-up. Nine patients had in vitro fertilization (IVF), 3 had a poor result, and all had an abnormal acrosome induction test. Six had a good result with IVF and all 6 had a normal acrosome induction test. Thus, the acrosome induction test described in this report may be performed in any office laboratory to detect subtle male factor problems. The results may be helpful for planning IVF, intracytoplasmic sperm injection, or varicocele surgery for infertile men.

Acrosome↗
PubMedDate not supplied

The pathophysiology of varicoceles in the light of current molecular and genetic information.

Varicoceles are a common cause of male infertility, but despite data being obtained from animal models and human studies the pathophysiology remains unclear. Recently, molecular and genetic information has been reported on men with varicoceles which may shed new light onto the causes of decreased semen parameters and poor sperm function. Here, a number of studies are reviewed in an attempt to develop a working hypothesis for the relationship of varicoceles and infertility. New studies on testicular tissue of men with varicoceles have demonstrated increased apoptosis among developing germ cells, which may be the cause of oligospermia. Other studies with semen have shown increased levels of reactive oxygen species (ROS) in association with poor sperm motility. Recent studies of morphologically abnormal spermatozoa have demonstrated disruption of the sperm head actin by cadmium, a cation reported to be present in high concentrations among some men with varicoceles. Finally, microdeletions of the alpha-1 subunit of the sperm calcium channels in a proportion of men with varicoceles suggests a genetic defect leading to abnormal acrosomal function. The intent of this review was to explain the pathophysiology of varicoceles, and the findings seem to support a 'co-factor' hypothesis. In order for varicoceles to be associated with infertility, they exist as 'co-factors' along with other molecular/genetic problems.

Acrosome Reaction↗