Adolescent varicocoele management controversies.

Varicocoele is defined as excessive dilatation of the pampiniform venous plexus of the spermatic cord. Varicocoele frequently appears during early puberty and is recognized to be the most common surgically correctable cause of male infertility. However, the actual incidence in adolescents, pathophysiology and the association with male factor infertility all remain somewhat controversial. The most accurate diagnostic technique for identifying young men who will benefit from surgical treatment has yet to be established. Observations of testicular asymmetry and deteriorating semen quality helped establish current guidelines and recommendations for surgical treatment. Further studies, comparing observation with surgical intervention, are needed to refine the current indications for varicocoele repair in the adolescent male.

Mass spectrometric techniques for characterizing low-molecular-weight resins used as paint varnishes.

The molecular structure of three low-molecular-weight resins used as paint varnishes has been characterized by use of an approach based on three different mass spectrometric techniques. We investigated the ketone resin MS2A, the aldehyde resin Laropal A81, and the hydrocarbon resin Regalrez 1094, now commonly used in restoration. To date, the molecular structures of these resins have not been completely elucidated. To improve current knowledge of the chemical composition of these materials, information obtained by gas chromatography-mass spectrometry (GC/MS), pyrolysis-gas chromatography-mass spectrometry (Py/GC/MS), and electrospray ionization mass spectrometry (ESI-Q-ToF) was combined. Analysis, in solution, of the whole polymeric fraction of the resins by flow-injection ESI-Q-ToF, and of the non-polymeric fraction by GC-MS, enabled us to identify previously unreported features of the polymer structures. In addition, the Py-GC/MS profiles that we obtained will help to enhance the databases currently available in the literature. The proposed approach can be extended to other low-molecular-weight resins used as varnishes in conservation.

Fertilization of human oocytes by microinjection of human sperm aspirated from the caput epididymidis of an individual with obstructive azoospermia.

Aspiration of spermatozoa from the caput region of the epididymis was performed, due to obstructive azoospermia. When all inseminated oocytes failed to fertilize in vitro, immotile spermatozoa were microinjected into the perivitelline space to achieve fertilization. Of six oocytes microinjected, one exhibited two normal pronuclei and two polar bodies and was subsequently transferred to a fallopian tube of the wife. One oocyte arrested at syngamy, while two additional oocytes cleaved to four cells each. The remaining two were damaged during microinjection. Although the patient did not conceive, this report provides evidence that (1) spermatozoal motility is not required for successful pronuclear formation when microinjection is performed, and such immotile sperm are not necessarily "dead," and (2) this further corroborates that caput epididymal spermatozoa can participate in the subzonal events of fertilization and that, in the human, exposure of spermatozoa to the distal epididymal milieu may not be a requisite to achieve fertilizing capacity.

Varicocele and its surgical management.

A discussion of the present role of varicocele in the management of the subfertile couple is presented, with emphasis on detection techniques and the increasing awareness of the presence of bilateral varicocele. The indications and techniques of surgical management are discussed, with particular emphasis on the use of the operating microscope to dissect the spermatic cord at the level of the external inguinal ring under local anesthesia on an outpatient basis with significant cost savings to the patient.