Seminal fibronectin-like antigen and transferrin concentrations in infertile and fertile men

Summary.  Fibronectin like antigen (Fn) and transferrin (Trs) levels were measured in the seminal plasma of 40 fertile and 102 infertile men. The concentrations of both proteins were significantly ( P <0.001) higher in the fertile controls compared to the infertile groups. The levels of Fn and Trs (mean value ± SEM) in the fertile men were 857.9 ± 9.8 μg ml^-1 and 164.0 ± 6.5 μg ml^-1, respectively; in the azoospermic men ( n = 17) 552.7 ± 24.65 μg ml^-1 and 20.7 ± 2.19 μg ml^-1, respectively; in the group of severe oligozoospermia ( n = 35) 568.34 ± 25.7 μg ml^-1 and 31.1 ± 4.18 μg ml^-1, respectively; in the moderate oligozoospermic group ( n = 8) 572.50 ± 47.9 μg ml^-1 and 43.4 ± 15.4 μg ml^-1 respectively, and in the asthenozoospermic group ( n = 26) 512.76 ± 40.4 μg ml^-1 and 47.0 ± 7.9 μg ml^-1, respectively. Of special interest was the finding from a group of 16 normospermic men (partners of couples with unexplained infertility) who showed significantly lower levels of Fn like antigen, 632.5 ± 26.9 μg ml^-1 ( P <0.001) and Trs 41.8 ± 6.94 μg ml^-1 ( P <0.0001) compared to normals. No correlation was found between Fn levels with either Trs or FSH levels or sperm count. In conclusion, our results indicate that male infertility is associated with changes in seminal plasma Fn like antigen concentrations and that it can be possibly used as an index of sperm fertilizing capacity.     

Use of a novel non-steroidal anti-inflammatory drug, nimesulide, in the treatment of abacterial prostatovesiculitis

Summary. Nimesulide, a novel non-steroidal anti-inflammatory drug, was used in cases of abacterial prostato-vesiculitis. Thirty patients with a mean age of 33.7 years (range 18–58) were studied. Nimesulide was administered orally 100 mg b.i.d. for three cycles of 10 d each. Dysuric symptoms, semen analysis, and transrectal ultrasound were examined during the study. The concentration-time curves of nimesulide (NIM) and its metabolite, hydroxynimesulide (OH-NIM) in seminal fluid were also evaluated after single oral administration (100 mg) using an HPLC technique. Following administration of the drug, the Cmax was reached in seminal fluid at the second hour for NIM (with a mean value ± SD of 0.58 ± 0.13 μg ml⁻¹) and at the fourth hour for OH-NIM (2.98 ± 0.38 μg ml⁻¹). Maximal seminal fluid concentrations compared to blood plasma levels were observed at the fourth hour for both substances (31.73 ± 2.34% for NIM; 31.87 ± 8.66% for OH-NIM.
Dysurie symptoms were relieved in 20 (66%) patients. A clear amelioration of inflammatory signs were observed at transrectal ultrasound evaluation in 16 (54%) patients. No statistically significant changes of sperm count and motility in the whole sample were observed, while a significant reduction in the number of abnormal forms occurred. From these results, nimesulide appears to be an effective anti-inflammatory drug with a good diffusion into the genital apparatus and low side-effects.     

Correlation between neutral alpha-glucosidase activity and sperm DNA fragmentation

To evaluate the association between neutral α-glucosidase (NAG) activity and sperm DNA fragmentation (DFI), ejaculates from 24 men undergoing evaluation for sperm DNA damage as a part of infertility assessment were analysed. The mean ± SD and range for the semen quality of the 24 ejaculates are as follows: volume (3.1 ± 1.3, 1.8–6.0 ml); sperm concentration (45.6 ± 41.1, 1.3–151.2 × 10⁶ ml⁻¹); sperm motility (52.8 ± 28.8, 1–95%); sperm with fragmented DNA (17.6 ± 15.4, 1.7–56.0%); sperm with immature chromatin (9.6 ± 3.8, 2.5–19.1%); NAG activity (37.9 ± 18.3, 4.4–75.3 mU ml⁻¹). The only sperm parameter significantly correlated with neutral α-glucosidase is the percentage of sperm DFI [correlation coefficient ( r ) = 0.4376, P  = 0.03].     

The influence of sperm/zona pellucida collision rates on zona binding

Summary. The satisfying success rates reported with intra-cytoplasmic sperm injection (ICSI) urged clinicians and scientists to re-address the emphasis in the management of the male factor patient towards gamete manipulation in order to circumvent the underlying problem causing fertilization failure. We have designed a study to (i) calculate the collision rate of a sperm population with the human zona pellucida, using a mathematical hypothesis and (ii) use the calculated collision rate to evaluate subsequent zona binding results obtained under hemizona assay conditions. Microdroplets were used to co-incubate sperm and human oocytes in order to evaluate zona binding. Using microvolumes, the track followed by sperm, as well as the maximum distance travelled were employed to calculate the collision rate of sperm and zona pellucida. The sperm concentrations of swim up samples were adjusted to 4 × 10⁶ and 0.8 × 10⁶ sperm ml⁻¹. Five separate droplets each of 20 μl containing 4 × 10⁶ sperm ml⁻¹ (80000 motile sperm) and 200 μl containing 0.8 × 10⁶ sperm ml⁻¹ (160000 motile sperm), respectively, were prepared. Both volumes were incubated for 18 h at 37°C. The mean (±SD) number of spermatozoa tightly bound to hemizona, incubated in 20 μl and 200 μl sperm droplets, was 2444±612 and 548±315, respectively ( P = 0.0001). The results can be used as a guideline to calculate the optimum insemination concentration needed for a specific sperm population to ensure the maximum collision rates with the oocyte.     

Relationship of sperm superoxide dismutase-like activity with other sperm-specific enzymes and experimentally induced lipid peroxidation in infertile men

Summary. Superoxide dismutase-like activity (SOD-like), isoenzyme lactate dehydrogenase-C4 (LDH-C4) and NADH-diaphorase activities in spermatozoa have been investigated from 58 normozoospermic and 27 oligozoospermic men. Significantly higher SOD-like, LDH-C4 and diaphorase activities ( P <0.01, P <0.005 and P <0.0001, respectively) were detected in spermatozoa from oligozoospermic men, compared to the activities found in normozoospermic samples. SOD-like activity (mean±SE) in oligozoospermic samples amounted to 8.3±1.6 U 10⁻⁸ spermatozoa, while in spermatozoa in normozoospermic men with a sperm concentration above 20 million of spermatozoa per ml amounted to 4.2±0.5 U 10⁻⁸. There was a close correlation between the SOD-like activity and biochemical indicators of the presence of residual cytoplasm i.e. isoenzyme LDH-C4 and NADH-diaphorase (r = 0.53 and r = 0.66 in normozoospermic and r = 0.63 and r = 0.54 in oligozoospermic men, respectively). A positive relationship between SOD-like activity and experimentally-induced lipid peroxidation was detected in 54 infertile men (r = 0.30; P <0.05). These findings suggest that a higher level of superoxide dismutase-like activity may reflect a defect in the development or maturation of spermatozoa and, thereby, a decreased fertility potential. Hence, determination of SOD-like activity may give information on the state of maturity of human spermatozoa, while its role in the antioxidative protection remains to be determined.     

L- carnitine in idiopathic asthenozoospermia: a multicenter study

Summary. The aim of the study described here was to evaluate any possible effect of L-carnitine on spermatozoal motility in a group of patients with unexplained asthenozoospermia in four different infertility centres. One hundred patients received 3 g d⁻¹ of oral L-carnitine for 4 months. Sperm parameters were studied before, during and after this treatment. Motility was also studied by means of a computer-assisted sperm analysis.
The results of the study indicate that L-carnitine is able to increase spermatozoal motility, both in a quantitative and in a qualitative manner (per cent motile spermatozoa increased from 26.9±1.1% to 37.7 ± 1.1% [ P < 0.001]; per cent spermatozoa with rapid linear progression increased from 10.8 ± 0.6% to 18.0 ± 0.9% [ P < 0.001]; mean velocity increased from 28.4 ± 0.6 μm s⁻¹ to 32.5 ± 0.8 μm s⁻¹ [ P < 0.001]; linearity index increased from 3.7 ± 0.1 to 4.1±0.1 [ P < 0.001], especially in the subgroup of patients with poor rapid linear progression of spermatozoa (per cent of motile spermatozoa increased from 19.3± 1.9% to 40.9± 1.4% [ P < 0.001], and per cent of spermatozoa with rapid linear progression increased from 3.1±0.4% to 20.3±1.6% [ P < 0.001]) An increase in spermatozoal output was also observed (total number of ejaculated spermatozoa increased from 142.4 ± 10.3 10⁶ to 163.3 ± 11.0 × 10⁶ [ P < 0.001]). The authors conclude that oral administration of L-carnitine may improve sperm quality at least in patients with idiopathic asthenozoospermia.     

The duration of action of mivacurium is prolonged if preceded by atracurium or vecuronium

We studied 45 patients (ASA I-II) during propofol-alfentanil-N₂O-O₂ anaesthesia to determine if recovery from neuromuscular block induced by mivacurium is influenced differently by prior injection of atracurium or vecuronium. Neuromuscular function was monitored by adductor pollicis EMG. Patients were randomized to receive two dosesof either mivacurium (150 and 70 μg kg^-1), atracurium (350 and 75 μg kg^-1) or vecuronium (70 and 15 μg kg^-1) followed by a final dose of mivacurium 70 μg kg^-1. The second and third doses of the muscle relaxants were administered at 25–30% recovery of the E₁ (first EMG response in the train-of-four series). Following the final dose of mivacurium, the EMG response recovered to 25 and 95% in 10.4±3.9 and 19.7±5.7 min (mean±SD), respectively, if mivacurium was the only muscle relaxant. Respective times were 100% longer if mivacurium had been preceded by atracurium (23.8 ± 3.3 and 39.8±6.9 mm) or vecuronium (22.6±3.5 and 44.1 ±7.9 min) ( P =0.000l). The 25–75% recovery times in the three groups were 4.9±1.0, 8.7±2.4 and 10.5±2.5 min, respectively ( P =0.0001). Our results indicate that there is no benefit in giving mivacurium at the end of surgery after peroperative use of atracurium or vecuronium.     

Effect of natural antioxidants, superoxide dismutase and hydrogen peroxide on capacitation of frozen-thawed bull spermatozoa

Summary.  Bovine spermatozoa from frozenthawed semen are sensitive to lipid peroxidation. Vitamin E protects sperm membrane against oxidative damage. Sperm capacitation produces structural changes on the plasma membrane. Reactive oxygen species could be involved in the capacitation process. The aim of this work was to study the influence of natural antioxidants on the plasma membrane and the influence of reactive oxygen species during bovine sperm capacitation. Sperm samples were frozen in a standard diluent, with and without vitamin E (1 mg ml^-1). Heparin (60 μg ml^-1) was used as a sperm capacitation inductor. Sperm capacitation was evaluated by chlorotetracycline assay. Lipid peroxidation was determined by the 2-thiobarbituric acid assay. A diminution of thiobarbituric acid reactive substances was observed in sperm samples frozen with vitamin E ( P < 0.05). The addition of vitamin E to the freezing diluent had no effect on the capacitated pattern ( P > 0.05).
When vitamin E and vitamin E + vitamin C were added to the capacitation medium, a significant decrease in the percentage of capacitated spermatozoa ( P < 0.05) was observed in both cases. The addition of superoxide dismutase (0.1 mg ml^-1) or H₂O₂ (50 μM) in the incubation medium, decreased the percentage of capacitated spermatozoa ( P < 0.05). Vitamin E protects the plasma membrane against lipid peroxidation during sperm capacitation, and the presence of superoxide anion would be necessary for frozen-thawed bull sperm capacitation.     

Potency and maintenance requirement of atracurium and vecuronium given alone or together

A synergism exists between some competitive muscle relaxants. However, maintenance requirement of a combination of muscle relaxants has been evaluated only in paediatric patients. We studied 45 elective adult surgical patients (ASA I-II) during propofol-alfentanyl-N₂O-O₂-anaesthesia. The first 30 patients were randomized to receive either atracurium or vecuronium to create individual dose-response curves for these muscle relaxants. ED₉₅-values for atracurium and vecuronium were 260±9 and 59±3 μg · kg^-1, respectively (mean±s.e.mean). Requirements of atracurium and vecuronium to maintain an 85–95% neuromuscular blockade were 301 and 83 μg kg^-1 h^-1, respectively. An additional 15 patients received a combination of atracurium and vecuronium (cAV) in an equipotent dose ratio. An ED₉₅ of a cAV was 94± 7 μg · kg^-1 of atracurium together with 21±2 μg · kg^-1 of vecuronium, or 72±6% of one ED₉₅ dose of a parent agent. Potentiation was significant ( P =0.0001). A maintenance requirement of a cAV was 120 μg kg^-1 h^-1 of atracurium together with 27 μg kg^-1 h^-1 of vecuronium. Thus, a significant potentiation was maintained also during the course of anaesthesia. A cAV had an effect like one intermediate-acting agent. If a cAV is used instead of using atracurium or vecuronium alone, the maximal reduction of drug consumption would be approximately 30%.     

Human sperm acrosin activity with relation to semen parameters and acrosomal ultrastructure

Summary. It was suggested that although not related to the standard semen parameters the level of the acrosin enzyme system is related to the fertility potential in men. Recently a simple clinical assay for total acrosin level was recommended for routine semen analysis. The improved clinical assay was analysed on the freshly liquified semen of 198 Astheno-teratozoospermic men and compared with the routine semen parameters including biochemical data and the ultrastructure of the acrosome. Only the sum of the per cent of live, motile, and normal-shaped spermatozoa had positive significant and reasonably high correlation with the acrosin level ( r = 0.382, P < 0.0001). Each characteristic exhibits significant but low (< 0.35) correlation. Similarly negative significant and reasonably high correlation was obtained between the acrosin level and the sum of the principle acrosomal malformations observed by TEM ( r = 0.396, P < 0.0001) while lower negative correlation was found only with agenesis or loss of the acrosome. Acrosin levels below 8.1 μIU 10⁻⁶ cells were obtained in 4 specimens with above 80% round-form associated with more than 95% of agenesis of the acrosome. The possible significance of the low correlation obtained between the acrosin levels and seminal plasma zinc levels, malformations in the acrosomal equatorial region, and the presence of white blood cells is also discussed. We concluded that the acrosin activity reflects an aspect of male fertility which is not diagnosed by the routine semen analysis or by the ultrastructure of the acrosome, and is therefore a useful diagnostic sperm parameter.     

Gonadal and Extragonadal Sperm Reserves of the Brazilian Nelore Zebu (Bos indicus)

Summary: Gonadal and extragonadal sperm reserves were estimated through hemocytometric method in six Nelore zebu bulls, aging 4–6 years, with normal spermatogenesis, and kept at sexual rest. Gonadal sperm reserve was estimated to be 47.8 ± 5.8 times 10⁶ sperm cells/g testis parenchyma and 9.8 ± 1.7 times 10⁹ sperm cells/testis. Using a time divisor of 4.94 days the daily sperm production was estimated to be 10.0 ± 0.9 times 10⁶ sperm cells/g testis parenchyma/day and 2.0 ± 0.3 times 10⁹ sperm cells/testis/day. Epididymal sperm reserve amounted 11.9 ± 1.6 times 10⁹ spermatozoa/organ, distributed as follows: 35.3 ± 3.6% in the head, 16.9 ± 1.7% in the body and 47.7 ± 3.7% in the tail.
Zusammenfassung: Gonadale und extragonadale Spermareserven des brasilianischen Nelore-Zebu (Bos indicus)
Bei sechs Nelore-Zebubullen im Alter von vier bis sechs Jahren mit normaler Spermatogenese und unter sexueller Karenz wurden mit einer haemocytometrischen Methode die gonadalen und extragonadalen Spermareserven bestimmt. Für die gonadale Spermareserve wurden Werte von 47.8 ± 5.8 times 10⁶ Spermatozoen/g Hodenparenchym und 9.8 ± 1.7 times 10⁹ Spermatozoen/Hoden gefunden. Unter Benutzung eines Zeitdivisors von 4.94 Tagen berechnet sich die tägliche Spermaproduktion zu 10.0 ± 0.9 times 10⁶ Spermatozoen/g Hodenparenchym/Tag und 2.0 ± 0.3 times 10⁹ Spermatozoen/Hoden/Tag. Die Spermareserve im Nebenhoden betrug 11.9 ± 1.6 times 10⁹ Spermatozoen/Nebenhoden in folgender Verteilung: 35.3 ± 3.6% im Nebenhodenkopf, 16.9 ± 1.7% im Nebenhodenkörper und 47.7 ± 3.7% im Nebenhodenschwanz.     

Experimental hypercholesterolaemia in rabbits. Effect on lipid domains in homologous spermatozoa

Summary. The distribution of membrane filipin sterol complexes (FSC) in the plasma membrane of the acrosomal region (PMAR) of rabbit sperm from epididymis and testis, in normal and hypercholesterolaemic rabbits, was examined at ultrastructural level. Membrane FSC were quantitatively analysed on freeze fracture replicas of filipin-treated cells. Cauda epididymal sperm shows a significant increase in filipin sterol complexes concentration in PMAR of hypercholesterolaemic animals compared to normal rabbits. Hypercholesterolaemic animals had 0.53±0.08 FSC μm⁻² in the marginal segment of PMAR and 0.26±0.03 FSC μm⁻² for normal animals. In the principal piece we found 0.70±0.07 FSC μm⁻² for hypercholesterolaemic and 0.43±0.03 FSC μm⁻² for control animals. We also counted 0.58±0.04 FSC μm⁻² in the equatorial segment of PMAR for hypercholesterolaemic and 0.38±0.03 FSC μm⁻² for normal animals respectively. The FSC concentration of testicular sperm, like sperm from corpus and caput of epididymis in hypercholesterolaemic animals, did not differ from the controls. Cholesterol, phospholipids and cholesterol: phospholipid ratio in caudal epididymal sperm from treated males did not differ from controls. Only the sphingomyelin concentration decreases in cauda epididymal sperm from hypercholesterolaemic males compared to controls.
The results presented in this paper suggest that the lipidic domains in PMAR of hypercholesterolaemic rabbits changes when the gametes go through the epididymis.—     

Endothelin-1 affects AVP-stimulated cAMP but not ANP-induced cGMP productions in cultured rat IMCD cells

Summary: The present study was undertaken to explore a potential interaction of endothelin-1 (ET-1) on vasopressin (AVP)-dependent cyclic 3',5'-adenosine monophosphate (cAMP) and atrial natriuretic peptide (ANP)-dependent cyclic 3',5'-guanosine monophosphate (cGMP) metabolisms in primary cultured rat inner medullary collecting duct (IMCD) cells. Endothelin-1 did not affect ANP-stimulated cGMP accumulation in the presence or absence of 3-isobutyl-1-methylxanthine (IBMX). Levels of 10⁻¹⁰ to 10⁻⁷ mol/LET-1 showed a dose-dependent inhibition of the AVP-dependent cAMP accumulation in the presence of IBMX and 10⁻⁷ mol/LET-1 inhibited the cAMP generation by 34 ± 5.3% ( n = 5, n = 20, P <0.01). Endothelin-1 did not affect the cAMP generation either by 100 ng/mL cholera toxin or by 10⁻⁴ mol/L forskolin. Endothelin-1 failed to inhibit the cAMP generation in the presence of 100 ng/mL pertussis toxin (PTX). the inhibitory effect of ET-1 was reversed by 10⁻⁸ mol/L staurosporin (SSP), a protein kinase C (PKC) inhibitor. Furthermore, this inhibitory effect of ET-1 was mimicked by 10⁻⁸ mol/L phorbol 12-myristate 13-acetate (PMA), an activator of PKC. A dose of 5 × 10⁻⁶ mol/L indomethacin did not affect this inhibitory effect of ET-1. From these results, we suggest that the effect of ET-1 on cyclic nucleotides metabolism seem to be selective. Endothelin-1 did not affect the cGMP generation by ANP, whereas it inhibited cAMP production by AVP via PTX and SSP sensitive pathway in cultured rat IMCD cells.     

Sperm morphology and male urogenital infections

Summary. The aim of this study was to investigate the influence of urogenital infections as indicated by leukocytospermia on human sperm morphology, diagnosed cytologically and by means of a leukocyte peroxidase test. A basic semen analysis, including a leukocyte peroxidase test, was prospectively performed on 150 consecutive semen samples. Cytology smears were microscopically investigated for the presence of WBC and the results expressed on a 4 point scale as ± to + + + WBCs/high power field (HPF). ROC curve analysis indicated that for cases with more than ± WBC/HPF the peroxidase determined WBC count cut-off value was >0.25 times 10⁶ WBC ml⁻¹ with a sensitivity of 75% and specificity of 90%. The presence of more than ±WBC/HPF was negatively correlated with sperm morphology characteristics studied. The mean (±SD) percentage of morphological normal spermatozoa was 7.0% (SD 4.4) in the WBC negative group ( n =134) compared to 4.3% (SD 3.5) in the WBC positive ( n =16) group ( P <0.0001). There was also an associated increase, 15.3% (SD 13.3) to 23.6% (SD 13.8), in the percentage of spermatozoa with elongated head forms in the WBC positive group ( P =0.0218). No other effect on sperm and acrosome morphology could be found. With the peroxidase determinations there was also a tendency in the WBC positive group ( n =10) towards poorer sperm morphology characteristics, but these changes were not statistically significant. The presence of urogenital infections as diagnosed cytologically was associated with statistically poorer sperm morphology characteristics. This statistical relationship was not found in the peroxidase diagnosed leukocytospermia positive groups.     

Lack of effect of flumazenil on the reversal of propofol anaesthesia

Propofol, like the benzodiazepines, activates the GABA_A receptor-chloride ionophore complex; they potentiate one another. Since neither pharmacodynamic nor pharmacokinetic data concerning drug interaction between flumazenil and propofol is available, and especially considering the relationship of binding sites, flumazenil, the antagonist of benzodiazepines, was investigated to determine its effect upon recovery from propofol anaesthesia. Forty women receiving dilatation and curettage procedures were included in this double-blind test. After 50 μg fentanyl, propofol 2 mg · kg^-1 was injected for induction and followed by infusion at the rate of 15 mg · kg^-1 · hr^-1. After the operation, patients were given normal saline (Group A) or flumazenil 10 μg · kg^-1 (Group B) randomly.
Recovery time in Group A was 15.2±5.1 min and Group B 15.8±4.8 min. Propofol concentrations at the end of infusion were 4.17±1.33 μg ·ml^-1 (Group A) and 4.03±1.45 μg · ml^-1 (Group B); these then declined to 1.22±0.17 μg · ml^-1 (Group A) and 1.18±0.15 μg · ml^-1 (Group B) when patients were able to open their eyes on command. No significant differences were found between the groups based on propofol concentrations and recovery time, nor did haemodynamic changes differ between them after administration of reversal agents. It was concluded that flumazenil 10 μg · ml^-1 does not influence recovery from propofol anaesthesia.     

Relation of human sperm acrosin activity and fertilization in vitro

The aim of the study described here was to determine the possible contribution of the acrosin activity test to routine semen analysis in enhancing the precision of the prognosis of IVF success in a group of patients in which the contribution of the egg factor to infertility was ruled out (20 cases) compared to a control IVF group (39 cases). Semen analysis, acrosin activity and acrosome ultrastructure were determined for all semen samples. The group with high fertilization rates was comprised of normozoospermic patients while the group with low fertilization rates was comprised of astheno-teratozoospermic patients. The mean acrosin level of the positive IVF group was significantly higher than that of the negative group (51.7 ± 33.2 and 28.6 ±13.7, respectively). Two parameters: per cent motile spermatozoa and acrosin level, were found to have a significant positive correlation with subsequent successful IVF ( r = 0.36, P < 0.006; r = 0.37, P < 0.004, respectively); and agenesis of the acrosome was found to have a significant negative correlation ( r = -0.33, P < 0.01). The ability of these parameters to correctly predict fertilization success was 59%, with 5% false positive, among which 15.4% was predicted solely by the acrosin level (above 54 μIU 10⁶ cells⁻¹) and 23% solely by per cent motile spermatozoa (above 50%). Abnormalities of the acrosome ultrastructure did not contribute further to the correct classification. The apparent clinical benefit of the acrosin level test is discussed.     

Mast cells in the seminal plasma of infertile men as detected by flow cytometry

Increased numbers of mast cells (MCs) in the testis have been associated with testicular dysfunction, where accumulation of MCs occurs. Furthermore, it has been reported that MCs might affect sperm function as it has been demonstrated that MC-derived tryptase in the seminal fluid might reduce sperm motility. Although MCs have been detected in rat epididymis, only little is known about the presence of MCs in human seminal plasma. Thus, we analysed MC numbers in the ejaculate of men during routine semen analysis of male patients suspected for infertility ( n  = 100). MCs were detected by c-kit (CD117) expression using flow cytometry. Thereby, we detected significant numbers of MCs in the ejaculate of most patients (559 ± 525 MCs ml⁻¹, mean ± SD). However, we could neither detect a correlation with respect to MCs and sperm count, motility or morphology nor to the seminal inflammatory markers like polymorphonuclear elastase. Nevertheless, a significant correlation of MCs to spermatozoa-bound IgA ( r  = 0.5; P  = 0.03; n  = 21) was observed. It is concluded that significant numbers of MCs can be detected in the human ejaculate without necessarily influencing sperm function. A potential role of MCs in seminal plasma as well as the association between MCs and IgA on spermatozoa remains to be elucidated.     

A Prospective Comparative Trial of a Gonadotropin-Releasing Hormone Analogue with Clomiphene Citrate for the Treatment of Oligoasthenozoospermia

Background: We undertook a prospective trial to compare the efficacy and adverse effects of a gonadotropin releasing-hormone analogue (CnRHa) and clomiphene therapy for idiopathic normogonadotropic oligoasthenozoospermia (INOA).
Methods: Between January and December 1995, 44 newly-diagnosed INOA patients were randomly allocated to treatment with GnRHa or clomiphene citrate. Efficacy was assessed by measuring changes in semen parameters prior to and after 3 months of treatment. Twenty-three INOA patients underwent GnRHa therapy with 15 μg of diluted buserelin acetate given once a day intranasally, and 21 INOA patients were treated with 50 μg of clomiphene citrate daily by oral administration.
Results: The mean sperm density in the GnRHa group increased from 1 6.1 times 10⁶/mL to 26.9 times 10⁶/ml(P < 0.05), while the mean sperm density did not change significantly in the group treated with clomiphene. Similarly, the mean sperm motility increased from 35.9% to 43.9% in the GnRHa group (P < 0.05), but did not significantly change in the clomiphene group. No adverse effects were observed in either group.
Conclusion: This GnRHa treatment protocol can be administered as an outpatient and is hoped to benefit INOA patients.     

Effect of inotropic stimulation on the synchrony of left ventricular wall motion in a dog model of myocardial stunning

Background: Reperfusion after short coronary occlusion induces regional myocardial dysfunction ("stunning"), including asynchrony of left ventricular (LV) wall motion. Contractile function of stunned myocardium can be increased by inotropic stimulation, but whether this has an influence on wall motion asynchrony is unknown.
Methods: In six anaesthetized dogs, the effect of inotropic stimulation on regional myocardial function, and LV asynchrony was tested after the induction of regional stunning (by 15 min of left circumflex artery side branch occlusion). Regional myocardial function was assessed as mean systolic wall thickening velocity (υ_swt) by sonomicrometry in the stunned (posterobasal wall) and normal myocardium (anteroapical wall), and LV asynchrony by the phase difference (φ) of the first Fourier transform of the wall thickness signals.
Results: In the stunned myocardium, υ_swt decreased from 8.6±1.0 to 1.7±1.4 mm s^-1 (mean±SEM), P <0.01, and simultaneously φ increased from 10.8±3.6 to 85.7±14.3°, P <0.01. Intra-coronary noradrenaline (NADR, 0.25 μg) improved υ_swt (8.3±1.4 mm s^-1, P <0.01) in the stunned region and changed φ to -38.1±18.0°, P <0.05. Systemic NADR (5 μg) also increased υ_swt of the stunned region (to 3.8±2.1 mm s^-1, P <0.05), but left φ unchanged (82.9±19.8°).
Conclusion: Regional function of stunned myocardium can be augmented by inotropic stimulation with noradrenaline, but this does not result in an improvement of LV wall motion asynchrony during systemic inotropic stimulation.     

Increased levels of interferon-gamma in seminal plasma of infertile men

Summary. The role of the cell-mediated immunity in male infertility is still far from clear. Interferon-gamma (INF-γ), a secretory product of activated T cells and natural killer cells, has been hypothesized to have a toxic effect on sperm function. The presence of INF-γ was investigated in seminal plasma of fertile and infertile subjects, using a specific enzyme-linked immunosorbent assay, in order to study its role in male infertility. Forty-one subjects were studied; 20 had proven fertility and normal semen quality (fertile group) and 21 showed male infertility for at least 2 years and poor semen quality (infertile group). INF-γ was present in significantly higher levels in the seminal plasma of infertile subjects (6.36±0.72 fmol ml⁻¹) compared to fertile subjects (3.68±0.30 fmol ml⁻¹). Moreover, a significant negative correlation between INF-γ levels and sperm count, motility and morphology was detected, whereas no correlation between INF-γ levels and leukocyte count was found. These findings (i) confirm INF-γ to be present in seminal plasma; (ii) show increased INF-γ secretion in the infertile group; (iii) demonstrate negative correlations of INF-γ with the main spermiogram parameters and (iv) no correlation with leukocyte count. INF-γ may therefore play an important role in male infertility.
Seminal plasma—