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Biomedical subjects

R E Berger

Publications and source records attributed to R E Berger.

At least 73 records · Page 4Linked to original sources
PubMed1987

Quantitation of corporeal venous outflow resistance in man by corporeal pressure flow evaluation.

We describe a technique that allows us to quantify intracorporeal penile venous resistance in papaverine-induced erections. By increasing intracorporeal pressure to greater than the mean arterial pressure by cavernous perfusion with Ringer's lactate solution we can control and measure cavernous flow and pressure, and, therefore, calculate venous resistance. We evaluated 78 impotent men and 6 controls with this method. The most important measure of the integrity of the venous resistance mechanism and of the ability to obtain an adequate erection was a post-distension steady state pressure of 50 mm. Hg or more and a venous outflow resistance of 20 mm. Hg minute per cc or more. Our method aids in the clinical evaluation of the etiology of erectile impotence.

Adult↗
PubMed1987

Diagnosis of bacteriuria in men: specimen collection and culture interpretation.

Bacteriologic criteria for diagnosing urinary tract infections in men have not been well defined. For determination of the bacterial colony count in voided specimens that most accurately reflects bladder bacteriuria, culture results were compared for voided urine and bladder urine (obtained by suprapubic aspiration and urethral catheterization) from men with various genitourinary problems. Bladder bacteriuria was found in 36 (47.3%) of 76 sets of specimens from 66 individuals. Culture results of bladder specimens showed excellent agreement with those of clean-catch midstream-void and uncleansed first-void specimens (weighted kappa = 0.924 and 0.906, respectively). The criterion for clean-catch midstream-void specimens that best differentiated sterile from infected bladder urine was growth of greater than or equal to 10(3) cfu of one predominant species/ml; this definition had a sensitivity of 0.97 and a specificity of 0.97. Uncleansed first-void specimens were equally sensitive (0.97) but less specific (0.91-0.92) in detection of bacteriuria. Pyuria (greater than or equal to leukocytes/mm3) and irritative genitourinary symptoms showed modest correlations with bladder bacteriuria.

Bacteria↗
PubMed1986

Operative recovery of vasal sperm from anejaculatory men: preliminary report.

Sperm showing good motility and function, as demonstrated by the in vitro sperm penetration assay using hamster ova, were collected from the vas deferens of 3 men with ejaculatory failure. The collection procedure may be repeated over multiple ovulatory cycles. The sperm may be used to attempt artificial insemination or in vitro fertilization.

Adult↗
PubMed1986

Increased frequency of pulsatile luteinizing hormone-releasing hormone administration selectively decreases follicle-stimulating hormone levels in men with idiopathic azoospermia.

Men with idiopathic azoo-oligospermia and selective elevations of follicle-stimulating hormone (FSH) levels have evidence for decreased luteinizing hormone-releasing hormone (LH-RH) pulse frequency. We assessed whether increasing the frequency of pulsatile LH-RH stimulation can lower FSH levels in such men. We administered 5.0 microgram of pulsatile LH-RH subcutaneously at intervals of 30, 60, and 120 minutes for 1 week to four men who had azoospermia, elevated FSH levels, and normal LH and testosterone (T) levels. The order of administration was varied among subjects. Frequent blood samples were obtained for 6 hours before LH-RH treatment and during the last 6 hours of each regimen. Before LH-RH treatment, the FSH levels (mean +/- standard error of the mean) were 359 +/- 18 ng/ml (normal range, 30 to 230 ng/ml). During LH-RH treatment, FSH levels progressively declined from 397 +/- 68 ng/ml to 237 +/- 70 ng/ml to 175 +/- 43 ng/ml as the frequency of administration increased from every 120 to 60 to 30 minutes, respectively (P less than 0.05). Unlike the FSH levels, which showed a progressive decline, LH, T, and estradiol levels showed no consistent relationship to LH-RH pulse frequency. We conclude that (1) in men with idiopathic azoospermia and elevated FSH levels, it is possible to decrease FSH levels by increasing the frequency of pulsatile LH-RH stimulation; (2) this decline does not appear to be a result of changes in steroid feedback or pituitary down-regulation; and (3) the frequency of pulsatile LH-RH stimulation can differentially modulate LH and FSH secretion by the pituitary gland.

Adult↗
PubMed1986

Comparison of gonadal function between fertile and infertile men with varicoceles.

The high prevalence of men with varicoceles who by history are fertile has led some to question the suggested causal relationship between a varicocele and male infertility. However, testicular function in these fertile men has not previously been studied in detail. Fifty-five normal fertile men, 42 fertile men with varicoceles, and 24 infertile men with varicoceles and normal female partners were studied. Semen analyses were done, baseline serum testosterone and gonadotropin levels tested and the gonadotropin response to luteinizing hormone-releasing hormone (LH-RH) measured. The infertile men with varicoceles exhibited lower sperm counts, abnormal sperm morphologic features, increased baseline serum gonadotropins, and increased gonadotropin responses to LH-RH, compared with the normal fertile men. The fertile men with varicoceles showed similar abnormalities, although this was not statistically significant in all cases. That semen and hormone abnormalities were observed in both the fertile and infertile men with varicoceles suggests that the presence of a varicocele is associated with some degree of primary testicular dysfunction, regardless of present fertility status.

Adult↗
PubMed1985

Amiodarone-associated epididymitis: drug-related epididymitis in the absence of infection.

An atypical epididymitis syndrome developed in 6 of 56 men (11 per cent) treated with amiodarone, an effective new anti-arrhythmic agent. Of the 6 patients 5 (87 per cent) had bilateral epididymal enlargement and pain. The mean dosage in the patients with epididymitis was 700 mg. per day compared to 377 mg. per day in all patients (p less than 0.01). No infectious etiology was implicated in any patient. Temporary discontinuation or decrease in dosage is recommended for patients who suffer noninfectious epididymitis while on amiodarone therapy.

Adult↗
PubMed1985

Sexually transmitted disease in men.

As sexual mores have changed, the primary care physician is increasingly challenged by patient sexually transmitted diseases. In this article, the authors attempt to aid in the proper diagnosis and management of men with sexually transmitted disease. Clinical understanding, approaches, and tables to direct management are emphasized.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Infertility in mice after unilateral vasectomy.

The effects of unilateral vasectomy upon fertility and antisperm antibody production were studied using DBA/1J mice. Thirty-six males underwent either unilateral vasectomy, unilateral orchiectomy, or sham surgery. In vivo effects upon fertility were monitored by matings. Antisperm antibody titers were measured monthly. In vitro fertilization was performed in the presence of serum obtained 4 months postoperatively, and serum testosterone levels were also determined. After 3 months, only 1 male in the vasectomy group induced a pregnancy (1 of 12), while all but 1 of the males in the two control groups induced a pregnancy (20 of 21). The geometric mean antisperm antibody titer was 1:169 in the vasectomy group, while the orchiectomy and sham surgery groups had titers of 1:4 and 1:14, respectively (P less than 0.0001). The percentage of eggs fertilized in vitro in the presence of serum from experimental mice fell from 80% in the two control groups to 40% in the unilateral vasectomy group. Unilateral vasectomy induced infertility in DBA/1J mice and an antisperm antibody response. Sera containing these antibodies inhibited in vitro fertilization. This suggests that infertility after unilateral vasectomy may be immunologically mediated by antisperm antibodies.

Animals↗
PubMed1984

Is the clean-catch midstream void procedure necessary for obtaining urine culture specimens from men?

To determine whether the results of voided urine cultures in men are affected by meatal cleansing, midstream sampling, or circumcision status, 308 paired (initial and midstream) specimens were collected from 254 urology clinic patients. Half of the patients cleansed their urethral meatus with povidone-iodine prior to voiding. The circumcision status of all patients was noted. The rates of true bacteriuria (growth of 10(4) or greater colony-forming units/ml urine with a single predominant species) and contamination (growth of 10(3) or greater colony-forming units/ml urine with two or more colonial types) were compared in the various collection technique subgroups. Neither the bacteriuria nor contamination rates were significantly different (p greater than 0.05) in circumcised and uncircumcised patients, or in those who cleansed their meatus and those who did not. Contamination, but not bacteriuria, rates were higher in initial as compared with midstream specimens. These data suggest that the clean-catch midstream void procedure is unnecessary for obtaining routine voided urine culture specimens from men.

Bacteriuria↗
PubMed1984

Genital tract examinations and zona-free hamster egg penetration tests from men exposed in utero to diethylstilbestrol.

Because most men with prenatal exposure to diethylstilbestrol (DES) are still young and have not attempted to father children, its reproductive effects are uncertain. In a previous pilot study, we had noted an association between in utero DES exposure and reduced penetration of zona-free hamster eggs by sperm. To test these findings in a controlled manner, we performed physical examinations on 51 men with in utero DES exposure and 29 unexposed men and evaluated the penetration of zona-free hamster eggs by their sperm. Epididymal cysts or abnormalities of the prostate, testicle, or penile meatus were present in 37% of men with in utero DES exposure, versus 4% of nonexposed men (P less than 0.001). The mean proportions of penetrated eggs were 25% after in utero DES exposure and 29% in the nonexposed group (P greater than 0.57). The genital abnormalities related to DES exposure were not related to reduced egg penetration. We conclude that in utero exposure to DES is not related to a significant change in the penetration of zona-free hamster eggs by sperm.

Abnormalities, Drug-Induced↗
PubMed1984

Use of nerve stimulator for simple and accurate obturator nerve block before transurethral resection.

Adductor contraction from obturator nerve stimulation occurs frequently in certain situations during transurethral operations. Bladder perforation is a common result. A simple and safe technique involving use of a nerve stimulator for accurate obturator blockade is described. There have been no adductor contractions in more than 275 transurethral resections during a 2-year interval. There were no complications from the block itself or use of the nerve stimulator.

Electric Stimulation↗
PubMed1984

Epidemiology of sexually transmitted diseases.

In the past decade, the recognized spectrum of sexually transmitted diseases has widened to a complex array of agents and syndromes. The authors correlate diseases with responsible pathogens and discuss the numerous and interrelated changes in industrialized societies that have contributed to the epidemics of sexually transmitted diseases.

Adolescent↗
PubMed1984

Prostatitis and epididymitis.

Ascending spread of urethral pathogens may be the mechanisms of infection of the prostate and epididymis. Sexually transmitted organisms cause most epididymitis in young men. Although evidence is mounting to suggest that sexually transmitted organisms may cause prostatitis, data are insufficient at this time to base a therapeutic approach on this concept. The authors present approaches to the management of these two disorders.

Acute Disease↗
PubMed1983

Selection of human spermatozoa according to their relative motility and their interaction with zona-free hamster eggs.

Human spermatozoa were separated according to their motility by centrifuging semen on discontinuous Percoll gradients. Fractions of the gradients were examined for sperm motility, velocity, viability, morphology, bacteria, and sperm function using the hamster ova sperm penetration assay. The percentage of motile sperm increased from 40% to 60% motile sperm in 60% Percoll to 90% to 100% Percoll. Sperm velocity increased proportionately. Staining showed that greater than 90% of sperm in the 100% Percoll were alive and had normal morphology, and that only sperm cells were found in Percoll concentrations greater than 80%. Sperm isolated in the 80% to 100% Percoll fractions penetrated hamster ova much more frequently than sperm found in the 60% to 70% fractions or than sperm that had not been separated on a Percoll gradient.

Cell Separation↗