Reliability and validity of eye-hand coordination pointing tests for older adults.

To examine the reliability and validity of eye-hand coordination pointing with pencil test (EHCPPT), which evaluates the spatial and temporal displacement of rhythmic movements. One hundred and thirty-five older adults participated in our study. Reproducibility of the EHCPPT was assessed by the participants tapping on the center of the circles using a tablet pen in response to 2 types of stimulus sound sequences (Test A and B) across 2 separate trials, the first and second half. Construct validity was assessed by comparison in the distances between ultimate and current processing abilities, based on the spatial and temporal displacement relationship across Test A and Test B. Concurrent validity was assessed by examining the relationship between the distances between ultimate and current processing abilities and the motor and cognitive functions. Spatial and temporal displacements showed an excellent intraclass correlation coefficient in both Tests A and B of EHCPPT. The distance between ultimate and current processing ability, based on the relationship of spatial and temporal displacement, was significantly shorter in Test A compared to Test B. Spatial and temporal displacements were correlated with motor and cognitive functions. The spatial and temporal displacements of EHCPPT indicated reproducibility and validity in older adults. The EHCPPT may serve as a rhythmic movement reflecting motor and cognitive functions.

Baseline Variability Affects N-of-1 Intervention Effect: Simulation and Field Studies.

The simulation study investigated the relationship between the local linear trend model's data-comparison accuracy, baseline-data variability, and changes in level and slope after introducing the N-of-1 intervention. Contour maps were constructed, which included baseline-data variability, change in level or slope, and percentage of non-overlapping data between the state and forecast values by the local linear trend model. Simulation results showed that baseline-data variability and changes in level and slope after intervention affect the data-comparison accuracy based on the local linear trend model. The field study investigated the intervention effects for actual field data using the local linear trend model, which confirmed 100% effectiveness of previous N-of-1 studies. These results imply that baseline-data variability affects the data-comparison accuracy using a local linear trend model, which could accurately predict the intervention effects. The local linear trend model may help assess the intervention effects of effective personalized interventions in precision rehabilitation.

Effects of Paired Associative Stimulation on Cortical Plasticity in Agonist-Antagonist Muscle Representations.

Paired associative stimulation (PAS) increases and decreases cortical excitability in primary motor cortex (M1) neurons, depending on the spike timing-dependent plasticity, i.e., long-term potentiation (LTP)- and long-term depression (LTD)-like plasticity, respectively. However, how PAS affects the cortical circuits for the agonist and antagonist muscles of M1 is unclear. Here, we investigated the changes in the LTP- and LTD-like plasticity for agonist and antagonist muscles during PAS: 200 pairs of 0.25-Hz peripheral electric stimulation of the right median nerve at the wrist, followed by a transcranial magnetic stimulation of the left M1 with an interstimulus interval of 25 ms (PAS-25 ms) and 10 ms (PAS-10 ms). The unconditioned motor evoked potential amplitudes of the agonist muscles were larger after PAS-25 ms than after PAS-10 ms, while those of the antagonist muscles were smaller after PAS-25 ms than after PAS-10 ms. The γ-aminobutyric acid A (GABAA)- and GABAB-mediated cortical inhibition for the agonist and antagonist muscles were higher after PAS-25 ms than after PAS-10 ms. The cortical excitability for the agonist and antagonist muscles reciprocally and topographically increased and decreased after PAS, respectively; however, GABAA and GABAB-mediated cortical inhibitory functions for the agonist and antagonist muscles were less topographically decreased after PAS-10 ms. Thus, PAS-25 ms and PAS-10 ms differentially affect the LTP- and LTD-like plasticity in agonist and antagonist muscles.

Evaluation of flexor digitorum superficialis function in adolescent baseball players.

Hypothesis and/or Background: Increased flexor digitorum superficialis (FDS) tendon activity can be a therapeutic target for elbow disorders in adolescent baseball players. The proportion of adolescent baseball players who can use FDS independently is unknown, and which finger is most often used remains unclear. This study investigated whether adolescent baseball players intentionally used FDS on each finger. Methods: Adolescent baseball players were recruited and assessed for FDS function for each finger using the standard technique. Results: Sixty-nine participants (mean age: 10.4 years) were recruited. Participants numbered 33, 56, 59, and 25 on the throwing side and those numbered 28, 46, 54, and 33 on the nonthrowing side could independently flex the proximal interphalangeal joint while holding their palms in the index, middle, ring, and small fingers, respectively. When assessing both throwing and nonthrowing participants, a significant number of participants could independently flex the proximal interphalangeals of the ring and middle fingers but had difficulty with the index and small fingers (P < .001). No significant difference was noted between the throwing and nonthrowing participants in any finger (P > .05). Discussion and/or Conclusion: One study reported that participating baseball players with elbow pain have more medial elbow joint space than those without pain symptoms. In another study on finger movements during pitching motion, the force of the thumb, index, middle, and ring fingers was greatest immediately before maximum external rotation. According to both reports, FDS function, especially in the index finger, can be a therapeutic target for medial-sided elbow injuries in adolescent baseball players.

Increased medial laxity of the elbow in preadolescent baseball players with or without medial elbow apophysitis.

BACKGROUND: Medial elbow apophysitis is a traction apophysitis observed in the medial epicondyle of the elbow in preadolescent baseball players. The purpose of this study was to determine the relationship between medial elbow apophysitis and elbow valgus instability in preadolescent baseball players. METHODS: The participants were classified into a control group and an injury group; the injury group included participants diagnosed with a medial elbow injury (inclusion criteria were only symptoms of the elbow joint or positive findings on physical examinations, or both). Elbow valgus instability was assessed by measuring the differences in ulnohumeral joint gapping width, with and without gravity stress induced by weight loading of the forearm using ultrasonography. RESULTS: The control and injury groups consisted of 81 and 23 preadolescent baseball players, respectively. In the throwing elbow, valgus instability in the injury group was significantly greater than that in the control group (1.07 vs. 0.57 mm, P = .001). In the non-throwing elbow, valgus instability in the injury group was significantly greater than that in the control group (0.57 vs. 0.37 mm, P = .011). The area under the curve for valgus instability of the throwing elbow was 0.89 mm (95% confidence interval, 0.64-0.77), and the cut-off value for elbow pain appearance was 0.80 mm. CONCLUSION: The increased elbow valgus instability in the injury group was associated with a medial elbow injury. For the elbow valgus instability of the non-throwing side in the injury group, we considered that players with medial elbow apophysitis inherently have elbow laxity.

Relationship between Information and Communication Device Usage and Development of Hand Disorders.

This study examined the association between hand disorders and time spent using information and communication devices. The participants in this study, conducted between January 2017 and 2020, were 150 healthy university students. They were tested for carpal tunnel syndrome and De Quervain's tenosynovitis. Average daily device usage time was found to be 5.76 ± 3.00 (1.9-16.2) h. Smartphones were used the most, followed by personal computers and gaming consoles. However, usage time did not vary significantly by device type. Intensive users were significantly more likely to have De Quervain's tenosynovitis (P < .001), while non-intensive users were significantly less likely to have hand disorders (P < .001) and less likely to have De Quervain's tenosynovitis. These results can form the basis of guidelines for the prevention of information and communication device overuse.

Long-term prognoses of patients with and without re-rupture after arthroscopic rotator cuff repair.

[Purpose] We followed-up patients who underwent arthroscopic rotator cuff repair (ARCR) for 2 years to assess the prognosis of rotator cuff tears and compared the outcomes of the patients with and without re-rupture. We also examined the usefulness of Shoulder36, a self-assessment tool, for assessing the long-term prognosis in patients undergoing ARCR. [Participants and Methods] We included 28 patients who received occupational therapy pre- and post-ARCR between April 2012 and August 2015 and categorized them based on the occurrence of re-rupture. We followed-up on their prognoses for 2 years using physical examination and Shoulder36 assessment. [Results] Re-rupture occurred in five patients within 3 months of treatment. During the 2 year follow-up, the control group showed a significant improvement in pain and bi-directional active range of motion during physical assessment and in five out of six domains during Shoulder36 assessment. In contrast, the re-rupture group showed significant differences for only three domains of the Shoulder36 assessment twelve months after surgery. [Conclusion] We confirmed the long-term functional improvement and maintenance in the re-rupture group, suggesting that continued rehabilitation, compensatory movements, and detailed guidance on daily life activities are required for patients after ARCR. Furthermore, Shoulder36 can be useful for assessing the prognosis of patients with and without re-rupture.

Limitation of the external glenohumeral joint rotation is associated with subacromial impingement syndrome, especially pain.

BACKGROUND: Subacromial impingement syndrome is a common disorder associated with functional impairment and disability of the shoulder. Internal/external glenohumeral rotation is important for shoulder function. However, because it is difficult to measure the glenohumeral joint rotation angle physically, the relationship between this angle and the clinical symptoms of subacromial impingement syndrome is still largely unknown. Using advanced cine-magnetic resonance imaging techniques, we designed a study to improve our understanding of the nature of this relationship. METHODS: We evaluated 100 shoulders with subacromial impingement syndrome. Patients underwent cine-magnetic resonance imaging during axial rotation with the arm adducted. During imaging, patients rotated their shoulder from maximum internal rotation to maximum external rotation over 10 seconds and then to maximum internal rotation over 10 seconds. The rotation angles were then evaluated using a series of axial images. The Constant-Murley (Constant) and UCLA scores for each patient were determined, and the correlation between the scores and rotational angles was assessed. Patients were divided into 3 groups according to the Constant pain score, and the rotational angles of each group were compared. Rotational angles were also compared between shoulders with and without night pain. RESULTS: The external rotation angle showed a significant but low correlation with the Constant and UCLA scores (ρ = 0.24 and 0.24, respectively), whereas the internal rotation angle did not. In comparing the pain groups of Constant score and UCLA score, the external rotation angle significantly decreased as pain increased (P < .01), demonstrating a negative correlation (ρ = -0.47, -0.41, respectively). Additionally, the shoulders of patients with night pain showed significantly more restriction of external rotation angles than the shoulders of those without night pain (P = .01). CONCLUSIONS: Limitation of the glenohumeral joint's external rotation is correlated with pain, for which we explore possible explanations. The results suggest that night pain can be effectively reduced using therapeutic interventions that target external rotational dysfunction.

Long-term effects of combined botulinum toxin treatment and rehabilitation on upper limb muscle spasms: a case report.

[Purpose] We report our experience with a patient with a central spinal cord injury who showed improved finger and upper limb functions after long-term treatment with a combination of rehabilitation and botulinum toxin type A. [Participants and Methods] The patient had spasms and pain that gradually became more profound and was given botulinum toxin type A at 1 year 3 months after sustaining a spinal cord injury. We administered 14 botulinum toxin type A injections periodically for 7 years 4 months after the injury. We administered the injections at an average interval of 5.6 months. Splints that allowed extension and improved finger muscle tone and contracture were made for the patient. [Results] The patient experienced gradual alleviation of the spasms in the proximal upper limb muscles and improved range of motion after receiving five doses of botulinum toxin type A. The spasms and range of motion in the fingers gradually improved around 4 years after the injury through splint therapy and a combination of botulinum toxin type A administration and rehabilitation. [Conclusion] The combination of botulinum toxin type A, splint, and rehabilitation therapies can lead to positive improvements in finger spasticity and range of motion and is recommended for hypertonia cases with severe contractures.

The clinical utility of a decision-aid to facilitate the use of the hand in real-life activities of patients with distal radius fractures: A case study.

BACKGROUND: Occupation-based intervention (OBI) in hand therapy has shown superior benefits in patient-reported performance and physical measures; however, only a few studies have used OBI. We developed a decision-aid to promote the use of an injured hand in the real world (Aid for Decision-making in Occupation Choice for hand; ADOC-H) PURPOSE: To investigate the clinical utility of the ADOC-H (paper version) in patients with distal radius fractures. STUDY DESIGN: A prospective case series and a clinical survey for occupational therapists. METHODS: This study comprised a prospective patient case series of 8 patients with distal radius fractures, treated using Volar locking plates, and a clinical survey of 4 experienced occupational therapists. RESULTS: No patient or therapist complaints or drop-outs were reported. Active range of motion (wrist), Grip strength, and Disabilities of the Arm, Shoulder, and Hand scores improved for all patients. The ADOC-H induced 158 activities using the injured hand, with activities of daily living (69.8%) selected earlier in the treatment period, and instrumental activities of daily living (63.3%) selected later. The feedback and case studies suggested that the ADOC-H was useful for patients who were afraid of using the hand and, interestingly, patients who were able to use their hand without pain or other problems. The clinical survey showed that most therapists found the ADOC-H effective in facilitating real-life use of an injured hand. CONCLUSIONS: The ADOC-H paper version is an useful tool that can be applied to facilitate patients with distal radius fractures to use their injured hands in real-life settings.

A Trial of the Effect of 2-Step Orthosis Treatment for Mallet Finger Fractures.

CONTEXT: Many patients report poor therapeutic outcomes following mallet finger fracture surgery. A more reliable technique is urgently needed. OBJECTIVE: To present a novel treatment for mallet finger fractures using a 2-step orthosis method. DESIGN: Prospective, observational study. SETTING: Hospital. PARTICIPANTS: Patients with mallet finger fractures. INTERVENTIONS: The finger is fixed with splints for 6 weeks, including 3 weeks for the proximal interphalangeal joint in the flexion position and the distal interphalangeal joint in the hyperextension position (first splint) and 3 weeks for the distal interphalangeal joint in the hyperextension position (second splint). Up to week 8, the second splint was attached at night and during physical exertion. MAIN OUTCOME MEASURES: Crawford criteria, Abouna-Brown criteria, bone fusion, grip strength, Doyle classification, Ishiguro classification. RESULTS: Sufficient bone fusion was achieved 12 weeks after fixation; at which time, the range of motion with the distal interphalangeal joint flexed, and extended in the 3 patients was 50° and 0°, 70° and -3°, and 60° and 0°, respectively. The right and left hand grip strengths in the 3 patients were 58 and 55 kg, 62 and 58 kg, and 31 and 29 kg, respectively; there were no problems with respect to function or work. The first 2 patients could start sports again with partial return after 1 week and complete return after 12 weeks and 8 weeks, respectively. For the third patient, rehabilitation was complete after 16 weeks. Evaluation of the fracture sites based on the Crawford criteria showed the condition to be perfect, and evaluation based on the Abouna-Brown criteria showed success. CONCLUSIONS: This method provides satisfactory fixation and can prevent proximal interphalangeal joint contracture. Favorable long-term outcomes were confirmed in all patients, suggesting that this method may be effective for previously untreated mallet finger fractures with little displacement.

A randomized controlled trial of the effect of 2-step orthosis treatment for a mallet finger of tendinous origin.

STUDY DESIGN: A randomized clinical trial, with patients treated either by new 2-step orthosis or by the figure-eight-type orthosis with the distal interphalangeal (DIP) joint extended. PURPOSE OF THE STUDY: To report on our new orthosis and to evaluate the treatment efficacy of using a 2-step orthosis for the treatment of a mallet finger of tendinous origin compared with a conventional orthosis. METHODS: Forty-four patients were randomized into the 2-step or conventional orthosis groups. Primary outcomes were active DIP joint flexion and extensor lag, pain, and the Abouna-Brown criteria. RESULTS: The 2-step orthosis was associated with a smaller active DIP extensor lag, compared with the conventional orthosis (-7.5 ± 4.5° vs -16.4 ± 6.9°, P = .001), combined with a significantly higher Abouna-Brown criteria (χ2 = 14.57, P = .01). No other between-group differences were identified. CONCLUSION: The therapeutic effectiveness of the 2-step orthosis, over a conventional orthosis, was supported by a large effect size of the treatment in improving residual active extensor lag at the DIP and overall Abouna-Brown criteria. Our study thus suggested that the initial immobilization involved in new 2-step orthosis and is thus a good immobilization technique. LEVEL OF EVIDENCE: Ib.

JMA's regional atmospheric transport model calculations for the WMO technical task team on meteorological analyses for Fukushima Daiichi Nuclear Power Plant accident.

The World Meteorological Organization (WMO) convened a small technical task team of experts to produce a set of meteorological analyses to drive atmospheric transport, dispersion and deposition models (ATDMs) for the United Nations Scientific Committee on the Effects of Atomic Radiation's assessment of the Fukushima Daiichi Nuclear Power Plant (DNPP) accident. The Japan Meteorological Agency (JMA) collaborated with the WMO task team as the regional specialized meteorological center of the country where the accident occurred, and provided its operational 5-km resolution mesoscale (MESO) analysis and its 1-km resolution radar/rain gauge-analyzed precipitation (RAP) data. The JMA's mesoscale tracer transport model was modified to a regional ATDM for radionuclides (RATM), which included newly implemented algorithms for dry deposition, wet scavenging, and gravitational settling of radionuclide aerosol particles. Preliminary and revised calculations of the JMA-RATM were conducted according to the task team's protocol. Verification against Cesium 137 ((137)Cs) deposition measurements and observed air concentration time series showed that the performance of RATM with MESO data was significantly improved by the revisions to the model. The use of RAP data improved the (137)Cs deposition pattern but not the time series of air concentrations at Tokai-mura compared with calculations just using the MESO data. Sensitivity tests of some of the more uncertain parameters were conducted to determine their impacts on ATDM calculations, and the dispersion and deposition of radionuclides on 15 March 2011, the period of some of the largest emissions and deposition to the land areas of Japan. The area with high deposition in the northwest of Fukushima DNPP and the hotspot in the central part of Fukushima prefecture were primarily formed by wet scavenging influenced by the orographic effect of the mountainous area in the west of the Fukushima prefecture.

World Meteorological Organization's model simulations of the radionuclide dispersion and deposition from the Fukushima Daiichi nuclear power plant accident.

Five different atmospheric transport and dispersion model's (ATDM) deposition and air concentration results for atmospheric releases from the Fukushima Daiichi nuclear power plant accident were evaluated over Japan using regional (137)Cs deposition measurements and (137)Cs and (131)I air concentration time series at one location about 110 km from the plant. Some of the ATDMs used the same and others different meteorological data consistent with their normal operating practices. There were four global meteorological analyses data sets available and two regional high-resolution analyses. Not all of the ATDMs were able to use all of the meteorological data combinations. The ATDMs were configured identically as much as possible with respect to the release duration, release height, concentration grid size, and averaging time. However, each ATDM retained its unique treatment of the vertical velocity field and the wet and dry deposition, one of the largest uncertainties in these calculations. There were 18 ATDM-meteorology combinations available for evaluation. The deposition results showed that even when using the same meteorological analysis, each ATDM can produce quite different deposition patterns. The better calculations in terms of both deposition and air concentration were associated with the smoother ATDM deposition patterns. The best model with respect to the deposition was not always the best model with respect to air concentrations. The use of high-resolution mesoscale analyses improved ATDM performance; however, high-resolution precipitation analyses did not improve ATDM predictions. Although some ATDMs could be identified as better performers for either deposition or air concentration calculations, overall, the ensemble mean of a subset of better performing members provided more consistent results for both types of calculations.

Development of a cell sheet transportation technique for regenerative medicine.

PURPOSE: A transportation technique for cell sheets is necessary to standardize regenerative medicine. The aim of this article is to develop and evaluate a new transportation technique for cell sheets. MATERIAL AND METHODS: We developed a transportation container with three basic functions: the maintenance of interior temperature, air pressure, and sterility. The interior temperature and air pressure were monitored by a recorder. Human oral mucosal epithelial cells obtained from two healthy volunteers were cultured on temperature-responsive culture dishes. The epithelial cell sheets were transported via an airplane between the Osaka University and Tohoku University using the developed cell transportation container. Histological and immunohistochemical analyses and flow cytometric analyses for cell viability and cell purity were performed for the cell sheets before and 12 h after transportation to assess the influence of transportation on the cell sheets. Sterility tests and screening for endotoxin and mycoplasma in the cell sheets were performed before and after transportation. RESULTS: During transportation via an airplane, the temperature inside the container was maintained above 32°C, and the changes in air pressure remained within 10 hPa. The cell sheets were well stratified and successfully harvested before and after transportation. The expression patterns of keratin 3/76, p63, and MUC16 were equivalent before and after transportation. However, the expression of ZO-1 in the cell sheet after transportation was slightly weaker than that before transportation. The cell viability was 72.0% before transportation and 77.3% after transportation. The epithelial purity was 94.6% before transportation and 87.9% after transportation. Sterility tests and screening for endotoxin and mycoplasma were negative for all cell sheets. CONCLUSION: The newly developed transportation technique for air travel is essential technology for regenerative medicine and promotes the standardization and spread of regenerative therapies.

Regeneration of spermatogenesis after testicular cancer chemotherapy.

PURPOSE: Azoospermia is a common side effect of chemotherapy. Although most patients restore spermatogenesis over time, the exact time course has not been well described. We analyzed the recovery of spermatogenesis in testicular cancer patients following chemotherapy. PATIENTS AND METHODS: 49 patients, consisting of 45 treated with a bleomycin, etoposide and cisplatin (BEP) regimen and 4 with high-dose chemotherapy, were followed up with occasional semen analyses. The primary endpoint of this study was the confirmation of motile spermatozoa in the patients' semen. RESULTS: Among 45 patients treated with BEP, 44 recovered spermatogenesis. The recovery of spermatogenesis was delayed depending on the increase in BEP cycles. In groups of patients who received 1-2, 3 and 4 cycles, the recovery rates of spermatogenesis within 2 year were 83.3, 80.0 and 66.7%, respectively. In the group with 5-6 cycles of BEP, re-spermatogenesis was significantly delayed and no patients re-established spermatogenesis within 2 years. The patients' age and semen parameters before chemotherapy were not useful as predictive factors for the recovery of spermatogenesis. CONCLUSION: The recovery of spermatogenesis was rather fast and was often observed as early as several months after BEP treatment when the number of cycles was <4.

[Dr Leonor Michaelis and early days of Hokkaido University School of Medicine; episodes among three medical researchers in the roaring twenties].

Little has been known about the personal history of Dr. Takaichi Mohri (Nakashima), the first professor of department of hygiene at Hokkaido University School of Medicine. We, therefore, have been inquiring academic backgrounds of Dr. Mohri for two decades. These inquiries show interesting episodes between Dr. Leonor Michaelis, one of the biggest names in enzymologists, and early days of this Medical School. In this article, we describe that at least two professors, Drs. Takaichi Mohri and Kaoru Ohguro, were in good acquaintances with Dr. Michaelis as follows; 1) the latter half of 1921, Dr. Ohguro visited a laboratory of Dr. Michaelis in Berlin, 2) from November 1922 to June 1923, Dr. Michaelis in Nagoya collaborated with Dr. Mohri in Sapporo, 3) Dr. Michaelis in Nagoya visited Dr. Ohguro's house and office in Sapporo at March 1925, and 4) at the same occasion, Dr. Michaelis made his lecture on biochemistry in Hokkaido University School of Medicine. Since Drs. Ohguro and Mohri were classmates of the University of Tokyo Faculty of Medicine, Dr. Ohguro could introduce Dr. Michaelis to Dr. Mohri who used to be a graduate student in department of biochemistry. As a result of relationships, Drs. Michaelis and Mohri published a paper entitled "Eine weitere Methode zur Bestimmung des isoelektrischen Punktes von Eiweisskoerpern und ihre Anwendung auf die Serumalbumine verschiedener Tiere" in Biochemische Zeitschrift, which was a part of Dr. Mohri's Ph.D. thesis.

Effects of 2.5-hour sumo training on serum opsonic activity.

Sumo is a traditional Japanese sport, but the effect of actual daily training on neutrophil function is unknown. We evaluated the effect of sumo training on serum opsonic activity (SOA), which is one of the main neutrophil-related functions. Seventeen male university sumo wrestlers participated in the study. Changes in anthropometric parameters, concentrations of serum immunoglobulins (IgG, IgA and IgM), complements (C3 and C4), myogenic enzymes (lactate dehydrogenase, asparate aminotransferase, alanine aminotransferase and creatine kinase), white blood cell/neutrophil counts and SOA were measured immediately before and after actual daily training for 2.5 h. Compared with the pre-values, immunoglobulins and complements, myogenic enzymes and white blood cell/neutrophil counts significantly increased (p < 0.01 for all). As for SOA, the values of the peak height and the area under the curve significantly increased after the training when assessed using lucigenin as a chemiluminigenic probe (p < 0.01 for all), but showed no significant change when luminol was used as the chemiluminigenic probe. In conclusion, daily actual sumo training for 2.5 h increases SOA, thus possibly activating the reactive oxygen species production of neutrophils.

Effect of reactive oxygen species in semen on the pregnancy of infertile couples.

OBJECTIVE: We intended retrospectively to investigate whether reactive oxygen species (ROS) levels, detected in whole semen, were correlated with the actual pregnancy rate. METHODS: A total of 89 patients with data of ROS in semen, attending our male infertility clinics from April 1994 to June 2000, were evaluated. Semen parameters were determined with computer assisted semen analyzer (CASA) and ROS production levels were measured using a computer-driven LKB Wallac 1251 Luminometer after the addition of 40 microL of 4 mM luminol at the patients' first visits. All of the participants were inquired about their partners' pregnancies after the mean follow-up of 24.0 months (range 1.4 to 74.1). They were divided into two groups (pregnant group: n = 41, non-pregnant group: n = 48) and their characteristics, semen profiles and integrated ROS levels were analyzed. RESULTS: There was no difference between the pregnancy rate of ROS detectable cases and negative cases. However, the mean integrated ROS level in detectable cases of the non-pregnant group was significantly higher than that in detectable cases of the pregnant group (115.61 +/- 74.32 mV/30 min/10(6) sperm versus 7.22 +/- 4.69 mV/30 min/10(6) sperm, P = 0.0033). Then, by calculating the receiver operating characteristics curve with 95% confidence intervals, 4.35 mV/30 min/10(6) sperm was considered as a cut-off value of ROS in semen for pregnancy. CONCLUSION: These results indicate that (i) highly detectable ROS in whole semen of infertile patients may have implications in their partners' pregnancies and that (ii) detection of ROS in whole semen has a prognostic value for idiopathic male infertility.