A study on the association between serum amyloid A and sperm concentration

Our aim was to compare peripheral blood and seminal fluid serum amyloid A (SAA) protein levels in men classified on the basis of sperm concentration and investigate whether SAA protein is an important marker of male infertility. A total of 74 first‐attempt IVF male partners of infertile couples classified as azoospermic (n = 25), oligozoospermic (n = 25) and normozoospermic group (n = 24) were recruited for this cross‐sectional study. There was no difference with respect to age, BMI, infertility period and smoking ratio. No difference in haematologic parameters including white blood cell count, neutrophil ratio, lymphocyte ratio, neutrophil‐to‐lymphocyte ratio and blood SAA level was found between the groups. Seminal fluid SAA level was 17.85 ± 2.21 ng ml^?1 in azoospermics, 16.13 ± 3.58 ng ml^?1 in oligozoospermics and 15.67 ± 4.77 ng ml^?1 in normozoospermics, showing no significant difference. Seminal SAA level was found to be not correlated with blood SAA levels. Therefore, we could not find any associations between these parameters at all. However, further studies with more participants are needed to address the exact action of SAA on spermatogenesis.     

Serum testosterone levels in diabetic men with and without erectile dysfunction

Diabetes mellitus is a common chronic disease, affecting 0.5–2% worldwide. The Massachusetts Male Aging Study reported that up to 75% of men with diabetes have a lifetime risk of developing ED. Type 2 diabetes is associated with low total serum testosterone (TT) identified in several cross‐sectional studies and systemic analyses. There is a lack of consensus regarding what constitutes the lowest level of testosterone within the boundaries of normality. In this retrospective study, we sought to evaluate the effect of associated co‐morbidities on serum total testosterone (TT) level in men with type 2 diabetes DM, either with or without erectile dysfunction (ED). Three hundred and ninety‐one patients were evaluated for erectile function using an abridged, five‐item version of the International Index of Erectile Function‐5. Measurements of TT, fasting lipid profile, blood sugar and glycated haemoglobin (HbA1c) were conducted. Penile hemodynamics was assessed using intracavernosal injection and penile duplex study. Hypogonadism was found in 126 cases (33.2%), and normal TT was observed in 254 (66.8%). ED was detected in 119 cases in the hypogonadal group (94.4%) as compared to 155/254 (61.0%) in eugonadal group, P = 0.0001. TT was lower in diabetic men with ED as compared to those with normal erectile function (EF), 392.4 ± 314.9 versus 524.3 ± 140.2 ng dl^?1, respectively, P < 0.0001. After exclusion of patients with hypertension and dyslipidaemia, 185 men were evaluated, and there was no difference in the mean TT level among men with ED 490.6 ± 498.2 ng dl^?1 versus normal EF 540.6 ± 133.4 ng dl^?1 although, HbA1c remained lower in men with normal erectile function. Receiver operating characteristic (ROC) curve of TT in men without associated co‐morbidities showed that EF was compromised at TT = 403.5 ng dl^?1 or less. Sensitivity of 63.3% and a specificity of 94.0% were detected. At this level, ED was found in 33/38 (86.8%) men with TT 403.5 ng dl^?1, whereas ED was observed in 57/147 (38.8%) men with TT ≥ 403.5 ng dl^?1 (P < 0.0001). We propose a cut‐off value of 403.5 ng dl^?1 of TT blood levels as an indicator for initiation of testosterone replacement therapy in diabetic men with ED. Further prospective controlled trials are recommended.     

Dutasteride in men receiving testosterone therapy: a randomised,double‐blind study

We investigate the impact of dutasteride on prostate specific antigen (PSA) and prostate volume in men receiving testosterone (T) therapy. Twenty‐three men on stable dose T therapy were randomised to receive either dutasteride or placebo for 12 months. Serum levels of PSA, T and dihydrotestosterone (DHT) and responses to the International Index of Erectile Function (IIEF) and Male Sexual Health Questionnaire (MSHQ) questionnaires were determined at baseline and at 3, 6, 9 and 12 months. Prostate volume (PV) was measured using transrectal ultrasound (TRUS) at baseline and again after 12 months. A total of 22 men (mean age 57.3) completed the study, with 11 men receiving placebo and 11 receiving dutasteride. Men receiving dutasteride had a significant decrease in PSA (?0.46 ± 0.81 ng ml^?1; P = 0.04) and in PV (?6.65 ± 11.0%; P = 0.03) from baseline over 12 months. DHT decreased significantly for men on dutasteride compared with men receiving placebo (P = 0.02). When compared with men who received placebo, men who received dutasteride demonstrated nonsignificant trends towards decreased PSA (?0.46 versus 0.21 ng ml^?1; P = 0.11), PV (?6.65% versus 3.4%; P = 0.08) and MSHQ scores (?10.2 versus 5.6; P = 0.06). Dutasteride reduces PSA and PV for men on T therapy, but perhaps less so than in men without T therapy.     

Can testosterone level be a good predictor of late‐onset hypogonadism?

Androgens are essential for the development and growth of the genitalia. They regulate the erectile physiology by multiple mechanisms. Several studies have examined associations among sex hormones' serum levels, erectile function and sex drive. We sought to identify a protocol for using testosterone in men with erectile dysfunction and late‐onset hypogonadism (LOH). During a 16‐month period, men with erectile dysfunction who presented to the andrology clinic were selected. They underwent a complete physical examination and filled out the International Index of Erectile Function‐5 questionnaire. Serum luteinising hormone (LH) and testosterone levels were evaluated. Patients received a single intramuscular injection of 250 mg testosterone. Thereafter, serum levels of LH and testosterone were measured 3 weeks later. The mean age was 53 years old. After treating patients with testosterone, 45 (94%) showed improvement in LOH symptoms including libido, loss of energy, irritability and quality of life. The mean International Index of Erectile Function was 9 and 13.1, prior to and after treatment respectively. Mean serum testosterone levels before and after treatment were 4.2 and 4.1 ng ml^?1 respectively (P = 0.849). Mean serum LH revealed a significant decrease after the study (P = 0.004) (6.12 and 5.1 ng ml^?1, before and after the study respectively). Our findings suggested that testosterone replacement therapy improves libido and LOH symptoms in individuals with almost normal or lower limit normal value of serum testosterone levels.     

Plasma levels of matrix metalloproteinase-9: a possible diagnostic marker of successful endovascular aneurysm repair

ObjectiveThe aim of the study was evaluating the diagnostic value of plasma matrix metalloproteinase- (MMP)-2 and -9 and tissue inhibitor of MMP-1 (TIMP-1) for endoleak detection after endovascular aneurysm repair (EVAR).ReportConsecutive EVAR patients (n = 17) with endoleak and matched controls without endoleak (n = 20) were prospectively enrolled. Increased levels of MMP-9 were observed in patients with endoleak (P < 0.001). Regression analysis showed no significant influence of age, sex or abdominal aortic aneurysm (AAA) size. The receiver operating characteristic (ROC) curve of plasma MMP-9 levels showed that a cut-off value of 55.18 ng ml^?1 resulted in 100% sensitivity and 96% specificity with an AUC value of 0.988 (P < 0.001) to detect endoleak.ConclusionsPlasma MMP-9 levels appear to discriminate between patients with and without an endoleak with high sensitivity and specificity.     

Role of preoperative platelet level in clinical and pathological outcomes after surgery for renal cortical malignancies

Study Type – Therapy (case series)
Level of Evidence 4 What's known on the subject? and What does the study add? Preoperative platelet count (PLT), which reflects the systemic inflammatory response, has been previously identified in several small studies as useful prognostic factor in a number of cancers including renal cell carcinoma. This study is the largest study to our knowledge to investigate the relationship between platelets and surgical outcomes in patients with renal cell carcinoma. Thrombocytosis (PLT > 400) was associated with and was an independent predictor of decreased overall and disease‐specific survival in patients undergoing extirpative renal surgery, and was associated with larger tumour size, and higher TNM stage at surgery. OBJECTIVE ? To investigate preoperative platelet level (PLT) as a prognostic factor for pathologic and clinical outcomes following surgery for renal cortical malignancy. PATIENTS AND METHODS ? 1422 patients underwent radical or partial nephrectomy at our institution from 1988–2009 for renal cortical lesions. ? The cohort with available PLT values was divided into group 1 (PLT ≤ 400 × 10⁹) and (PLT > 400 × 10⁹) based on institutional laboratory upper threshold (400 × 10⁹ cells/liter). RESULTS ? 961 patients were divided into groups 1 (n = 870) and 2 (n = 91), with mean age at surgery of 61 and 60 years, 70.6% and 50.6% males (P ≤ 0.0001), 56% undergoing radical nephrectomy in each group, 39.1% vs. 22% undergoing partial nephrectomy (P = 0.001) respectively. ? Groups differed significantly inmedian tumour size (5.06 vs. 7.28 cm) (P ≤ 0.001), pathologic T stage (P = 0.002), and metastases (P ≤ 0.0001). No significant difference existed regarding histologic findings at surgery. ? With median follow‐up of 24 months, PLT > 400 × 10⁹ cells/liter was associated with decreased overall (OS) and disease‐specific survival (DSS) using log rank test (P ≤ 0.0001). ? On multivariate analysis, controlling for TNM stage, histology, and tumour diameter, PLT > 400 × 10⁹cells/liter independently predicted decreased OS (HR 1.67, P = 0.007) and DSS (HR 2.39, P = 0.001). As a continuous variable, PLT predicted OS (HR 1.002, P = 0.005) and DSS (HR 1.003, P =  0.004). ? With metastatic patients excluded, PLT was significantly associated with OS and DSS, but was not an independent predictor. CONCLUSION ? PLT is a clinically significant independent predictor of OS and DSS in continuous and categorical analyses in patients undergoing renal cortical malignancy surgery. PLT may be clinically useful for risk stratifying patients undergoing surgery for renal cancer, especially for prognosis assessment of patients with renal cortical malignancy and micrometastatic disease at surgery.     

Circulating lipoprotein-associated phospholipase A2 in high-grade carotid stenosis: a new biomarker for predicting unstable plaque

ObjectiveTo test plasma levels of lipoprotein-associated phospholipase A2 (Lp-PLA2) in patients with high-grade carotid stenosis according to plaque histology.MethodsThis cross-sectional single-centre study included patients with ≥70% North American Symptomatic Carotid Endarterectomy Trial (NASCET) carotid stenosis, who were treated surgically. Serum Lp-PLA2 and high-sensitivity C-reactive protein (hs-CRP) were determined on the day of surgery. Histopathological analysis classified carotid plaque as stable or unstable, according to AHA classification.ResultsOf the 42 patients (mean age 70.4 ± 10.5 years; 67% men), neurological symptoms were present in 16 (38%). Unstable plaques were found in 23 (55%). Median plasma level of Lp-PLA2 was significantly higher in patients with unstable plaque compared to those with stable plaque (222.4 (174.9–437.5) interquartile range (IQR) 63.5 vs. 211.1 (174.9–270.6) IQR 37.2 ng ml^?1; p = 0.02). Moreover, median Lp-PLA2 level were higher in asymptomatic patients with unstable plaque (226.8 ng ml^?1 (174.9–437.5) IQR 76.8) vs. stable plaque (206.9 ng ml^?1 (174.9–270.6) IQR 33.7; p = 0.16). Logistic regression showed that only the neurological symptoms (OR = 30.9 (3.7–244.6); p < 0.001) and the plasma Lp-PLA2 level (OR = 1.7 (1.1–12.3); p = 0.03) were independently associated with unstable carotid plaque as defined by histology.ConclusionsThis study showed that circulating Lp-PLA2 was increased in patients with high-grade carotid stenosis and unstable plaque. Lp-PLA2 may be a relevant biomarker to guide for invasive therapy in asymptomatic patients with carotid artery disease.     

The efficacy,bioavailability and safety of a novel hydroalcoholic testosterone gel 2% in hypogonadal men: results from phase II open‐label studies

Pharmacokinetics, pharmacodynamics and safety of a novel hydroalcoholic testosterone gel 2% (TG) were evaluated in phase II sequential dose escalation studies using 3 application sites (thigh, abdomen and shoulder/upper arm) and 2 application methods. Hypogonadal men (n = 40), 18–75 years, with serum testosterone <300 ng dl^?1 were included in both studies. Study 1 evaluated hand‐applied multiple doses of TG 1.25, 2.50 and 3.75 ml (23, 46 and 70 mg of testosterone, respectively), once daily for 10 days to shoulder/upper arm. Study 2 evaluated applicator‐applied (TG 1.25, 2.50 and 3.75 ml) versus hand‐applied (TG 2.5 ml) doses, once daily for 7 days to shoulder/upper arm. Primary endpoint for both studies was responder rate (C_ave testosterone levels between 298 and 1050 ng dl^?1). In Study 1 following multiple applications, >70% participants in each group were responders. Dose‐dependent increase was observed in PK values for total testosterone, free testosterone and DHT. In Study 2, responder rate was dose proportional: 16.7%, 50.0% and 77.8% responders in TG 1.25, 2.50 and 3.75 ml groups respectively. The bioavailability was highest for the shoulder application. There was a significant improvement in almost all the domains of sexual functioning. Applicator‐application was preferred over hand‐application by majority of the participants. TG was found to be safe and well tolerated in hypogonadal men.     

Association between serum folic acid level and erectile dysfunction

This study measured the serum folic acid (FA) level in patients with erectile dysfunction (ED) and evaluated the possible association between the serum FA level and erectile function. The study divided 120 patients with ED into 3 groups of 40 patients each: those with severe, moderate and mild ED. Forty healthy men served as controls. Fasting serum samples were obtained, and the total testosterone, cholesterol and FA levels were measured using chemiluminescent immunoassays. There were no significant differences in the mean age, mean body mass index or mean serum total testosterone and cholesterol levels among the three ED groups and controls (P > 0.05). The mean serum FA concentrations were 7.2 ± 3.7, 7.1 ± 3.2, 10.2 ± 4.6 and 10.7 ± 4.6 ng ml^?1 in the severe, moderate and mild ED and control groups respectively. The mean serum FA concentration was significantly higher in the control group than in the severe and moderate ED groups (both P < 0.001), but not the mild ED group (P = 0.95). Considering the significant differences in the serum FA levels between the control and ED groups, serum FA deficiency might reflect the severity of ED.     

Sublingual midazolam premedication in children: a dose response study

The purpose of this study was to evaluate various doses of sublingual midazolam premedication in children. In our prospective, double-blind, placebo-controlled trial, children (n=102, age range 12 to 129 months) scheduled for day surgery were randomized to receive either midazolam in one of three doses (0.25, 0.5, or 0.75 mg·kg^?1) or placebo. Injectable midazolam was mixed with a thick grape syrup and placed under the tongue; the patient was asked to hold it as long as possible before swallowing. Children readily accepted the mixture. Analysing all patients randomized, none of the children receiving placebo vs 28% receiving 0.25 mg·kg^?1 (P=0.02), 52% receiving 0.5 mg·kg^?1 (P<0.001), and 64% receiving 0.75 mg·kg^?1 (P<0.001) of midazolam showed satisfactory sedation (drowsy) at 15 min after administration. Children receiving the two higher doses of midazolam (0.5 and 0.75 mg·kg^?1) accepted mask induction willingly, while the group receiving 0.25 mg·kg^?1 resembled the placebo group (P<0.05).     

Saturated,omega‐6 and omega‐3 dietary fatty acid effects on the characteristics of fresh,frozen–thawed semen and blood parameters in rams

The aim of this study was to investigate the effects of several dietary fatty acids (FAs) on semen quality and blood parameters in rams. We gave diet‐supplemented treatments (35 g day^?1 ram^?1) by C16:0 (palm oil), C18:2 [sunflower oil (SO)] and an n‐3 source [fish oil (FO)] to 12 rams, who were fed for 15 weeks during their breeding season. Semen was collected once per week. Semen samples were extended with Tris‐based cryoprotective diluents, then cooled to 5 °C and stored in liquid nitrogen. Positive responses were seen with FO after 4 weeks. The mean prefreezing semen characteristics improved with the intake of FO (P < 0.05). Interestingly, maximum sperm output in FO was achieved 7.5 × 10⁹ when compared to palm oil 5.3 × 10⁹. Rams that received FO had the highest total testosterone concentrations (11.3 ng ml^?1 for FO, 10.8 ng ml^?1 for SO and 10.2 ng ml^?1 for palm oil) during the experiment (P < 0.05). FO also improved the rams' sperm characteristics after thawing (P < 0.05). Although C16:0 is a major saturated FA in ram sperm and all rams have been fed isoenergetic rations, the unique FAs of FO improved fresh semen quality and freezing ability compared to other oils.     

Seminal level of clusterin in infertile men as a significant biomarker reflecting spermatogenesis

The objective of this study was to assess the impact of seminal clusterin level on spermatogenesis in infertile men. This study included 89 men who visited our clinic due to infertility, consisting of 28, 33, and 28 diagnosed with normospermia, oligozoospermia and nonobstructive azoospermia (NOA) respectively. The seminal clusterin concentrations measured by enzyme‐linked immunosorbent assay were 47.9, 28.2 and 18.4 ng ml^?1 in men with normospermia, oligozoospermia and NOA, respectively, with significant differences among these three groups (P < 0.01). Microdissection testicular sperm extraction (MD‐TESE) was performed in the 28 men with NOA, and spermatozoon was successfully retrieved from 9. There was a significant correlation between seminal clusterin level and testicular clusterin protein expression evaluated by immunohistochemical staining in these men with NOA (P = 0.026). Of several parameters available before MD‐TESE, the univariate analysis identified serum follicle‐stimulating hormone (FSH) level <10 IU ml^?1 and seminal clusterin level ≥18 ng ml^?1 as significant predictors of sperm retrieval, and of these, only serum FSH level <10 IU ml^?1 was shown to be independently associated with sperm retrieval in the multivariate analysis. Accordingly, it might be worthy to further evaluate the significance of seminal clusterin level as a biomarker for the assessment of spermatogenic status in infertile men.     

Effect of the SK/IK channel modulator 4,5-dichloro-1,3-diethyl-1,3-dihydro-benzoimidazol-2-one (NS4591) on contractile force in rat, pig and human detrusor smooth muscle

What’s known on the subject? and What does the study add? Increased urinary bladder detrusor smooth muscle phasic contractility has been suggested to be associated with idiopathic bladder overactivity. Small conductance Ca2⁺‐activated K⁺ (SK 1–3) channels have attracted considerable interest as putative target for new therapeutic strategy for treating overactive bladder. These channels play an important role in regulating the function and activity of urinary bladder smooth muscle (UBSM), and the loss of SK channel function has been shown to increase UBSM excitability and contractility. However, it is not known whether activation of SK channels has the converse effect of reducing UBSM excitability and contractility. In this paper, we investigated this possibility in the rat, pig and human UBSM by using the novel SK channel opener NS4591. These studies demonstrate that the SK channel modulator NS4591 has a potential role as a pharmacological tool to study the involvement of SK (and IK) channels in mammals and rodents urinary bladder. NS4591 may have therapeutic potential for treatment of detrusor overactivity.

OBJECTIVE

• ? To investigate the importance of small (SK)‐ and intermediate (IK)‐conductance Ca2⁺‐activated K⁺ channels on bladder function, by studying the effects of 4,5‐dichloro‐1,3‐diethyl‐1,3‐dihydro‐benzoimidazol‐2‐one (NS4591), a new modulator of SK/IK channels, on contractions induced by electrical field stimulation (EFS) and carbachol in rat, pig and human detrusor.

PATIENTS AND METHODS

• ? Detrusor biopsies were obtained from rats, pigs and male patients undergoing cystectomy because of bladder cancer.
• ? Force was recorded using myographs.
• ? Intracellular free Ca²⁺ was measured in myocytes using microfluorimetry.

RESULTS

• ? In rat bladder rings subjected to EFS, cumulative addition of NS4591 (0.1–30 µM) decreased force by 82 ± 2.9% (n = 6).This effect was reduced by 64 ± 5.2% in the presence of 0.3 µM apamin, a specific inhibitor of SK channels. Apamin increased the force evoked by EFS significantly: force was increased by 14.2 ± 3.4% (n = 5) and 10.1 ± 2.6% (n = 7) in pig and human detrusor strips, respectively (P = 0.04 and P = 0.02).
• ? The cumulative addition of NS4591 (0.3–30 µM) significantly reduced the amplitude of carbachol‐induced rhythmic oscillations by 62.0 ± 12.0% (n = 12) and the minimum force between oscillations by 30 ± 5% (n = 9) in pig detrusor strips (P < 0.005). In the presence of 10 µM NS4591, carbachol (1 µM) induced rhythmic contractions with an amplitude and normalized mean power frequency (nmeanPF) of 8.4 ± 5.1% and 0.11 ± 0.06 mN root mean square (rms) Hz (n = 12), respectively, vs. 21 ± 3.4% and 0.17 ± 0.04 mN rms Hz in control strips (n = 13). Apamin induced 6‐ and 11‐fold increases in amplitude and nmeanPF vs. 1.3‐ and 2‐fold increases in control strips.
• ? In human detrusor strips (n = 15), the cumulative addition of NS4591 (1–30 µM) significantly reduced the amplitude by 69 ± 11%, the nmeanPF by 78 ± 6% and the minimum force between carbachol‐induced oscillations by 59 ± 5% (P < 0.008). The addition of apamin (0.3 µM) before application of 1 µM carbachol abolished the effects of NS4591 on amplitude and partially abolished its effect on nmeanPF by 41 ± 7%, vs. a 78 ± 6% reduction in the absence of apamin (n = 8).
• ? In spontaneously active detrusor preparations, NS4591 reduced or abolished contractions.
• ? Furthermore, NS4591 (10 µM) decreased the carbachol‐induced increase in the fura‐2 ratio by 43 ± 3% compared with control (n = 12) (P < 0.03).

CONCLUSIONS

• ? The SK/IK channel modulator NS4591 inhibits EFS‐ and carbachol‐induced contractions in rat, pig and human detrusor muscle.
• ? NS4591 may have therapeutic potential for treatment of detrusor overactivity.

     

Effects of smoking on fatty acid composition of phospholipid sperm membrane and the malondialdehyde levels in human seminal plasma

The aim of this study was to investigate fatty acids composition of sperm phospholipids, level of lipoperoxidation represented by malondialdehyde and to examine differences between recent smokers and nonsmokers. The levels of malondialdehyde were in the group of all patients 1.51 ± 0.56 μmol l^?1, in smokers 1.36 ± 0.59 μmol l^?1 and in nonsmokers 1.53 ± 0.55 μmol l^?1. Total sperm membrane phospholipid fatty acids were profiled into several groups, saturated acids (in smokers 61.86 ± 9.02%, in nonsmokers 61.20 ± 11.66%), polyunsaturated acids n‐3 (in smokers 12.62 ± 8.18%, in nonsmokers 14.28 ± 13.65%), polyunsaturated acids n‐6 (in smokers 9.13 ± 4.37%, in nonsmokers 10.10 ± 3.79%) and other acids (in smokers 14.36 ± 3.94%, in nonsmokers 13.88 ± 2.31%). Significant correlations were found between the level of malondialdehyde (MDA) and total sperm motility in all patients (r = ?0.358, P = 0.013), between both the level of MDA and progressive motility (r = ?0.465, P = 0.001) and between the level of MDA and total motility (r = ?0.382, P = 0.037) in nonsmokers. There were no statistically significant differences between composition of sperm phospholipid important fatty acids in smokers and nonsmokers. Significant correlations between selected sperm fatty acids and sperm motility and morphology in smokers and nonsmokers were not observed.     

Antioxidative effects of cysteamine,hyaluronan and fetuin on post‐thaw semen quality,DNA integrity and oxidative stress parameters in the Brown Swiss bull

The aim of this study was to compare the effectiveness of antioxidants including cysteamine (2.5, 7.5 mm ), hyaluronan (0.25, 1 mg ml^?1) and fetuin (5, 10 mg ml^?1) in the freezing of Brown Swiss bull semen. The best percentages of CASA motilities were achieved with 10 mg ml^?1 of fetuin and 2.5 mm of cysteamine. For sperm morphology, 10 mg ml^?1 of fetuin and 2.5 mm of cysteamine had better protective effects (P < 0.001). The results of hypo‐osmotic swelling test showed that the percentage values of membrane integrity in all the groups, excluding that supplemented with 5 mg ml^?1 of fetuin, were higher than those of the control group (P < 0.001). Results obtained for the DNA damage of sperm cells demonstrated that 0.25 mg ml^?1 of hyaluronan, and 2.5 and 7.5 mm of cysteamine led to lower rates of spermatozoa with damaged DNA, compared with the control group (P < 0.001). The maintenance of superoxide dismutase and glutathione peroxidase antioxidant activities following freeze‐thawing with 2.5 and 7.5 mm of cysteamine and 10 mg ml^?1 of fetuin was demonstrated to be at a higher level in comparison with the control group (P < 0.001). Malondialdehyde formation was found to be lower in the groups supplemented with 0.25 mg ml^?1 of hyaluronan and 7.5 mm of cysteamine after the freeze‐thawing process (P < 0.001).     

Effect of Coenzyme Q10 supplementation on antioxidant enzymes activity and oxidative stress of seminal plasma: a double‐blind randomised clinical trial

Low seminal plasma concentrations of coenzyme Q10 (CoQ10) have been correlated with impaired sperm parameters, but the exact mechanism remains of dominating interest. This randomised, placebo‐controlled study examined the effect of CoQ10 on catalase, superoxide dismutase (SOD) and F₂‐isoprostanes in seminal plasma in infertile men and their relation with CoQ10 concentration. Sixty infertile men with idiopathic oligoasthenoteratozoospermia (OAT) were randomised to receive 200 mg d^?1 of CoQ10 or placebo for 3 months. 47 persons of them completed the study. Semen analysis, anthropometric measurements, diet and physical activity assessment were performed for subjects before and after treatment. Independent and paired t‐test, chi‐square test and ancova were compared outcomes of supplementation between two groups. CoQ10 levels increased from 44.74 ± 36.47 to 68.17 ± 42.41 ng ml^?1 following supplementation in CoQ10 (P < 0.001). CoQ10 group had higher catalase and SOD activity than the placebo group. There was a significant positive correlation between CoQ10 concentration and normal sperm morphology (P = 0.037), catalase (P = 0.041) and SOD (P < 0.001). Significant difference was shown between the mean of changes in seminal plasma 8‐isoprostane in two groups (P = 0.003) after supplementation. Three‐month supplementation with CoQ10 in OAT infertile men can attenuate oxidative stress in seminal plasma and improve semen parameters and antioxidant enzymes activity.     

Effect of DDAH/ADMA/NOS regulation pathway on cavernae corporum cavernosorum rat penis of different age

The effect of DDAH/ADMA/NOS pathway in penile tissue of rats of different age was investigated to better understand the mechanism of age‐related erectile dysfunction (ED). The Sprague Dawley male rats were assigned as the young group (3 month old, n = 10) and the old group (18 month old, n = 10) respectively. Intracavernous pressure (ICP) was measured before and after papaverine intracavernous injection. Pathology structure of penile tissue was evaluated under transmission electron microscope. The expression amounts of asymmetric dimethylarginine (ADMA) and cyclic guanosine monophosphate (cGMP) in penile tissue were detected by ELISA; the expression levels of isoform‐specific DDAH and NOS were assessed via Western blot. Compared with the young group, the ICP in the old group rat decreased significantly (33.46 ± 5.37 versus 39.71 ± 3.67 mmHg, P = 0.02) after papaverine injection. Diffused fibrosis and impairment of endothelial cell were observed in corpus cavernosum in the old group rats. Higher level of ADMA (10.83 ± 0.96 versus 7.51 ± 1.39 μmol per gpro, P = 3.14 × 10^?4) and lower level of cGMP (29.42 ± 3.84 versus 47.09 ± 6.07 nmol per gpro, P = 1.57 × 10^?6) were detected in penile tissue of the old group compared with those of the young group. Expression of DDAH1, DDAH2, endothelial NOS (eNOS) and neuronal NOS(nNOS) all decreased significantly in penile tissue of the old group rat. The DDAH/ADMA/NOS regulation pathway changes dramatically accompanying with lower ICP in old group rat compared with those of the young group. Such findings in rats are suggestive in understanding the mechanism of age‐related ED in humans.     

Relationship of inhibin serum level to bioactive and immunoreactive FSH in oligospermic and azoospermic patients

Summary. The purpose of the study described here was to evaluate the relationship between inhibin (INH) and bioactive FSH (B-FSH) or immunoreactive FSH (I-FSH) in oligoazoospermic patients. To accomplish this, the authors measured serum levels of INH, I-FSH, B-FSH, LH and testosterone (T) in 98 male patients attending the Andrology Centre at Malphighi Hospital (Bologna) for infertility workup. On the basis of the mean sperm concentration, patients with sperm output ≥4 × 10⁷ ml^?1 (n = 30) formed the control group (group A), whereas oligozoospermic patients were divided arbitrarily into three groups. Sperm concentrations for these groups ranged as follows: B, 2–4×10⁷ml^?1 (n = 14); C, 5× 10⁶-2× 10⁷ml^?1 (n = 18); D, < 5 × 10⁶ ml^?1 (n = 17). In addition, the authors studied a group of patients with possible nonobstructive azoospermia (n = 19, group E), confirmed in 16 of them through testicular biopsy. There were no significant differences in serum levels of LH and T among groups. However, azoospermic patients had a significant reduction of the T/LH ratio. Similarly, B-FSH and B/I-FSH ratios were significantly elevated only in group E. INH serum levels did not show any appreciable changes among groups and in azoospermic patients INH correlated significantly and in a positive manner with I-FSH serum levels and negatively with B/I-FSH and T/LH ratios. Within the azoospermic patient group no consistent relationship was evident between INH serum concentration and various degrees of spermatogenetic arrest. Indeed, patients having the same qualitative tubular damage, presented low, normal or high INH levels in serum. The failure of serum INH to correlate with the degree of tubular damage may be due either to the fact that the damage to Sertoli cells in azoospermia is not severe enough to decrease cell function, or to the lack of a specific assay for measuring INH.     

Circulating Angiopoietin‐2 levels predict mortality in kidney transplant recipients: a 4‐year prospective case–cohort study

Angiopoietin 2 (Angpt2) impairs endothelial function by preventing angiopoietin 1 from binding to their common endothelial‐specific receptor Tie2. Here, we examined whether circulating Angpt2 predicts outcome in kidney transplant recipients. For this case–cohort study, we selected 130 kidney transplant recipients who had died or returned to dialysis within the first 2 years of follow‐up of our cohort study, as well as 130 age‐ and gender‐matched kidney transplant recipients without an event (controls) from a total of 993 kidney transplant recipients. The total of 260 selected patients were followed in median 4 years. Serum Angpt2 at baseline was measured using an in‐house immunoluminometric assay. Median Angpt2 concentrations were significantly higher in patients who died [median (interquartile range – IQR) 3.6 (2.8–5.9) ng/ml] as compared to patients who did not die during the study period [2.8 (2.1–4.1) ng/ml; P < 0.001]. Ln (natural log) Angpt2 levels correlated positively with C‐reactive protein levels (r = 0.315, P < 0.001) and the Charlson Comorbidity Index (r = 0.188, P = 0.002) and were inversely associated with eGFR (r = ?0.301, P < 0.001) hemoglobin (r = ?0.269, P < 0.001), and serum albumin concentrations (r = ‐0.382, P < 0.001). On multivariate analyses, baseline Angpt2 levels independently predicted all‐cause mortality (multivariable‐adjusted hazard ratio associated with one natural log unit higher Angpt2 level: 1.70 (95% confidence interval: 1.10–2.61)). In our analysis, circulating Angpt2 was an independent predictor of all‐cause mortality in stable, prevalent kidney transplant recipients.     

Low body mass index might be a predisposing factor for varicocele recurrence: a prospective study

We investigated the possible relationship between body mass index (BMI) score and varicocele recurrence in an infertile patient population. A total of 255 primary infertile male patients (138 with varicocele and 117 for control) were included in this study. Height and weight measurements, clinical examination for varicocele, determination of serum hormone levels and spermiogram were performed in all cases. The BMI score was calculated, and patients with varicocele were operated with subinguinal technique and re‐examined for recurrences. The varicocele group had significantly lower weight and the BMI score than the control group (P < 0.001). Varicocele recurrences were found in 22 patients (16% of them) after the operations. The BMI score was significantly lower in the recurrent group than in the nonrecurrent and control groups (P < 0.001). 73% of the recurrent, 50% of the nonrecurrent and 25% of the control group patients' BMI scores were under 25 kg m^?2 (P < 0.001). In logistic regression analysis, the BMI score was found as a determinant for varicocele recurrence (P = 0.027; OR: 1.25). It is concluded that BMI score lower than 25 kg m^?2 significantly increases the recurrence rate after varicocele operation, and it can be used as an objective indicator for microsurgical varicocelectomy.