Interferon alpha-2b modulates beta-galactoside alpha-2,6-sialyltransferase gene expression in rat testes

Sperm surface glycoproteins are modified during passage through the epididymis, a process believed to be important in the production of functionally mature spermatozoa. The effect of various cytokines on reproductive events has recently been investigated, with conflicting results. In the present investigation, the effect of interferon-alpha-2b (IFN alpha 2b) on sialyltransferase (ST) activity and beta-galactoside alpha-2,6-sialyltransferase (Gal 2,6-ST) mRNA expression was studied in rat testicular tissue. The results revealed the presence of Gal 2,6-ST mRNA in rat testicular tissue, similar in molecular size to that found previously in rat spleen, lung, ovary, kidney, heart, and brain. In addition, we observed that IFN alpha 2b reduced Gal 2,6-ST mRNA and ST activity in rat testes by a comparable magnitude. These findings provide insight into an additional mechanism by which cytokines may affect the reproductive system.

Effect of interferon alpha IIb on the activity of sialyltransferase in testis homogenates of adult rats

Interferon alpha IIb was injected to adult male rats at doses ranging from 10,000 to 200,000 units. Animals were dissected at intervals of 12 h, 24 h, and 5 days. The activity of the enzyme sialyltransferase in testis homogenates was estimated. In the majority of experiments enzyme activity decreased in comparison to controls.

Separation of human semen on Percoll gradients: effect on percentage of motile and morphologically normal sperm and proportion of acrosome reacted sperm

OBJECTIVES

To examine whether sperm motility and morphology correlate with ability to undergo the acrosome reaction in vitro.

METHODS

Sixty-one seminal specimens were separated on a discontinuous Percoll gradient (70%, 40%). Percentages of motile and morphologically normal sperm, their motility grade, and percentages of acrosome-reacted sperm before and following acrosome reaction inducing treatment were estimated.

RESULTS

Percentage of motile sperm from normozoospermic specimens increased from whole semen (47.6 +/- 5.6) to sediments (59.6 +/- 13.0). Motility grade exhibited a similar trend (2.1 +/- 0.5 and 3.6 +/- 0.5-scale of 1-4). Percentage of morphologically normal sperm increased from semen (27.3 +/- 10.9) to sediment (53.8 +/- 14.8). All differences were statistically significant, (P < 0.00). In abnormal semen the motility grade and percentage of morphologically normal sperm also increased from semen to sediment (1.9 +/- 0.4 to 3.2 +/- 0.8 and 17.7 +/- 7.8 to 37.1 +/- 15.4 respectively, (P < 0.001). Percentages of motile sperm were similar. In normozoospermic sediments, both non-treated or treated to induce the acrosome reaction, proportions of acrosome-reacted sperm were significantly higher than in semen (18.3 +/- 6.9% and 20.0 +/- 6.5% vs. 6.8 +/- 4.2% respectively, P < 0.001). A similar trend was obtained using abnormal aliquots; however, the acrosome-reacted sperm accounted for only 9.0 +/- 5.1% and 10.8 +/- 4.3% versus 5.4 +/- 2.8% (P < 0.025).

CONCLUSIONS

Morphology and motility of sperm were correlated with the proportion of acrosome-reacted sperm.

Predictors of hand function in older persons: a two-year longitudinal analysis

OBJECTIVE

To validate a hierarchical model of hand function in older persons, using longitudinal data.

DESIGN

Longitudinal observational study (2-year data from an ongoing longitudinal study).

SUBJECTS

689 persons older than age 60, including Continuing Care Retirement Community (n = 230), homebound (n = 204), and ambulatory (n = 255) respondents. Mean age at baseline 76.6 (SD = 8.8).

MEASUREMENT

Independent variables included sociodemographics, physician measures of upper joint impairment, self-reported comorbidity, arthritis pain, depression, and anxiety. The dependent variables included grip strength and a timed manual performance test.

MAIN RESULTS

Using generalized estimated equations (GEE) to test our hierarchial model, we found that gender and upper extremity joint impairment were the strongest predictors of a longitudinal measure of grip strength. Grip strength, in turn, along with demographics, comorbidity, and a measure of psychological status, was significantly related to timed manual performance.

CONCLUSIONS

The longitudinal analyses confirmed a previous cross-sectional finding that upper extremity joint impairment contributes significantly to reduced grip strength, which, in turn, contributes to reduced hand performance on a timed test.

Clomiphene citrate reduces procarbazine-induced sterility in a rat model

Chemotherapy with the cytotoxic drug procarbazine (PCB) causes permanent infertility in most male patients. Since many patients treated with this cytotoxic drug are of reproductive age, it is important to develop a method to protect spermatogenesis and fertility. It has been hypothesised that 'spermatogenic arrest' by pharmacological intervention may render the testes less susceptible to the effects of chemotherapy. The present study investigated whether recovery of fertility in a male rat model could be achieved by suppression of spermatogenesis with high doses of clomiphene citrate (CC) prior to PCB administration. It was demonstrated that young male rats treated with a combination of CC and PCB partially recovered spermatogenesis and achieved almost normal fertility. In contrast, animals treated with PCB alone exhibited abnormal spermatogenesis and remained infertile.

Echogenic emboli upon tourniquet release during total knee arthroplasty: pulmonary hemodynamic changes and embolic composition

Echogenic venous emboli accompany tourniquet deflation during total knee arthroplasty. The associated pulmonary hemodynamic alterations and determined embolic composition were measured in 34 patients, undergoing 35 procedures. Ten patients received a femoral venous catheter on the operative side. Hemodynamic variables, heart rate and mixed venous oximetry, end-tidal CO2 and nitrogen tensions, and transesophageal echocardiograms were recorded after induction of anesthesia (baseline), after tourniquet inflation, after cementing, and for 15 min after tourniquet deflation. Echocardiograms revealed either showers of miliary echogenic material (Group S, 9 patients), or large echogenic masses superimposed on the showers (Group MS, 26 patients). In Group MS only, pulmonary vascular resistance index increased above baseline (205 +/- 16 [SEM] dyne.s.cm-2) beginning 5 min after tourniquet deflation (maximum 328 +/- 29, P < 0.05). Mean pulmonary arterial pressure increased above baseline (20 +/- 1.0 mm Hg) for both Groups S and MS beginning 3 min after tourniquet deflation (27 +/- 1.0, P < 0.05). Cardiac index did not change. Five of 10 patients demonstrated fresh thrombus from the catheter in the operative limb. Echogenic emboli occurred in all patients upon tourniquet deflation during knee arthroplasty. Pulmonary vascular resistance index increased only in patients with large echogenic material. Our data suggest that these emboli represent fresh thrombus formation during tourniquet inflation. Heparin administration prior to tourniquet inflation may diminish embolic showers.

Soluble interleukin-2 receptor levels in cytomegalovirus disease and graft versus host disease after T-lymphocyte depleted bone marrow transplantation for hematological neoplasias

In recent years, the soluble Interleukin-2 Receptor (sIL-2R) has gained recognition as a valuable marker of in vivo activated immune functions in a variety of diseases. We studied sIL-2R levels in patients with cytomegalovirus (CMV) disease, and/or graft versus host disease (GVHD) following bone marrow transplantation (BMT). Our study included 36 patients after T-cell depleted allogenic BMT and 11 healthy controls. Mean sIL-2R serum levels were significantly higher after BMT than before (1273 u/ml vs. 629 u/ml, respectively, p < 0.007). In the patients who developed CMV disease, with or without GVHD, mean sIL-2R levels increased significantly (2866 u/ml p < 0.004); there was a drop after recovery (1949 u/ml), but not a return to pre-CMV onset levels. Similar elevated sIL-2R levels were found in patients during CMV disease only, GVHD only, or both. In patients who developed GVHD, sIL-2R levels were positively correlated with the severity of GVHD (Pearson's correlation coefficient .8322, p < 0.003). We conclude that sIL-2R may serve as a valuable nonspecific marker for the presence of CMV disease and severity of GVHD following T-lymphocyte depleted BMT.

Joint impairment and ambulation in the elderly

OBJECTIVE

To test the impact of joint impairment on ambulation in the elderly, using a multivariate model.

DESIGN

Cross-sectional observational study (baseline data from an ongoing longitudinal study).

SUBJECTS

Five hundred thirty-two persons over age 60, including continuing care retirement community (CCRC) (n = 222), homebound (n = 63), and ambulatory (n = 247) respondents. Mean age at assessment = 76.6 (SD = 6.6).

MEASUREMENT

Independent variables included sociodemographics, physician measures of lower joint impairment, an index of cormorbidities derived from physical examination or chart abstract, self-assessed arthritis pain, depression, and anxiety. The dependent variable, ambulation, was measured as walk-rate, based on the time required to walk 50 feet.

MAIN RESULTS

For the total sample, 61% of the subjects were impaired in more than one lower joint group, with almost 50% of the homebound impaired in more than three joint groups. Demographics (particularly age and education) explained much of the variance in walk-rate. After controlling for demographics and membership in the groups purposely sampled (CCRC, homebound, ambulatory), lower joint impairment accounted for an additional 7% of the variance in walk-rate. Total amount of variance explained by the model was 56% (Adjusted R2 = .56). A 3-point change in lower joint impairment score, equivalent to the maximum impairment score for a single joint group, is associated with a 4-second change in the mean time required to walk 50 feet. The knee and lower spine joints contributed most to the impact of the lower joint impairment measure.

CONCLUSIONS

Among the elderly, age and education are strong predictors of performance on a walk-rate test. Independent of demographics and non-musculoskeletal conditions, joint impairment is associated with diminished walking ability in this population.

[Epithelioid leiomyosarcoma of the stomach with hemorrhagic ascites]

In two men (69 and 65 years old) a gastric epithelioid leiomyosarcoma more than 25 cm in diameter first manifested itself by an increase in abdominal girth and ascites. In case 1, a cylindrical mass was palpable in the abdomen increasing in size over two years. Sonography and computed tomography showed a large cystic tumour which could not be related to any one organ. Cytology of the ascites fluid did not reveal any tumour cells. At operation a pedunculated tumour, 29 x 20 x 9 cm, was found, originating from the stomach. Six litres of ascites fluid were aspirated. There were no detectable abdominal metastases. The patient died nearly 4 years later after the tumour had been resected, three further laparotomies had to be performed because of extensive metastases to peritoneum and liver from the leiomyosarcoma. In case 2, no abdominal mass was palpable, but the patient's girth had increased over the last year. Sonography revealed a cystic tumour, about 30 cm in diameter. Examination of haemorrhagic ascites fluid (700 ml) did not show any tumour cells. The tumour, originating from the stomach wall, was excised (no metastases were seen). The patient remains symptom-free after 35 months.

The lines and grooves of the face: a suggested nomenclature

The lines and grooves of the face commonly recognized and used by plastic surgeons, biological anthropologists, forensic medicine specialists, artists, and others are described. Proper Latin anatomical names for them are suggested. It is hoped that eventually these will be adopted by those who use them and published by the International Anatomical Nomenclature Committee.

Percentages of acrosome-reacted sperm in human semen close to liquefaction and following acrosome-reaction inducing treatment

OBJECTIVES

To compare spermatozoa from normal and subnormal seminal specimens in their ability to undergo the acrosome reaction, as defined by the triple-staining method.

METHODS

Normal (39) and abnormal (23) specimens were examined by staining promptly after liquefaction. In a total of 32 specimens, the reaction was examined before and after acrosome-reaction-inducing treatment, which was essentially incubation of isolated sperm in BWW containing 0.3% BSA and 4 mM calcium chloride.

RESULTS

Percentage of vital acrosome-reacted sperm (true acrosome reaction) of untreated specimens: normal, 10.0 +/- 4.9%, abnormal, 5.3 +/- 3.6% (P < .001). After treatment: increase in reacted sperm from normal specimens, 9.0 +/- 7.1% to 22.7 +/- 14.0% (P = .005); abnormal specimens, 5.4 +/- 2.9% to 7.3 +/- 4.2% (NS).

CONCLUSIONS

Low capability of sperm to undergo the acrosome reaction might be a decisive factor in the low fertility potential characterizing the majority of abnormal semen. Effort in infertility treatment should be directed to increasing the proportion of acrosome-reacted sperm.

Ergonomics: your chair and you

In a profession such as medical transcription which requires sitting for prolonged periods of time, finding the right chair can be as important to your job performance as using the latest state-of-the-art technology.

Antibodies to soluble human T cell receptor beta chain recognize multiple epitopes on cell surface TcR

The T cell receptor (TcR) is an integral membrane protein occurring as a disulfide linked heterodimer, non-covalently associated with CD3 on the surface of T lymphocytes. Antibodies to the TcR have been shown to be effective for treating autoimmune disorders in animals. We describe here a method for producing antibodies to cell surface determinants of the human TcR, using a soluble form of the receptor as antigen. Soluble V alpha 1.2, V beta 8.1, V beta 11 TcR chains are expressed from a construct in which the extracellular domains of the TcR are fused to the mouse gamma 2a heavy chain constant region lacking the CH1 domain. These chimeric molecules contain both immunoglobulin and TcR determinants, as revealed by antibody probes. Amino-terminal sequence analysis of a chimeric V beta 8.1 molecule indicates that the TcR leader peptide is correctly processed from the soluble form. Antibodies raised against the soluble human V beta 8.1 molecule recognize the native determinants on Jurkat cells, and on natural T cells derived from resting human peripheral blood lymphocytes. Epitope mapping studies using competitive binding assays suggest that the anti-V beta 8 antibodies produced using soluble antigen recognize multiple overlapping determinants on the cell surface form of the TcR.

Joint impairment and hand function in the elderly

OBJECTIVE

To test the contribution of joint impairment to observed hand function (grip strength and Williams Test) in the elderly, using a multivariate model.

DESIGN

Cross-sectional observational data (baseline data from an ongoing longitudinal study).

SUBJECTS

Five hundred forty-one persons over age 60, including continuing care retirement community (n = 222), homebound (n = 72), and ambulatory (n = 247) respondents. Mean age at assessment 76.7, (SD = 9.0).

MEASUREMENT

Independent variables included sociodemographics, physician measures of upper joint impairment, an index of comorbidities derived from physical examination or chart abstract, self-assessed arthritis pain, depression, and anxiety. The dependent variables included grip strength and a modified Williams Test [Williams Test (M)].

MAIN RESULTS

The multiple regression explained 59% (Adjusted R2 = .59) of the variance in grip strength, with joint impairment accounting for a change in R2 of .07. Upper joint impairment and grip strength accounted for 3% and 5%, respectively, of the variance in the Williams Test (M) (total amount of explained variance = 45%).

CONCLUSIONS

Demographics explain most of the variance in grip strength and performance on the Williams Test (M). Controlling for demographics, musculoskeletal disease represented by joint impairment is associated with diminished grip strength. Reduced grip strength is associated with poorer performance on the Williams Test (M).

Atropine poisoning in children during the Persian Gulf crisis. A national survey in Israel

OBJECTIVE

To evaluate the effects of high doses of atropine in children accidentally injected with automatic atropine injectors. These were distributed in Israel during the Persian Gulf Crisis as an antidote for chemical warfare agents.

DESIGN AND SETTING

A national survey in pediatric emergency departments in Israel, involving 22 medical centers, with prospective data collection in 14 centers.

PATIENTS

Children (n = 268) presenting to emergency departments following misuse of automatic atropine injectors.

MAIN OUTCOME MEASURES

Documentation of atropine dose and clinical manifestations; determination of a clinical severity score and its correlation with atropine dose; measurements of serum atropine levels in six patients.

RESULTS

Over a period of 4 months, 268 cases were reported, of which 240 were clinically evaluated. The most common site of injection (75%) was the finger or palm. Doses were up to 17-fold higher than standard doses for age. In 116 children (48%), systemic effects of atropine were observed, and 20 (8%) had severe atropinization. Seizures and life-threatening arrhythmias were not reported, and there were no fatalities. The severity of atropinization was correlated with the dose following a classic nonlinear, dose-response relationship. Serum atropine levels (6.2 to 61.0 ng/mL) were much higher than those observed after administration of therapeutic doses.

CONCLUSIONS

The high incidence of injection in the hand implies accidental use of automatic atropine injectors among children. The lack of mortality or life-threatening complications from injection of large doses of atropine attests to its relative safety in children. The low risk from atropine injections weighed against expected benefit as a lifesaving antidote justifies the distribution of personal atropine injectors to children at risk of organophosphorus nerve agent attack.

Prenatal diagnosis of tetralogy of Fallot with absence of the leaflets of the pulmonic valve

Tetralogy of Fallot with absence of the leaflets of the pulmonic valve is relatively rare. We describe the prenatal diagnosis of this malformation in two fetuses. The association between the agenesis of the arterial duct and absence of the valvar leaflets is discussed. The diagnosis of the syndrome in the presence of dilated and pulsatile pulmonic arteries is easy to make. It should allow early counselling and planning of early care after delivery.

Cyclophosphamide, doxorubicin, dexamethasone and procarbazine: effect on seminal plasma sialyltransferase activity

The influence of chemotherapy agents, doxorubicin (adriamycin), cyclophosphamide, procarbazine, and dexamethasone on the activity of sialyltransferase in human semen has been examined. Aliquots of 25 mcL semen were incubated for 2 hours with the above substances at concentrations ranging from 10 to 800 mcg/incubation mixture. The measurement of sialyltransferase activity was based on the incorporation of radioactive sialic acid from CMP (14) C sialic acid) into asialofetuin. Doxorubicin and cyclophosphamide, at the maximal concentration of 800 mcg/incubation mixture exhibited an inhibiting effect on sialyltransferase activity which accounted for 15.7 +or- 16% and 12.2 +or- 16%, respectively. The rate of inhibition following incubation with maximal doses of dexamethasone (400 mcg) was 25.3 +or- 13%, respectively. The rate of inhibition following incubation with maximal doses of dexamethasone (400 mcg) was 25.3 +or- 12%. Inhibition caused by procarbazine did not exceed 5%. Inhibition of sialyltransferase in human semen by the materials examined in this study can diminish the transfer of sialic acid, thus interfering with normal glycoprotein's and glycolipid's syntheses in semen and possibly also in other fluids and tissues.

Some characteristics of azoospermic human semen

Of 260 volume measurements and 265 fructose determinations on 257 azoospermic semen samples, the volume was normal (1-6 mL) in 78%, low in 16.7%, and high in 5.2%. The percentage of azoospermic samples with low volume was greater than that found for samples containing sperm. Mean fructose concentrations were similar in high-volume and normovolemic azoospermic samples, but significantly lower in low-volume samples. There was no correlation between (a) the etiology of the azoospermia and abnormal semen volume or fructose concentration (save for cases of obstruction and/or atrophic seminal vesicles) or (b) semen volume, fructose concentration, and serum LH, FSH, testosterone, or prolactin.

Nontraumatic, acute neonatal paraplegia

Nontraumatic, acute neonatal paraplegia with associated lower limb vascular phenomena is a relatively rare condition. Three such cases are reported. The paralysis is primarily motor with minimal neurologic recovery. Contractures and bizarre deformities develop at an early stage and necessitate repeated orthopaedic intervention. The most likely etiology appears to be a vascular insult to the spinal cord.