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Affiliation(s)
- L. Mewissen
- Studicentrum Voor Kernenergie/Centre d’Etude de l’Energie Nucleaire, B-2400 Mol, Belgium
| | - F. Poortmans
- Studicentrum Voor Kernenergie/Centre d’Etude de l’Energie Nucleaire, B-2400 Mol, Belgium
| | - E. Cornelis
- University of Antwerp, R.U.C.A., Antwerp, Belgium
| | - G. Vanpraet
- University of Antwerp, R.U.C.A., Antwerp, Belgium
| | - A. Angeletti
- Euratom, Central Bureau for Nuclear Measurements, B-2440 Geel, Belgium
| | - G. Rohr
- Euratom, Central Bureau for Nuclear Measurements, B-2440 Geel, Belgium
| | - H. Weigmann
- Euratom, Central Bureau for Nuclear Measurements, B-2440 Geel, Belgium
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2
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Eggert-Kruse W, Rohr G, Wolf M, Klinga K, Weltin M, Runnebaum B. Zirkulierende Sperma-Antikörper im Serum - Vergleich verschiedener Kollektive. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2007-1023041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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3
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Eggert-Kruse W, Ziegler A, Horlbeck S, Rohr G, Strowitzki T. Thrombophilie-Screening nur bei positiver Familienanamnese? Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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4
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Eggert-Kruse W, Boit R, Rohr G, Aufenanger J, Hund M, Strowitzki T. Relationship of seminal plasma interleukin (IL) -8 and IL-6 with semen quality. Hum Reprod 2001; 16:517-28. [PMID: 11228223 DOI: 10.1093/humrep/16.3.517] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The concentration of interleukin (IL) -8 and IL-6 was determined in seminal plasma (SP) samples from 137 randomly chosen subfertile males to evaluate the relationship with other potential parameters of subclinical infection/inflammation such as seminal leukocytes, and with semen quality in a prospective study. All patients were asymptomatic for genital tract infection. A comprehensive semen evaluation included sperm analysis, sperm migration testing, antisperm antibody screening, immunocytochemical round cell differentiation to determine seminal leukocytes counts and the leukocyte ratio, complement fraction C(3) (C(3c)) determination, and semen cultures, in aliquots of the same ejaculates. The SP concentration of IL-8 was inversely related to semen quality, e.g. to the total number of motile spermatozoa or to the outcome of the sperm migration test (motile sperm harvested after a swim-up procedure). IL-8 concentrations were significantly correlated with leukocyte counts per ml (P < 0.0001) and per ejaculate (P < 0.0001), and with the leukocyte ratio (P < 0.001). All leukocytospermic samples had high IL-8 concentrations (< or =2 ng/ml). The SP concentration of IL-6 was much lower, but was significantly correlated with IL-8 (P < 0.0001). Both IL-8 and IL-6 were significantly related with the C(3c). No association of interleukin concentrations with the bacterial colonization of semen samples was found. The results indicate a marked relationship of some pro-inflammatory cytokines with semen quality. The significant association with seminal leukocytes and other potential inflammation markers suggests that IL-8 might be used as sensitive marker for silent male genital tract infection.
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynaecological Endocrinology and Reproductive Medicine, Women's University Hospital, Heidelberg, Germany
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5
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de Bree E, Tsiftsis DD, Santos RM, Lavelle SM, Cuervas-Mons V, Gauthier A, Gips C, Malchow-Moeller A, Molino G, Rohr G, Theodossi A, Tsantoulas D. Objective assessment of the contribution of each diagnostic test and of the ordering sequence in jaundice caused by pancreatobiliary carcinoma. Scand J Gastroenterol 2000; 35:438-45. [PMID: 10831270 DOI: 10.1080/003655200750024038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Computer-assisted diagnostic systems are not substantially more accurate than the clinician in the differential diagnosis of jaundice but may help in optimal selection and sequencing of tests. The present study aimed to assess with an electronic diagnostic tool the pattern of ordering tests and the diagnostic contribution and related financial cost of each test in jaundiced patients with pancreatobiliary carcinoma, in an effort to make the clinician's diagnostic behaviour more efficient and economical. METHODS Clinical and diagnostic test data were prospectively gathered from 356 jaundiced patients with pancreatobiliary carcinoma and entered in a Bayesian diagnostic programme. The test results were added to the existing diagnostic evidence, and the programme calculated the diagnostic contribution of each test. RESULTS A total of 1804 diagnostic tests were ordered. Quantitative assessment of the diagnostic contribution of each test showed that percutaneous transhepatic cholangiography and computed tomography were associated with the highest provision of information. The most cost-effective tests were ultrasonography and liver function tests. CONCLUSIONS It is possible to determine objectively the diagnostic contribution of each test in establishing the diagnosis of pancreatobiliary carcinoma. The observed physician behaviour in ordering the various diagnostic tests might be improved with regard to its efficacy and its cost-effectiveness profile.
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Affiliation(s)
- E de Bree
- Dept. of Surgical Oncology, University Hospital, Herakleion, Crete, Greece
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6
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Abstract
The antibacterial activity of human cervical mucus (CM) was examined on standardized microbial colonized agar plates (agar diffusion test). In parallel, the lysozyme content of CM was determined by means of a turbidimetric test system in aliquots of the same CM specimens. Suspensions of living lyophilized Micrococcus lysedeikticus were used as bacterial substrate. Testing was performed in a total of 133 CM samples, obtained at mid-cycle from sexually active women from unselected infertile couples with a median age of 30 (range 21-42) years. All mucus specimens showed considerable antibacterial activity with clearly visible circular inhibition zones around the CM-filled holes in the colonized agar plates. Related to the effect of hen's egg white (HEW)-lysozyme on the same plates, the median activity of the CM specimens in the agar diffusion test was equivalent to 33.0 (range 6.4-391.4) microg/ml HEW-lysozyme. However, there was a wide inter-individual range of antibacterial effects of cervical secretions. The cervical index did not significantly influence the outcome of either test. The pH of the endocervical CM also was not correlated with the antibacterial effect. Sexual activity leading to the presence of spermatozoa in CM considerably increased its antibacterial effect. The activity was markedly higher in samples obtained within hours after intercourse compared with those taken after sexual abstinence of >/=5 days (P < 0.05). In microbially colonized CM specimens compared to sterile CM, all obtained under hormonally standardized conditions, the antibacterial activity in the agar plate test was significantly lower (P < 0.05). The results of this pilot study demonstrate the considerable antibacterial activity of human CM.
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynaecological Endocrinology and Reproductive Medicine, Women's Hospital, Klinikum Mannheim, University of Heidelberg, Heidelberg, Germany
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7
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Eggert-Kruse W, Mildenberger-Sandbrink B, Schnitzler P, Rohr G, Strowitzki T, Petzoldt D. Herpes simplex virus infection of the uterine cervix--relationship with a cervical factor? Fertil Steril 2000; 73:248-57. [PMID: 10685523 DOI: 10.1016/s0015-0282(99)00530-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the prevalence of genital herpes simplex virus (HSV) in women of reproductive age and to evaluate a potential relation of asymptomatic HSV shedding with a cervical factor. DESIGN Prospective study. SETTING Outpatient infertility clinic of a university hospital. PATIENT(S) Randomly chosen asymptomatic women (n = 1,262) with a median age of 30 years. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Prevalence of cervical HSV, cervical index parameters, and other variables of CM quality, including CM penetrability in vivo and in vitro. RESULT(S) The prevalence of HSV infection of the uterine cervix was 5.2% (identified with cell culture). There was a tendency toward increased viscosity of the CM in HSV-positive women, but no significant relation with the other variables of CM quality (amount, spinnbarkeit, ferning, cervical appearance, and cellularity of the CM), or with the summarized Insler score or the cervical index according to World Health Organization guidelines. Postcoital testing and the in vitro penetration test, using either partners' or donors' semen, showed that the penetrability of the CM did not differ significantly between women with and without cervical HSV shedding. Asymptomatic cervical HSV infection was not significantly associated with bacterial colonization of the lower genital tract, with leukocyte counts in cervical secretions, with the pH of the CM or the vaginal fluid, or with antisperm antibodies in the CM. CONCLUSION(S) The results suggest that in asymptomatic women under controlled endocrine conditions, cervical HSV infection is not a significant cause of impaired quality and penetrability of the CM.
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynaecological Endocrinology and Reproductive Medicine, Women's University Hospital, University of Heidelberg, Germany
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8
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Eggert-Kruse W, Boit R, Zwick E, Rohr G, Runnebaum B, Petzoldt D. R-003. No relationship between complement C3 as potential infection parameter and open sperm functional capacity in asymptomatic subfertile males. Hum Reprod 1999. [DOI: 10.1093/humrep/14.suppl_3.279-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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9
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Eggert-Kruse W, Fischer C, Becker W, Zwick E, Rohr G, Runnebaum B, Petzoldt D. P-003. Screening for leukocytes in semen. Hum Reprod 1999. [DOI: 10.1093/humrep/14.suppl_3.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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10
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Eggert-Kruse W, Rohr G, Probst S, Rusu R, Hund M, Demirakca T, Aufenanger J, Runnebaum B, Petzoldt D. Antisperm antibodies and microorganisms in genital secretions--a clinically significant relationship? Andrologia 1998; 30 Suppl 1:61-71. [PMID: 9629445 DOI: 10.1111/j.1439-0272.1998.tb02828.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
In asymptomatic infertility patients, no significant relationship was found between the presence of antisperm antibodies (ASA) in serum and in semen samples (IgG and/or IgA ASA), differentiated with the mixed antiglobulin reaction (MAR), and the microbial colonization of ejaculates covering a broad spectrum of microorganisms. Likewise, there was no significant association of ASA with microbial findings in patients' female partners, who also presented without symptoms of genital tract infection and were screened at the same time. Furthermore, ASA in semen (IgG and IgA) were not significantly related to several potential markers of subclinical male sexual gland infection or inflammation (leukocytes, PMN elastase, albumin, C3c) evaluated in aliquots of the same ejaculates used for immunological testing.
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynecological Endocrinology and Reproductive Medicine, Women's Hospital Heidelberg, Germany
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Abstract
The clinical significance of antichlamydial antibodies (Chlam Ab) was determined in a total of 1303 subfertile couples consulting for infertility investigation and treatment. Median age of the women was 30 (range 22-44) years and of the men 33 (range 21-53) years. The median duration of infertility was 4 (range 1-21) years. All patients were asymptomatic for genital tract infection. A comprehensive infertility investigation included examination of the endocrine, cervical, and tubal factor, and semen analysis, antisperm antibody (ASA) testing, sperm-mucus interaction testing in vitro using a standardized protocol, and post-coital testing (PCT). Screening for Chlam IgG Ab was performed in serum of both partners, obtained at the same time. Simultaneous microbial cultures in genital secretions of both partners included a broad spectrum of potentially pathogenic bacteria. Elevated titres of Chlam IgG Ab as seromarker for previous infection were found in 20.8% of all women, and in 12.6% of men. Chlam Ab were significantly more frequent in partners of seropositive patients (in 51.8% of women with a Chlam Ab positive partner, compared to 15.8% of the other women). Microbial screening outcome was not significantly related to results of chlamydial serology in both partners. In women, elevated titres of Chlam Ab were significantly associated with a tubal factor, but were not related to reduced quality of the endocervical mucus (CM), including the in-vitro penetrability of the CM (using partners' or donors' spermatozoa). In males, Chlam Ab were not significantly related to the outcome of semen analysis, including screening for ASA (IgG and/or IgA) in semen, and several parameters of sperm functional capacity. After exclusion of couples with tubal disease, subsequent male fertility did not significantly differ in males with or without Chlam Ab. The results suggest that during basic infertility investigation, positive chlamydial serology as an easy screening procedure indicates a higher risk for a tubal infertility factor. However, in asymptomatic patients, Chlam IgG Ab in serum are not associated with a cervical factor or with the male factor, using several determinants for evaluation of semen quality including subsequent fertilizing capacity.
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynaecological Endocrinology and Reproductive Medicine, Women's University Hospital, Heidelberg, Germany
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Eggert-Kruse W, Rohr G, Rusu R, Zelt C, Weltin M, Runnebaum B. O-183. Screening for
Chlamydia trachomatis
infection in semen from subfertile males. Hum Reprod 1997. [DOI: 10.1093/humrep/12.suppl_2.90-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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Eggert-Kruse W, Rohr G, Probst S, Rusu R, Hund M, Demirakca T, Augenanger J, Näher H, Runnebaum B. P-003. Potential cross-reactivity between micro-organisms in semen and seminal antisperm antibodies? Hum Reprod 1997. [DOI: 10.1093/humrep/12.suppl_2.121-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Rohr G, Kragstrup J. [General practitioners' choice of treatment for young women with metrorrhagia as evaluated by vignettes]. Ugeskr Laeger 1997; 159:761-4. [PMID: 9045467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A consensus conference on menstrual disorders concluded that a discrepancy exists between the large number of curettages performed annually on fertile women and the actual findings of cancer of the endometrium in this group of patients. Based on three written simulated consultations (vignettes) with 42-year-old women with metrorrhagia but without increased risk of cancer a decision analysis was performed among 695 general practitioners in Denmark and the Faroe Islands. The first choice of treatment was curettage in 43% of the responders. It was found that a large proportion of doctors decided on curettage when the patient had developed anaemia. The choice of curettage was associated with the doctors' assessment of need to exclude cancer of the endometrium, while doctors who gave high priority to non-invasive treatment and cessation of bleeding were less likely to refer for curettage. A larger proportion of male than female doctors chose curettage as primary treatment.
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Affiliation(s)
- G Rohr
- Odense Universitet, Forskningsenheden for Almen Medicin
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16
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Eggert-Kruse W, Buhlinger-Gopfarth N, Rohr G, Probst S, Aufenanger J, Naher H, Runnebaum B. Antibodies to chlamydia trachomatis in semen and relationship with parameters of male fertility. Hum Reprod 1996; 11:1408-17. [PMID: 8671477 DOI: 10.1093/oxfordjournals.humrep.a019410] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
To screen for infection with Chlamydia trachomatis in semen samples from asymptomatic men in couples consulting for infertility and to determine the relationship of seminal chlamydial antibodies with clinically relevant parameters of male fertility, 197 randomly chosen patients were enrolled in a prospective study. The median duration of infertility was 4 years (range 1-18). Screening for C. trachomatis and chlamydial antibodies of the immunoglobulin (Ig) A and IgG classes were performed in ejaculates and, in parallel, endocervical material from the partners of the patients and serum samples from both partners were evaluated. A comprehensive examination of semen quality included sperm analyses, semen cultures, local antisperm antibody (ASA) testing, the determination of potential infection markers, and sperm-cervical mucus interaction testing in vitro (SCMPT) and in vivo (post-coital testing). Chlamydial IgA antibodies were found in the semen samples of 18.8% (37/197) of the patients, while chlamydial IgG antibodies were found in 8.1% (16/197) of the patients. Screening for C. trachomatis was negative in all semen and cervical specimens. Only 5.5% of men remembered a past genital infection. Chlamydia antibodies (IgA/Ig/G) in semen were significantly correlated with chlamydia IgG antibodies in serum samples (P < 0.001). No marked relationship was found between the presence of seminal chlamydial antibodies and the major parameters of sperm analysis, semen cultures, local ASA and sperm penetration testing as an indicator of functional capacity. Seminal chlamydial antibodies were not significantly associated with potential infection or inflammation markers in aliquots of the same ejaculates. However, a significant relationship of chlamydial antibodies in patients' semen with past genital infections of their female partners was found with clinical relevance for a tubal infertility factor. The results indicate that in asymptomatic patients the presence of chlamydial antibody IgA or IgG in semen is not associated with reduced semen quality, potential seminal infection markers or impaired functional capacity as important determinants of male fertility; however, seminal chlamydial antibodies suggesting a previous sexually transmitted disease are significantly related to a tubal infertility factor of female partners.
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynaecological Endocrinology and Reproductive Medicine, Women's Hospital, Heidelberg, Germany
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Back W, Rohr G. Morphologic distribution of transforming growth factor alpha in the gastrointestinal tract--its presence in neuroendocrine cell type of the colon mucosa. Gen Diagn Pathol 1996; 142:17-24. [PMID: 8793482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Among the growth factor proteins of the epidermal growth factor (EGF)-family especially the transforming growth factor alpha (TGF-alpha) and EGF can be detected in the mucosa of the gastrointestinal tract. In this study, immunohistochemistry on 15 different human tissue probes of gastrointestinal and colonic mucosa was carried out to visualize possible deposits for TGF-alpha in the mucosa and to compare different compartments of the upper and lower gastrointestinal epithelium. Most interestingly, in the colon there is a strong TGF-alpha-like immunoreactivity in neuroendocrine cells as evidenced by double labeling experiments with common neuroendocrine markers and by immunoelectron microscopy. In the upper gastrointestinal epithelium, however, all neuroendocrine cell types are negative for TGF-alpha, but parietal cells of the gastric corpus epithelium show strong cytoplasmic immunostaining for TGF-alpha. The neuroendocrine cells of the colon-harboring TGF-alpha-like immunoreactivity in their neurosecretory granules belong morphologically to the so-called L-cell type. Along with the well-known presence of EGF-receptor in the mucosa of the gastrointestinum, TGF-alpha, which is very likely to be released by this neuroendocrine cell type of the colon, acts in a paracrine mode. These findings represent the first morphologic indication that in the colonic epithelium growth regulation is under neuroendocrine control.
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Affiliation(s)
- W Back
- Institute of Pathology, Klinikum Mannheim, University of Heidelberg, Germany
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18
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Eggert-Kruse W, Probst S, Rohr G, Tilgen W, Runnebaum B. Induction of immunoresponse by subclinical male genital tract infection? Fertil Steril 1996; 65:1202-9. [PMID: 8641498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To determine the relationship of subclinical infection or inflammation of the male genital tract, as evaluated with seminal markers, with local antisperm antibodies as potential parameter of immunoresponse. PATIENTS One hundred ninety-one randomly chosen males of subfertile couples who were asymptomatic in terms of genital tract infection. SETTING Outpatient Infertility Clinic of the University of Heidelberg, Germany. MAIN OUTCOME MEASURES Determination of leukocytes rates in semen using an immunocytochemical method for differentiation of round cells and measurement of polymorphonuclear (PMN) granulocyte elastase concentration in seminal plasma in addition to semen cultures as screening for subclinical infection of the male genital tract. Determination of local antisperm antibodies (Ab) with the mixed antiglobulin reaction ([MAR] immunoglobulin [Ig] G and IgA) in aliquots of the same ejaculates. RESULTS Leukocyte rates of the round cells ranged from 0% to 93%, leukocytospermia was found in 6.8%. This was not related significantly to the presence of local antisperm antibodies of the IgG or IgA class. There was also no significant association of antisperm Ab with the concentration of PMN granulocyte elastase in seminal plasma and the outcome of semen cultures. CONCLUSIONS The results of this prospective study suggest that when the rate or number of leukocytes or the concentration of PMN elastase in semen are taken as markers for subclinical infection or inflammation of the male genital tract, this is not associated significantly with the production of local antisperm Ab of the IgG or IgA class as indicator of immunoreaction.
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynaecological Endocrinology and Reproductive Medicine, Women's University Hospital, Heidelberg, Germany
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19
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Eggert-Kruse W, Rohr G, Kerbel H, Schwalbach B, Demirakca T, Klinga K, Tilgen W, Runnebaum B. The Acridine Orange test: a clinically relevant screening method for sperm quality during infertility investigation? Hum Reprod 1996; 11:784-9. [PMID: 8671329 DOI: 10.1093/oxfordjournals.humrep.a019255] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
To determine the clinical usefulness of Acridine Orange (AO) staining of spermatozoa as a screening test for the evaluation of semen quality during basic infertility investigation, semen smears from 103 randomly chosen males of subfertile couples were examined. The median duration of infertility was 4.5 years (range 1-15) and the median age was 33 years (range 21-43). The outcome of AO staining ranged from 5 to 81%, with a median of 24%, green fluorescent spermatozoa. Results were not significantly related to the parameters of semen analysis (sperm count, motility, standard morphology, viability, pH and volume, as well as fructose concentration and number of found cells) or to local sperm antibody testing and semen cultures. Fluorescence after AO staining was also not related to sperm functional capacity (evaluated using sperm-mucus interaction tests in vitro and in vivo), or the medical history of the patient. No significant differences in the AO test outcome were seen in patients with explained and unexplained infertility, or with regard to subsequent fertility [with a median value of 21% (range 5-46) green fluorescence in the fertile group, compared with a median value of 28% (range 9-81) green fluorescence in the other men]. The results of this prospective study indicate that under the usual conditions of conception, the AO test is not clinically useful as a screening procedure to determine semen quality during basic infertility investigation.
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynecological Endocrinology and Reproductive Medicine, Women's Hospital, Heidelberg, Germany
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20
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Eggert-Kruse W, Schwarz H, Rohr G, Demirakca T, Tilgen W, Runnebaum B. Sperm morphology assessment using strict criteria and male fertility under in-vivo conditions of conception. Hum Reprod 1996; 11:139-46. [PMID: 8671176 DOI: 10.1093/oxfordjournals.humrep.a019007] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The clinical significance of sperm morphology assessment according to very strict criteria was determined using semen samples of randomly chosen males from couples not submitted to assist procreation techniques, with a median duration of infertility of 4 years (range 1-17; n = 89). The relationships of sperm morphological properties to the results of standard sperm analysis, including the differentiation of round cells in semen by monoclonal antibodies and semen cultures, the testing of sperm functional capacity in vitro with the standardized sperm-cervical mucus penetration test (SCMPT) and the subsequent pregnancy rate under in-vivo conditions of conception, were evaluated in a prospective study. The quick staining method (DiffQuick(R) stain) for sperm morphology proved to be practical and suitable for routine use. The percentage of normal forms according to strict criteria ranged from 1 to 36%, with a median of 12%. Morphological findings were not markedly related to the medical history, but significant relationships between standard parameters of sperm analysis, in particular the sperm count, the progressive motility and standard sperm morphology, were found. The percentage of normal forms was not significantly associated with the microbial colonization of semen samples but was negatively related to high leukocyte rates. Semen samples with a higher percentage of normal spermatozoa (shown, for example, for >4,> 7 or >=14% normal) were significantly more frequent in cases of an adequate SCMPT. The subsequent pregnancy rate within an observation period of 12 months was 20.2%. The pregnancy rate under in-vivo conditions was significantly higher when semen samples had a better sperm morphology, with significant differences for thresholds at 4, 7 and 14% of strictly normal forms. Although sperm morphology is only one among a multiplicity of factors determining fertility, the results suggest that the evaluation of sperm morphology using strict criteria provides valuable information during basic infertility investigations.
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynaecological Endocrinology and Fertility Disorders, Women's Hospital, University of Heidelberg, Vossstrasse 9, 69115 Heidelberg, Germany
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21
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Rohr G, Eggert-Kruse W, Kalbitzer HR. NMR spectroscopy in andrology: research uses and possible clinical applications. Int J Androl 1995; 18 Suppl 2:12-9. [PMID: 8719853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Research uses and possible clinical applications of NMR spectroscopy are considered. By monitoring extracts of testes using 31P-NMR spectroscopy, detailed analysis of high-energy phosphates, or pathways such as phospholipid biosynthesis or glycolysis, is possible. By using in-vivo 31P NMR spectroscopy of testes in animal experiments it has proved possible to discriminate non-invasively between experimentally impaired and control testes. It has been demonstrated in several human studies that discrimination between normal testes and those with impaired spermatogenesis and obstruction is possible by non-invasive NMR spectroscopy. In studies of semen, seminal plasma or spermatozoa, NMR spectroscopy is of high experimental value for analysis of sample composition, the kinetics of metabolites or the structure of single components, but clinical applications have not yet been clearly defined.
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Affiliation(s)
- G Rohr
- Klinikum Mannheim University of Heidelberg, Germany
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Eggert-Kruse W, Rohr G, Böckem-Hellwig S, Huber K, Christmann-Edoga M, Runnebaum B. Immunological aspects of subfertility. Int J Androl 1995; 18 Suppl 2:43-52. [PMID: 8719858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
No significant relationship between semen quality [determined by standard sperm analysis and sperm-cervical mucus (CM) interaction testing in vivo and in vitro] and the presence of antisperm antibodies (ASA) [determined using three different methods] in serum samples of males and/or females of subfertile partnerships was found. These circulating ASA were not associated with reduced fertility in prospective studies. On the other hand, ASA in semen, particularly those of the IgA class, significantly impaired the ability of spermatozoa to penetrate CM and the fertility prognosis of the couple. ASA in CM must also be considered as a severe infertility factor but are a very rare cause of poor mucus quality.
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynaecological Endocrinology and Reproductive Medicine, Women's Hospital, University of Heidelberg, Germany
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Eggert-Kruse W, Probst S, Rohr G, Aufenanger J, Runnebaum B. Screening for subclinical inflammation in ejaculates. Fertil Steril 1995; 64:1012-22. [PMID: 7589620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To determine the clinical significance of albumin determination in ejaculates by means of an easy office test to screen semen samples for subclinical infection-inflammation. PATIENTS One hundred fifty-nine randomly chosen males of couples with longstanding infertility (median duration of infertility 4 years (range 1 to 19 years) without clinical signs or symptoms of genital tract infection. SETTING Outpatient Infertility Clinic of the University of Heidelberg, Germany. MAIN OUTCOME MEASURES Screening of ejaculates for subclinical infection-inflammation by means of a ready-to-use kit for semiquantitative detection of albumin in addition to determination of leukocytes rates by means of monoclonal antibodies for differentiation of round cells and measurement of granulocyte elastase concentration in semen samples. Evaluation of sperm quality by means of standard sperm analysis including determination of local antisperm antibodies with the mixed antiglobulin reaction, evaluation of sperm functional capacity in vitro with the standardized sperm-cervical mucus (CM) penetration test, and semen cultures. All tests were performed from aliquots of the same ejaculates. RESULTS Screening of semen samples for elevated albumin with the modified paper strips proved to be very easy, quick, and suitable for routine use. Positive results were not related markedly to medical history and outcome of clinical examination as well as to standard parameters of sperm analysis and were not influenced by local antisperm antibodies of the immunoglobulin (Ig)G and/or IgA class and microbial colonization. However, albumin-positive semen samples were significantly less frequent in case of very good outcome of the sperm-CM penetration test. A significant relationship was found with high rates of leukocytes of the round cells in semen samples (total range 0% to 96%) and the concentration of granulocyte elastase (total range 1 to 880 micrograms/L). CONCLUSIONS The results of this prospective study suggest that the determination of albumin in semen samples with ready-to-use test kits might be a valuable additional marker for subclinical infection-inflammation of the male genital tract and therefore suitable for screening during infertility investigation.
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynaecological Endocrinology and Reproductive Medicine, Women's University Hospital, University of Heidelberg, Germany
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Abstract
The clinical significance of micro-organisms in semen samples of asymptomatic subfertile patients is a matter of constant debate. Usually little attention is paid to anaerobic bacteria as they are sensitive to transportation and culturing, and differentiation is difficult, costly and time-consuming. In the present study, special screening was carried out for anaerobes in ejaculates in addition to the routine microbial cultures of genital secretions of both partners. In addition to standard semen analysis and evaluation of sperm ability to penetrate cervical mucus (CM) in vivo (post-coital testing) and in vitro using a standardized test system, semen samples from 126 randomly chosen males of couples with a median duration of infertility of 4 years were examined for colonization with anaerobic bacteria. All couples were without clinical signs or symptoms of genital tract infection. The special care taken for anaerobic growth in semen samples gave a high rate of positive cultures and showed that nearly all ejaculates (99%) were colonized with anaerobic micro-organisms, and potentially pathogenic species were found in 71% of men. This rate was more than four times higher than that obtained with routine cultures and standard transportation (16%). Anaerobic bacterial growth of > or = 10(6) colony forming units (CFU)/ml was seen in 42% (total range 10(3)-10(8) CFU/ ml). In addition, aerobic growth was found in 96% (> or = 10(6) CFU/ml in 21%), potentially pathogenic species in 61% of semen specimens. There were no marked differences in the prevalence of anaerobic micro-organisms in patients with reduced or normal sperm count, motility or morphology. Nor was there any significant difference in anaerobic colonization between samples with impaired or good ability to penetrate CM of female partners (in vivo or in vitro), or the CM of fertile donors in the in-vitro sperm-cervical mucus penetration test (SCMPT) in this asymptomatic group of patients. There was no clear association between microbial colonization and subsequent fertility in vivo within an observation period of 6 months. The results of this study suggest that anaerobic bacteria are often not detected when routine methods for microbial evaluation are used. This should be considered during assisted reproduction and in patients with symptoms of genital tract infection and should lead to further studies in infertile patients where subclinical infection or inflammation is indicated by specific markers in semen samples.
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynecological Endocrinology and Reproductive Medicine, Women's Hospital, University of Heidelberg, Germany
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Eggert-Kruse W, Reimann-Andersen J, Rohr G, Pohl S, Tilgen W, Runnebaum B. Clinical relevance of sperm morphology assessment using strict criteria and relationship with sperm-mucus interaction in vivo and in vitro. Fertil Steril 1995; 63:612-24. [PMID: 7851596 DOI: 10.1016/s0015-0282(16)57435-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To determine the relationship of the differentiated morphological pattern of semen samples according to strict criteria and sperm-mucus interaction in vivo and in vitro. PATIENTS One hundred sixty-three randomly chosen couples with long-standing infertility (median duration of infertility 4 years, range 1 to 19 years). SETTING Outpatient clinic of the fertility unit at the Women's University Hospital of the University of Heidelberg, Heidelberg, Germany. MAIN OUTCOME MEASURES Sperm morphology assessment using strict criteria (Tygerberg or Norfolk classification) parallel to standard methods of sperm analysis: Evaluation of the cervical factor of patients' female partners, including a microbial screening of genital secretions of both partners; Examination of sperm migration ability in vivo under hormonally controlled conditions for the cervical mucus (CM) quality and in vitro with the crossed sperm-CM penetration test performed with CM of patients' partners, as well as with CM and spermatozoa of donors; Determination of the selection capacity of CM with regard to sperm morphology by means of a biological model; Prospective analysis of the differentiated morphological pattern with respect to couples' subsequent fertility within 6 months. RESULTS Using stict criteria, amorphous sperm heads were the most frequently found sperm anomaly (severely amorphous forms: median, 28%; range, 4% to 62%). The morphology index offered a median of 45% (range, 7% to 80%). Results correlated significantly with routine sperm analysis, including standard morphology. The morphological pattern differed significantly in samples offering adequate or inadequate ability to penetrate CM in the standardized sperm-CM penetration test or in the postcoital test, with the percent of severely amorphous heads as the most important parameter. Neck and tail defects did not play an important role. During passage of mucus columns in vitro, the rate of pathological spermatozoal forms was reduced significantly, from a median of 65% to a median of 38%. Better functional capacity of spermatozoa with normal head morphology also was reflected by a significantly higher pregnancy rate under natural conditions of conception. CONCLUSIONS Sperm morphological properties, determined with strict criteria, are important factors for sperm ability to penetrate the mucus barrier at the uterine cervix before reaching the site of fertilization, but sperm morphology is only one among other parameters determining the complex phenomenon of sperm-mucus interaction.
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynaecological Endocrinology and Reproductive Medicine, Women's Hospital, University of Heidelberg, Germany
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Eggert-Kruse W, Kruse W, Rohr G, Müller S, Kreissler-Haag D, Klinga K, Runnebaum B. [Hormone profile of elderly women and potential modifiers]. Geburtshilfe Frauenheilkd 1994; 54:321-31. [PMID: 8088487 DOI: 10.1055/s-2007-1022849] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
In 136 women with a median age of 78 (60-98) years the serum concentrations of FSH, LH, prolactin, estradiol-17 beta, testosterone and DHEA-S were determined completed by GnRH and ACTH stimulation tests in a subgroup. This resulted in median values for FSH of 15.8 ng/ml, LH 6.4 ng/ml, prolactin 6.9 ng/ml, estradiol 16 pg/ml, testosterone 270 pg/ml and 306 ng/ml for DHEA-S. No correlation with age in this population was found for gonadotropins as well as the other hormones for an age level of up to 98 years. Determination of multiple general clinical and laboratory parameters demonstrate the significance particularly in a geriatric group of patients to consider these patient characteristics when interpreting the serum hormone levels. In summary, the results of this prospective study underline the importance for health, of the secretion of gonadotropic and sexual hormones even at a very advanced age.
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Affiliation(s)
- W Eggert-Kruse
- Abteilung für Gynäkologische Endokrinologie und Fertilitätsstörungen, Universitäts-Frauenklinik Heidelberg
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Rohr G, Reimnitz P, Blanke P. Treatment of hypertensive emergency. Comparison of a new dosage form of the calcium antagonist nitrendipine with nifedipine capsules. Intensive Care Med 1994; 20:268-71. [PMID: 8046120 DOI: 10.1007/bf01708963] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To present the efficacy and tolerability of a new oral dosage form of the calcium antagonist nitrendipine compared to nifedipine capsules in patients with hypertensive emergency. DESIGN Multicenter randomized double blind clinical study. SETTING 23 study centres (hospitals) in Germany. PATIENTS 161 patients between 20 and 70 years with acutely elevated blood pressure (systolic 200-250 mmHg, diastolic between 110-140 mmHg) with and without concomitant clinical symptoms. INTERVENTIONS Double blind treatment with 10 mg nifedipine or 5 mg nitrendipine. Nifedipine was administered as capsules, nitrendipine was given from a small plastic tube (vial), containing 1 ml alcoholic solution. Every patient received in addition to the test medication a placebo corresponding to the other product. Patients with insufficient treatment after 45 min were given either an additional capsule of 10 mg nifedipine or a further vial containing 5 mg nitrendipine according to their group and maintaining the double dummy procedure. MEASUREMENTS AND RESULTS Blood pressure and heart rate were measured repeatedly during 4 h, before and 90 min after beginning of the treatment a 12 channel resting ECG was recorded. At 45 min after administration the blood pressure had fallen significantly from 216.0/117.4 mmHg to 170.0/93.3 mmHg under nifedipine and from 216.9/117.3 mmHg to 177.4/94.4 mmHg under nitrendipine. 61.6% of the nifedipine patients and 58.8% of the nitrendipine patients had already reached blood pressure values < 180/100 mmHg after 45 min and in both groups 83% of these patients were still in this limit at the end of the observation period after 4 h. Tolerability was very good in both groups. CONCLUSION The new dosage form of nitrendipine (vial with 1 ml of alcoholic solution) represents an alternative in the treatment of hypertensive emergency.
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Affiliation(s)
- G Rohr
- Mannheim Faculty of Clinical Medicine, University of Heidelberg, Germany
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28
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Eggert-Kruse W, Huber K, Rohr G, Runnebaum B. Determination of antisperm antibodies in serum samples by means of enzyme-linked immunosorbent assay--a procedure to be recommended during infertility investigation? Hum Reprod 1993; 8:1405-13. [PMID: 8253926 DOI: 10.1093/oxfordjournals.humrep.a138269] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The clinical significance of antispermatozoal antibody (ASA) testing in serum samples with an enzyme-linked immunosorbent (ELISA) technique using a commercially available kit was evaluated in 95 randomly chosen couples under infertility investigation. Results were related to many other parameters of male and female fertility, e.g. outcome of sperm analysis, testing of sperm functional capacity including the crossed in-vitro sperm-cervical mucus penetration test (SCMPT), results of a microbial screening in genital secretions, testing for local IgG- and IgA-class sperm antibodies in semen by means of the mixed antiglobulin reaction (MAR) and the subsequent pregnancy rate in a prospective study. Results of ASA testing did not show any relationship with medical history and results of clinical examination, the semen quality including sperm function tests and seminal cultures, outcome of the crossed SCMPT, and local ASA. All patients with MAR (IgG or IgA) positive ejaculates were ELISA negative in serum samples. No significant difference with regard to circulating ASA (ELISA) was found in couples with and without a subsequent pregnancy. Furthermore there was no significant difference of antibody levels in subfertile female patients, virgins (n = 36), 'normal' pregnant women (n = 39) and prostitutes (n = 40). In summary, the results of this study clearly demonstrate that the use of this method for detection of antisperm antibodies during infertility investigation cannot be recommended.
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynaecological Endocrinology and Fertility Disorders, Women's University Hospital, Heidelberg, Germany
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29
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Eggert-Kruse W, Schwalbach B, Rohr G, Klinga K, Tilgen W, Runnebaum B. Evaluation of polyacrylamide gel as substitute for human cervical mucus in the sperm penetration test. Fertil Steril 1993; 60:540-9. [PMID: 8375540 DOI: 10.1016/s0015-0282(16)56174-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To compare polyacrylamide gel as synthetic medium with human cervical mucus (CM) for the in vitro sperm-penetration test during infertility investigation. PATIENTS One hundred sixty-nine randomly chosen couples with a median duration of infertility of 4 (range, 1 to 16) years presenting at the infertility unit of the Women's University Hospital of Heidelberg, Germany. MAIN OUTCOME MEASURES Evaluation of sperm migration in polyacrylamide gel used in four different concentrations (1.5%, 1.6%, 1.7%, 1.8%) in the capillary tube test in parallel with CM of patients' female partners and CM of fertile donors, obtained under standardized conditions. Correlation of migration test results with outcome of semen analysis including microbial cultures and testing for local antisperm antibodies by means of the mixed antiglobulin reaction, postcoital testing, and the subsequent pregnancy rate after control for female infertility factors in a prospective study. RESULTS Sperm ability to penetrate the synthetic medium (concerning all concentrations) correlated significantly with the penetration of human CM, although polyacrylamide proved to be a stronger barrier. Sperm velocity and duration of progressive motility were markedly reduced in polyacrylamide. Polyacrylamide results correlated with the outcome of standard sperm analyses but not with sperm antibody testing. No clear differentiation was obtained with regard to subsequent fertility (19% after 6 months), although adequate sperm migration in polyacrylamide 1.8% was significantly more frequent in the fertile group. CONCLUSIONS In analyzing the intrinsic motility, penetration testing with polyacrylamide gel provides important information not obtained by routine sperm analysis. However, particularly with regard to immunological factors and fertility prognosis, human CM should be preferred whenever possible.
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynecological Endocrinology and Reproductive Medicine, Women's Hospital, University of Heidelberg, Germany
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30
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Abstract
To determine the incidence and the clinical significance of antisperm antibodies (ASA) in cervical secretions in an unselected subfertile population, cervical mucus samples of 192 patients with long-standing infertility were screened by means of the indirect mixed antiglobulin reaction (MAR) test allowing differentiation for immunoglobulin (Ig)A and IgG in a parallel test setting. In addition, the indirect MAR IgG test in cervical mucus was evaluated by means of IgG coated latex particles instead of sensitized erythrocytes as the indicator system. All cervical mucus samples were taken under standardized conditions. Results of ASA determination were related to microbial findings in the cervix and the outcome of sperm-mucus interaction testing in vivo and in vitro, and the subsequent fertility in a prospective study. The total incidence of cervical mucus ASA within this population was low (< 2%). A significant correlation was found between sperm antibodies of the IgG and IgA class and of IgG ASA, determined with the standard MAR and testing with latex microspheres as indicator particles. Results were not influenced by microbial colonization of the cervix and were not markedly related to lymphocytes subset testing. All ASA positive women had a negative outcome of the post-coital test, but the majority of negative post-coital tests was not caused by local mucus antibodies of the IgG and/or IgA class. In patients with positive indirect MAR testing in cervical mucus, there was no pregnancy within an observation period of > 12 months. In conclusion, the results indicate the ASA in cervical secretions are not frequent but nevertheless are a severe cause of infertility when present.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynaecological Endocrinology and Fertility Disorders, Womens' University Hospital, University of Heidelberg, Germany
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Knoll MR, Rohr G, Singer MV. [HLA-association of lymphocytic colitis: indications for an independent disease entity?]. Z Gastroenterol 1993; 31:414-6. [PMID: 8212761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- M R Knoll
- IV. Med. Klinik (Gastroenterologie) Klinikum Mannheim, Universität Heidelberg, Bundesrepublik Deutschland
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32
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Eggert-Kruse W, Köhler A, Rohr G, Runnebaum B. The pH as an important determinant of sperm-mucus interaction. Fertil Steril 1993; 59:617-28. [PMID: 8458467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To determine the clinical significance of endocervical mucus pH on sperm-mucus interaction during infertility investigation. PATIENTS AND MATERIAL Two hundred sixteen couples with a median duration of infertility of 4 years (range, 1 to 19 years) presenting at the infertility unit of the Women's University Hospital of Heidelberg, Germany. MAIN OUTCOME MEASURES Determination of endocervical pH by colorimetric and electrometric measurement and correlation of results with the outcome of postcoital testing (PCT) and other parameters of infertility investigation (semen and cervical mucus [CM] quality, microbial colonization of cervix and ejaculates, medical history, hormonal status, and specific medication) and the subsequent fertility in a prospective study. In vitro experiments with the sperm-cervical mucus penetration test (SCMPT) used as biological model. RESULTS The colorimetric determination of endocervical mucus pH is an easy method, suitable for routine clinical use, correlating significantly with electrometric measurement of pH. Median pH was 7.0 (range, 5.4 to 8.2). The mucus pH was significantly related with the results of PCT, even when mucus and semen variables were taken into account. No significant relationship was seen between the cervical index and mucus pH and the microbial colonization of cervix and ejaculates. The pH of endocervical secretions correlated with the peripheral hormonal status: low pH levels were significantly more frequent in patients with hyperandrogenemia, indicated by high testosterone and/or dehydroepiandrosterone sulfate levels before medication was started, and in hyperandrogenemic patients treated with dexamethasone than in the other women. Oral administration of estrogens led to a subtle alkalinization of the CM. With regard to subsequent fertility 6 months after pH testing, the pregnancy rate was significantly lower in women offering reduced mucus pH on occasion of the PCT in the group of couples with primary infertility and in couples with oligozoospermia of the male partner. The significant influence of pH on sperm-mucus interaction was confirmed in vitro with the SCMPT. CONCLUSIONS The results indicate that the pH of the CM, easily determined with pH indicator paper, is an important parameter of mucus quality with significant influence on spermatozoal viability in CM, which correlates with peripheral hormonal status and can be affected by oral medication with estrogens. Therefore the routine determination of pH on occasion of the PCT is recommended during infertility investigation.
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynecological Endocrinology and Reproductive Medicine, Women's Hospital, University of Heidelberg, Germany
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33
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Knoll MR, Rohr G, Heine M, Saeger HD, Jaschke W, Müller MK, Singer MV. [26-year-old patient with recurrent semi-consciousness, tonic seizures and pathological EEG]. Med Klin (Munich) 1993; 88:99-104. [PMID: 8450818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- M R Knoll
- Medizinische Klinik für Gastroenterologie, Universität Heidelberg
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Eggert-Kruse W, Bellmann A, Rohr G, Tilgen W, Runnebaum B. Differentiation of round cells in semen by means of monoclonal antibodies and relationship with male fertility. Fertil Steril 1992; 58:1046-55. [PMID: 1426357 DOI: 10.1016/s0015-0282(16)55458-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To differentiate round cells in semen samples of subfertile men and evaluate the clinical significance during infertility investigation. PATIENTS One hundred and eight randomly chosen couples with a median duration of infertility of 4 (range, 1 to 20) years presenting at the outpatient infertility clinic of the University of Heidelberg, Germany. MAIN OUTCOME MEASURES Differentiation of round cells in semen by means of monoclonal antibodies (mABs) and a streptavidin-biotin system for staining. Correlation of results with medical history, outcome of clinical examination, sperm analysis, microbial screening of both partners, evaluation of sperm functional capacity in vivo by means of the postcoital test (PCT) and in vitro with the standardized crossed sperm-cervical mucus penetration test (SCMPT) and the subsequent fertility in a prospective study. RESULTS The method used for differentiation of round cells proved to be practical and suitable for routine use. The percentage of leukocytes ranged from 0% to 58% with a median of 3%. Number of round cells and percentage of leukocytes did not differ markedly with regard to andrologic history, clinical findings, for example, varicocele, results of standard sperm analysis, and microbial colonization of semen samples. However, high rates of leukocytes of the round cells correlated with reduced sperm count and morphology and results of PCT. Leukocyte-positive (> 15% leukocytes) specimens were also significantly more frequent in case of inadequate SCMPT and reduced sperm penetration ability in vitro. CONCLUSIONS In asymptomatic patients (in terms of genital tract infection), the majority of round cells consist of immature germ cells and < 5% are white blood cells. The streptavidin-biotin system and the mABs used in this study proved to be useful to identify patients with elevated rates of leukocytes in semen possibly reflecting subclinical genital tract infection with influence on sperm functional capacity and subsequent fertility. Thus the procedure can be recommended to be included in a comprehensive evaluation of male fertility.
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynecological Endocrinology and Fertility Disorders, Womens' Hospital, University of Heidelberg, Germany
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35
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Eggert-Kruse W, Rohr G, Jochum R, Adolph M, Runnebaum B. [The effect of heavy metals on the in vitro interaction between human sperm and cervical mucus]. Dtsch Med Wochenschr 1992; 117:1383-9. [PMID: 1516536 DOI: 10.1055/s-2008-1062454] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The sperm-cervical mucus-penetration test (SCMPT) was used in vitro to examine the influence of heavy metals (mercury, cadmium and copper) on sperm function. 30 each of freshly obtained different sperm samples with varying starting sperm motility and oestrogen-stimulated cervical mucosa from women of known fertility were used. Mercury chloride (HgCl2; 0.005-0.5 mmol/l), cadmium chloride (CdCl2; 0.05-10 mmol/l) and copper sulphate (CuSO4; 0.0001-10 mmol/l) were added to the in-vitro system. After incubation, at 37 degrees C for 6 hours, linear progression, penetration depth and motility index of the sperm (cumulative SCMPT score) were analysed. An untreated control was run in parallel with each test. The added substances, especially CdCl2 and HgCl2, significantly reduced the quantitative and qualitative penetrability of sperm (P = 0.001), in step with the concentration. The concentrations which were used, especially those of mercury, were in the range of in-vivo. measured levels. These results make clear that heavy metals can influence human sperm function.
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Affiliation(s)
- W Eggert-Kruse
- Abteilung für Gynäkologische Endokrinologie und Fertilitätsstörungen, Universitäts-Frauenklinik, Heidelberg
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36
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Abstract
Biochemical evaluation of cervical mucus is difficult due to the characteristic rheological properties of this hydrogel. The application of high resolution nuclear magnetic resonance spectroscopy proved to be a valuable new method for differentiated biochemical analyses of human cervical mucus. A particular advantage is that it is non-destructive, that it can be applied to specimens of small volume and that no sample preparation, such as solubilization, is necessary.
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Affiliation(s)
- G Rohr
- Department of Gynaecological Endocrinology and Fertility Disorders, Women's Hospital, University of Heidelberg, FRG
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37
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Rohr G, Henrich D, Hoepfel D, Singer MV. [Possibilities of proton spin tomography (MRI) in the gastrointestinal tract]. Z Gastroenterol 1991; 29:267-9. [PMID: 1950037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- G Rohr
- Medizinische Klinik für Gastroenterologie, Klinikum Mannheim der Universität Heidelberg, Mannheim Bundesrepublik Deutschland
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39
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Abstract
A new protein was purified from the pancreatic juice of rats with acute pancreatitis. That protein, not detectable in control animals, was called "pancreatitis-associated protein." It was first observed 6 hours after induction of experimental pancreatitis with taurocholate or cerulein, reached maximal levels of 45 micrograms/mg protein in zymogen granules and 1.8 micrograms/mg protein in pancreatic tissue during the acute phase (48 hours), and disappeared during recovery (day 5). It was never detected in spleen, liver, kidney, heart, or lung. The detection limit of the assay system was 12 ng/mg protein, so that pancreatitis-associated protein levels increased at least 100-fold in pancreatic tissue during the acute phase. The molecular weight (12,000) and isoelectric point (8.2) were determined by two-dimensional gel electrophoresis. Subcellular fractionation and immunoelectron microscopy showed that the protein was synthesized on the rough endoplasmic reticulum and stored in zymogen granules before being secreted, similar to other pancreatic secretory proteins. Immunoblotting and two-dimensional gel electrophoresis revealed that the same protein was synthesized upon induction of pancreatitis by cerulein infusion, by retrograde injection of bile acids, or pancreatitis induced by pancreatic surgery. The pancreatitis-associated protein is therefore an acute-phase protein that differs from other proteins of that family because of its exocrine nature.
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Affiliation(s)
- V Keim
- Medizinische Klinik Mannheim, Universität Heidelberg, Germany
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40
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Schaaf L, Baur EM, Kusterer K, Huc K, Bode H, Rohr G, Usadel KH. Meningococcemia in a group of Canadian students on a European trip. Can Dis Wkly Rep 1989; 15:229-31. [PMID: 2582527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Rohr G, Shelley R, Brusegan A, Poortmans F, Mewissen L. Nonstatistical effects observed with 52Cr+n resonances. Phys Rev C Nucl Phys 1989; 39:426-439. [PMID: 9955216 DOI: 10.1103/physrevc.39.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Abstract
The secretion of newly synthesized pancreatic enzymes was studied in pancreatic duct cannulated rats after intravenous injection of 100 microCi of [35S]methionine. Secretion rate was stimulated by intravenous infusion of either cerulein (0.2 microgram/kg h) or carbachol (10 nmol/kg h) starting simultaneously with or 180 min before the injection of the labeled methionine. Secretory proteins were analyzed by sodium dodecyl sulfate (SDS) gel electrophoresis or by nondenaturing gel electrophoresis followed by determination of the radioactivity associated with the individual proteins. Similar to unstimulated controls in all experiments, an early secretion of newly synthesized trypsinogen and chymotrypsinogen was found, whereas amylase and lipase were secreted only after a certain lag period. The results suggest that the intracellular transit of endoproteases is faster than that of other enzymes, irrespective of whether or not secretagogues were applied.
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Affiliation(s)
- V Keim
- Institute of Applied Physiology, University of Marburg, FRG
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Abstract
Labeled proteins which appeared in pancreatic juice after the intravenous (i.v.) injection of [35S]methionine into conscious rats with chronic pancreatic duct fistulae were separated by gel electrophoresis and measured by determination of the radioactivity of each of the separated bands. Radioactivity appeared in the secreted proteins 20 min after injection of the label. In the subsequent 10 min, 6.44% of the radioactivity was found in trypsinogen, whereas 100 min later only 3.4% of the radioactivity was associated with this enzyme. The values at 10 and 100 min for amylase were 10.85% and 21%, respectively, showing an earlier appearance of labeled trypsinogen than of amylase. Chymotrypsinogen behaved similarly to trypsinogen. Early secretion of labeled proteases was also demonstrated by separation of pancreatic proteins by two-dimensional gel electrophoresis followed by fluorography. In pancreatic duct cannulated rats, zymogen granules were prepared 30 and 60 min after injection of the labeled methionine. Determination of the radioactivity of the individual proteins demonstrated a similar time course of the labeling pattern in the zymogen granule fraction to that in pancreatic juice. The results of the experiments suggest an asynchronous secretion of newly synthesized rat pancreatic proteins.
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Affiliation(s)
- V Keim
- Institute of Applied Physiology, University of Marburg, F.R.G
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Abstract
The secretion of newly synthesized pancreatic proteins was studied in conscious rats with cannulated pancreatic ducts. Labeled amino acids (3H-leucine and 14C-amino acid mixture) were injected intravenously. The proteins of the pancreatic juice were separated by gel electrophoresis, and the radioactivity in each band was determined. An early secretion of labeled trypsinogen and chymotrypsinogen was found, whereas amylase and lipase were secreted after a certain lag period. In vitro pulse chase experiments showed that amylase was synthesized in the acinar cell but did not move with the same efficacy to the zymogen granules and into the pancreatic juice as proteases.
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Scheele G, Rohr G. Enteropancreatic circulation of digestive enzymes. Gastroenterology 1984; 86:778-9. [PMID: 6698378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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Abstract
An additional protein in rat pancreatic juice has been observed, which is present in healthy rats after pancreatic duct cannulation or in rats in which experimental pancreatitis has been induced by either cerulein or taurocholate. The protein appears 1/2-1 day after surgery or onset of pancreatitis, is present for the following 3-4 days and disappears afterwards. It is found in pancreatic homogenate or in zymogen granules from rats with pancreatitis, but not in normal rats. It does not seem to be related to the recently described 'pancreatic stone protein'. We would like to refer to this protein as 'pancreatitis-associated protein'.
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Rohr G, Scheele G. Fate of radioactive exocrine pancreatic proteins injected into the blood circulation of the rat. Tissue uptake and transepithelial excretion. Gastroenterology 1983; 85:991-1002. [PMID: 6618114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
[35S]methionine or [35S]methionine-labeled exocrine pancreatic proteins were injected into the bloodstream of conscious rats. Samples of blood, urine, bile, and pancreatic juice were collected at varying intervals through 7 h. Injection of [35S]methionine resulted in the appearance of trichloroacetic acid--soluble radioactivity [( 35S]methionine) in bile and urine within 4 min and trichloroacetic acid-insoluble radioactivity in blood, bile, and pancreatic juice after 20 min. Analysis of these body fluids by two-dimensional isoelectric focusing/sodium dodecyl sulfate gel electrophoresis and fluorography indicated that rat serum, biliary, and pancreatic proteins were labeled, respectively. After the injection of [35S]methionine-labeled pancreatic proteins, half of the trichloroacetic acid-insoluble radioactivity disappeared from the serum in 10-15 min. Radioactive proteins appeared after 5 min in urine and bile, and, over the course of the experiment, accounted for 1%-2% and 0.3%-0.5% of the injected radioactivity, respectively. Analysis of individual radioactive proteins excreted into bile by two-dimensional isoelectric focusing/sodium dodecyl sulfate gel electrophoresis indicated preferential transhepatic transport of negatively charged pancreatic proteins. The majority of pancreatic proteins (approximately 97%) were taken up by a variety of body tissues, particularly kidney, liver, spleen, and lung. Trichloroacetic acid-soluble radioactivity, largely representing [35S]methionine, appeared sequentially in serum, urine, and bile within 2-12 min. At later experimental time points (greater than 60-90 min), radioactive rat serum, biliary, and pancreatic proteins appeared in blood, bile, and pancreatic juice, respectively. After the injection of 35S-labeled guinea pig pancreatic proteins into the blood circulation of the rat, trichloroacetic acid-insoluble radioactivity, observed in pancreatic juice after 60-90 min, exclusively represented rat exocrine pancreatic proteins as judged by the two-dimensional gel procedure. These studies indicate that pancreatic proteins are removed from the blood circulation by at least three separate pathways: (a) uptake and degradation by a variety of tissues in the body (approximately 97% of injected radioactivity), (b) excretion of intact proteins into urine (1%-2%), and (c) transport of intact proteins into bile (0.3%-0.5%). Transport of exocrine pancreatic proteins from the blood circulation to pancreatic juice could not be demonstrated.
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Abstract
Peptide and cholinergic secretagogues both produce biphasic dose-response curves for pancreatic enzyme secretion in vitro: supraoptimal doses result in submaximal secretory responses. We compared the effects of maximal and supramaximal doses of a cholinergic agent (carbachol) on rat exocrine pancreas in vivo. In conscious rats, volume and enzyme output were measured from the cannulated pancreatic duct during infusion of carbachol for 3 h. Infusion of 5 X 10(-7) mol . kg-1 . h-1 carbachol caused optimal stimulation, whereas a supraoptimal dose (5 X 10(-6) mol . kg-1 . h-1) resulted in submaximal response. Similar results were achieved when discharge of amylase and protein synthesis was determined in vitro after carbachol in vivo. Supraoptimal doses of carbachol increased serum amylase and enhanced acinar cell lysosomal activity in the Golgi area. The latter appeared to induce fusion of zymogen granules, which resulted in cytoplasmic vacuoles. The in vivo results corroborate in vitro findings of a biphasic dose-response relationship for carbachol and demonstrate destructive effects of supraoptimal concentrations on target cells.
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