Assessment of seminal plasma laminin in fertile and infertile men / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To assess laminin levels in the seminal plasma of infertile and fertile men, and to analyze the correlation of laminin levels with sperm count, age, sperm motility and semen volume.</p><p><b>METHODS</b>One hundred and twenty-five recruited men were equally divided into five groups according to their sperm concentration and clinical examination: fertile normozoospermia, oligoasthenozoospermia, non-obstructive azoospermia (NOA), obstructive azoospermia (OA) and congenital bilateral absent vas deferens (CBAVD). The patients' medical history was investigated and patients underwent clinical examination, conventional semen analysis and estimation of seminal plasma laminin by radioimmunoassay.</p><p><b>RESULTS</b>Seminal plasma laminin levels of successive groups were: 2.82 +/- 0.62, 2.49 +/- 0.44, 1.77 +/- 0.56, 1.72 +/- 0.76, 1.35 +/- 0.63 U/mL, respectively. The fertile normozoospermic group showed the highest concentration compared to all infertile groups with significant differences compared to azoospermic groups (P<0.05). Testicular contribution was estimated to be approximately one-third of the seminal laminin. Seminal plasma laminin demonstrated significant correlation with sperm concentration (r = 0.460, P < 0.001) and nonsignificant correlation with age (r = 0.021, P = 0.940), sperm motility percentage (r = 0.142, P = 0.615) and semen volume (r = 0.035, P = 0.087).</p><p><b>CONCLUSION</b>Seminal plasma laminin is derived mostly from prostatic and testicular portions and minimally from the seminal vesicle and vas deferens. Estimating seminal laminin alone is not conclusive in diagnosing different cases of male infertility.</p>

Early cystoscopic examination in yesicovaginal fistulae, Is it a must?

This study was performed on ten female patients who were exposed to total abdominal hysterectomy, and suffering from early postoperative [2-7 days] leakage of urine through the vagina. Cystoscopy was done for all cases and showed traumatic lesion in the bladder mucosa with a stitch in 6 cases and shready necrotic defect in the posterior bladder wall in the remaining 4 cases. Supratrigonal shreds and necrotic mucosa were found over the suture material [vicryl] in 6 cases. Via cystoscopy the suture thread was cut using the cold-knife resectoscope, bilateral ureteric catheters number 8 Fr were introduced and fixed, and a silicon urethral catheter was fixed while urine diversion via urethra catheter was done to the other 4 cases. Follow-up with methylene blue [MB] test was done weekly. MB test was -ve in 8 cases after 3 weeks. Two cases did not improve and were operated upon 3 months later

Cytological screening for cervical cancer in an Egyptian prison

To determine the incidence and the risk factors of cytologically diagnosed squamous intraepithelial lesions of the cervix in an Egyptian prison and to compare it with Benha Faculty of medicine out patient clinic. 200 females in an Egyptian prison and 200 females attending the gynecologic outpatient clinic of Benha faculty of medicine hospital were included in this study. Cervical smear was taken from every female. Result: Squamous intraepithelial lesions were detected in 35% of prisoners, and in 11% of out patient females. High grade squamous intraepithelial lesions were detected in 10% of prisoners and in 1.5% of out patient females. Risk factors for cervical intraepithelial lesions were young age of first coitus, multiple male sexual partners, heavy smoking and clinically suspicious cervix. Incidence of squamous intraepithelial lesions increase in female prisoners in comparison with out patient females. Early age of first coitus and multiple sexual partners are the most significant factors associated with occurrence of high grade squamous intraepithelial lesions in prisoners

feasibility and accuracy of transperitoneal laparoscopic lymphadenectomy in bladder and prostate cancer

To evaluate the procedure of transperitoneal laparoscopic lymphadenectomy and to assess the predictive value of stage and grade of nodal metastases in bladder and prostate cancer, 47 patients were evaluated for elective laparoscopic pelvic lymph node dissection [LPLND]. The procedure was done for prostatic cancer in 28 patients and bladder cancer in 19 patients. All patients were evaluated by history taking, urine analysis and culture, complete blood picture, liver function tests, serum urea and creatinine and blood sugar. In addition, bladder cancer patients were subjected to plain X-ray and intravenous urography, abdominal and pelvic sonography, CT scan, cystoscopy and biopsy. Prostatic cancer patients were subjected to an estimation of prostatic specific antigen, abdominal and pelvic sonography, transrectal ultrasound guided biopsy, CT scan and bone scan. Transperitoneal laparoscopic lymphadenectomy was done. A histopathological examination of lymph nodes removed laparoscopically was also done. The operative time, intra and postoperative complications encountered were recorded. The results showed that LPLND offers a relatively safe, accurate and minimally invasive alternative to st and ard open lymphadenectomy with minimal morbidity, short hospital stay and rapid recovery

Transurethral prostatic resection in patients on anticoagulant therapy

in this prospective study 26 patients on chronic anticoagulant therapy for a histoty of life-threatening thromboembolic disease were candidate for TURP due to refractory urinary retention or severe obstructive symptoms not responding to other treatment modalities. Patients stopped taking warfarin 5 days prior to TURP and LMWH was given twice daily subcutaneously 3 days before the operation. Heparin was stopped 12 hours before TURP regarding international normalized ratio [INR] <1.4 and restarted again in the first post operative day. Warfarin was restarted together with LMWH After resolving of the hematurea. LMWH was discontinued when INR>2. The results were compared to a control group comprised of 26 randomly selected non warfarin treated patients who underwent TURP during the same period The mean weight of prostate resected was 24.2 [range 6-60] and 26 [range 8-56] gms in warfarin and non warfarin group respectively. The need for blood transfusions did not significantly differ between the two groups. The mean perioperative decrease in hemoglobin was 1.2 +/- 0.3 gm/dl and 1.3 +/- 0.2 gm/dl in heparin and non-heparin group respectively. Average catheterization and hospitalization period in the heparin group was 3.2 +/- 0 3 and 4.2 +/- 0.4 days respectively compared to 2.1 + 0.2 and 2.1 + 0.4 days in the control group respectively [p< 0.01]. One patient in the study group was readmitted for secondary hemorrhage 9 days after discharge but hematurea resolved with catheterization and bladder irrigation. No long term hemorrhage or thromboembolic complications were recorded 3 months postoperatively. Transurethral resection of prostate can be conducted safely in this high risk group of patients with a regimen that allows a brief but controlled interruption to their full anticoagulation

Ureteroscopy versus extracorporeal shock wave lithotripsy in the management of distal ureteral calculi

To compare, ureteroscopy [URS] and extracorporeal shock wave lithotripsy [ESWL] in the management of distal ureteral calculi. Between January 2000 and May 2001, 120 patients with distal ureteral calculi had been prospectively randomized between extracorporeal shock wave lithortipsy and retrograde ureteroscopy in the urology department of Cairo University hospitals and Suez Canal University Hospital. Our patients were divided into two groups, 60 patients each. The first group was treated with extracorporeal shock wave lithotripsy [ESWL] and the second group with rigid ureteroscopy. The patients were evaluated by history taking, clinical examination, laboratory investigations and radiological investigations including plain X ray film for kidney, ureter and bladder [KUB] and intravenous urography [IVU]. All patients of URS required spinal or general anaesthesia, URS was found to be significantly less time consuming than ESWL with a mean time of 40 +/- 9.25 and 60 +/- 10.68 minutes respectively.The mean fluoroscopy time was 3.9 +/- 1.45 minutes and 7.2 +/- 2.04 minutes in URS and ESWL group respectively. No ureteric stens were inserted pre or postoperatively in ESWL group but in URS group ureteric stents were inserted in all successful cases.The overall success rates in URS and ESWL groups were 95% and 90% respectively.The hospital stay of ureteroscopy is significantly longer than that of ESWL [P < .05]. Postoperative IVU revealed significant improvement in the state of upper urinary tract in URS and ESWL groups. There was no statistical significant difference in the overall complication rate of URS and ESWL. In our study we found that ESWL is a valid and effective alternative for treatment of distal ureteral calculi, however the patients must be informed about the possibility of colic during passage of fragments, retreatment and the need for close follow up to monitor the passage of stone fragments until they were stone free.We concluded that URS should be the procedure of choice for lower ureteral calculi, as it has advantages of, high immediate success rate [95%], low retreatment rate, short operative time, short fluoroscopy time in addition to immediate and reliable technique to relieve the obstruction of upper urinary tract

Herpes simplex virus type-1 and apoptosis in pemphigus: a causal relationship

The objective of this study was to evaluate the possible role of herpes simplex virus type-I [HSV-I] infection and apoptosis in the etiopathogenesis of pemphigus vulgaris [PV]. The study included 29 patients with PV and 7 apparently healthy subjects as controls. The patients were grouped into three groups: Group I [recent acute onset [6 cases]], group II [chronic exacerbated under steroid therapy [16 cases]] and group III [chronic controlled with steroid therapy [7 cases]]. Apoptosis was detected in peripheral blood monocytes [PBMC] using flow cytometry and that in the skin by TUNEL. HSV-I DNA was detected in PBMC and the skin using PCR. The antibody titer of serum IgG for HSV-I was detected using indirect immunofluorescence technique [IF]. The study concluded that apoptosis is increased in PV. Both HSV-I and apoptosis have to be considered in the immune-pathogenesis and can be used for immuno-modulation and suggestion of strategy of therapy or even to prevent exacerbation

Development of uteroplacental vasuclature, granulated metrial gland cells and trophoblasts in the uterine wall of the mouse during pregnancy

The development of the uteroplacental vasculature was studied by Indian ink injection method. The non-pregnant [estrus] endometrium was supplied by radial and terminal arteries. On day 5 of pregnancy the radial arteries became spiral arteries. All these changes appeared as an indication for the increased uterine blood volume. In this early five days interval of rapid development prior to blastocyst attachment, the endometrium underwent a decidual reaction by transforming its fusiform stromal cells into large polyhedral cells [decidual cells]. Ultrastructurally, their processes appeared to penetrate the basement membranes of the uterine epithelial cells and might aid in its disintegration. In the subsequent stages [days 6-8 of pregnancy] during the initial stages of invasion of the endometrial stroma by the embryo, most trophoblastic cells surrounding the blastocyst were flat [or roughly low cuboidal]. As pregnancy proceeded [on day 8], the area occupied by the trophoblasts became larger and some of these cells became giant. This was associated with an activation of the giant cells and their aquistion of invasive behavior, to complete the process of implantation previously experienced by decidual cells. From day 8 to day 14, the products of conception continued to enlarge at the expence of th surrounding endometrium. On day 8 erosion of endometrial blood vessels became more extensive. The outward growth of the trophoblasts from the trophoblastic shell forming primary villi. When the latter villi were invaded by mesenchymal connective tissue and branches of the umbilical arteries, they were termed chorionic villi. This was the anatomical bases for the achievement of the labyrinthine hemochorial placenta which increases in size in the subsequent stages [11-14 days]. It was considered the first step towards establishing the uteroplacental circulation on which the growth of the embryo will later depend. Numerous GMG cells characterized by their PAS positive cytoplasmic granules were found to differentiate in the deciduas basalis and metrial glands of the uterine wall during the first half of pregnancy [till day 8]. By day 8 and the subsequent stages of pregnancy some of the GMG cells were lying adjacent to the labyrinthine placenta

Immunohistochemical alterations of the small penile arteries in impotent patients

This study included 20 organically impotent men. All patients were subjected to history taking, general and local examination, biothesiometry test, papaverine and phentolamine test, duplex, rigiscan and cavernosometry examination. The study also included five control cases from the postmortem room. For all included cases, an open biopsy was taken from the cavernous tissue of the mid shaft of the penis. The prepared histologic sections were stained by hematoxylin and eosin stain, PAS [periodic acid Schiff] and Ulex Europeans agglutinin type-1 lectin [UEA-1] immunostaining to detect the changes in the endothelial cells. Based on the results, it was concluded that the endothelial alterations in the vascular spaces of the corpora cavernosa in impotent patients are functional rather than morphological

Structural changes of lung alveoli and alveolar macrophages of the albino rat following invivo and invitro exposure to sodium fluoride

In this work both the effect of ingestion of sodium fluoride [NaF] for three months on the ultrastructure of lung alveoli and, the effect of NaF on macrophages isolated from the lung and cultured invitro were studied. The results revealed that ingestion of NaF led to distortion of alveolar epithelia, thickening of the blood air barrier and interstitial edema due to transudation of fluid from the dilated blood capillaries into the interstitial spaces. Also, Pneumocyte type II [P2] were degenerated and their secretory granules showing amellar structure [lamellar bodies] were decreased. This was an indication of increased surfactant secretion without a corresponding increase in the rate of synthesis. There was increase of pulmonary alveolar macrophages [PAM] and most of them showed heterogeneity of their cytoplasmic inclusions mainly in the form of heterophagic vacuoles, Most of PAM showed apoptotic changes [in the form of nuclear pyknosis or even fragmentation of the nuclei] after NaF ingestion and after invitro culture with NaF, From this work it could be concluded that NaF ingestion caused damage of the lung alveoli. Also, NaF particles acted as a stimulating factor for the proliferation of macrophages to engulf these foreign particles. Eventually the toxicity of fluoride leads to apoptosis of macrophages. So it could be concluded that NaF acts as an environmental toxicant that carries the risk of occurance of pulmonary dysfunction

IL-10 gene expression as a marker for detection of protective immunity levels with irradiated cercarial vaccine against experimental Schistosoma mansoni infection

Cercariae were obtained in a large number from the maintained life cycle of S. mansoni. They were attenuated at different doses [20 Kr, 50 Kr,60Kr, 70 Kr and 80 Kr] of gamma radiation. Laboratory bred Swiss Albino mice were classified into 7 groups. Five groups were immunized with +/- 500 S. mansoni cercariae. Two groups were used as positive and negative controls. All animals were sacrificed after 8 weeks. Spleen cell proliferative responses to Phytohaemagglutinin [PHA] were assessed in all groups. IL-10 was measured by ELISA in serum and splenic cells secretion in vitro. RNA extracted from freshly isolated liver cells was analyzed for detection of m RNA of IL-10 by reverse transcriptase polymerase chain reaction [RT-PCR]. The results showed augmentation of proliferative cell from the spleen in all vaccinated groups except with 80 Kr. irradiated cercariae group. The highest percentage of lymphocytes transformation was recorded among the mice immunized with 60 Kr. irradiated cercariae. After challenge, splenic reasponses in all groups declined progressively to the control level. IL-10 secretion from spleen cells of all vaccinated groups increased after challenge with the least level in 60 Kr. immunized challenged group IL-10 m RNA expression was higher among 60 Kr. immunized with irradiated cercariae group than 70 Kr. one, but with no expression among 80 Kr. cercariae immunized ones

Electron microscopic study of the toxicological effects of sodium fluoride on lungs of adult albino rats

Since sodium fluoride [NaF] is implicated in the acute respiratory failure, the toxic effects of NaF ingestion on lung tissues were investigated. This experimental study was conducted on 40 adult albino rats. Experimental fluorosis was induced by daily oral administration of 18 mg/kg NaF for three successive months to twenty rats, while the other twenty rats were served as reference group with no medication. Electron microscopic study of the lung revealed injury of type I and II pneumocytes, haemorrhage, increase collagen fibers and apoptotic changes in alveolar macrophages in the form of fragmentation of nuclei. It was concluded that prolonged fluoride ingestion damages pulmonary tissues of rats

Dendritic reticulum cells of lymph nodes in the rat using zinc iodide - osmium technique

Ten adult Sprague - Dawly rats of both sexes, weighing between 180 - 220 g were used in this study. They were maintained under convential laboratory conditions with free access to water and commercial rat food. The morphological architecture of dendritic reticulum cells [DRCs] in the rat lymph nodes was studied by light and electron microscopy after tissue impregnation and staining by zinc iodide-osmium [ZIO] method. DRCs represented the main stromal cell population. These cells were located both in the cortex and in the medulla and exhibited various configurations. In the cortex they appeared elongated and fusiform in shape with slender and long dendritic processes that ramify in a complex fashion. They were observed in the lymphoid follicles [especially in the germinal centre], lymphatic sinuses and the deep cortex, the DRCs were detected in close association with the subcapsular sinus, they might be located just underneath the sinus endothelium or directly share in forming the sinus lining. In the medulla, the DRCs appeared irregular in shape with coarse or delicate cytoplasmic processes forming an extensive cellular reticulum. This cellular reticulum spanned the region between the sinuses and the blood vessels such as capillaries and / or high endothelial venules [HEVs]. In this instance they were organized in a discontinuous sheath - like fashion around the vessel wall. By light and electron microscopy, DRCs have been observed to come in close spatial relationship with each other and with various other cell types including small, medium sized and large lymphocytes, lymphoblasts, plasma cells, interdigitating cells, sinus endothelial cells, the endothelium of HEVs and capillaries. These microanatomical features were consitent with the proposal that DRCs might be involved in the communicative networks between the different lymph node compartments. In particular, DRCs were thought to provide efficient anatomical arrangements which influence the lymphocyte traffic patterns and might be involved in the transport of molecules from the sinus compartment to the HEVs or to the distinct cell populations in the lymphoid parenchyma. From the previous data, it was suggested that the DRCs serve as accessory cells for the development of immune responses. Further studies should be performed to clarify the role of these cells in the regulation of lymphocyte mediated immunity

Ultrastructural study of the toxicological effect of formalin on liver and kidney of adult albino rat

Formalin which is an aqueous solution of formaldehyde [HCHO] in water is used as disinfectant.Antiseptic and as a food preservative. This study was conducted on 40 adult albino rats to evaluate formalin ultrastructural effect on liver and kidney. Formalin was administered orally for three successive weeks at a daily dose of 50 mg/kg body weight in fresh cow's milk to the treated group [twenty rats] while the other twenty rats served as a control group which orally received milk only [1 cc / rat/day]. At the end of the experiment, light microscopic examination revealed dilatation, congestion of the central vein and hydropic degeneration of liver cells. Also hypercellularity of the glomeruli and cloudy swelling of renal tubules can be observed. Electron microscopic study showed, degeneration of most hepatocytes, mitochondriae were degenerated and cristae were absent. Also glomeruli with degenerated podocyte, proximal convoluted tubules with vacuolation of the cytoplasm and necrotic debris in the lumen of convoluted tubules can be detected. So, it can be concluded that the chronic oral administration of formalin causes toxic effects in the liver and kidneys of albino rats

Cervical herpes simplex virus in Benha University Hospital clinic: cytologic, virologic and colposcopic study

Our objective was to determine the isolation rate of cervical HSV in relation to different clinical conditions and colposcopic findings, among the patients attending the outpatient clinic of Benha University Hospital and to find out the sensitivity and specificity of Papanicolaou [Pap] smear and direct fluorescence antibody stain [DFA] in relation to tissue culture. Our study comprised 250 patients. For each patient a Pap. smear was obtained and two endocervical scrapings were collected. The first one was used for staining with DFA. The second one was used for isolation of HSV-2 on monolayer of Buffalo Green Monkey kidney [BGM] cell culture. Colposcopy was done in all patients. Punch biopsy was taken from cases suggestive of squamous intraepithelial lesion. Out of the 250 patients, 36 [14.4%,] were positive for HSV by culture on BGM cells, 29 [11.6%] by DFA staining and 16 [6.4%] by Pap. smear. DFA has higher sensitivity [58.3% versus 33.3%,] and negative predictive value [93.2% versus 89.7%] than Pap smear. The virus isolation rate was not sign higher in the multigravida, multipara, patients with a history of 2 or more abortions, pregnant females, women using pills or intrauterine contraceptive device [IUCD], or patients with atypical transformation zone. The isolation rate of cervical HSV is 14.4% in the patients attending the outpatient clinic of Benha University Hospital. Pap. Smear is not useful in detection of HSV. The virus isolation rate was significantly higher in the age group [20-30 years], patients with a history of herpetic like lesions on the genitalia, patients with cervical ectopy and patients with infected typical transformation zone

Histopathology of lymph nodes of babesia infected cattles with estimation of adenosine deaminose activity in blood cells and serum

The present work was carried out on cattles infected with Babesia bigemina. Blood examination showed various forms of the parasite intraerythrocytes. The histopathological study of the lymph nodes revealed follicular hyperplasia and marked dilatation and congestion of the medullary blood sinusoids with parasitized and non-parasitized RBCs. The activity of adenosine deaminase [ADA] was determined in erythrocytes, leukocytes and serum of infected cattles with acute babesiosis. ADA activity was significantly increased in both erythrocytes and serum, while leukocyte ADA activity showed a significant decrease indicating suppression of cell-mediated immunity

Effect of giardiasis on absorption of oral antibiotics in children and experimental animals

Intestinal absorption of oral antibiotics, in giardiasis has been studied in children and experimental animals. Serum concentrations of oral antibiotics [amoxicillin, ampicillin, cephalexin and cefaclor] were assayed in 20 children with different acute bacterial infections and concomitant presence of Giardia-lamblia in their feces with unexplained treatment failure with these antibiotics. Antigiardia therapy was given and after complete recovery from giardiasis, the initial used oral antibiotic were used again to test its absorption. Serum concentration of oral antibiotics were significantly higher after treatment of giardiasis. The experimental study was done on 2 groups of albino rats each of them was fed [amoxicillin, ampicillin, cephalexin, cefaclor, erythromycin and sulfamethoxazole. The sera were assayed for drug concentrations one hour after ingestion. The first group was infected with high dose of Giardia-lamblia, while the second group with a small dose. The results obtained showed that the mean serum concentration for all antibiotics were significantly higher before infection with Giardia-lamblia when compared to the same rats after infection. While sulfamethoxazole showed no difference

Early detection of hearing loss in preterm neonates: maturation and follow-up

Auditory brainstem response screening test at 40 and 70 db above the normal adult hearing threshold was done for 76 intensive care unit premature neonates in addition to 15 full term neonates as a control group. The presence of wave V, the criterion for pass, was strongly related to postconceptual age. It appeared in the preterm group at 70 dB in 65.2% in preterm infants between 28 and 32 weeks gestational age, in 83.6% in infants between 33 and 36 weeks and in 100% in full term infants. The hearing threshold was found to be at 46.6 dB and 35.2 dB in preterm infants with gestational age between 28 and 32 weeks and between 33 and 36 weeks, respectively and at 25 dB in full term infants. On follow-up, the incidence of hearing loss in the preterm infants was 26.7% at one year of age ranging from mild to profound hearing loss. Profound hearing loss occurred in 6.7% of infants who survived despite very low birth weight [

Plasma fibronectin level in malignant external otitis

This study was carried out on twenty diabetic patients [10 had malignant external otitis, and 10 were under medical control] in a trial to find out any relationship between plasma fibronectin level and severity of malignant external otitis infection. Plasma fibronectin was significantly high in cases of malignant external otitis compared to uncomplicated diabetic cases and normal individuals. Plasma fibronectin was positively correlated with blood glucose level and with the severity of the disease as detected by radionuclide imaging; also it was significantly increased in cases of malignant external otitis compared to the same cases after treatment or in diabetic cases under medical control. Therefore, the degree of increase of plasma fibronectin level can be considered as a parameter reflecting the severity of malignant external otitis. On the other hand, a decrease of its level indicates heading of malignant external otitis. However, trial for evaluating the therapeutic efficacy of exogenous fibronectin in promoting healing of malignant external otitis might be recommended as a future research