The evaluation of routine andrological parameters in human serum

A study was carried out to evaluate the andrological parameters in 540 human semen specimens divided into groups according to sperm counts. The parameters were: motility percentage and grade, percentage of viability and of morphologically normal sperm and immature cells. The Duncan multiple range test and the Kruskal-Wallis test with multiple comparison of ranks were used in the statistical analyses. Of particular interest, among other our findings, were the significant differences obtained by comparing the group with sperm counts up to 5 x 10(6) per ml semen and that with counts ranging from 5.1 to 10 x 10(6) per ml semen. This was true for all parameters with the exception of semen volume. Comparison of the oligozoospermic groups (up to 20 x 10(6)/ml) with those having higher sperm counts also showed significant differences. There was a trend towards improvement of the examined parameters with the increase in sperm density, but with a remarkable heterogeneity particularly within the oligozoospermic groups. In all groups motility, viability and morphological normality of sperm showed a positive correlation with each other. "Normal values" of the parameters studied could be derived from scatterplot charts over the entire range of sperm counts and from the statistical evaluation of the grouped material.

Laboratory evaluation of the Du Pont "Dimension Clinical Chemistry System"

We evaluated the analytical performance of the Du Pont Dimension Clinical Chemistry System to assess its suitability as a replacement for the Du Pont aca III, currently routinely used for analysis of pediatric, high-risk, and emergency specimens. Twenty-six analyses were studied. These generally fulfilled pre-set analytical goals for precision based on biological variation or "state of the art." Significant economies were achieved and we found the Dimension to be reliable, easy to operate, and simple to maintain. It also fulfilled safety requirements for analysis of specimens of high risk to laboratory staff.

Pulse oximeter in the ambulatory aesthetic surgical facility

One-hundred consecutive patients undergoing aesthetic surgical procedures with adjunctive intravenous sedation in an office-based ambulatory surgical facility were monitored by an anesthesiologist with an ECG, stethoscope, automatic sphygmomanometer, and pulse oximeter. The pulse oximeter detected hypoxemia occurring intraoperatively and in the recovery room earlier than the traditional methods of monitoring. By detecting early drops in the SAO2 with the pulse oximeter, appropriate corrective measures could be instituted and titration of intravenous anesthetics adjusted, avoiding progression to more profound hypoxemia and thus resulting in the safer delivery of anesthesia. The pulse oximeter is a useful and recommended adjunct to the traditional methods of monitoring in an office-based ambulatory surgical facility.

Methodology of forensic neurotoxicity evaluation: PCB case

Many scientists and doctors are not aware that the level of certainty for litigation purposes differs from that usually associated with scientific studies. Although the 0.05 probability level is commonly used in scientific studies ("beyond a reasonable doubt"), in U.S. civil litigation the diagnostic criteria is "more probable than not" (greater than 0.50 or chance probability level). The following case of PCB neurotoxicity will be discussed within the context of a forensic evaluation. A number of workers were employed by a metal salvage company to strip copper coils from used electrical transformers. Symptoms of neurotoxicity developed in the men, which were evaluated by questionnaire, interview and psychological examination. Neuropsychological and nerve conduction tests were administered. Results showed deficits in nervous system function related to PCB exposure. An individual case is described in detail.

Sialyl transferase in human semen

The activity of the enzyme sialyl transferase, which is responsible for the transfer of sialic acid, has been examined in the following human seminal plasma: (1) originating from semen with sperm counts above 30 X 10(6)/ml and exhibiting normal values of other andrological parameters; (2) from semen with sperm counts below 25 X 10(6)/ml and with other andrological parameters of poor quality; (3) from semen devoid of sperm. Additionally, enzyme activity was examined in fractionated (split) semen. The activity in plasma based on measurement of radioactivity incorporated into asialofetuin, following incubation in the presence of 14C sialic acid, was expressed as cpm both per volume and per mg protein. There was a tendency for decreased activity with the decrease in sperm density of semen. The difference, however, lacked statistical significance. Enzyme activity in split semen was significantly lower in the first than in the second fraction.

Sialic acid content of human spermatozoa in relation to age and quality of sperm

Sialic acid (SA) has been estimated in human spermatozoa separated according to age by the use of a discontinuous gradient of human serum albumin (HSA), and according to quality (viability and motility) by the use of a discontinuous gradient of bovine serum albumin (BSA). The amount of SA in the "mature" sperm was 3.5 +/- 0.7 (SD) micrograms/mg protein, whereas in the immature sperm subpopulation, enriched with morphologically abnormal sperm, it was 6.9 +/- 3.4 micrograms/mg protein (P = .05). SA estimated in spermatozoa separated according to quality had values of 3.6 +/- 1.2 micrograms/mg protein in sperm of higher quality and 4.1 +/- 1.3 micrograms/mg protein in that of lower quality; this difference was not of statistical significance. It is suggested that changes in SA levels might reflect differences in the degree of sialylation of protein in the subpopulation of sperm, and thus be related to various stages in the fertilization process.

Endocrinological parameters and cell-mediated immunity postoperation for cryptorchidism

Andrological and endocrinological parameters and cell-mediated immunity (CMI) were assessed in 25 postpubertal males who had undergone repair of unilateral or bilateral cryptorchidism in childhood or early adolescence. Among 20 patients with unilateral cryptorchidism, approximately 30% had decreased sperm density, whereas among 5 bilaterally affected, 1 was azoospermic and 2 oligozoospermic. In most patients the motility and viability values were normal, although the percentage of morphologically pathological sperm was higher than normal. Levels of testosterone, dihydrotestosterone, LH, and prolactin were within normal ranges in all the patients. Levels of FSH were slightly elevated. These findings may suggest a better fertility prognosis of postcryptorchid oligozoospermic patients than in patients with oligozoospermia of other etiology. CMI toward autologous semen revealed a positive reaction in 80% of the bilateral group and in 45% of the unilateral group. This response might be due to the damage of seminiferous tubules of undescended testis causing unmasking and exposure of antigenic determinants.

Decreased semen quality in a male infected with malaria

A 33-year-old male of proven fertility suffered six attacks of malaria while resident in an African country. For this he received anti-malarial drugs. Semen analysis performed after the fourth attack, and repeated during the following 2 years after his return to Israel, revealed severe oligozoospermia, necrozoospermia and occasionally even azoospermia. Immunological examination of the patient revealed an inverse ratio of T-cell subsets and mast cell degranulation in response to palludrin. Twenty-five months after the last attack of malaria a significant improvement was found in semen quality and there was an increase in the ratio of T-helper to T-suppressor cytotoxic cells. These observations indicate that although malaria and its treatment may affect spermatogenesis, recovery may be expected eventually.

Peripheral neurotoxicity in workers exposed to inorganic mercury compounds

Nerve conduction velocity (NCV) of the median motor, median sensory, and sural nerves was assessed in 16 workers chronically exposed to various inorganic mercury compounds. Exposed workers were compared with an unexposed control group using t test analyses. Slowing of the median motor nerve NCV was found, which was correlated with both increased levels of mercury in blood and urine, and with increased number of neurologic symptoms. Sensitive evaluation of neural function was found to be practical and informative for investigating mercury toxicity. Such evaluation can help determine safe mercury levels at the workplace.

Progression of neuropsychological deficits following toluene diisocyanate exposure

Three wharf workers were acutely exposed to toluene diisocyanate (TDI) during an accidental chemical spill. Toluene is neurotoxic as a solvent, while cyanates can cause nervous tissue injury or death by hypoxia. Chronic symptoms which occurred following the incident included headache, fatigue, concentration problems, irritability, depression, sleep disturbance, memory and sexual dysfunction. Compared with two months post-exposure, at 16 months post-exposure Full Scale IQ dropped an average of 23 points. Results from additional neuropsychological testing at 16 months post-exposure indicated severe deficits in all three subjects in memory, manual dexterity, visuomotor tracking, mental flexibility, ability to detect figure-ground relationships, and word fluency. Nerve conduction velocity testing indicated abnormal peripheral nervous system function in two of the three workers; however, its etiology is not certain. These results may be relevant to the neurotoxicity of methyl isocyanate exposure, such as occurred in Bhopal, India, where an increasing magnitude of depression, anxiety, fatigue, restlessness, and headaches 18 months post-exposure have been reported. In general, continuing decrement in mental function without concomitant environmental exposure should be considered in neuropsychological assessment of chemical toxicity.

A high proportion of double-headed and double-tailed sperm in semen of a human male. A case report

We present the case of a patient whose semen contained 30% of sperm with double heads and double tails at various stages of attachment due to abnormal meiosis. The genital system, sperm density, endocrinological profile and karyotype were normal. It is postulated that abundance of the above-noted type of sperm pathology in the human semen might not necessarily be associated with oligozoospermia or fertility impairment.

Andrological parameters in patients with varicocele and fertility disorders treated by high ligation of the left spermatic vein

The results of surgical treatment of 50 subfertile patients with left varicocele are presented. Improvement of the spermiogram was noted as follows: 70% of patients had improvement of semen count, 48% of semen motility and 69.4% in the morphological pattern of spermatozoa. Pregnancy occurred in 50% of patients' wives. Eighty-four percent of the pregnancies took place during the first 12 months after the operation. A direct correlation was observed between the size of the varicocele and the number of pregnancies. Severely oligozoospermic patients with sperm count less than 10 million per milliliter semen constituted 72% of the men whose wives became pregnant. There was no statistically significant change after the operation in levels in the semen of luteinizing hormone, follicle stimulating hormone, testosterone and prolactin.

Hyaluronidase activity in split human semen

Hyaluronidase is an acrosomal enzyme which participates in the dissolution of the cumulus oophorus matrix, containing hyaluronic acid, and is essential for the fertilization process. In this study hyaluronidase activity was determined in two fractions of split normozoospermic and oligozoospermic human semen. The method consisted of measurements of areas of digestion of hyaluronic acid in agar (Petri dishes) as compared to activity obtained by commercial testicular hyaluronidase. It was found that the first splits of semen, which are generally characterized by higher sperm density and better quality of sperm, exhibit higher enzyme activity (136.0 +/- 11.6-207.0 +/- 15.1 micrograms/mL) as compared to the second splits (117.8 +/- 10-134.0 +/- 12.9 micrograms/mL).

Hyperthermia induced by open-field stress is blocked by salicylate

Psychological stress results in a rise in body temperature. Here we report that in rats, hyperthermia induced by open-field stress can be blocked by administration of the antipyretic drug sodium salicylate. These data suggest that this rise in body temperature is a true fever, perhaps mediated by prostaglandins.

Oligozoospermia, asthenozoospermia, and sperm abnormalities in ex-addict to heroin, morphine, and hashish

A 40-year-old male had been addicted to heroin, morphine, hashish, and other narcotics for 12 years. At examination, 2 years after abstinence from drugs, his semen analysis revealed oligozoospermia, asthenozoospermia, and morphologically abnormal spermatozoa such as "round-headed" and "kinked"--sperm with neck abnormalities and immature forms. There was no evidence of other morphological abnormalities or of the presence of morphologically normal sperm. A possible correlation is discussed between the long-lasting drug addiction and morphological sperm abnormality, endocrinological function, karyotype, and immunological status.

Separation of normozoospermic human spermatozoa into subpopulations by selective agglutination with peanut agglutinin

Incubation of human spermatozoa of normozoospermic origin with the galactose specific lectin peanut agglutinin (PNA) resulted in agglutination of the majority of sperm. This finding enabled separation of sperm into two subpopulations. The major one, accounting for 87.0 +/- 12.7 (SD)% consisted of agglutinating sperm (PNA+), while the minor subpopulation (PNA-) did not bind the lectin. The correlation between the percentages of PNA- sperm and acrosome-damaged sperm, as detected by light microscopy prior to separation, was analysed and an overlapping has been found. Light and electron microscopy examination revealed that the PNA- cells were either acrosomeless or possessed severely damaged acrosomes while the PNA+ sperm were mostly free of such pathologies. Following treatment of sperm with fluorescin-conjugated PNA the single cells lacked any labeling while the agglutinates exhibited fluorescence. However, the binding of the lectin to sperm was non-uniform and differences in fluorescence intensity at various parts of the head have been observed. The sialic acid content in PNA+ sperm was found to be significantly higher (7.5 +/- 2.2 micrograms/10(8) sperm) as compared to PNA- sperm (2.1 +/- 0.6 micrograms/10(8) sperm). It was suggested that sialic acid content could be a biochemical indicator of acrosomal integrity. Separation of sperm by selective PNA agglutination might be valuable for elimination of sperm affected by acrosomal pathologies from the ejaculate.