Treatment of Oligoasthenozoospermia with Tranilast,a Mast Cell Blocker,After Long-Term Administration

The authors retrospectively examined whether long-term administration of tranilast improves semen parameters in severe oligoasthenozoospermia. Fifty-two patients presenting with sperm concentration of less than 10 &#50 10 6 sperm/mL were enrolled. Subjects were partitioned into 3 groups as follows: patients displaying an atrophic testis with elevated (FSH) (group 1), patients exhibiting normal testicular volume with elevated FSH (group 2), and patients with normal testicular volume and normal FSH levels (group 3). Tranilast (300mg/day) was administered until pregnancy was achieved or for a period of up to 12 months. Sperm concentration was significantly increased at 3 months in 16 subjects (44%) in groups 1 and 3. In group 2, sperm concentration was increased at 12 months (5 of 16 subjects; 31%). Total sperm count was obviously elevated at 3 months in groups 1 and 2, and at 6 months in group 3. Six pregnancies were achieved via natural intercourse. Tranilast, a mast cell blocker, demonstrates a certain clinical benefit in terms of improvement of semen parameters involving severe oligoasthenozoospermia, but it does not appear to afford clinical benefit in long-term administration.     

Chronic oral disadvantage,a measure of long-term decrements in oral health-related quality of life

Few studies have investigated the relation between oral health-related quality of life (HRQL) and key demographic, socioeconomic, and oral health decrements. METHODS: Data were taken from 873 participants from the Florida Dental Care Study. Chronic oral disadvantage was defined from incident oral disadvantage, a measure of oral HRQL, reported for a minimum of two consecutive 6-month intervals. Patterns of chronic oral disadvantage over the 24-month period were described. Associations between the dependent variable, chronic oral disadvantage, and demographic variables, socioeconomic variables, oral health decrements, and dental services were evaluated. RESULTS: During 24 months of follow-up, 30% of subjects reported chronic oral disadvantage. Chronic oral disadvantage was significantly associated with approach to dental care, area of residence, situation if faced with an unexpected dollars 500 dental bill, teeth that are stained or look bad, cavities, sore or infected gums, loose tooth or cap, toothache or abscess, dental sensitivity, and chewing difficulty. A recent dental visit was associated with reduced progression to chronic oral disadvantage. CONCLUSION: A large proportion of subjects avoided certain daily activities due to oral health decrements for longer than 6 months. Recent dental visits were significantly associated with limitation of long-term progression of oral disadvantage.     

Control of diabetes mellitus in shift workers.

OBJECTIVE--To determine whether the control of diabetes is different in insulin treated diabetic subjects who work shifts compared with those who do not work shifts and whether control is related to the type of shift worked. DESIGN--Prospective controlled study of 32 diabetic subjects working either regular days or shifts in a large car assembly factory. Insulin treated subjects who underwent a change in their pattern of shift work had diabetic control assessed before and six months after a change in shifts. MAIN OUTCOME MEASURES--Random plasma glucose, serum fructosamine, and haemoglobin A1 while at work. RESULTS--Diabetic control of insulin treated subjects who worked shifts was not significantly different from insulin treated subjects who worked days only. Diabetic control was poor in both groups and similar to that of diabetic subjects treated with oral hypoglycaemic agents. In those subjects that moved to a more rapidly rotating shift pattern there was a significant deterioration in control (serum fructosamine concentration before, 405 (SD 68); after, 481 (SD 90) mumol/l, p less than 0.01). CONCLUSIONS--The control of diabetes in insulin treated diabetic subjects who worked shifts was no worse than those who worked days only. Slowly rotating shifts were associated with better diabetic control than more rapidly rotating shifts.     

Lipid metabolism in Norplant-2 users--a two-year follow-up study. Total cholesterol, triglycerides, lipoproteins and apolipoproteins.

Changes in lipid metabolism in 25 healthy female volunteers during a 24-month application of Norplant-2 were evaluated in an open clinical trial. Total serum cholesterol decreased significantly (p less than 0.05/p less than 0.05) by 10%/9% after 12 months and by 3%/7% (n.s./n.s.) after 24 months of Norplant-2 use (all subjects/subjects completing 24 cycles). Serum triglycerides decreased by 34%/28% (n.s./p less than 0.05) after 12 months and by 29%/25% (p less than 0.05/p less than 0.05) after 24 months of Norplant-2 use (all subjects/subjects completing 24 cycles). HDL-cholesterol decreased significantly by 18%/12% (p less than 0.01/p less than 0.05) after 12 months and by 12%/12% (p less than 0.05/p less than 0.05) after 24 months of Norplant-2 use (all subjects/subjects completing 24 cycles). No statistically significant difference between serum levels of LDL-cholesterol prior to and after 12 and 24 months of Norplant-2 use could be found. VLDL-cholesterol levels decreased significantly by 38%/38% (p less than 0.05) after 12 and by 25%/25% after 24 months of Norplant-2 application (p less than 0.01) (all subjects/subjects completing 24 cycles). Apolipoprotein Al decreased significantly by 23%/23% (p less than 0.001/p less than 0.01) after 12 and by 21%/22% after 24 months of Norplant-2 application (p less than 0.01/p less than 0.01) (all subjects/subjects completing 24 cycles). No statistically significant difference between apolipoprotein All levels prior to and after 12 and 24 months of Norplant-2 implantation could be found. Apolipoprotein B decreased significantly by 27%/17% (p less than 0.05/p less than 0.05) after 12 months of Norplant-2 application (all subjects/subjects completing 24 cycles). The decline after 24 months of Norplant-2 use was not significant. Changes in lipid metabolism caused by oral hormonal contraceptives differ in the various clinical trials; however, most investigators found that serum levels of total cholesterol and triglycerides increase under the application of OCs. Contrary to this, a decrease of total cholesterol and triglycerides under Norplant-2 use was noted. Furthermore, we found a significant decrease of lipoproteins and apolipoproteins--with the exception of LDL-cholesterol and apolipoprotein All, which did not show any significant modifications. Thus, Norplant-2 seems to be non-contributory to cardiovascular risk and might even provide protection against such risks.     

Control of diabetes mellitus in shift workers.

OBJECTIVE--To determine whether the control of diabetes is different in insulin treated diabetic subjects who work shifts compared with those who do not work shifts and whether control is related to the type of shift worked. DESIGN--Prospective controlled study of 32 diabetic subjects working either regular days or shifts in a large car assembly factory. Insulin treated subjects who underwent a change in their pattern of shift work had diabetic control assessed before and six months after a change in shifts. MAIN OUTCOME MEASURES--Random plasma glucose, serum fructosamine, and haemoglobin A1 while at work. RESULTS--Diabetic control of insulin treated subjects who worked shifts was not significantly different from insulin treated subjects who worked days only. Diabetic control was poor in both groups and similar to that of diabetic subjects treated with oral hypoglycaemic agents. In those subjects that moved to a more rapidly rotating shift pattern there was a significant deterioration in control (serum fructosamine concentration before, 405 (SD 68); after, 481 (SD 90) mumol/l, p less than 0.01). CONCLUSIONS--The control of diabetes in insulin treated diabetic subjects who worked shifts was no worse than those who worked days only. Slowly rotating shifts were associated with better diabetic control than more rapidly rotating shifts.     

Pituitary response to LHRH stimulation in women on oral contraceptives.

Gonadotropic response to an LHRH bolus was tested on 12 patients who were taking two different contraceptive agents. Half of the subjects were on a short-term therapy, 2–3 months, and the other half were taking oral contraceptives for over three consecutive years. Six women who had a normal menstrual history and who had not taken any oral contraceptives for at least one year, served as controls. 150 ug LHRH was given intravenously during cycle day 20–25. Serum samples were obtained prior to bolus injection and at 20-minute intervals for two hours. Ovulation in control patients was confirmed by elevated serum progesterone. LH response in treated subjects was significantly lower than that of the controls. There were no differences between the long- and short-term groups. FSH response was not significantly altered in the treated groups. The suppression of LH response was greater in patients taking ethinyl estradiol preparation (Ovral) than in the patients taking mestranol preparation ($\text{Norinyl}\text{1}\text{50}$). No statistically significant differences were found in FSH response to LHRH in the two oral contraceptive groups.     

Inhibition of spermatogenesis in men with monthly injections of medroxyprogesterone acetate and testosterone enanthate

Twenty-five healthy men were treated with monthly injections of 100 mg of medroxyprogesterone acetate (MPA) and 250 mg of testosterone enanthate (TE) for periods from 4 to 16 months. In 24/25 subjects, a marked drop in sperm count occurred by 1–3 months following the first combined injections of MPA and TE. Eleven subjects out of 14 who completed 9 months of treatment became azoospermic or developed marked oligozoospermia. Of the 8 men treated for 12–16 months, only one failed to respond to the treatment. Two subjects reported decreased libido and potency; 4 subjects reported increased libido and potency. There were no changes in the size, consistency or sensitivity of the testicles or breasts. No significant changes occurred in serum transaminases or in alkaline phosphatase during the treatment. With 2 possible exceptions, serum triglycerides also seemed to be unaffected by treatment. There were no changes in blood pressure. Weight gain was common.     

Occupational asthma in a mineral analysis laboratory.

An epidemic of symptoms suggestive of occupational asthma in workers in a mineral analysis laboratory necessitating exposure to vapours of hydrochloric, hydrofluoric, nitric, perchloric, and sulphuric acid solutions was investigated. Variable airflow obstruction was confirmed by serial measurement of FEV1 in two subjects who showed 18% and 22% fall in FEV1 during a workshift. Of a workforce of 21 laboratory staff, 20 took part in a study of ventilatory capacity and bronchial reactivity. All but one subject had normal ventilatory capacity but five had bronchial hyperreactivity (PC20 less than or equal to 8 mg/ml histamine). Four of the five with hyperreactivity had a history of chest tightness at work whereas only two subjects with chest tightness had PC20 greater than 8 mg/ml (p less than 0.01). Other work related symptoms were cough (two subjects) and breathlessness (three subjects). Four of the subjects with bronchial hyperreactivity were atopic, suggesting that hyperreactivity may have predated exposure to irritant material at work and resulted in their being susceptible to the development of symptoms and raises the possibility of identifying susceptible subjects by preplacement examination. In two of these subjects, however, bronchial reactivity has returned to normal after 205 and 376 days away from work, suggesting that bronchial inflammation resulted from occupational exposure to acid vapours.     

Occupational asthma in a mineral analysis laboratory

An epidemic of symptoms suggestive of occupational asthma in workers in a mineral analysis laboratory necessitating exposure to vapours of hydrochloric, hydrofluoric, nitric, perchloric, and sulphuric acid solutions was investigated. Variable airflow obstruction was confirmed by serial measurement of FEV1 in two subjects who showed 18% and 22% fall in FEV1 during a workshift. Of a workforce of 21 laboratory staff, 20 took part in a study of ventilatory capacity and bronchial reactivity. All but one subject had normal ventilatory capacity but five had bronchial hyperreactivity (PC20 less than or equal to 8 mg/ml histamine). Four of the five with hyperreactivity had a history of chest tightness at work whereas only two subjects with chest tightness had PC20 greater than 8 mg/ml (p less than 0.01). Other work related symptoms were cough (two subjects) and breathlessness (three subjects). Four of the subjects with bronchial hyperreactivity were atopic, suggesting that hyperreactivity may have predated exposure to irritant material at work and resulted in their being susceptible to the development of symptoms and raises the possibility of identifying susceptible subjects by preplacement examination. In two of these subjects, however, bronchial reactivity has returned to normal after 205 and 376 days away from work, suggesting that bronchial inflammation resulted from occupational exposure to acid vapours.     

Long-term effects of Depo-Provera on carbohydrate and lipid metabolism

Long-term effects of injection Depo-Provera (depo-medroxyprogesterone acetate) on carbohydrate and lipid metabolism were studied in 157 women who were treated continuously for a mean duration of 43.3 months. The patients were matched with 162 controls for race, age, parity and height. Glucose tolerance was impaired with higher intolerance at longer duration. Glucose areas were significantly higher at 48 and 60 months of injection. Insulin levels were also significantly decreased at 30 minutes and increased at 150 minutes but the area was normal. Triglycerides were initially decreased, being significant at 36 months (p less than 0.001) and returned to normal at 60 months while cholesterols were significantly higher at 24 and 36 months (p less than 0.05) and 60 months (p less than 0.001). In view of these findings, Depo-Provera may have an advantage over oral pills on a short term basis as there are less alterations in carbohydrate and lipid metabolism.     

Long-term use of an injectable contraceptive: effect of depot-norethisterone oenanthate on carbohydrate metabolism

In order to determine the metabolic effects of long-term use of the injectable contraceptive norethisterone oenanthate, plasma glucose and serum insulin concentrations were studied in two groups of women who had used the method continuously for at least five years. Group 1 comprised 24 subjects, from whom only fasting blood samples were taken. Despite similar plasma glucose concentrations to those of the controls, the subjects had significantly increased serum insulin concentrations (164.5 (39.9) v 120.3 (34.3) pmol/l, p less than 0.01). In addition the insulin:glucose ratios were also significantly increased (34.3 (8.5) v 24.6 (6.7), p less than 0.01), consistent with decreased insulin sensitivity. Group 2 comprised 13 of the original 24 subjects who also had an oral glucose tolerance test. Basal plasma glucose concentrations were similar in the subjects and their controls, whilst the significantly increased insulin:glucose ratios (35.0 (7.7) v 28.7 (5.6), p less than 0.05) were consistent with the results of the larger group. Following oral glucose challenge, plasma glucose concentrations, serum insulin concentrations and insulin:glucose ratios were similar in the subjects and their controls throughout the test. Thus, long-term use of norethisterone oenanthate injections is associated with a decrease in peripheral insulin sensitivity. However, these changes are not associated with any evidence of oral glucose intolerance.     

Quantification of plasma cholesterol and triglyceride levels in hypercholesterolemic subjects receiving ascorbic acid supplements.

In order to assess the possible effects of ascorbic acid on plasma cholesterol and triglyceride levels and plasma lipoprotein composition, nine hypercholesterolemic subjects were treated with oral ascorbic acid (4 g/day) for 2 months. The data demonstrate: 1) no significant change in plasma cholesterol or triglyceride levels; 2) no significant change in the cholesterol or triglyceride concentrations of the major lipoprotein classes; and 3) the unexpected appearance of extra pre-beta bands on lipoprotein electrophoresis by the end of the ascorbic acid treatment period.     

自拟方剂联合小剂量西药预防小儿支气管哮喘发作的临床研究

目的:观察自拟方剂与小剂量西药联用预防小儿支气管哮喘发作的临床疗效。方法:选择该院自2010年1月～2011年10月收治的140例小儿支气管哮喘患儿,按照患儿家长自愿原则,随机分为实验组与对照组。实验组70例,口服哮喘清合剂加用小剂量西药;对照组70例,吸入糖皮质激素和(或)孟鲁斯特钠咀嚼片,观察3个月为1个疗程。同时在发作期、缓解期及1个疗程结束后分别做嗜酸粒细胞计数、FENO、肺功能水平。结果:治疗组的总有效率为91.43%(64/70),高于对照组总有效率70.00%(49/70),具有统计学意义(P<0.05);治疗组在肺功能、嗜酸粒细胞计数、FENO指标比较,有统计学差异(P<0.05)。结论:中西医结合疗法防治小儿支气管哮喘,其疗效显著,能明显改善患者的临床症状,提高治愈率,同时安全性高,值得进一步推广应用。     

Effect of oral contraceptives and pyridoxine on the metabolism of vitamin B6 and on plasma tryptophan and alpha-amino nitrogen.

The effect of supplementary pyridoxine on the metabolism of vitamin B6 as well as plasma tryptophan and alpha-amino nitrogen was determined in women using oral contraceptive agents. Ten women who were taking oral contraceptive agents and 11 who had never taken them served as subjects. Blood from the various biochemical measurements was drawn from fasting subjects before and after they had received an oral dose of 50 mg of pyridoxine-HCl daily fo 2 days. The use of oral contraceptive agents had no effect on the levels of blood vitamin B6, plasma pyridoxal phosphate, and plasma tryptophan. The activity of erythrocyte glutamic oxaloacetic transaminase was higher (P less than 0.05) in the oral contraceptive agent users than in the nonusers but the stimulation in vitro by pyridoxal phosphate was similar for the two groups. Plasma alpha-amino nitrogen was slightly lower in the oral contraceptive agent users than in the nonusers, but the difference was not statistically significant. The rise in blood vitamin B6 in response to pyridoxine was similar in the two groups, but the rise in plasma pyridoxal phosphate tended to be lower in the oral contraceptive agent treated subjects. Following pyridoxine supplementation, the basal activity of erythrocyte glutamic oxalocetic transaminase increased (P less than 0.01) in both groups of subjects and the stimulation in vitro by pyridoxal phosphate decreased correspondingly. Plasma tryptophan and alpha-amino nitrogen were unaffected by the supplementary pyridoxine.     

Airways responses to oral ethanol in normal subjects and in patients with asthma.

The effect of oral ethanol on airflow was studied in 5 normal subjects and 5 patients with asthma. On 4 different study days, each subject was asked to drink 40 ml of either water or 20%, 40% or 60% ethanol, and measurements were made of specific airways conductance (sGaw), blood ethanol levels, pulse rate and blood pressure. In some subjects in both groups there was a significant immediate fall in sGaw after drinking ethanol (below 5% confidence limits). Once absorbed, ethanol had a slight bronchodilator effect in 2 normal subjects and in 3 patients with asthma (5% level). Sixty per cent ethanol, when drunk slowly, showed significant bronchodilatation in 4 out of 5 patients with asthma and in one normal subject (5% level) with no acute fall in sGaw. Pulse rate and blood pressure did not change after water, 20% and 40% ethanol in either group, but immediately after 60% ethanol normal subjects showed a significant rise in pulse rate (P less than 0.01) which was not seen in patients with asthma. The immediate changes in sGaw and pulse rate may be due to stimulation of irritant receptors in the upper airways. Ethanol may act directly on bronchial smooth muscle to produce bronchodilatation and may be useful as a bronchodilator when given intravenously.     

Assessing dermatitis in epidemiologic studies: occupational skin disease among California grape and tomato harvesters

We conducted a cross-sectional investigation to determine whether table grape harvesters, who have significant cutaneous contact with crop-associated materials that may cause skin disease, are more likely to develop dermatitis than are a control group of tomato workers performing mechanical harvesting with minimal cutaneous contact with crop-associated substances. A secondary aim was to develop methods for studying skin disease in farm workers, including a standard questionnaire and physical examination. California table grape workers (n = 183) and tomato workers (n = 43) completed an interviewer-administered questionnaire and waist-up physical examination at their work site during harvest operations. On physical examination, pustular eruptions such as acne and folliculitis were present in 30% of subjects, and eczematous rashes were noted in 10% of subjects. Irritant or allergic contact dermatitis was diagnosed in 2% of subjects. No significant differences in prevalence for these skin conditions were observed between the two groups of workers. In contrast to the physical examination results, grape workers were more likely than tomato workers to report a rash occurring in the previous 3 months (52% vs. 19%, p less than 0.001). Explanations for this discrepancy are discussed. The sensitivity of the questionnaire for current skin conditions was 31%, and the specificity was 94%. Improved sensitivity was seen for eczematous skin conditions (55%). We conclude that questionnaires provide an efficient means of assessing subject characteristics, but may have limited sensitivity for some dermatologic outcomes.     

Stature of adult coeliac patients: no evidence for decreased attained height

Height, weight and body mass index (BMI) in 160 adult coeliac patients, treated with a gluten-free diet for at least 18 months, were compared to an age-matched, randomly selected, normal reference population. No differences were detected in height. In fact, females tended to be slightly taller than normal. Mean weight in females was 7.31 kg (P less than 0.001) and in males 11.98 kg (P less than 0.001) lower than in the reference population, with corresponding differences in BMI. No significant differences between age-weighted mean height, weight or BMI were found between a group of subjects who had experienced abdominal symptoms and were untreated in childhood compared to a group of subjects without such symptoms. Thus, coeliac disease, which has a well-documented retarding effect on growth during childhood, does not influence the final, attained height.     

氨溴特罗口服液治疗婴幼儿支气管肺炎34例临床研究

目的通过研究和探讨氨溴特罗口服液治疗婴幼儿支气管肺炎的效果,总结经验,以更好地指导婴幼儿支气管肺炎的临床用药和治疗。方法随机选择我院最近一年中的68名婴幼儿支气管肺炎患者,将其平均分成A、B两组,A组为治疗组给予氨溴特罗口服液进行治疗;B组为对照组,给予盐酸氨溴索颗粒进行治疗。将两组治疗效果进行对比分析,并加以总结。结果经过治疗后,A组治疗组患者疗效明显高于B组对照组,有效率较高。结论氨溴特罗口服液对于治疗婴幼儿支气管炎具有较好的效果,疗效显著,具有较高的临床推广价值。     

Airway sensitivity of asthmatics to sulfur dioxide

The purpose of this study was to describe for asthmatic subjects the distribution of individual bronchial sensitivity to sulfur dioxide (SO2). Subjects were nonsmoking male asthmatics (n = 27) who were sensitive to inhaled methacholine. None of the subjects used corticosteroids or cromolyn sodium. Oral medications were withheld for 48 hr, inhaled medications for 12 hr prior to all testing. Each subject participated in four separate randomly ordered 10 min exposures to 0.00, 0.25, 0.50 and 1.00 ppm SO2 at 26 degrees C, 70% relative humidity. During exposures, subjects breathed naturally and performed moderate exercise (VE, normalized for body surface area = 21 1/m2 X min). Before and 3 min after exposure, specific airway resistance (SRaw) was measured by body plethysmography. Those subjects whose SRaw was not doubled by exposure to 1.00 ppm were also exposed to 2.00 ppm SO2. Dose response curves (relative change in SRaw, corrected for change in clean air vs SO2 concentration) were constructed for each subject. Bronchial sensitivity to SO2 [PC(SO2)], defined as the concentration of SO2 which provoked an increase in SRaw 100% greater than the response to clean air, was determined. Substantial variability in sensitivity was observed: for 23 subjects, PC(SO2) ranged between 0.28 and 1.90 ppm, while for the remaining 4 subjects, it was greater than 2.00 ppm SO2. The median PC(SO2) was 0.75 ppm SO2, and 6 subjects had a PC(SO2) of less than 0.50 ppm. PC(SO2) was not related (r = 0.31) to airway sensitivity to methacholine.