Single-center thorough evaluation and targeted treatment of globozoospermic men.

PURPOSE: To characterize, by specific biomarkers and nucleic acid sequencing, the structural and genomic sperm characteristics of partial (PG) and complete globozoospermic (CG) men in order to identify the best reproductive treatment. METHODS: We assessed spermatozoa from 14 consenting men ultrastructurally, as well as for histone content, sperm chromatin integrity, and sperm aneuploidy. Additional genomic, transcriptomic, and proteomic evaluations were carried out to further characterize the CG cohort. The presence of oocyte-activating sperm cytosolic factor (OASCF) was measured by a phospholipase C zeta (PLCζ) immunofluorescence assay. Couples were treated in subsequent cycles either by conventional ICSI or by ICSI with assisted gamete treatment (AGT) using calcium ionophore (Ionomycin, 19657, Sigma-Aldrich, Saint Louis, MO, USA). RESULTS: Ultrastructural assessment confirmed complete acrosome deficiency in all spermatozoa from CG men. Histone content, sperm chromatin integrity, and sperm aneuploidy did not differ significantly between the PG (n = 4) and CG (n = 10) cohorts. PLCζ assessment indicated a positive presence of OASCF in 4 PG couples, who underwent subsequent ICSI cycles that yielded a 36.1% (43/119) fertilization with a 50% (2/4) clinical pregnancy and delivery rate. PLCζ assessment failed to detect OASCF for 8 CG patients who underwent 9 subsequent ICSI cycles with AGT, yielding a remarkable improvement of fertilization (39/97; 40.2%) (P = 0.00001). Embryo implantation (6/21; 28.6%) and clinical pregnancies (5/7; 71.4%) were also enhanced, resulting in 4 deliveries. Gene mutations (DPY19L2, SPATA16, PICK1) were identified in spermatozoa from CG patients. Additionally, CG patients unable to sustain a term pregnancy had gene mutations involved in zygote development (NLRP5) and postnatal development (BSX). CG patients who successfully sustained a pregnancy had a mutation (PIWIL1) related to sperm phenotype. PLCZ1 was both mutated and underexpressed in these CG patients, regardless of reproductive outcome. CONCLUSIONS: Sperm bioassays and genomic studies can be used to characterize this gamete's capacity to support embryonic development and to tailor treatments maximizing reproductive outcome.

Is There a Link Between Carotid Atherosclerosis and Idiopathic Overactive Bladder Among Women with Metabolic Syndrome?

PURPOSE: To evaluate the association between increased intima-media thickness (IMT) and atherosclerotic carotid plaque (CP) with idiopathic overactive bladder syndrome (OAB) in women with metabolic syndrome (MetS). METHODS: This is a cross-sectional study, which included consecutive women aged 40-75 years with MetS, seeking medical assistance at a reference center between April and December 2016. OAB-V8 questionnaire was used to estimate the prevalence of OAB symptoms, which were defined by a score ≥8 points. All patients underwent bilateral carotid artery ultrasound to assess IMT and CP. Atherosclerosis was defined by the identification of CP during ultrasound, which was diagnosed according to the Mannheim carotid intima-media thickness and plaque consensus. RESULTS: Forty-five women were prospectively included. Mean age was 60±9.3 years (range 40-75 ys). Eighteen (40%) patients were diagnosed with OAB. IMT in the general population was 0.72 mm (SD = 0.20). Overall prevalence of atherosclerosis, defined by the presence of the carotid artery plaque, was 51%. OAB prevalence among women with atherosclerosis was higher than in those without atherosclerosis (56.52% versus 22.73%), with a prevalence ratio of 2.49 (p=0.04). Additionally, OAB was associated with degree of carotid stenosis (p = 0.029). CONCLUSION: In this cohort of female patients with MetS, there was an association between carotid atherosclerosis and OAB. Identification of carotid ultrasound abnormalities may lead to refined treatment decision-making among OAB patients.

Anti-dyskinetic effect of the neuronal nitric oxide synthase inhibitor is linked to decrease of FosB/deltaFosB expression.

Rodents with lesion of dopaminergic pathway when receiving repeated l-3,4-dihydroxiphenylalanine (l-DOPA) treatment develop abnormal involuntary movements called dyskinesia. We demonstrated that nitric oxide synthase (NOS) inhibitors mitigate l-DOPA-induced dyskinesia in rodents. The aim of the present study was to verify if the in vivo preferential neuronal NOS (nNOS) inhibitor 7-nitroindazole (7-NI) affect the expression of the transcription factor FosB/ΔFosB in the lesioned striatum, an indicator of neuronal activity associated with dyskinesia. Male Wistar rats with unilateral microinjection (medial forebrain bundle) of either the neurotoxin 6-hydroxidopamine (6-OHDA; n=4-6/group) or saline (sham; n=6/group) were provided with l-DOPA (30mg/kg plus benserazide 7.5mg/kg/day, oral gavage), once a day during 22 days. 6-OHDA-lesioned animals developed abnormal involuntary movements (AIMs) classified as axial, limb, orofacial and locomotive dyskinesia and presented FosB/ΔFosB increase in the dopamine-depleted striatum. Administration of 7-NI (30mg/kg, i.p.), 30min prior to l-DOPA reduced the severity of AIMs (≈65% for axial, limb and orofacial and 74% for locomotive AIMs scores), without interfering with the rotarod performance. Simultaneously, 7-NI attenuated the expression of FosB/ΔFosB in dopamine-depleted striatum (≈65% in medial and ≈54% in lateral striatum, bregma 0.48mm). FosB/ΔFosB expression in lateral striatum was correlated with l-DOPA-induced dyskinesia. The findings described here corroborate a new approach to the management of l-DOPA-therapy in Parkinson's disease (PD) treatment.

Spontaneous poisoning by Leucaena leucocephalai in a goat from Rio de Janeiro State, Brazil

Poisoning of a goat by Leucaena leucocephalai (Leg. Mimosoideae) in the State of Rio de Janeiro, Brazil, is described. Fresh leaves of the plant were ingested as the animal's main meal for at least 4 months before it developed total alopecia. At necropsy the thyroid was moderately enlarged. Histological examination revealed a decrease in the number of hair follicles (empty or in telogenic phase), vacuolation of keratinocytes of the epidermis and hair follicles, and superficial and follicular hyperkeratosis. Myxedema was found between skeletal and cardiac muscles fibers, in the kidneys, and in the submucosa/muscular layer of the digestive tract. The thyroid follicles were enlarged and filled with copious amounts of colloid (colloidal goiter). Although L. leucocephala is common in several tropical regions, natural poisoning by this plant in goats seems to be rare. It is the first report about spontaneous poisoning in goats by L. leucocephala in Brazil.

Este trabalho descreve a intoxicação natural por Leucaena leucocephalai em um caprino, no município de Maricá, RJ. No ano de 1997, o animal ingeriu voluntariamente as folhas da planta fresca como alimentação quase exclusiva, por pelo menos 4 meses, e, aos poucos, foi perdendo os pêlos até tornar-se totalmente alopécico. À necropsia, a tireóide estava moderadamente aumentada. O exame microscópico revelou decréscimo do número de folículos, além de folículos sem pêlos ou em fase telogênica, vacuolização de queratinócitos da epiderme e de folículos e acentuada hiperqueratose superficial e folicular. Havia mixedema entre fibras musculares esqueléticas e cardíacas, no rim e na submucosa, e muscular do trato digestório. Os folículos tireoideanos estavam dilatados e preenchidos por grande quantidade de colóide ("bócio coloidal"). Embora essa planta seja freqüente em várias regiões tropicais, a ocorrência natural dessa intoxicação parece bastante rara e ainda não havia sido descrita em caprinos no Brasil.

Mordedura canina: 140 casos em 6 meses / Dog bites: 140 cases in 6 months

O presente estudo é do tipo série prospectiva de casos e compreendeu 140 pacientes consecutivos atendidos inicialmente na emergência do Hospital do Trabalhador no período de maio a novembro de 2001. Oitenta e quatro por cento dos pacientes procediam da cidade de Curitiba; 65 por cento eram homens. A idade mais atingida foi entre 0 e 10 anos (25,7 por cento), sendo a mediana de 23 anos. Trinta e um por cento dos cäes tinham história anterior de ataque a outras pessoas. A face doi atingida em 31 pacientes (22,1 por cento) sendo 22 (71 por cento) destes, menores de 10 anos.Os membros superiores foram atingidos 102 vezes e o inferior 51. As crianças foram as mais atingidas, sendo o membro superior, membro inferior e face respectivamente os mais afetados. Quinze pacientes (10,7 por cento) necessitaram de internamento para tratamento cirúrgico, demonstrnado maior gravidade em nossa casuística do que o visto na literatura (4 por cento)

Estudo morfofuncional do ducto arterioso em humanos / Morphofunctional study of the ductus arteriosus in man

O arranjo estrutural dos elementos fibrosos que constituem as paredes do ducto arterioso foi estudado, a nível mesoscópico, em 12 coraçoes de fetos humanos juntamente com os vasos da base. Dez peças eram provenientes de natimortos e 2 de nascidos vivos com 5 dias de idade sem malformaçoes cardíacas congênitas. Este material foi analisado por meios de dissecçao fina, com ajuda de lupa estereoscópica, de técnicas histológicas de rotina e de cortes espessos. A parede do ducto arterioso é composta de três camadas: adventícia, média e íntima. Nos natimortos, a adventícia está formada por feixes de fibras colágenas semicirculares e oblíquas; a média está constituída por fibras musculares lisas, com trajetória predominantemente semicircular e oblíqua, em forma de espirais, envolvidas por feixes colágenos e redes de fibras elásticas. A íntima consiste de uma camada endotelial e de delicadas fibras colágenas e elásticas. Nos natimortos, a túnica média é pobre em fibras musculares lisas e está constituída principalmente de tecido fibroso. A parte profunda da túnica média mostra uma proliferaçao de fibras colágenas e elásticas, que acarretam a diminuiçao da luz do ducto. Estes resultados demonstram que o dueto arterioso tem um substrato morfológico capaz de, ao se contrair, obliterar a luz do vaso e em seguida, através, principalmente, da proliferaçao do tecido fibroso de sua parede, causar o fechamento anatômico ou definitivo do ducto, interrompendo o fluxo sanguíneo entre o tronco pulmonar e a artéria aorta.

Anatomia funcional da junção entre o átrio esquerdo e as veias pulmonares / Functional Anatomy of the Junction Between the Left Atrium and The Pulmonary Veins

PURPOSE--To study the spatial arrangement of the bundles of myocardial fibers presents in the left atrial-venous junctions and in the wall of the pulmonary veins. METHODS--The study was made on 24 human adult hearts, together with pulmonary vessels, fixed in 10 per cent formaldehyde solution. Each specimen was cleared of remnants of pericardium to expose the myocardial fibers as clearly as possible. Particular attention was paid to the atrial-venous junction and the extension of the myocardial fibers in the pulmonary veins. The specimens were embedded in celloidin and cut serially at a thickness of 70 mu and stained by methods of Azan's trichrome. RESULTS--The myocardial bundles leave the atrial wall around the openings of all pulmonary veins forming a sphincter-like structure. These fibers are continuous in the adventitial coat running in oblique or spiral directions. Some bundles, more external, leaving from the atrial wall, surround the ostium of the veins and return to the atrium, forming true loops. CONCLUSION--The extremities of the pulmonary veins and their junctions with the atrium have a morphological substract which may be of physiological importance in the control of the pulmonary venous pressure and blood flow