Computer assisted sperm motility analysis

The CellSoft system was employed to study its reliability in the evaluation of seminal data in fertile and infertile subjects. In addition new motility data were introduced and added to the classic parameters. Various clinical and experimental applications are reported. The system is valid and extremely useful in seminal research. In order to obtain the above mentioned benefits it is necessary for the users to have extensive experience of seminology and computer technology.

Radio-immuno binding test for anti-sperm antibody detection: analysis and critical revision of various methodological steps

The authors report the results of a methodological study to optimize a radioimmunoassay to detect anti-sperm antibodies. They describe here the definitive methodology with all the data relating to the laboratory trials conducted at each step of the technique. Results seem to demonstrate that this radioimmunological method is sufficiently simple, specific, sensitive and reliable for use in a highly specialized laboratory of reproductive immunology. Furthermore, this type of analytical approach, whilst indicating once more the difficulty of the technical study of anti-sperm autoimmunity, confirms (with concrete data) the necessity of being extremely "prudent" in evaluating the results of this kind of anti-sperm antibody test.

Decreased platelet serotonin uptake in bipolar I patients

The 5HT transporter complex in platelets is similar to that in the brain and thus widely used in biological psychiatry as a peripheral marker of the 5HT system. Our study aim was to measure 14C-5HT uptake parameters (Vmax and Km) in platelets from 12 patients affected by bipolar disorder, as compared with 12 healthy controls. The uptake assay was performed according to the method of Arora and Meltzer (1981). The results showed that the Vmax was significantly lower in bipolar patients than in healthy controls, with no modification of the Km. These preliminary data would indicate therefore that the mechanism of 5HT transport is altered in platelets of bipolar patients.

[Enoxacin in the treatment of male genital infections in patients with antisperm autoimmune pathology]

Anti-sperm antibodies are frequently present in patients bearing infections of the genital tract and a cause-effect relationship is suspected in these two pathological conditions. In an open, uncontrolled study, the Authors tested the therapeutical effect on both autoimmune anti-sperm and infectious genital tract diseases. Thirty patients, age 30.3 +/- 3.6 years (mean +/- D.S.; range 25-42), were admitted to the study. In all patients the clinical diagnosis was confirmed by a positive sperm culture for enoxacin sensitive germs. Eleven out of 30 patients (36.7%) were also found to be positive by both immunofluorescence and immunoenzymatic tests for Chlamydia Trachomatis at the beginning of the study. At day 0 (first menstrual cycle day of the patients' partner) enoxacin treatment (300 mg twice daily) was started with the patients and their partners for a period of 30 and 12 days respectively. Sperm culture and both the above mentioned tests for Chlamydia Trachomatis were subsequently repeated on day 5 of therapy (first control) and at 1, 3, 6 and 12 months (2nd, 3rd, 4th, and 5th controls respectively) after the end of treatment. Statistical analysis of the results was performed by both Dunnett and Chi-square tests as appropriate. Isolated germs from pre-treatment sperm culture were classified as Enterococcus (17/30 cases: 56.7%) E. Coli (8/30: 26.6%), Klebsiella (2/30: 6.6%) and St Albus, Proteus and Enterococcus-Klebsiella coinfections (1/30 cases: 3.3% each).(ABSTRACT TRUNCATED AT 250 WORDS)

[Male genito-urinary tract infection caused by Chlamydia trachomatis and seminal characteristics: use of minocycline]

The authors evaluated the activity of Minocycline in 30 male patients with urinary tract infection caused by Chlamydia trachomatis (Ct) and alterations of the seminal parameters using three different dosage schedules (100 mg/day for 10 days, 200 mg/day for 10 days and 200 mg/day for 20 days). At baseline, at the end of therapy and one month after clinical and bacteriological parameters and seminal characteristics, including some sperm function tests (acridine orange test to study chromatin heterogeneity; triple staining technique, to study acrosome; swim-up technique, to study the sperm kinetics) were verified. The seminal characteristics were checked again three and six months after the end of the therapy. All the results show that Minocycline is an excellent drug for the treatment of urinary tract infection caused by Chlamydia trachomatis both for its therapeutic efficacy and for the absence of side effects. Although 10 days cycles using 1 cap/day are sufficient to eliminate inflammation and infection, in order to obtain more valid results it is preferable to use the following dosage schedule: 200 mg/day of antibiotic (100 mg twice daily) for 10 days. The results of our trial show that in cases of Chlamydia trachomatis infection associated with dispermia (reduced nemaspermic concentration, hypomotility, teratozoospermia, increased number of leucocytes), if the parameters of sperm function are within normal limits, the resolution of the infection is usually followed by a recovery of normozoospermia. Follow-up performed 3 and 6 months after the end of treatment showed an increase in the number of spermatozoa, a percentage increase in their motility, mostly in the progressive motility, and a reduction of the atypical forms.(ABSTRACT TRUNCATED AT 250 WORDS)

Amniotic fluid test for the diagnosis of neural tube defects

Alpha-fetoprotein and acetylcholinesterase were assayed in 374 amniotic fluids from normal pregnancies, at 9-15 weeks of gestation. We have investigated the correlations with the gestational age and have established our cutoff levels for these biochemical markers. We also report the values, that we have obtained in two cases of neural tube defects (NTD) and in several chromosomal aberrations. For early prenatal diagnosis of NTD, we wide to point out the importance of the contemporary determination of the two analytes and of the ultrasonographic investigation and biometry.

Predictors of compliance with lithium and carbamazepine regimens in the long-term treatment of recurrent mood and related psychotic disorders

This study examined compliance with lithium and carbamazepine regimens from the perspective of the illness and its characteristics. Patients were more likely to stay in treatment when prophylaxis was begun following a depressive episode and in the presence of congruent psychotic experiences. The reverse was true for grandiose and manic patients and those with somatic preoccupations.

Laser radiation and motility patterns of human sperm

Human sperm were exposed in vitro to laser radiation. An increase in progressive sperm motility was associated with a faster rate of sperm ATP consumption. Computer-assisted analysis of sperm motility confirmed the positive effect of laser irradiation on velocity and linearity of sperm.

Comparative study of middle-latency responses and auditory brainstem responses in elderly subjects

Auditory senescence is studied through an electrophysiological investigation of the brainstem, midbrain and thalamocortical tracts of auditory pathways. For this purpose, comparative electrophysiologic studies were carried out by recording middle-latency responses (MLR) and auditory brainstem responses (ABR) in elderly subjects in the 7th-8th and 9th decades of life and in a control group consisting of young subjects in the 3rd decade of life. All these subjects were free of otological, neurological, vascular and metabolic pathologic states. In elderly subjects, the statistical analysis of the results, especially of MLRs, showed a deterioration in the progression of information from the periphery to the center due to changes in morphology, increased latency, reduced amplitude and poorer reproducibility. Furthermore, a different behavior was noticed in females versus males. Indeed, the shorter latency of evoked potentials in the female control group was remarkably reduced in the elderly subjects. MLRs scan a wide tract of auditory pathways and give evident results even by adopting a juxtaliminal stimulation; therefore, they are a more complete and sensitive test than ABRs for the study of involutional processes.

Immunological usefulness of semen manipulation for artificial insemination homologous (AIH) in subjects with antisperm antibodies bound to sperm surface

The authors report trials carried out in the preparation of semen for homologous artificial insemination in subjects with antisperm autoantibodies. The tests have demonstrated that swim-up is not able to select spermatozoa free of antibodies bound to the sperm surface. All the experiments of migration, dilution, antigenic competition and cryoconservation, carried out to evaluate the theoretical possibility of a better recovery of non "immunologically compromised" spermatozoa, have confirmed such negative results both with the Immunobead Test and Cytofluorimetric analysis.

Exploration of the clinical profile of rubidium chloride in depression: a systematic open trial

Thirty-one female inpatient depressives underwent a systematic open trial with rubidium chloride, 180 to 720 mg/day. By week 2, at least two-thirds had improved significantly (p less than 0.01) as measured by standard rating instruments such as the Brief Psychiatric Rating Scale and the Hamilton Depression Scale. Regression analysis suggested that the retarded endogenous pattern was most predictive of positive response. Treatment-emergent symptomatology, such as diarrhea, polyuria, and excitement, was generally mild and rarely necessitated interruption of the trial. The authors conclude that this salt has shown sufficient clinical promise to warrant more extensive trials under double-blind conditions.

Inhibition of lymphocyte-mediated antibacterial activity by human seminal plasma

Seminal plasma displays a suppressive function on many immunological responses. In light of recent findings on the antibacterial activity mediated by different lymphocyte subsets, we have assessed the effect of male inhibitory material (MIM) in this system. Results provide evidence that MIM pretreatment of peripheral blood lymphocytes (PBL) leads to a significant inhibition of antibacterial activity against Salmonella typhi and S. minnesota R345 (Rb). Both CD4+ and CD8+ cell-mediated activities are reduced by this treatment, while another defense mechanism (bacterial binding to PBL) is unaffected. Taken together, these results indicate a role for MIM in the depression of immune response and suggest that lymphocytes mediating antibacterial activity and bacterial cytoadherence are different entities.

High-affinity 3H-imipramine binding sites: a possible state-dependent marker for major depression

Ten patients with DSM-III diagnoses of nonbipolar recurrent major depression were studied in an attempt to assess the relationship between 3H-imipramine binding site density and clinical depressive state. They were compared with eight healthy controls who had no past or family history of affective disorders. Evaluations with the Hamilton Rating Scale for Depression and the Self-Rated Scale for Depression were done on the same day as platelet collection at baseline, and also at 2 and 5 weeks after the beginning of treatment with tricyclic antidepressants. The number (Bmax) and the affinity (Kd) of platelet 3H-imipramine binding sites were highly correlated with the improvement of the clinical depression. These results raise the interesting possibility that a decrease in 3H-imipramine binding sites may be a state-dependent marker in patients suffering from nonbipolar recurrent major depression.

Immunobiology of male infertility

Experimental and clinical data reported in the literature emphasize the important role that immune factors may play in the genesis of male infertility even if many problems still remain to be solved. Auto or homo-sensitization in animals (and in male volunteers) can be obtained with testicular homogenate or epididymal spermatozoa and complete Freund's adjuvant. Immune orchitis in spontaneous human pathology has also been reported. Vasectomy for the voluntary control of male fertility may be considered a particular form of experimental autoimmunization; and many vasectomized individuals develop antisperm antibodies in blood serum and/or in seminal plasma. In spontaneous male infertility antisperm antibodies can: (i) be a mere epiphenomenon; (ii) be a factor aggravating a pathologic situation already able to cause infertility; (iii) play a pathogenetic role in some forms of so-called idiopathic infertility and so could be defined as infertility due to antisperm antibodies. If the antisperm autoimmune reaction represents the casual factor of infertility, corticosteroid therapy seems to give the most satisfactory results, administered either in high doses for a very short time period or in low doses over a prolonged period, or even after transient pharmacologically induced azoospermia.

Antisperm antibodies detection with the immunobead test as viewed by TEM

The immunobead test (IBT) was used for the detection of antisperm antibodies. Scanning electron microscopy (SEM) was used to study ultrastructural aspects of this technique. This brief communication aims to present some ultrastructural evidence using transmission electron microscopy (TEM).

Renal tolerance of rubidium chloride: short-term clinical evaluation

The rubidium and lithium ions are known to have opposite effects on a wide range of biochemical and behavioral parameters in experimental animals. Based on the proven effectiveness of lithium as an antimanic agent, several trials have been conducted with rubidium in the acute treatment of the depressive phase of bipolar illness. The results to date are promising. However, the 30- to 60-day biologic half-life of rubidium has mandated careful studies of potential toxicity before engaging in long-term administration of this ion to depressive subjects. One area of potential concern is the possibility of renal toxicity, which could be expressed as unexpectedly increased retention of rubidium. The data in this paper show that after 15 days of rubidium administration, there are no changes beyond the normal range in a variety of kidney function tests, including in four enzymes which are specific markers of tubule cell function.

Post-vasectomy antisperm immune reaction after testosterone-induced azoospermia

We describe preliminary experiments on the effects of testosterone-induced azoospermia on post-vasectomy antisperm antibody reaction in two subjects. Progressive resumption of spermatogenesis following gradual suspension of testosterone therapy was still associated with antisperm antibody formation. Post-vasectomy antisperm antibody production does not seem to be triggered exclusively by acute, sudden and massive reabsorption of spermatoza after vasectomy but also by slow, gradual and late sperm antigen reabsorption.

The comparative efficacy and safety of carbamazepine versus lithium: a randomized, double-blind 3-year trial in 83 patients

The comparative usefulness of carbamazepine and lithium carbonate in the acute and prophylactic management of DSM-III diagnosed major affective, schizoaffective, or schizophreniform psychoses was investigated in a 3-year, prospective double-blind randomized trial with 83 in- and outpatients. The incidence of side effects was similar in both treatment groups, and side effects generally responded well to dosage reduction. Both drugs were effective in two thirds of the patients and appeared about equal in most outcome measures, except for a significantly higher dropout rate for patients with mood-incongruent psychotic features who were assigned to the lithium group. Both drugs appeared more effective in preventing excited rather than depressive symptoms.

[Lithium and the kidney. Acute effects on ADH secretion and enzymuria]

The short-term (30 days) effects of lithium carbonate on ADH secretion, urinary enzyme secretion (specific markers of tubular damage), fractional excretion of sodium, calcaemia, calciuria and fractional reabsorption of phosphate, plasma and urinary Ca, urea and creatinine clearance were assessed in 15 female patients with emotional disorders. An immediate increase in diuresis was noted. At least in the acute initial phase, this phenomenon appears to be caused by inhibited ADH incretion. No significant variation were noted in calciuria or the fraction of sodium secretion but there was a significant increase of enzymuria, confirming the potential nephrotoxicity of lithium treatment.

Use of carbamazepine in acute psychosis: a controlled study

A randomized double-blind study was performed to compare the therapeutic effects of lithium and carbamazepine (CBZ) each administered in combination with chlorpromazine (CPZ) for 3 weeks in women with acute psychosis. Thirty patients were studied. The initial dose was 1200 mg/day for CBZ and 900 mg/day for lithium, and it was subsequently modified according to plasma levels and clinical indications. The dose of CPZ was free and depended on the severity of symptomatology. Both treatments produced a significant improvement in psychotic symptoms without significant differences between the treatment groups. Also, as regards tolerability no clinically relevant differences were found between the two groups. During the first week of treatment the CPZ dose required in the CBZ group was significantly lower than that administered to the lithium group, indicating that CBZ had a greater sedative action; however, this difference decreased as treatment continued. These results confirm that CBZ is a valid alternative to lithium in the treatment of acute psychosis.

Correlation between the direct IgG MAR test (mixed antiglobulin reaction test) and seminal analysis in men from infertile couples

The direct IgG mixed antiglobulin reaction (IgG MAR) test was carried out in 395 male subjects from infertile couples, selected on the basis of their seminal characteristics (sperm concentration greater than 10 X 10(6)/ml, sperm motility greater than 10%); attempts were made to correlate results with the seminologic aspects of the ejaculate. A significant correlation was observed between a positive MAR test and spontaneous sperm autogglutination. No correlation was observed, however, between test positivity and concentration, motility and sperm morphologic features, the macroscopic aspects studied (viscosity, fluidification), or increased concentration of leukocytes.

Intraventricular morphine in paraneoplastic painful syndrome of the cervicofacial region: experience in thirty-eight cases

The authors report their personal experience with the administration of microdoses of morphine hydrochloride by the intraventricular route through a subcutaneous reservoir for the treatment of paraneoplastic painful syndrome of the cervicofacial region in 38 patients. The results obtained are very encouraging.

Vasectomy: study of circulating immune-complexes and its correlation with antisperm immunity in man, with a twelve-month follow-up study

Circulating immune-complexes (CIC) have been detected in sera of vasectomized subjects using the Clq Binding Assay. Results seem to indicate that CIC are a feature of the early post-operative period and a consequence of acute immunization against sperm antigens. The progressive disappearance of CIC from the third month after vasectomy with the simultaneous increase in antisperm antibody percentage and titre suggests that CIC could be a temporary feature in vasectomized men and do not lead to a chronic disease, related to a Type III immune reaction.

Immunoglobulins in human seminal plasma

Single radial immunodiffusion has been used to evaluate immunoglobulins and secretory piece (SP) in human seminal plasma. Samples were collected from 90 healthy volunteers, 202 subjects submitted to vasectomy for contraceptive purposes, tested at various intervals after surgery, and 725 patients grouped according to selected andrological disorders. Results may be summarized as follows. In normal subjects IgG and IgA were constantly present (mean values +/- SD: 8.14 +/- 2.82 mg/dl; 1.91 +/- 1.03 mg/dl, respectively) while IgM were detected in trace amounts (from 0.7 to 3.3 mg/dl) in 10% of subjects, and negligible or absent in the remaining subjects. In vasectomized subjects IgG and IgA showed a significant increase only in the first 3 months after vasectomy, probably due to surgery. In andrological patients Ig showed an increase in cases with antisperm antibodies (A b) and in those with infections of genital tract and positive semen culture. On the basis of these findings and the secretory piece assay data the importance appears to be stressed of the local immunocompetent system at least in some andrological diseases.

Sperm antibodies in infertile women: a comparison of three methods for handling the cervical mucus for extraction of immunoglobulins

Three procedures commonly employed in the extraction of soluble proteins from cervical mucus, for the application of the technique for the detection of sperm antibodies also in this biological fluid, were compared in order to establish which provided the highest yield. Studies were therefore carried out on 125 women with primary and secondary sterility characterized by good rheologic qualities of their mid-cycle cervical mucus and in presence of repeatedly poor PCTs, not justified by the seminal characteristics of their partners. The laboratory results and the statistical analysis have shown that as far as concerns IgG, liquefaction with bromelin and solubilization with Baker's buffer provide a better yield than ultracentrifugation; while bromelin alone has the best yield with IgA.

Intraventricular and intravenous use of amphotericin B in a case of non-surgical cerebral aspergillosis

After a short review of the literature regarding aspergillosis, the authors report a case of a 7-year-old child suffering from cerebral aspergillosis with disseminated lesions. The authors emphasize the use of amphotericin B both intraventricularly and intravenously to obtain a longer survival when surgery is impossible because of the presence of multiple abscessual lesions in central nervous system. Authors' experience shows that the intraventricular administration of amphotericin B is well tolerated and does not cause collateral effects of the parenteral way.

Cell-mediated antisperm immunity in selected forms of male infertility

Leukocyte migration inhibition test (LMT) with semipurified spermatozoal antigen was carried out in two groups: normal males (fertile subjects before vasectomy; normal volunteers) and selected forms of male infertility. The percent positivity to the LMT in all the pathological groups considered, compared with controls positivity in only one out of 40 cases and only at the highest concentrations of Ag, stresses the important role played by cell-mediated antisperm immunity in male infertility. No characteristic seminal pattern was observed in the patients with positive LMT, probably on account of the particular selection of the patients studied. Finally, no significant correlation between humoral and cell-mediated antisperm immunity was observed, at least not in these selected series of patients.

Treatment and follow-up of patients with infertility due to spermagglutinins

A therapeutic trial based on pharmacologically induced azoospermia followed by the administration of corticosteroids was carried out in 48 patients with infertility due to spermagglutinins. Three types of responses were observed: type A, no modifications in the blood and spermagglutinating (SA) titer (19 cases); type B, disappearance or significant decrease in SA titer during treatment, with return to normal values upon resumption of spermatogenesis (7 cases); and type C, disappearance or significant decrease in SA titer for at least 1 year after stopping treatment (22 cases). Within the 1st year after stopping therapy only men who responded in type C fashion were able to impregnate partners, three pregnancies ended in abortion and nine in normal births.

Recording of vesical voiding pressure by means of CO2-perfusion

By means of a CO-2-cystometer, carbon dioxide is introduced through a urethral catheter (F5) into the full urinary bladder while the subject is urinating around the catheter. A reproducible pressure curve can be recorded. The pressure values measured by CO2-perfusion correlate very well with those measured simultaneously by a conventional fluid method. It can be statistically demonstrated that the CO2 flowing into the bladder does not influence the vesical voiding pressure. It is concluded that the vesical pressure during micturition can be accurately recorded by CO2-perfusion.

Third ventricle intrinsic craniopharingioma. Case report

A case of craniopharingioma developed and situated in the cavity of the third ventricle with no connections with the base of the skull is reported. The patient was a thirty-year-old man, who within a few months had developed a diencephalic syndrome followed by psychic disorders and intracranial hypertension. Cerebral scan: large area of accumulation in the supra and retrosellar region. Bilateral carotid angiogram: no pathological staining but the venous angle and the internal cerebral vein were elevated and shifted posteriorly. Pneumoencephalogram: free and normal basal cisterns; the third ventrical is almost totally filled by a mass; small dilatation of the lateral ventricles. Operation: right trans ventricular approach to the third ventricle. The tumour was the size of an apricot encapsulated with a smooth surface, and adherent to the wall of the third ventricle only in the region of the infundibulum. There was little bleeding and no cystic component. Total removal was performed except for a few millimeters of capsule in the infundibular region. The postoperative course was complicated by an irreversible diencephalic insufficiency with death on the 27th postoperative day. Autopsy clearly showed that the inferior surface of the brain in the diencephalic region was not involved by the mass which hystologically was doubtless a craniopharingioma. Only two other cases of craniopharingioma of the third ventricle were so far reported in the literature by Cashion and Young in 1971.