Morphological observations of turkey (Meleagris gallopavo) spermiophages maintained in tissue culture.

Spermiophages were isolated from turkey semen using Percoll gradient centrifugation, cultured in Roswell Park Memorial Institute 1640 medium at room temperature, and characterized by transmission electron microscopy. After 1 to 2 h, the cells enlarged and developed numerous motile mitochondria. Over time, the mitochondria appeared to increase in number and were released into the extracellular medium. Few mitochondria were observed in spermiophages from fresh semen. However, there was an apparent increase in the number and size of mitochondria after Percoll isolation, which was more pronounced in cultured spermiophages. Over a period of 3 h in culture, many spermiophages became engorged with mitochondria, which subsequently appeared to be released as blebs pinched off from the surface. The release of mitochondria resulted in spermiophages with large, empty vacuoles, although their remaining cytoplasm was engorged with mitochondria. Many free mitochondria were present in the medium. The results of the current research suggest that isolating and culturing turkey spermiophages elicit mitochondrial biogenesis, which proceeds unabated until the cells are engorged with and release numerous mitochondria. This may be due to conditions under which the spermiophages were cultured or to nonhistocompatibility of these cells in pooled semen.

Sertoli cells in culture are heterogeneous with respect to transferrin release: analysis by reverse hemolytic plaque assay.

It has been reported that not all Sertoli cells store the same product or respond morphologically to secretagogue stimulation. The following studies were performed to determine whether functional differences among these cells are also present with respect to the secretion of a product. Sertoli cells obtained from 18- to 20-day-old rats were cultured for 3 days and then subjected to reverse hemolytic plaque assays for transferrin (TF). Release of TF could be detected from only 62.7 +/- 0.47% (mean +/- SE; n = 4 experiments) of all cells in culture. Results obtained from immunocytochemical staining of different batches of cells from the same dispersions agreed quite closely with these plaque assay values, indicating that not all Sertoli cells in culture contain or secrete TF. Differences in the basal rate of TF release were observed among these secretors, as evidenced by a gradual appearance of plaques over an 8-h period. Addition of FSH, cAMP, or isoproterenol to the assay incubation mixture resulted in an acceleration in the rate of plaque formation. Although approximately twice as many secretors could be identified after 0.5 and 1 h of incubation in the presence of these agents than in their absence, it still required at least 4 h for the remainder of the TF cells to form plaques. This would indicate that only a portion of all TF secretors respond acutely to these modulators. Thus, our observations that not all Sertoli cells secrete TF, and those that do release this substance respond differently to at least three stimulatory agents demonstrate clearly that Sertoli cells are heterogeneous with respect to TF release. Moreover, these findings raise the possibility that differences in the functional capacity of individual cells may be an important factor contributing to the modulation of Sertoli cell secretion.

Urinary tract infection in the adult. A guide to treatment.

Urinary tract infection usually responds to any general urinary chemotherapeutic agent. In this article, the another describes therapies for specific infections that he has used for over 20 years in hundreds of patients, with excellent results.

Epidermoid carcinoma of the penis.

One hundred and twenty-two cases of penile carcinoma at the Medical University of South Carolina from 1945 to 1979 have been analysed. The age and race distribution of these patients, initial clinical staging and surgical treatment have been recorded. In addition, clinical inguinal involvement, results of inguinal lymphadenectomy and survival data based on retrospective staging are listed. The role of adjunctive lymphadenectomy is discussed and the importance of pelvic lymphadenectomy in addition to inguinal node dissection is emphasised. A treatment plan is outlined for the management of penile carcinoma in order to increase survival without increasing patient morbidity.

Vasectomy reversal: use of microsurgical technique.

PIP: O'Connor in 1948 reported the results of a questionnaire sent to members of the American Urological Association asking for their results in vasovasostomy. The conclusion at that time was that the success rate was 30-40%; 420 operations had been performed by 135 surgeons. Derrick and Associates, in 1973, reported the results of a similar questionnaire. 1630 procedures had been performed by 542 doctors with an overall success rate of around 20%. Since 1977 several microsurgical techniques of vasovasostomy have been developed and reported with much greater expectation than previous techniques or devices. Some investigators are reporting up to 90-95% incidence of expected sperm return and as much as 60-70% chance of pregnancy. The microsurgical technique of a 2-layer closure placing 8-0 polyglycolic acid in the muscularis of the vas deferens and 8 or 9-0 nylon in the mucosal layer has been used by these 2 reporting physicians. The microsurgical instruments such as the vas approximater, needle carriers, probes and needle guides have been proven absolutely necessary in the performance of this type surgery. Most recently 20 vasovasostomies were performed utilizing the microsurgical technique described in this discussion with a 95% incidence of sperm return to the semen and a 70% pregnancy rate.^ieng

Renal calculi in association with hyperparathyroidism: a changing entity.

Hyperparathyroidism as a cause of renal calculous disease has decreased considerably during the last 50 years. From 1972 to 1977, 5,034 cases of calculous disease were seen in 5 major hospitals in South Carolina and only 9 patients had hyperparathyroidism as the underlying etiology. There is a 0.178 per cent incidence of hyperparathyroidism as a cause of renal calculous disease in this series, or between 1 and 2 patients per 1,000 cases of stone disease. This finding is compared to a high incidence of 8 per cent in 1934. This change probably is owing to the large-scale use of multiphasic screening blood tests.

Problems + Solutions.

Readers are invited to submit questions relating to problem cases. Inquiries will be answered by qualified consultants and replies forwarded by mail promptly. Selected problems and solutions are published every month in this section.

Clinical significance of sperm antibodies in infertility.

Sperm antibody (AB) titers, determined by passive hemagglutination and cytotoxicity assays, were found to be elevated in 62 males and 46 females of 103 couples with primary infertility; 15 males and 12 females of 25 couples with secondary infertility; 10 males and 8 females of 18 couples with histories of repeated abortion; 21 males and 17 females of 25 couples in which the husband had a history of prostatitis; and 29 males and 17 females of 38 couples in which the husband had oligospermia. Of the couples in which one or both partners had elevated sperm AB titers, only 4 achieved pregnancy: 3 from the group with secondary infertility, all of which ended in spontaneous abortions, and 1 in which the husband was oligospermic. This suggests an etiologic role of sperm immunity in infertility. Immunosuppressive treatment of autoimmune males with prednisone (15 mg/day for 3 weeks to 6 months) resulted in significant decreases in AB titers. Pregnancies were achieved by 9 of 25 couples after treatment (36%). The observed increase in pregnancy rate in the prednisone-treated versus untreated groups of couples with elevated sperm AB titers was significant (P less than 0.02).

Kidney stone disease: evaluation and medical management.

Over the past 15 years we have developed a protocol for evaluation and medical management of urinary calculi that has proved quite effective. For all patients we include plain x-ray films of the urinary tract, intravenous pyelograms, urine cultures and sensitivity studies, serum and 24-hour urinary chemical determinations, and analysis of any stones recovered. Although the cause of calcium stones, the most common type of urinary calculi, has not been established, specific treatment regimens have been devised. Maintenance of a dilute urine remains the mainstay of therapy, and diuretics, alkalinizing or acidifying agents, and various specific drugs may be indicated, depending on laboratory findings. Surgery is not indicated unless the stone is large, is in the upper part of the urinary tract, or shows no signs of movement.

Interference of human spermatozoal motility by trichomonas vaginalis.

Human spermatozoa were exposed to concentrations of live Trichomonas vaginalis varying from 10(4) to 10(7) organisms per ml. A striking decrease in spermatozoal motility ensued. The possible role of trichomoniasis in human reproductive failure is considered.

PIP: Trichomonas vaginalis is a flagellated parasite often found as an occult resident of the genital tract of sexually active women. A pure culture of T. vaginalis was isolated from urine and maintained at 37 degrees C by in vitro passage in Diamond's broth. Fresh semen specimens were incubated in .2 ml of serial dilutions of T. vaginalis culture. Spermatozoal motility was observed immediately on mixing and again after 2, 4, and 6 hours of incubation. Marked lessening of spermatozoal activity was observed but no agglutination. The motion of T. vaginalis continued normally. In control samples containing saline or Diamond's broth, only minor retardation of spermatozoal activity was noted during 6 hours of incubation. Filtered Diamond's broth, which prior to filtration had supported a dense concentration of protozoa, when added to equal volumes of fresh human ejaculate caused a similar retardation of spermatozoal activity. It was speculated that some metabolic metabolites of T. vaginalis decrease spermatozoal activity. T. vaginalis should be included among other factors that lead to infertility. In subfertile couples eradication of T. vaginalis may enhance fertility.

Interference of human spermatozoal motility and spermatozoal agglutination by Candida albicans.

Human spermatozoa were exposed to concentrations of 10(2) to 10(7) organisms per ml. Candida albicans. A subsequent striking decrease in spermatozoal motility and significant agglutination were observed. The possible role of mycotic genital tract infections in human infertility is considered.

PIP: Candida albicans, isolated from a urine culture, was grown in beef heart infusion containing penicillin and streptomycin. Several 10-fold dilutions were made in physiological saline. Semen ejaculations were obtained from 8 volunteers. Drops of a suspension of semen in various dilutions of Candida albicans culture, or in culture media alone, were immediately observed microscopically for spermicidal motility and agglutination. After 2 and 4 hours of incubation, observations were repeated. On immediate examination spermatozoal motility was observed to decrease as the concentration of Candida albicans was increased. In control samples spermatozoal activity remained normal. The pH of all samples remained between 7-8. Spermatozoal agglutination was not noted immediately but after 2 and 4 hours of incubation clumping was obvious. Infertility may follow as a result of mycotic vaginitis, particularly with a marginal state of fertility. In evaluation of couples for infertility, the presence of clinical or subclinical genital tract infection with these organisms should be considered. Antimycotic treatment may be a simple solution for a seemingly complex problem.

Benign lesions of the tunica albuginea.

Although most testicular masses are malignant we present 7 cases to demonstrate that benign lesions of the tunica albuginea do occur and that these may be a source of diagnostic confusion. Consideration should be given to the possibility of a benign lesion of the tunica albuginea when the lesion is small, discrete, painless and projecting above the surface of the tunica albuginea. All of our patients were referred to us with a tentative diagnosis of testicular malignancy. We do not wish to decrease the importance of vigilance concerning testicular masses but the cases presented herein demonstrate that all masses of the testis are not malignant.