Side-effects of rinsing fluids on the rat femoral artery. A histological and electron microscopic study.

Rinsing rat femoral arteries with various fluids in experimental conditions similar to those in clinical practice was found to have deleterious effects on the intimal and medial layers of the vessels. No statistically significant difference was found between the effects of Ringer's lactate and normal saline. Heparinized saline produced significantly less damage to the medial layer and less platelet cell deposition. Lignocaine 2% was found to be extremely damaging to the whole vessel wall, and highly thrombogenic. Nevertheless, all the arteries in each group remained patent 4 days after rinsing.

Observations in infertile African males at an andrology clinic in South Africa.

The major cause of infertility among black Africans is traditionally attributed to a female factor and few reports are available on the male factor. This study analyzed the clinical and seminal data obtained from a population of 1726 suspected infertile African men evaluated from July 1985 to June 1991. The possible cause of infertility was judged on the results of first semen analysis. Of these men, 49% were secondarily infertile and 36% had previously received treatment for a urethral discharge. Varicocoeles were present in 183 cases (11%) and 11% had serological evidence of previous exposure to syphilis. Azoospermia was present in 152 patients (9%), 5% had polizoospermia, 45% had hypospermia (< 2 mL) and 9% (> 6 mL) had hyperspermia. In 70% of patients a possible contributing male factor for infertility was found. It would appear that the male factor contributed significantly to infertility, and evaluation of the black African male can therefore be regarded as a rewarding venture.

Urine as an alternative to urethral swabs for the diagnosis of Chlamydia trachomatis in infertile males.

Swabbing the urethrae of men has been the traditional approach for collecting specimens for detection of Chlamydia trachomatis. Recently, however, urine testing using enzyme immunoassay has yielded promising results. A total of 105 patients attending the Andrology Clinic at Ga Rankuwa Hospital, Medunsa were included in the study. These patients were asymptomatic and had no urethral discharge. Three endo-urethral swabs and first-catch urine were collected from each patient. The urethral swabs were used for enzyme immunoassay (EIA) (IDEIA III), tissue culture and direct immunofluorescent antibody (DFA) test (IMAGEN) to detect C. trachomatis. In addition about 15-30 ml of first-catch urine, or urine collected at least 2h after the previous micturition, was collected for each patient for EIA testing. Fifteen (14.3%) of 105 patients were positive on urethral swab EIA, in comparison with the DFA test in which 14 (13.3%) were positive. Eight (7.8%) were positive in tissue culture. Urine EIA was positive in 17 (16.2%) patients, of whom five (4.8%) were positive in urine EIA only. All EIA positive urines were confirmed by DFA. We recommend that first-catch urine or urine collected at least 2h after the previous micturition in infertile males may be considered a suitable alternative to urethral swab for chlamydial diagnosis because it is noninvasive and nontraumatic.

Syphilis serology in men attending the Andrology Clinic at Ga-Rankuwa Hospital.

The worldwide resurgence of syphilis may have serious implications on neonatal morbidity. The aim of this study was to evaluate the seroprevalence of syphilis in men attending an infertility clinic. Blood samples from 782 males were screened using the titrated RPR and TPHA tests. If either of these tests was positive, FTA-ABs IgG was performed. The RPR was positive in 63 (8%) cases. In 24 (3%) patients the titer was 1:8 with positive TPHA and FTA-Abs IgG tests and these were regarded as current infections. Thirty-nine (4.9%) cases had RPR titers 1:8 with positive specific tests. These were probably patients either treated inadequately or in the early stage of primary syphilis. In addition, 92 (12%) patients were RPR negative but TPHA and FTA positive. This was evidence of previous exposure to syphilis. The overall seropositivity in this group was 20% (155 cases). Six hundred and twenty-seven (80%) tested negative with RPR and TPHA. Syphilis may still have a major impact on health in Southern Africa. Since syphilis is significantly associated with HIV seropositivity, efforts to prevent and control syphilis may also be important in limiting the spread of HIV.

Syphilis serology in men at an andrology clinic in South Africa.

PIP: Much attention has recently been given to the serious health implications of AIDS, hepatitis B infection and the human papillomavirus. In spite of these, syphilis/gonorrhea are still the most common of the "old" sexually transmitted diseases (STDs) and syphilis is, with the exception of AIDS, the STD with potentially the most destructive sequelae. Recent observations indicate that syphilis may be an important cofactor in facilitating transmission of HIV. A history of syphilis or a positive serologic test for syphilis is associated with HIV seropositivity in men. Although the incidence of syphilis in the UK is 1 of the lowest in the world, syphilis is increased in most countries. In several areas of the US there has been a dramatic increase in the prevalence of syphilis and in some first-world areas congenital syphilis is now considered epidemic. Syphilis is considerably more common in Africa than in Europe/US. Syphilis is also prevalent in most developing countries. The worldwide resurgence of syphilis has a serious implication on neonatal morbidity. The aim of this study was to evaluate the seroprevalence of syphilis in men attending and infertility clinic. Blood samples from 782 males were screened using the titrated RPR/TPHA tests. If either of these tests was positive, FTA-Abs IgG was performed. The RPR was positive in 63 (8%) cases. In 24 (3%) patients the titer was or= 1/8 with positive TPHA and FTA-Abs IgG tests and these were regarded as current infections. 39 (5%) cases had RPR titers 1/8 with positive specific tests (Table 1). These were probably patients either treated inadequately, or in the early stage of primary syphilis. In addition 92 (2%) patients were RPR negative but TPHA and FTA positive. This was evidence of previous exposure to syphilis. The overall seropositivity in this group was 20% (155 cases). 627 (80%) tested negative with RPR and TPHA. Syphilis may still have a major impact on health in Southern Africa. Since syphilis is significantly associated with HIV seropositivity, efforts to prevent and control syphilis may also be important in limiting HIV spread. The 3-8% incidence of active disease among an asymptomatic group of men, referred for evaluation of infertility underlines the statement that "serologic screening should be done at the least indication". A community-based program with continuous adequate screening and treatment would be of great help. While the absolute yield for such screening may be low, the potential for reducing the morbidity and mortality of congenital syphilis is great. (full text)^ieng

The onset of puberty in Tswana schoolboys: a need for sex education.

Spermaturia can be used as an indicator of genital and sexual maturation in puberty. In this study the mean age of the onset of puberty in Tswana schoolboys was determined. Of the boys between 10 and 13 years, only one (1.22%) aged 13 had spermaturia, compared with 61 boys (88.4%) in the group 14-16 years. The mean age of boys with spermaturia was 14.95 +/- 0.85 years. The possible onset of puberty as calculated by the presence of spermaturia was between 14.10 and 15.80 years. It would seem, therefore, that from the age of 14 years, a boy might theoretically be able to father a child. The need for sex education at school is thus of paramount importance.

[Microbial flora in semen of infertile African men at Garankuwa hospital].

This study was undertaken to determine the frequency of bacteria and Mycoplasmas in semen of infertile African men and to compare abnormal semen parameters with the presence of these organisms. Routine semen analysis were performed on 100 patients, and semen and first-voided urine samples were cultured. Mycoplasma hominis was cultured in 28% of seminal fluid and Ureaplasma urealyticum in 42%. These organisms were both present in 22% of cultures. Bacteriological cultures were positive in 6 urine and 21 seminal specimens. The frequency of tail abnormalities in the Mycoplasma positive group was greater as compared to normal values. From these it would appear that culture for Ureaplasma should probably be performed routinely at the Andrology Clinic.

Melatonin and steroid-dependent carcinomas.

In this study the concentrations of plasma melatonin in patients with either prostatic or breast carcinoma were compared to the levels of controls. The mean melatonin was statistically lower in patients with breast cancer as compared to controls (p less than 0.005). In prostatic carcinoma patients, the mean melatonin was statistically higher than in the control group (p less than 0.005). From the results it would seem that low melatonin levels could possibly play a role in breast carcinoma, but the same did not necessarily applied to prostatic cancer.

Melatonin and sperm motility.

Several substances can interfere with microtubular function eg. colchicine. Melatonin, a hormone secreted by the pineal gland has similar effects as colchicine on microtubules. In this study melatonin levels were determined in both plasma and seminal plasma of patients with good or impaired motility and forward progression. There was no statistically significant difference between the mean plasma and seminal plasma values of patients with good or impaired motility and forward progression. There was no correlation between seminal plasma melatonin and impaired motility or any other semen parameter. There was also no correlation between plasma and seminal plasma concentrations of melatonin. High seminal plasma melatonin concentrations were not necessarily associated with impaired sperm motility. From these it is concluded that seminal plasma melatonin plays no important role in sperm motility.