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Influence of serum prolactin on semen characteristics and sperm function.

The role of serum prolactin (sPRL) in male infertility is still unclear. For assessing the clinical significance of prolactin determination during infertility investigation, serum samples of 204 males attending the Infertility Clinic of Heidelberg were examined during a 1-year period. None of the patients exhibited galactorrhoea or complained of impotence. Results were correlated with age, duration of infertility, sperm count, motility, morphology, viability, and other parameters of routine sperm analysis and postcoital testing (PCT). Additionally, in vitro sperm penetration testing (SCMPT) in cervical mucus of partners and donors was performed as an important measure of functional sperm capacity. The subsequent pregnancy rate was determined after 6 months. Prolactin levels ranged from 1.4 to 24.7 ng/mL, with a median of 5 ng/mL. Only one patient had prolactin levels out of the normal range (greater than 20 ng/mL). No significant correlation of sPRL concentration was found with results of semen analysis, PCT outcome, or SCMPT. The functional sperm capacity was better in the groups of patients with sPRL above the median level (P less than .005). No significant difference in pregnancy rate was found between the high (greater than 5 ng/mL) and low (less than or equal to 5 ng/mL) prolactin groups; these were 20% and 26%, respectively. The results suggest that routine screening of asymptomatic male patients during infertility investigation for sPRL concentration is not helpful for assessing fertility prognosis. Prolactin should be preferentially determined in patients with clinical symptoms of hyperprolactinemia to exclude pituitary adenoma.

Adult↗

PubMed1991

Swedish Aspirin Low-Dose Trial (SALT) of 75 mg aspirin as secondary prophylaxis after cerebrovascular ischaemic events. The SALT Collaborative Group.

The efficacy of aspirin in daily doses of 300 mg and more as secondary prophylaxis after cerebrovascular events is well established. Since much lower doses of aspirin can inhibit platelet function, and carry a lower risk of adverse effects, the Swedish Aspirin Low-dose Trial (SALT) was set up to study the efficacy of 75 mg aspirin daily in prevention of stroke and death after transient ischaemic attack (TIA) or minor stroke. 1360 patients entered the study 1-4 months after the qualifying event: 676 were randomly assigned to aspirin treatment and 684 to placebo treatment. The median duration of follow-up was 32 months. Compared with the placebo group, the aspirin group showed a reduction of 18% in the risk of primary outcome events (stroke or death; relative risk 0.82, 95% confidence interval 0.67-0.99; log-rank analysis p = 0.02), and reductions of 16-20% in the risks of secondary outcome events (stroke; stroke or two or more TIAs within a week of each other necessitating a change of treatment; or myocardial infarction). Adverse drug effects were reported by 147 aspirin-treated and 123 placebo-treated patients Gastrointestinal side-effects were only slightly more common in the aspirin-treated patients, but that group had a significant excess of bleeding episodes (p = 0.04). Thus, we have found that a low dose (75 mg/day) of aspirin significantly reduces the risk of stroke or death in patients with cerebrovascular ischaemic events.

Aspirin↗

PubMed1990

[Factors of gastric lesions following after transcatheter arterial embolization for primary hepatoma].

To clarify the influence of Transcatheter Arterial Embolization (TAE) on the stomach, endoscopic examination was carried out before and after TAE. Forty-six TAE were performed in 27 patients with primary hepatoma. New gastric lesions, erosions and ulcers, were developed in 25 of 46 TAE. There was no significant relationship between the incidence of the lesions in the cases with esophageal varices (15/24) and the cases without (10/22) and there was no significant relationship between the incidence of the lesions after the first TAE (12/22) and after the second TAE (5/14). Period between the first and the second TAE had no statistical influence on the lesions after the second TAE. Hepatic functions (Child's classification; Rmax, K, R15 of ICG; serum total protein; serum albumin; total bilirubin; prothrombin time; hepaplastin test) before TAE were not statistically related to the appearance of the gastric lesions following TAE (Table 1). On the other hand, the cases which showed apparent effects of TAE including 0.2 time decrease of AFP had the more gastric lesions (P less than 0.05) (Table 2). The cases with upper abdominal pain after TAE had more gastric lesions (24/38) than the cases without (2/8) (P less than 0.05). But the cases undergone TAE with high possibility of the influx of gelatin sponge pieces, lipiodol or anticancer agents into the supplying vessels for the stomach did not exhibit significant incidence of the lesions (Table 3). Thus, when TAE is followed by a 0.2 time decrease in AFP, it is necessary to pay more attention to the gastric lesions. The prophylactic administration of H2 antagonist before or just after TAE did not seem useful to prevent the gastric lesions. These findings suggest that the influx of gelatin sponge pieces, lipiodol or anticancer agents to the stomach does not always cause gastric ulcer or erosion.

Aged↗

PubMed1990

[Clinical evaluation of Cernilton on benign prostatic hypertrophy--a multiple center double-blind study with Paraprost].

A multiple center double blind study was performed to study the effectiveness of Cernilton (CN) on benign prostatic hypertrophy in comparison to Paraprost (PP). Among a total of 192 patients, overall effect was studied on 159 patients, overall safety rate on 178 patients and rate of effectiveness on 159 patients. There were no differences between the two groups in the selected patients, criteria for exclusion and drop out cases or background data of the patients. Impression of patients and overall effect by committee and physician judgment were slightly higher in the CN group compared to the PP group, but there was no significant difference between the two groups. For the improvement in subjective symptoms, the rate of moderate improvement or more after 4 weeks by committee judgement was higher in the CN group compared to the PP group. The rate of improvement in protracted miction, which is an effective marker of urinary disturbance, was also higher in the CN group compared to the PP group. An analysis of objective symptoms showed a significant improvement in residual urinary volume, average flow rate, maximum flow rate and prostatic weight in the CN group. A significant improvement in the phased change of residual urinary volume was also seen in the CN group. No side effects or abnormalities in clinical test levels were noted in the CN group. By committee judgement, the rate of more than moderate effectiveness was 49.1% in the CN group compared to 41.2% in the PP group, but there was no significant difference between the two groups. By physician's judgment, the rate of more than moderate effectiveness was 49.4% in the CN group compared to 46.3% in the PP group, but there was also no significant difference between the two groups. These results suggested that Cernilton was an effective drug for benign prostatic hypertrophy.

Aged↗

PubMed1990

S100 immunophenotypes of uveal melanomas.

To determine whether ocular melanomas are immunophenotypically identical to cutaneous melanomas, 34 primary and metastatic choroidal melanomas representing all major histotypes defined by the Callender's classification, plus one melanoma of the iris and one conjunctival melanoma, were subjected to a panel of immunostains designed to distinguish anaplastic biopsies of cutaneous melanomas from carcinomas and lymphomas. All ocular melanomas were found to express the intermediate filament vimentin but not keratin, and all but 2 were melanotic by immunostaining. Thirty-three of 34 (97%) choroidal melanomas were strongly stained with a rabbit polyclonal antibody (P-S100) developed against the S100 protein family. In contrast, none of 14 spindle cell type primary lesions was stained with a monoclonal antibody (MAB-079) specific for both S100 alpha and S100 beta, the best-characterized S100 polypeptides. Furthermore, only 2 of 5 epithelioid and 3 of 10 mixed-cell-type melanomas were weakly reactive. Overall, 14.7% (5 of 29) were stained. In comparison, MAB079 stained 85% of all cutaneous melanomas. Five metastases of choroidal melanomas (spindle B, epithelioid, and mixed cell types) from different organ sites also were stained by P-S100 but not by MAB079. These findings were corroborated by immunostaining with another monoclonal antibody (MAB4D4) specific for S100 beta. Differential staining by the polyclonal but not the monoclonal antibodies suggests the possible presence of a variant S100 polypeptide(s) in choroidal melanomas. Since S100 alpha, S100 beta, and related proteins appear to be physiologically important, additional studies of these S100 proteins may shed light on the etiology or pathology of choroidal melanomas.

Antibodies, Monoclonal↗

PubMed1990

Prophylactic bladder neck incision in the treatment of small benign prostatic hyperplasia.

From May 1986 to January 1989, a total of 178 patients with small prostate (less than 20 grams) received transurethral resection for benign prostatic hyperplasia. Twenty-two patients (12.4%) developed bladder neck contracture with an average interval of 247 days. The prophylactic bladder neck incision was performed concomitantly with transurethral resection of the prostate on 72 patients. Although smaller adenoma (average weight: 11.4 grams) was resected in this group, the bladder neck contracture occurred in 4 patients (5.6%), compared to 18 contractures in 106 patients (16.9%) who underwent transurethral resection of the prostate alone for larger adenoma (14 grams), P value less than 0.05. The operation time, peri-operative morbidity and hospital stay were similar in these two groups. It appeared that prophylactic bladder neck incision could protect against the formation of bladder neck contracture in patients with small obstructing prostatic adenoma.

Chi-Square Distribution↗

PubMed1990

[A clinical evaluation of distant metastases from a hepatocellular carcinoma with reference to location, frequency, symptoms, treatment & prognosis].

A clinical analysis of patients with hepatocellular carcinoma (HCC) associated with a distant metastases has been undertaken by the authors. Studied were eight patients (Group A) whose distant metastases were detected at the time of their initial examination, and 24 patients (Group B) whose distant metastases had been diagnosed during the course of treatment of their primary lesions. Complications arising from liver cirrhosis in Group A was less than in Group B. The location of the metastases were the bone in 16, the lung and the adrenal gland in four, the brain and the skin in two and the kidney in one. The mean survival times were 4.6 months (Group A), and 6.3 months (Group B). The cause of death was chiefly a progression of the primary lesion, except for one brain metastases. This analysis had shown that treatment of a bone metastasis is necessary for the relief of pain, and that care should be taken for the prevention of a fracture or paralysis, and that control of the primary lesion is necessary for improving the chances of survival.

Adrenal Gland Neoplasms↗

PubMed1991

Signs and symptoms of temporomandibular joint muscle pain dysfunction syndrome: a retrospective study of one hundred patients.

A retrospective serial study was carried out on one hundred randomly selected temporomandibular joint muscle pain dysfunction syndrome (TMJMPDS) patients who had attended a private prosthodontic practice over an eight year period. The study looked at common signs, symptoms and referral patterns in this group and compared them with those quoted in a large section of the literature on the subject.

Adolescent↗

PubMed1978

Log normal distribution of ovarian and placental steroid values in early human pregnancy.

Concentrations of estradiol, progesterone, 17OH-progesterone were measured by radioimmunoassay in individual serum samples obtained from a group of 304 women with normal gestations between the 4th and 17th week of pregnancy. Values obtained underwent statistical analysis in order to determine the arithmetic mean and the 95% normal range (+/- two standard deviations). It was noted hereby that the spread of values above the mean was greater than that below the mean, and that very often the mean minus two standard deviations was either close to zero or negative. Therefore, the data for each hormone were analyzed for normality of the distributions by the chi-square test. For each hormone the chi-square test was significantly different (p less than 0.001) from the normal distribution (Gaussian). Subsequently, linear transformation by rankit analysis revealed the log-normal distribution of our data. Furthermore, rankit analysis was used as a graphical method to delineate a useful clinical range, which includes the mean and meaningful 95% confidence limits for estradiol, progesterone, and 17OH-progesterone in early normal pregnancies.

Estradiol↗

PubMed1992

Pituitary adenomas: tumor cell growth by cluster formation. Pattern analysis based on immunohistochemistry.

The topographical distribution of adrenocorticotropic hormone, growth hormone and prolactin was studied in nine multihormonal pituitary adenomas and two normal adenohypophyses using quantitative immunohistochemical methods. For each pituitary hormone paraffin sections stained by antihormone antibodies were scanned with a light microscope equipped with a projection and scanning device. The number of immunoreactive cells of each square in the grid was counted and transformed into pseudocolors. In this way, the distribution of each hormone was documented. A chi-square test was applied to these distribution patterns to prove randomness. A nonrandom distribution of immunoreactive cells was observed in all pituitary adenomas and normal pituitary glands. Cluster formations of immunoreactive cells were found for each hormone. The clusters were surrounded by halo-like areas of decreasing number of immunoreactive cells from center to periphery. The cluster-halo type of immunoreactive cells was found not only in the adenomas but also in the normal pituitary gland. This may be explained by the similarity of biological processes during cell proliferation either in normal development or in adenoma formation. It can be concluded from our studies that pituitary adenomas in most cases develop by multicentric but not diffuse proliferation of cell clones of different endocrine activity.

Adenoma↗

PubMed1992

Anti-toxoplasma serotitres in uveitis and ocular toxoplasmosis.

This study was based on anti-toxoplasma serotitres obtained from 80 normal healthy adults and 103 consecutive patients with anterior, posterior and panuveitis over a 42 month period. Twelve out of 80 (15%) normal healthy sera were found to have low titres (1:64 to 1:256), while 3 (3.8%) had high titres (1:1024 or higher). The distribution of serotitres in patients with clinical toxoplasmosis was significantly different from the population sample (p less than 0.001, chi-squared test). Similarly, the distribution of serotitres in patients with posterior uveitis (of which 28 out of 54 were clinically ocular toxoplasmosis) having serotitres of 1:1024 or greater, was found to be significantly different from the normal population (p less than 0.001, Chi-squared test), but not statistically different from those with clinical ocular toxoplasmosis. Hence, anti-toxoplasma serotitre is useful as a diagnostic screening tool only in patients with posterior uveitis. It is also useful in confirming cases of suspected clinically positive ocular toxoplasmosis in our local population.

Adolescent↗

PubMed2026

A profile of suspected female homicide cases at the Johannesburg and Diepkloof Forensic Pathology Service Medico-legal Mortuaries for 2020-2022.

This study profiles suspected female homicide victims in Johannesburg, South Africa, during the COVID-19 period marked by socio-environmental changes from lockdown restrictions. Guided by the Socio-Ecological Model, a retrospective case series of 369 victims was reviewed using medico-legal mortuary records from Johannesburg and Diepkloof Forensic Pathology Service facilities. Descriptive analyses were conducted, supplemented by a chi-square test to assess whether distributions of causes of death among women differed between COVID-19 and non-COVID-19 periods. No statistically significant association was found, χ2 (6, N = 339) = 6.68, p = 0.35. Key findings highlight that Black, unemployed, unmarried women aged 21-40 were at greatest risk. Cause of death was established in 97.0% (358/369) of cases, with firearm injuries predominating (43.9%), followed by sharp‑force (24.5%) and blunt‑force trauma (13.1%). Approximately 90% of victims were suspected to have been killed by males, with half of deaths attributed to intimate partner violence. Homicide frequency decreased during strict lockdowns but rose as restrictions eased, suggesting that movement and alcohol controls may reduce risk. Despite temporary disturbance caused by COVID‑19 restrictions, the underlying risk profile of female homicide victims remained unchanged. These findings inform multi-level prevention and intervention strategies in South Africa.

Humans↗

PubMed2026

PIK3CA Polymorphisms in Cervical Cancer: Differential Impact of rs6443624 and rs141178472.

BACKGROUND: Cervical cancer remains a major cause of mortality in low- and middle-income settings. We assessed whether two PIK3CA single-nucleotide polymorphisms (SNPs) rs6443624 (A/C) and rs141178472 (C/T) are associated with disease risk, clinicopathological features, and survival. MATERIALS AND METHODS: In a prospective case control study at a tertiary center, 154 participants were enrolled (77 cases, 77 controls). Genomic DNA was isolated from FFPE cervical tumors (QIAamp DNA FFPE Tissue Kit) and genotyped using TaqMan allelic discrimination. Clinicopathological variables (FIGO stage, histology, grade, treatment, tumor-infiltrating lymphocytes [TILs]) were abstracted from records. Genotype distributions were compared by Pearson chi-square. Associations with clinicopathological features used chi-square/Fisher's exact as appropriate; ANOVA compared age across genotypes. Overall survival (OS) was estimated by Kaplan-Meier and compared with the log-rank test; mean OS with SE and 95% CI is reported. RESULTS: Cases were predominantly locally advanced at presentation and squamous histology; most were moderately differentiated. rs6443624 differed significantly between cases and controls (χ²=21.1, p<0.001), with CC over-represented in cases and CA less frequent. rs141178472 showed no significant case control difference (χ²=2.9, p=0.086). For OS, rs6443624 showed a significant genotype effect (log-rank χ²=23.45, p=0.001): AA had the poorest survival, CA the longest, CC intermediate. rs141178472 was not associated with OS (χ²=1.06, p=0.588). Genotype clinicopathological correlations for stage group, grade, TILs, and treatment were non-significant or inconsistent, with some comparisons limited by small sample sizes. CONCLUSION: The PIK3CA rs6443624 variant appears to influence both susceptibility and prognosis in cervical cancer, highlighting its potential as a biomarker for molecular risk stratification. Validation in larger, multi-center cohorts incorporating HPV/p16 assessment and extended follow-up is warranted to confirm its clinical relevance.

Humans↗

PubMed1992

[A study on effects of parents age, birth order and mental retardation of unknown etiology].

On this report 461 matched cases of mental retardation of unknown aetiology were analysed on the relationship between the diseases and the parents age, birth orders with conditional Logistic regression. These cases were accurately diagnosed and selected from the Epidemiologic Survey of genetic diseases of Sichuan, China. The results found that mental retardation of unknown aetiology is related to the age of parents and birth order. The paternal age is the main factor while the maternal age in not a significant effect and birth order also in not a significant effect after readjusting the other factors. Compared to paternal age group of under 25. There are significant increase of relative risks of age group 30-34 and 45 above, about 1.8 and 2.7 fold increase in univariate analysis and 1.9 and 3.3 fold increase in controlling the maternal age and birth order, a chi-square test for trend of distribution of paternal age also indicates a significant dose response relationship between increasing risk with age. The significance of result and methods of analysis were discussed.

Adult↗

PubMed1992

[Nursing needs of the elderly in hospital from the nurses' viewpoint].

The human needs of elderly people in hospital were studied from the point of view of the nursing staff in order to describe how important nurses perceive the satisfaction of these needs to be, what kinds of needs they regard as significant or insignificant and what opportunities they have to influence their satisfaction. The data were collected using questionnaires, filled in by 130 nurses working in 14 geriatric wards in the hospital attached to a Health Centre. Human needs were evaluated on a scale based on the theory of human needs created by Yura and Walsh. The data were analysed by quantitative statistical methods: frequency and percentage distributions, cross tabulations and the Chi-Square test. The nurses regarded the satisfaction of human needs among the elderly as extremely or very important in most of the answers (70%) and as important in 27%. In only 3% did the nurses describe this aspect as being of little importance or insignificant. The satisfaction of many psychosociological and physiological needs was also regarded as extremely or very important. Nearly half of the nurses (49%) described the satisfaction of sexuality needs as important, a quarter (25%) as extremely or very important, and the remaining quarter (25%) regarded these needs as of little importance or insignificant.

Aged↗

PubMed1992

Factors influencing resident career choices in emergency medicine.

OBJECTIVE: To assess the attitudes of residents in emergency medicine regarding a career in academics. DESIGN: A 22-item questionnaire was administered to residents in conjunction with the yearly American Board of Emergency Medicine inservice examination. Demographic information and factors influencing career intent were elicited. Respondents were classified by intent on a career in emergency medicine. A three-way analysis of variance was used to address group differences for eight specific factors impacting on career decision. Chi-square analysis was used to address questions involving relationships among variables with dichotomous or categorical responses. RESULTS: The survey was distributed to 1,654 residents, and 1,238 (75%) completed the questionnaire. Motivating factors demonstrating significant differences between those residents planning an academic career and those not interested in academe were a desire to do research, desire to teach, desire to make a contribution to medicine, and exposure to role models, with less emphasis on the need for free time for other interests and less concern regarding practice location. More than 80% of those not going into academic emergency medicine believed they were adequately exposed to research in residency compared with 65% of those intent on a career in academe (P less than .01). Research in medical school, residency, and authorship of a research paper were significantly more prevalent for those residents desiring a career in academe (P less than .01). Twenty-six percent of residents responded that their role models for research were less than adequate. Seventeen percent of residents intend to take fellowship training. The most popular fields for fellowships were toxicology (25%), emergency medical services (21%), pediatrics (15%), and research (9%). CONCLUSION: The results of this survey address attitudes among residents toward a career in academic emergency medicine. Factors such as motivation, role models, and exposure to research may help academicians plan strategies to meet the future needs of academic emergency medicine.

Attitude of Health Personnel↗

PubMed1976

The distribution of fetal death in control mice and its implications on statistical tests for dominant lethal effects.

In dominant lethal testing fetal death is generally assumed to follow either a Poisson or binomial distribution. However, both of these models were found to be inappropriate when three large sets of mouse control data and other data sets from the literature were examined. The validity of statistical test procedures based on these inappropriate models was then studied in detail. It was found that chi-square tests (which assume an underlying binomial distribution) may seriously exaggerate the level of significance and hence should not be used. In contrast, the inappropriateness of the underlying Poisson or binomial model appeared to have little effect on the validity of pairwise comparisons by analysis of variance procedures. Unlike chi-square, these procedures regard the pregnant female rather than the individual implant as the experimental unit. However, a statistical analysis of dominant lethal data generally involves more than a series of pairwise comparisons, and it is unclear how an invalid underlying model may affect statistical test procedures in this more complex situation. Moreover, it is difficult to justify the use of statistical models that are demonstrably invalid when a reasonable alternative exists. Thus, until a satisfactory parametric model can be found and appropriate test procedures derived, we prefer to analyze dominant lethal data by non-parametric (distribution-free) methods. Proportion of dead implants per female appears to be a more meaningful measure of fetal death than number of dead implants per female for several seasons which include (1) analyses based on proportions take the total number of implants per female into account and (2) analyses based on proportions make more reasonable assumptions concerning pre-implantation losses and are more powerful when such losses occur. Despite our concern with the appropriateness of the underlying model, in practice we have found few instances in which non-parametric and analysis of variance procedures have led to markedly different conclusions.

Animals↗

PubMed1992

Technique of renal biopsy by ultrasound guided percutaneous puncture with a spring loaded "gun".

The study consisted of 89 consecutive patients (mean age = 41.5, range = 16-82, 64 men, 25 women) referred for renal biopsy because of clinical suspicion of renal parenchymal disease. Neither transplant kidneys nor tumour evaluation were included. A biopsy "gun" (Biopty) and 14 (2.0 mm) and 18 (1.2 mm) gauge needles were used with ultrasound guidance. Sixtyseven renal biopsies were guided using a freehand technique 42 using a fixed angle guide attachment. The mean glomerular yield was 9.4 glomeruli. Almost 25% of the 18 gauge needle biopsies (n = 57) had to be repeated and 29.3% of the 14 gauge needle biopsies (n = 75). The yield difference was not statistically significant (Chi-squared = 0.37, p = 0.54). There was no statistically significant difference between the distributions of failure to obtain a significant material for evaluation caused by the biopsy technique used (Chi-squared = 0.08, p = 0.78). When analysing cases of single successful pass the thinner needle produced 6.7 glomeruli (n = 36, SD = 5.08) and the thicker needle 13.8 glomeruli (n = 18, SD = 6.82). No serious complications occurred.

Adolescent↗