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Outcome of microsurgical reconstruction in men with suspected epididymal obstruction.

PURPOSE: Approximately 3 to 6% of all men presenting with infertility (excluding those with a history of vasectomy) are suspected of having epididymal obstruction. However, other anatomical abnormalities within the male reproductive tract are often encountered. In this study we attempted to define the range and frequencies of anatomical abnormalities in the reproductive tract and the outcome of surgical reconstruction in men with suspected epididymal obstruction and no history of vasectomy. MATERIALS AND METHODS: Between July 1992 and July 1996, 80 azoospermic men with suspected epididymal obstruction underwent scrotal exploration. The anatomical findings and outcomes of reconstructive surgery were reviewed. RESULTS: Of a possible 160 reproductive tract units (2 per patient) we thoroughly examined 147 with suspected epididymal obstruction. Epididymal obstruction was found in 52.7% of the cases with other anatomical abnormalities accounting for the remaining 47.3%. Of the patients 49 (61%) had sperm identified in the epididymis on at least 1 side and underwent vasoepididymostomy, and 3 (4%) had sperm unilaterally in the proximal vas but had ipsilateral distal vasal obstruction. These 3 men underwent crossed vasovasostomy. We were more likely able to perform reconstruction in men whose obstruction was due to an infectious etiology (13 of 14, 93%) compared to either a surgical (5 of 7, 71%) or idiopathic (34 of 59, 58%) etiology. In 28 patients (35%) no sperm was identified in the epididymis or they had no other abnormalities that precluded successful reconstruction on either side. Of those patients who underwent vasoepididymostomy for epididymal obstruction 61% had sperm in the ejaculate postoperatively. CONCLUSIONS: In nearly half the men with suspected epididymal obstruction other reproductive tract abnormalities were detected, most of which precluded successful vasoepididymostomy. Other reproductive tract abnormalities are much less likely to be found, and the outcomes of reconstruction are better if the cause of the obstruction is infectious compared to surgical or idiopathic.

Epididymis↗

[Primary epididymal tumors: report of 24 cases].

24 cases of primary epididymal tumors including 23 benign and 1 malignant tumors were treated. In these cases, 66.7% situated at epididymal tail, and 12.5% involved both tail and body. Smooth muscle tumor of one case was bilateral, and adenomatoid tumor of another one was multiple. The symptoms of primary epididymal tumors were mild even absent, so the tumor was easily confused with non-tumorous mass of epididymis. Benign epididymal tumor should be differentiated from tuberculosis, chronic inflammation or granuloma. Besides signs of malignant mass, malignant epididymal tumor usually showed thickened spermatic cord, especially enlarged ductus deferens. The removal of the tumor mass or whole epididymis of the same side could cure benign epididymal tumor without recurrence. Malignant epididymal tumor should be treated as malignancy of testis or spermatic cord, with adjuvant chemotherapy or radiotherapy as indicated by the pathological type.

Adenomatoid Tumor↗

Histological differentiation between chlamydial and bacterial epididymitis: nondestructive and proliferative versus destructive and abscess forming--immunohistochemical and clinicopathological findings.

Chlamydia trachomatis (CT) and Escherichia coli (EC) antigens were sought in routinely prepared paraffin-embedded sections from 31 cases of acute and chronic epididymitis by indirect immunoperoxidase staining. Chlamydia trachomatis antigens were detected in epithelial cells as cytoplasmic inclusions in samples from six patients (mean age, 43 years) with severe epididymitis, characterized by minimally destructive, periductal, and intraepithelial inflammation with active epithelial proliferation. Squamous metaplasia and formation of lymphoepithelial complexes occasionally were noted. Escherichia coli antigens, common to other pyogenic bacteria, were observed in the cytoplasm of foamy histiocytes in samples from seven patients (mean age, 60 years), characterized by highly destructive epididymitis forming large abscesses and xanthogranulomas. Specimens from 18 patients were negative for either antigen. Pre-embedding immunoelectron microscopy on paraffin-embedded sections demonstrated positive reactions on the cell wall of the chlamydial bodies and rod-shaped bacteria. Escherichia coli-positive cases were accompanied by scrotal pain, pyuria, positive bacterial culture, leukocytosis, accelerated erythrocyte sedimentation rate, and a positive C-reactive protein test. Chlamydia trachomatis-positive cases were clinically indolent and manifested by an epididymal tumor. Chlamydial epididymitis can be distinguished from bacterial epididymitis not only clinically and immunohistochemically but also histologically.

Abscess↗

Scrotal ultrasonography: a predictor of complicated epididymitis requiring orchiectomy.

The decision between continued medical therapy and surgical exploration in patients with complicated epididymitis is difficult. We evaluated scrotal ultrasonography as a noninvasive aid in such problematic cases. During a 48-month period 95 patients were hospitalized for treatment of epididymitis; 23 underwent scrotal ultrasonography and 10 required orchiectomy. Analysis of the 21 cases with abnormal findings demonstrated that orchiectomy was necessary in 1 of the 10 patients (10 per cent) with epididymal enlargement only, in 2 of 8 (25 per cent) with epididymal enlargement plus hypoechoic testes and in all 3 with epididymal enlargement plus testicular inhomogeneity (p equals 0.0099). Patients with progressive testicular changes on serial ultrasound examinations uniformly required orchiectomy (5 of 5). Sonographic findings of testicular inhomogeneity correlated with testicular infarction and findings of decreased testicular echogeneity correlated with acute or chronic orchitis. In the appropriate clinical setting gray scale ultrasonography provides objective information supporting the need for surgical intervention in selected patients with complicated epididymitis.

Epididymitis↗

Epididymitis: aspects concerning etiology and treatment.

Extended microbiological studies were performed on 49 patients with acute or chronic epididymitis, including bacteriology of epididymal specimens in cases of scrotal surgery. In no patient had instrumentation or catheterization resulted in epididymitis. The microbiological data showed a prevalence of Chlamydia trachomatis epididymal infections in men less than 40 years old, whereas common urinary tract pathogens prevailed in older patients. Cultures of urethral swabs and midstream urine provided reliable information on the type of microorganism that caused epididymitis. Ofloxacin, an antibiotic of the new quinolone group, was proved to be highly effective in the treatment of acute and chronic bacterial as well as chlamydial epididymitis.

Adult↗

[The role of Chlamydia trachomatis and Ureaplasma urealyticum in patients with acute epididymitis].

1. Fifty-eight patients suffering from acute epididymitis were investigated to assess the etiologic role of Chlamydia trachomatis and Ureaplasma urealyticum. Sixteen (42.1%) of the thirty-eight patients without underlying diseases yielded C. trachomatis from the urethral swabs, but no bacteriuria (greater than or equal to 10(4) CFU/ml) was recovered. C. trachomatis was isolated from epididymal aspirates in 4 out of 10 patients in whom C. trachomatis was isolated from the urethral swabs. Of the twenty patients having underlying diseases, 11 men were associated with urinary tract infections, but C. trachomatis was not isolated from the urethral swabs from any of these patients. 2. The antibodies to C. trachomatis in 21 sera was determined by micro-immunofluorescence test. IgG antibodies to C. trachomatis were found in 88.9% (8/9) of the men with chlamydial infections and in 25% (3/12) of the men without chlamydial infections. IgM antibodies to C. trachomatis were not demonstrated in any case. 3. U. urealyticum was isolated from urethral swabs in 15 (25.9%) patients with acute epididymitis, but was not isolated from epididymal aspirates in any of the cases. In conclusion, C. trachomatis was regarded as the major pathogen in acute epididymitis, especially in patients without underlying diseases. But, the significance of U. urealyticum in acute epididymitis was not certain.

Acute Disease↗

[Acute epididymitis].

A series of 86 cases of acute epididymitis observed over a period of 3 years is analyzed and findings reported. Testicular lesions were frequent and 35% of these cases involved a purulent testicular pocket. The epididymal lesion was usually of a total nature (77% of cases), only the tail of the epididymis being involved in 17%. Sterile urine was a frequent finding (50% of cases). Chlamydiae were rarely identified, but administration of medication ineffective against chlamydiae was effective in most cases, suggesting that these organisms are a rare cause of acute epididymitis. Iatrogenic epididymitis was a frequent diagnosis when compared with epididymitis due to cases of known cervico-urethral obstruction. Catheterization, endoscopic resection of prostate, transvesical prostatic adenomectomy were the main cause in the absence of ligature of deferens, the latter being considered as a certain preventive procedure. The affection is possible in children or adolescents (3 cases between 10 and 16 years) with an acute hydrocele as the presenting sign. Tuberculosis is still a possible cause (5 cases) with Koch's bacillus present in the urine in 4 of these patients. In the majority of cases, however, the etiology was unknown (62 of 86 patients = 72%). Treatment can be by a cycline as sole therapy, anti-inflammatory steroid or non-steroid agents also being effective. Medical treatment was rapidly and totally effective in 56 of the 86 patients, but residual foci were noted in 19 of 86 cases. Epididymectomy may be necessary for painful lesions or recurrence of epididymitis, while castration may be indicated (6 cases) for fistula formation, purulent pockets of testis, or ischemic necrosis of testis.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

A cytochemical study on surface charges and lectin-binding sites in epididymal and ejaculated spermatozoa of Macaca fascicularis.

Changes in electronegative and electropositive surface charges and in lectin receptors (concanavalin A and wheat germ agglutinin) were investigated on sperm plasma membranes of the monkey (Macaca fascicularis) during epididymal transit and after ejaculation. Electronegative charges at pH 1.8, which were uniformly distributed on the whole plasma membrane of caput epididymal spermatozoa, increased mainly on the postacrosomal cap and the tail during epididymal passage. Electropositive charges at pH 9 were simultaneously found on the whole cell surface of caput epididymal spermatozoa with a stronger labeling on the acrosomal apex, the postacrosomal cap, and the tail. These charges disappeared during passage through the epididymis corpus. The surface distribution of lectin receptors varied inversely during epididymal transit with an increase in concanavalin A receptors and a decrease in wheat germ agglutinin receptors. These data show that changes in the monkey sperm plasma membrane during epididymal maturation occur in the distal corpus of the epididymis.

Animals↗

Lactate production from glucose and response to insulin in perifused adipocytes from mesenteric and epididymal regions of lean and obese rats.

Lactate, an important metabolic substrate for peripheral tissues and the liver, is released in significant amounts from adipose tissue. Using a perifusion system, we measured lactate production from glucose and response to insulin in isolated mesenteric and epididymal adipocytes removed from fed or fasted male Wistar rats at two stages of growth and development: (a) lean rats (7 weeks to 9 weeks old, weighing approximately 250 g), and (b) fatter rats (6 months to 8 months old, weighing approximately 550 g). The results show that lactate production in perifused adipocytes is regulated by the prior nutritional state of the animals, by the adipose tissue region, and by the presence of insulin in the perifusate. In fat cells from lean rats, basal lactate production was significantly higher (p<0.05) in mesenteric cells when compared with epididymal cells, both in the fed state (7.8 nmo/10(7) fat cells per minute vs. 2.9 nmol/10(7) fat cells per minute) and after 2 days of fasting (13.6 nmol vs. 3.5 nmol). When the response to 1 mU/mL insulin was studied, however, the relative increase in lactate production produced by insulin was greater in the epididymal cells than in the mesenteric cells, in both the fed (194% vs. 91% over basal, respectively) and fasted (360% vs. 55% over basal, p<0.05) state. When larger epididymal adipocytes from fatter rats were compared with an equal number of smaller epididymal cells from leaner rats, the larger cells produced 4.99 nmol of lactate/10(7) fat cells per minute, whereas the smaller cells produced 2.93 nmol (p=0.08). Large fat cells showed a small and nonsignificant response to insulin in either type of cell (epididymal vs. mesenteric) or nutritional state (fed vs. fasted). This study indicates that distinct regional differences exist in lactate production and response to insulin. Mesenteric adipose tissue, which drains directly into the portal vein and provides substrates to the liver, may be an important source of lactate for the hepatic processes of gluconeogenesis and glycogenesis.

Adipocytes↗

Epididymal fluid macromolecules do not act as auto- or alloantigens.

Because epididymal secretory glycoproteins form important functional associations with maturing spermatozoa, the possibility has been explored that epididymal antigens might be useful in contraceptive vaccine development. Male and female rabbits, hamsters, and rats were immunized for several weeks with epididymal fluid, initially either with complete Freund's adjuvant, or conjugated with glutaraldehyde. Some female rabbits were also immunized using albumin-free rabbit epididymal fluid. The sera of all the immunized animals were then examined for autogenous, allogeneic, or [in guinea pigs also] xenogeneic immune responses, using immunodiffusion and ELISA techniques. In each instance, xenogeneic immunization produced a marked antibody response. However, no animals developed any detectable antibody reactive with epididymal fluids following auto- or alloimmunization (ie with fluid from the same species), and they remained fertile even when immunized males were mated with immunized females. Furthermore, when female rabbits were immunized with ejaculated rabbit spermatozoa, they produced antibodies reactive only with the sperm homogenate, but not with any epididymal fluid component. These results indicate that macromolecules secreted by the epididymis, including those that associate with spermatozoa, do not act as auto- or alloantigens and, at present, would seem to have no immediate promise for contraceptive vaccine development in males or females.

Animals↗

Identification and isolation of epididymal luminal proteins of the mouse.

Proteins of mouse cauda epididymal fluid were analyzed by polyacrylamide gel electrophoresis. Fluid expressed from the cauda epididymidis and samples obtained by micropuncture of the epididymal lumen showed very similar patterns with respect to the major proteins they contained, with the exception of a small amount of serum albumin found in expressed caudal fluid. Eight prominent peptides present in both micropuncture fluid and expressed caudal epididymal fluid were selected for further study, and were designated CP 47, 42, 35, 29, 27, 25, 18, and 13 according to their mobility. Six of these were never detected in serum. Periodic acid-Schiff staining indicated that at least three were glycoproteins. The epididymal proteins were purified by preparative polyacrylamide gel electrophoresis and electroelution. Upon re-electrophoresis, the individual purified peptides comigrated with the corresponding bands in whole epididymal fluid, and no additional bands were detected, indicating that the proteins were purified to a high degree of homogeneity. Several of the mouse epididymal peptides resemble in their mobility proteins identified previously in other species, most notably the widely studied 33 Kd and 16 to 18 Kd proteins detected in the rat.

Animals↗

Hormonal regulation of bovine secretory proteins derived from caput and cauda epididymal epithelial cell cultures.

The goal of this study was to investigate the effect of hormones (testosterone, dihydrotestosterone [DHT], and hydrocortisone) on the protein secretion of caput and cauda epididymal epithelial cells cultured in principal cell medium (PCM). A confluent monolayer of caput and cauda epididymal epithelial cells was obtained from serum-containing PCM in the presence or absence of hormones after 7 days of culture at 38.5 degrees C (5% CO(2) in air). The protein secretion of epididymal epithelial monolayers incubated in serum-free PCM for 3 days was examined. The secreted proteins were separated by 2-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis (2D SDS-PAGE). A comparison of the different protein patterns showed 61 spots, of which 11 were secreted only in the presence of hormones, 3 appeared to show hormone-related changes, and 25 were region-specific. Most of these secreted proteins were low-molecular-weight acidic proteins. To obtain evidence of the epididymal origin of the secreted proteins, proteins present in caput and cauda epididymal plasma were analyzed. In conclusion, our data indicate that hormones influence the synthesis of a number of caput and cauda epididymal proteins. Some of these proteins could be important for improving our understanding of spermatozoa maturation and storage and their acquisition of fertilizing ability.

Animals↗

Characterization of secretory proteins from cultured cauda epididymal cells that significantly sustain bovine sperm motility in vitro.

Epididymis provides a safe environment in which stored-spermatozoa could survive for days before ejaculation. In vitro studies suggested that epididymal proteins seem to be implicated in sperm survival during coincubation with cultured epididymal cells. This study was basically designed to confirm if secretory proteins from bovine epididymal cell cultures provide sperm protection against rapid loss of sperm motility in vitro. Bovine spermatozoa were incubated in conditioned media (CM), which were prepared from cultured cauda epididymal cell (CEC). Motion parameters were recorded using a computer-assisted sperm analyzer. Sperm-free protein extracts from CM were fractionated by ultrafiltration through a 10-kDa cut off membrane. A significantly positive effect on sperm motility was observed when spermatozoa were incubated in CM (54 +/- 4%) and CM > 10 kDa (57 +/- 4%) compared to CM < 10-kDa fraction (30 +/- 3%) or fresh media (34 +/- 3%), after a 6-hr incubation period. This beneficial effect on sperm motility was abolished when the CM > 10-kDa fraction was heat-treated at 100 degrees C for 10 min. The CM > 10 kDa fraction provides factors that remained active even though spermatozoa were washed twice after a 2-hr preincubation period. To identify potential beneficial factors, bovine spermatozoa were incubated with radiolabeled proteins obtained using (35)S-methionine in culture medium. SDS-PAGE analysis of proteins extracted from CM-preincubated spermatozoa revealed the presence of a 42-kDa protein strongly associated to the sperm surface. This 42-kDa spot was trypsin-digested and identified by matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) as a protein homologue to a 35-kDa bovine estrogen-sulfotransferase. This protein can play a role in epididymal biology and sperm function. Taken together, these results suggest that specific epididymal proteins can be implicated in the sperm protection in vitro, and can be characterized in our cell culture system.

Animals↗

Identification of anti-agglutinin for spermatozoa in epididymal boar plasma.

The present report identifies epididymal boar anti-agglutinin and examines its effect on sperm motility. Boar spermatozoa from the cauda epididymidis were washed and incubated in modified Krebs-Ringer bicarbonate at 37 degrees C (5% CO2 in air). In the samples washed three or five times and then incubated for 3-5 h, higher rates (72-79%) of spermatozoa were associated with one another at the acrosomal region, mainly in groups of 2-5 cells (head-to-head agglutination), and many cells exhibited intensively flagellant and/or circular types of movement but rarely progressive motility. The addition of epididymal plasma or 25 kDa protein purified from it markedly inhibited the occurrence of head-to-head agglutination in washed spermatozoa, whereas heat treatment and subsequent removal of insoluble materials reduced the anti-agglutination activity of epididymal plasma. The percentages of progressively motile cells in the samples incubated with epididymal plasma or 25 kDa epididymal protein rose coincident with the reduction of sperm agglutination. These findings demonstrate that the 25 kDa epididymal protein is an anti-agglutinin for the cauda spermatozoa and that it effectively functions to maintain progressive motility of the cells in vitro.

Animals↗

Suppression of endogenous estrogen during development affects porcine epididymal sperm maturation.

Estrogen plays an important role in male reproduction, critical for sustained fertility in some species. Reducing estrogen's interaction with its receptor(s) in monkey and mouse models is associated with reduced sperm motility and, in some cases, documented elimination of sperm fertilizing ability, suggesting that normal epididymal function may be estrogen dependent. The objective of these experiments was to evaluate the effects of reduced endogenous estrogen on development of epididymal function in the pig, a species in which males have very high levels of endogenous estrogen. Letrozole, a potent inhibitor of estrogen synthesis, was administered to neonatal boars from 1 week of age and markedly suppressed estrogen production. Epididymal function assessed as acquisition of sperm fertilizing ability (in vitro fertilization of zona-free oocytes) was reduced in Letrozole-treated animals at 24 and 28 weeks of age (23% and 30% fertilization, respectively compared with 37% and 54% in vehicle controls) but had recovered by 32 weeks of age. Cauda epididymal sperm numbers were reduced in treated animals (35% of control values at 20 weeks of age) but appeared to be recovering at 32 weeks of age. Reduction of endogenous estrogen had no effect on other aspects of epididymal function (percentage of motile sperm, sperm motion parameters, sperm head morphometrics, or ability of sperm to undergo an acrosome reaction). Reducing endogenous estrogen during postnatal development appears to have transient effects on porcine epididymal function. These transient effects suggest that the pig, with its high endogenous estrogen, may respond differently than other species to reduced estrogen synthesis.

Aging↗

Induction of oxidative stress in rat epididymal sperm after exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin.

The ability of 2,3,7,8-tetrachlorodibenzo- p-dioxin (TCDD) to induce oxidative stress in various tissues of animals has been reported. The nature and mechanism of action of TCDD on the antioxidant system of sperm has not been studied. In the present study we have sought to investigate whether TCDD induces oxidative stress in the epididymal sperm of rats. Subchronic doses of TCDD (1, 10, and 100 ng/kg body weight per day) were administered orally to male Wistar strain rats for 45 days. After 24 h of the last treatment the rats were killed using diethyl ether. The epididymides were removed and cleared from the adhering tissues. Epididymal sperm were collected by cutting the epididymides into small pieces in Ham's F12 medium, and counted using a hemocytometer. The epididymal sperm counts in the TCDD-treated groups decreased in a dose-dependent manner from the control value of 8.2+/-0.14 x 10(8) to 5.31+/-0.15 x 10(8). Since a positive correlation (r=0.95; n=24) was observed between sperm count and DNA content of the epididymal sperm, DNA content was routinely used as an indicator of sperm count, and the results were expressed in terms of both protein and DNA. There was a significant decline in the activities of superoxide dismutase (40+/-2.17 to 27.1+/-0.76/mg protein and 32.41 to 18.07+/-0.76/mg DNA), catalase (2.49+/-0.13 to 2.03+/-0.05/mg protein and 2.01+/-0.05 to 1.35+/-0.05/mg DNA), glutathione reductase (71.2+/-3.87 to 48+/-1.79/mg protein and 57.58+/-1.52 to 31.94/mg DNA) and glutathione peroxidase (22.4+/-1.43 to 16.9+/-1.57/mg protein and 18.08+/-0.61 to 11.38+/-1.22/mg DNA) while there were increases in the levels of hydrogen peroxide (20.8+/-1.96 to 55.3+/-0.88/ mg protein and 16.18+/-1.88 to 36.87+/-0.88/ mg DNA) and lipid peroxidation (2.17+/-0.2 to 6.08/mg protein and 1.75+/-0.12 to 4.05+/-0.12/mg DNA) in the epididymal sperm. The results suggest that graded doses of TCDD elicit depletion of antioxidant defense system in sperm, indicating TCDD-induced oxidative stress in the epididymal sperm. In conclusion, the adverse effect on male reproduction in TCDD-treated rats may be due to the induction of oxidative stress in sperm.

Animals↗

High dietary 18:3n-3 increases the 18:3n-3 but not the 22:6n-3 content in the whole body, brain, skin, epididymal fat pads, and muscles of suckling rat pups.

The objective of this study was to test the hypothesis that increasing maternal dietary 18:3n-3 by decreasing the 18:2n-6/18:3n-3 ratio will increase the 18:3n-3 and 22:6n-3 content of the whole body, liver, skin (epidermis, dermis, and subcutaneous tissue), epididymal fat pads, and muscles (arms and legs) of 2-wk-old rat pups. Sprague-Dawley dams at parturition were fed semipurified diets containing either a low (18:2n-6 to 18:3n-3 ratio of 24.7:1) or a high (1 8:2n-6 to 18:3n-3 ratio of 1.0:1) 18:3n-3 fatty acid content. During the first 2 wk of life, rat pups received only their dams' milk. Fatty acid composition of the pups' stomach contents (dams' milk), whole body, brain, liver, skin, epididymal fat pads, and muscles was determined. The stomach fatty acid composition of 18:3n-3 reflected the dams' diet. The content of 18:3n-3 in whole body, brain, liver, skin, epididymal fat pads, and muscles was significantly (P< 0.05) greater in rat pups fed the high compared with the low 18:3n-3 fatty acid diet. The 22:6n-3 content of the whole body, brain, skin, epididymal fat pads, and muscles was not quantitatively different in rat pups fed either the low or high 18:3n-3 fatty acid diet. The 20:5n-3 and 22:5n-3 content of the whole body, skin, and epididymal fat pads was significantly increased in rat pups fed the high compared with the low 18:3n-3 fatty acid diet. High content of 18:3n-3 was found in the skin of rat pups fed either a low or high 18:3n-3 fatty acid diet. These findings demonstrate that high maternal dietary 18:3n-3 significantly increases the 18:3n-3 but not the 22:6n-3 content of the whole body, brain, skin, epididymal fat pads, and muscles with approximately 39 and 41% of the whole body 18:3n-3 content being deposited in the skin of suckling rat pups fed either the low or high 18:3n-3 diet, respectively.

Adipose Tissue↗

Quantification of aerobic energy turnover in epididymal bull spermatozoa.

Turnover rates of oxidative energy metabolism were measured as oxygen consumption in untreated and caffeine-stimulated epididymal bull spermatozoa respiring with lactate. Incubation of spermatozoa with 1 mM caffeine led to an increase in respiration of approx. 60%. The rate of uncoupled respiration and the vanadate-insensitive part of oxygen consumption were not affected by caffeine. The small effect of ouabain on respiration (-10%) indicated a minor contribution of Na+/K+-ATPase to the ATP consumption. The major part of ATP turnover was caused by motility shown by the strong linear correlation between respiration and motility in untreated and caffeine-treated spermatozoa. In comparison with ejaculated spermatozoa investigated in a previous study, epididymal cells exhibited the same rates of uncoupled and ouabain-sensitive respiration. The efficiency of transforming mitochondrially-produced ATP into cell motion was the same in epididymal and ejaculated spermatozoa. The ATP-producing capacity of sperm mitochondria was utilized in untreated epididymal, in caffeine-stimulated epididymal and in ejaculated spermatozoa, by 20-25%, 40-45% and 45-50%, respectively. The results showed that the capacity of mitochondrial. ATP formation remains unchanged after ejaculation and is utilized to a higher extent by stimulated motility. Treatment with caffeine affected epididymal spermatozoa in a similar manner.

Aerobiosis↗