Predictive factors for motile sperm recovery using testicular biopsy in nonobstructive azoospermic patients

OBJECTIVE

The objective of the present study was to assess the predictive value of hormone values, histological analysis for the finding of motile spermatozoa on testicular biopsy in nonobstructive azoospermia.

METHODS

This cross-sectional study assessed serum follicle-stimulating hormone (FSH), luteinizing hormone, prolactin and total testosterone values in 50 patients undergoing testicular biopsy prior to ICSI. P < 0.05 was considered significant.

RESULTS

Recovery was successful in 28 cases, and motile spermatozoa were retrieved in 7. Significant differences were detected between presence of motile spermatozoa and absence of spermatozoa in terms of FSH values (P = 0.003, one-way ANOVA). The other variables did not present statistical differences. A receiver operating characteristic curve showed that FSH levels below 17.00 IU/L were predictive of motile spermatozoa recovery.

CONCLUSIONS

FSH values can serve as a predictive factor for the recovery of motile spermatozoa using biopsy in azoospermic patients. On the other hand, histological analysis and other hormone values were not helpful in the prediction of motile sperm.

Determination of Cd and Pb in food slurries by GFAAS using cryogenic grinding for sample preparation

A simple method combining slurry sampling after cryogenic grinding and the use of a permanent modification of the integrated platform inside the transversely heated graphite atomizer (THGA) was proposed for the determination of Cd and Pb in foods. Potentialities of the cryogenic grinding were evaluated for grinding different materials of difficult homogenization such as high fat and high fiber tissues. Animal and vegetal samples were cut into small pieces and ground in liquid nitrogen for 2 min. Slurries were prepared directly in the autosampler cup after cryogenic grinding by transferring an exact amount of homogeneous powdered material (5-20 mg) to the cup, followed by 1.00 mL of 0.2% (v/v) HNO3 containing 0.04% (v/v) Triton X-100 and sonication for 30 s, before transferring into the platform previously coated with 250 microg W and 200 microg Rh. Use of a tungsten carbide-rhodium permanent modifier combined with NH4H2PO4 conventional modifier improves tube lifetime and increases the pyrolysis temperature for Cd. Homogeneity tests, carried out by comparing the between- and within-batch precision for each kind of sample, showed no significant differences at the 95% confidence level, indicating good homogeneity for 5-20 mg masses. Detection limits were 3.3 ng g(-1) Cd and 75 ng g(-1) Pb for 1% m/v slurries. Results for determination of Cd and Pb in foods slurries were in agreement with those obtained with digested samples, since no statistical differences were found by the paired t-test at the 95% level.

Evaluation of carboxymethylcellulose, hydroxypropylmethylcellulose, and aluminum hydroxide as potential carriers for rhBMP-2

Conventional iliac crest nonvascularized corticocancelous bone grafts and bone flaps have been used to treat bony defects. However, these treatments have some limitations, namely, the availability of donor tissue, donor site morbidity, difficulty to shape the bone flap to the defect, and complexity of the surgery. The bone morphogenetic protein (rhBMP-2) is osteoinductive. However, its implantation requires a matrix (carrier) in order to define the shape of the resulting bone and to retain the protein at the site for the time required for induction to occur. When the ideal carrier is found, an unlimited supply of material would be available for all applications where bone is needed. In this in vitro study, we evaluated the suitability of some potential carriers for rhBMP-2 by measuring the alkaline phosphatase (ALP) activity of fibroblast cultures. Either rhBMP-2 or sodium carboxymethylcellulose significantly increased the ALP activity, when used alone. When sodium carboxymethylcellulose was combined with rhBMP-2, there was an increase in the ALP activity, but lower than those obtained when the products were used alone. Hydroxypropylmethylcellulose alone did not affect ALP activity. However, the combination of rhBMP-2 with hydroxypropylmethylcellulose did not increase the ALP activity, despite the presence of rhBMP-2. Aluminium hydroxide proved to be an unsuitable rhBMP-2 adsorbent.

Cervical Cancer Screening in Porto Alegre, Brazil: Alternative Methods for Detecting Cancer Precursors in a Developing Country

OBJECTIVE

This study was conducted to test the performance characteristics of cervical cancer screening by visual inspection of the cervix with acetic acid and iodine solution.

METHODS

A total of 100 women were screened for cervical cancer by Pap smear and naked eye inspection of the cervix after application of acetic acid and iodine solution.

RESULTS

Comparing visual inspection to the Pap test, a sensitivity of 85.7%, specificity of 78.5%, and concordance of 79% (p < .0011) was established. Comparing the Pap test with colposcopy, the corresponding figures were 42.9%, 92.3%, and 66.6% (p < .077), respectively. Visual inspection compared to colposcopy showed corresponding figures of 100%, 7.7%, and 55.5% (p = .48), respectively. Colposcopy and biopsy had an agreement of 100%.

CONCLUSIONS

Visual inspection with acetic acid and iodine solution proved to be a reasonable method of screening for cervical cancer precursors.

Examination of the lower limb in high risk patients

When 'at risk' patients say that their feet are killing them, they may be right. Diabetes mellitus accounts for 50 to 70% of all nontraumatic amputations with a three year survival rate of those who undergo a lower limb amputation of 50%. Furthermore, when compared to the 'normal' foot, the 'at risk' foot is more likely to develop complications, thus it is vital to identify such 'at risk' individuals in an attempt to prevent the risk of deformity, ulceration, infection and/or necrosis/gangrene. The assessment involves history taking, the examination and further investigations, providing the necessary information to make a clinical diagnosis and identify 'at risk' groups. During the examination the foot-wear should be checked, nails and skin condition should be closely inspected and tests should be carried out for signs of peripheral neuropathy, ischaemia and venous/lymphatic deficiency. Other complications like deformity and increases in foot pressure may cause ulceration. Where ulcers are present, an in-depth systematic inspection is necessary. A thorough lower limb examination of high risk patients provides the necessary information to make a clinical diagnosis and plan preventative measures to avoid future complications.

Expression of antisense hsp70 is a major determining factor in heat-induced cell death of P-19 carcinoma cells

Overexpressed heat shock protein 70 (Hsp70) is known to be associated with thermoprotection in a number of cell lines and transgenic animals. We hypothesized that because overexpression of Hsp70 protects cells from lethal heat stress, inhibition of expression should make cells susceptible to heat stress. The model used for this study was a stably transfected P-19 carcinoma cell line expressing antisense hsp70 under the control of the hsp70b promoter. The results showed marked inhibition of Hsp70 expression after heat shock correlated with heat-induced cell death. Hsp90 and Hsc70 protein expression were not affected by the antisense construct. Unexpectedly, heme oxygenase (HO-1), another highly inducible heat shock protein, was not induced after heat shock in the antisense hsp70 cell line. Heat shock transcription factor-1 (HSF-1) was in a highly phosphorylated state in the antisense cell line before and after heat shock. This was in contrast to the untransfected control P-19 cells where HSF-1 was primarily highly phosphorylated after heat shock. A control cell line expressing only the vector, pMAMneo, without the antisense construct also showed partial loss of Hsp70 induction but not increased cell death after heat shock. The findings support the role of Hsp70 in thermoresistance.

Induction of cell death by L-alpha-aminoadipic acid exposure in cultured rat astrocytes: relationship to protein synthesis

The excitotoxin, L-alpha-aminoadipic acid (L-AAA), kills primary astrocytes in the brain. The mechanism underlying the induction of cell death is not well understood although many possible mechanisms are theorized. Previous studies have reported that astrocytes die after prolonged exposure to L-AAA suggesting a delayed programmed cell death and apoptosis. In this study rat cortical astrocytes exposed to continuous 1 mM L-AAA exposure for 24-, 48-, or 72 hours demonstrated increased DNA laddering, a characteristic of apoptosis. Unexpectedly, this was not ameliorated by the presence of cycloheximide at 0.1 microg/ml medium. Because of our interest in cytoprotective heat shock proteins induced by excitoxic stress, we studied the effect of prolonged exposure of L-AAA on the synthesis of stress proteins and protein synthesis in rat cortical astrocytes. Protein synthesis as measured by [35S]-methionine labeling showed a marked and significant decrease in incorporation of radiolabel after 24 hours of exposure to L-AAA and prior to induction of significant cell death noted at 48- and 72 hours of L-AAA exposure. The inhibition of protein synthesis was partially reversible at 24 hours if cells were labeled in medium without L-AAA during the radiolabeling period. Heat shock or stress proteins, HSP70 and heme oxygenase-1 (HO-1), were analyzed after a 24 hour exposure to L-AAA and showed no significant induction of HSP70 or HO-1. The findings suggest that the prolonged inhibition of protein synthesis and associated lack of induction of HSP70 and HO-1 synthesis contributed to apoptotic cell death induced by the excitoxin L-AAA.

[Radiotherapy-induced pemphigus]

The authors report the clinical case of a woman exposed to ionizing radiotherapy, for the treatment of breast carcinoma, in whom a pemphigus lesion developed within the area of irradiation. This is, to the authors' knowledge, the 14th case of ionizing radiation-induced pemphigus.

nov: a new genetic locus that affects the response of Escherichia coli K-12 to novobiocin

We have identified a new gene locus (nov) affecting the resistance of Escherichia coli K-12 to novobiocin. The gene also affects, although to a lesser extent, tolerance to another gyrase inhibitor coumermycin. Transductional and complementation analysis show that nov is located between att phi 80 and the osmZ (hns) genes at minute 27 of the E. coli K-12 genetic map. In standard laboratory strains of E. coli K-12 nov exists at least in two allelic forms.

[Nephrotic syndrome in children. Retrospective study at a concentration hospital]

In order to evaluate the usefulness of certain clinical and paraclinical characteristics to be able to discriminate the minimal change disease (MCD) from other histopathological lesions associated with the nephrotic syndrome (NS), the clinical charts of 31 patients were reviewed and relevant data were analyzed. Those patients with no history of biopsy and those with documented MCD through biopsy, were placed in one group (MCD = 25) and the rest as others (others = 6). None of the clinical or paraclinical indicators analyzed showed significant differences between either group. In the MCD group, 76% of the patients entered remission after receiving steroid treatment, while none of the others entered remission. The magnitude of the proteinuria, hypoalbuminemia, hypercholesterolemia, and the presence of hematuria, hypertension or hyperazoemia, were not useful to discriminate those with MCD from other lesions. The response to treatment with prednisone was the most useful data to differentiate the groups.

[Histocompatibility antigens and acute vascular purpura]

INTRODUCTION

Some kidney diseases are associated to HLA antigens. Nyulassy found an increase in HLA-B35 in patients with Henoch-Schönlein's purpura suffering nephritis (HSP-N). Our study searched for associations of HLA antigens and anaphylactoid purpura nephritis in Mexican mestizo patients.

MATERIAL AND METHODS

HLA-A,B, and C antigens were detected by two-step microcytotoxicity in 22 patients with HSP-N and compared to those of 665 healthy subjects of the same ethnic background.

RESULTS

A significant association was found between HSP-N and HLA-Aw19 single (pc less than 0.05) or in haplotype form (Aw19-B35) (pc less than 0.005). HLA B35 alone was associated to HSP-N but only at non corrected level (pc less than 0.05).

DISCUSSION

The significant association between HLA-Aw19 and Aw19-B35 and HSP-N may indicate a risk factor in Mexican mestizo patients to develop this case.

Comparison of methods of carbamazepine dosage, individualization in epileptic patients

The aim of the present work was to analyse the predictive capacity of different optimization methods for carbamazepine dosage regimens according to population pharmacokinetic parameters and/or serum levels data. Calculations were performed using a multiple non-linear regression program (MULTI 2 BAYES) with two different options: (a) using the ordinary least squares methods and (b) the least squares method based on the Bayesian algorithm. The predictive capacity of the three methods was analysed comparing the serum levels values in patients predicted by each method and those observed later. The performance obtained was poor and even unacceptable when dosage prediction was based on the mean parameters of the population studied (Method A) and when only one data point relating to the serum carbamazepine levels was available (Method B). When two serum levels data were used the standard deviation of the mean prediction error was only clinically acceptable when Bayesian non-linear regression was applied (Method C). When the number of serum levels data points was 3 or 4 the errors were acceptable from a clinical point of view and no significant differences could be found between the use of the simple and Bayesian version at the same level of information.

The construction and use of a human-mouse myeloma analogue suitable for the routine production of hybridomas secreting human monoclonal antibodies

A human-mouse myeloma analogue termed HMMA2.11TG/O was constructed by fusion of the mouse myeloma cell line P3x63Ag8.653, a mutant derivative of MOPC21, with bone marrow mononuclear cells from a patients with IgA myeloma. The HMMA2.11TG/O cell line is resistant to 6-thioguanine and ouabain and sensitive to HAT. The cell line secretes no detectable immunoglobulin and has a hybrid karyotype and cell surface phenotype. An average fusion efficiency for growth of hybridomas of 1/17,000 fused cells was obtained in fusions with human peripheral blood mononuclear cells (PBM), Pokeweed Mitogen (PWM) stimulated PBM, and Epstein-Barr Virus (EBV) transformed polyclonal B cell lines. Over 75% of hybrids secrete detectable immunoglobulin and the cloning efficiency of the hybrids at 1 cell/well averages 25%. Antibody secreting cloned hybridoma cell lines were obtained by fusion directly with PBM from an immunized volunteer and by fusion with in vitro, secondarily immunized, EBV transformed polyclonal cell lines. Five hybridomas secreting human monoclonal IgM anti-tetanus antibodies and 2 secreting human monoclonal IgG anti-tetanus antibodies were selected and cloned from 6 fusions performed specifically for anti-tetanus antibody. Immunoglobulin and antibody secretion by cloned hybrids has been stable for 5-10 months at present. Immunoglobulin and antibody secretion in routine cultures passaged every 3-4 days has been 8-42 micrograms/ml. This human-mouse myeloma analogue should prove useful for the routine production of human monoclonal antibodies.

Bupivacaine protein binding in the term parturient: effects of lactic acidosis

The effects of lactic acidosis on bupivacaine serum protein binding was studied in a group of term parturients and a group of nonpregnant female control subjects. Groups were matched in age and health. Distribution characteristics of bupivacaine in pregnancy were determined. Bupivacaine protein binding was best characterized by the model for two classes of binding sites in all studies. The parturients exhibited a lower capacity for the high-affinity, low-capacity (alpha 1-acid glycoprotein) site and higher affinity for the low-affinity, high-capacity (albumin) site. Lactic acidosis decreased the affinity constant for the high-affinity, low-capacity site in the control group but did not change binding characteristics in the parturients. Free concentration of bupivacaine (Cu) was elevated at low total bupivacaine concentrations (Ct) (less than 10 micrograms/ml). No differences in Cu were detected at concentrations in the cardiotoxic range (greater than 20 micrograms/ml). The Cu values predicted by the estimated binding parameters from in vitro experiments were compared with actual Cu measured in nine parturients at delivery; they correlated significantly (r = 0.94). Distribution changes for bupivacaine in the parturients were consistent with known physiologic changes in body composition associated with pregnancy. Alterations that occur in serum protein binding during pregnancy should not result in increased risk of central nervous system or cardiovascular system toxicity since these alterations do not increase free tissue concentration.

Renal function in protein-energy malnutrition

So far, most studies on renal function in children with advanced protein-energy malnutrition have shown an impairment of glomerular filtration rate and renal plasma flow, as well as diminished ability to excrete an acid load and a concentrated urine. Investigation of these functions in eight marasmic infants and eight children with kwashiorkor once they were free of obvious infections and acute electrolyte disturbances has shown a practically normal renal performance.

[Asymptomatic nephritis in relatives living with children with acute poststreptococcal glomerulonephritis]

We studied a group of 114 persons living together with children admitted in the hospital because of poststreptococcal glomerulonephritis; minute count of the urinary sediment, antistreptolysin 0 and throat culture were done. An increased was found in the urinary excretion of erythrocytes in 31% of the population studied; 71% showed a rise of serum antistreptolysin 0 and 9% showed beta hemolytic streptococci in their throat culture. It is important to search for these asymptomatic patients among relatives and follow their course; there is a possibility that some will developed chronic nephritis. It is also important to erradicate the streptococcal infection.

Isolation and characterization of a new temperature-sensitive cell division mutant of Escherichia coli K-12

A new temperature-sensitive mutant strain of Escherichia coli K-12 which forms filaments at 42 C has been described. The mutant, Y16, maintained growth and deoxyribonucleic acid synthesis at 42 C. The resulting multinucleate filaments gradually lost their viability at 42 C but could be recovered, even after 240 min of incubation, upon return to 30 C. Septation was resumed and growth was promptly re-established at normal rates. Recovery still took place in the presence of chloramphenicol added to the culture at the time of temperature shift from 42 to 30 C. A study has been made of the effects of adenine and various nucleosides on cultures of strain Y16 as compared with another filament-forming mutant, T44 tif-. Adenine (75 mug/ml), known to promote filamentation of strain T44 tif-, prevented the development of filaments and the loss of viability in cultures of Y16. Recovery of septation after temperature shift in cultures containing adenine presented a pattern similar to that found with the adenine-less cultures. Protection afforded by adenine at 42 C could be reversed by the addition of guanosine plus cytidine (100 mug/ml each). The effects of high concentrations of adenine and nucleosides on strain Y16 thus are the reverse of those observed with mutant T44 tif-. However, whereas tif-1 mutation promotes prophage induction at restrictive temperatures, no modification could be detected in the process of prophage induction in cultures of the lambda-lysogenic derivative of Y16 at 42 C, be it spontaneous or ultraviolet-mediated induction. The osmolarity increase afforded by 1% NaCl added to the medium did not alter the phenotype characteristics of strain Y16. The mutation has been mapped between argG and bgl. A close linkage has been observed between ftsH and argG, thereby locating the new mutation near 61 min on the map of E. coli chromosome, a previously undescribed region involved in cell division. The evidence reported indicates that strain Y16 differs in several respects from the already descirbed strains of the same class.