Advances in the evaluation and treatment of the infertile man

Numerous advances in technology have been made in the last several years in the diagnosis and treatment of the infertile man. Using case presentations, this article highlights these important new developments and reviews the basics of a comprehensive male infertility evaluation. The use of ultrasound as a critical, indispensable, yet noninvasive tool in the evaluation of possible male reproductive tract obstruction is discussed. Since assisted reproductive techniques (ARTs) have be come increasingly important in the management of the otherwise untreatable infertile man, specialized testing of sperm function, e.g., the sperm penetration assay (SPA), and strict morphology assessment are often useful prior to the initiation of some of these assisted reproductive procedures such as intrauterine insemination (IUI) or in vitro fertilization (IVF). Testicular touch preparation cytology and image analysis are also important additions to routine testicular biopsy for quantifying the extent of spermatogenesis. Finally, the revolutionary micromanipulation procedure of intracytoplasmic sperm injection (ICSI) has forever changed the practice of andrology by enabling men previously thought to be irreversibly infertile the chance to initiate their own biologic pregnancy.     

Possibility of correcting atherogenic dyslipoproteinemia by the mountain climate treatment]

Whether dyslipoproteinemias can be corrected with 24-day mountain therapy in a mid-mountainous area (the village of Malinovka, 1600 m above the sea-level) was studied in 225 males who had sustained large myocardial infarction. The posthospital rehabilitation of postinfarction patients in a mid-mountainous sanatorium caused a substantial change in blood lipoprotein composition, which were generally antiatherogenic. The antiatherogenic changes in blood lipoprotein composition retained within 10 months after their stay at the sanatorium, which indicates that mid-mountain climate is a promising tool for non-drug prevention and correction of atherogenic dyslipoproteinemias.     

Soft-tissue alterations associated with acute, extended open reduction and internal fixation or orbital fractures.

Soft-tissue alterations associated with radical degloving of the overlying soft tissues during extended open reduction and rigid internal fixation of facial fractures involving 51 orbits in 36 patients were studied. In all patients, the blepharoplasty skin muscle flap incision was employed in conjunction with, as necessary, a gingivobuccal sulcus and coronary incisions. Patients were evaluated between 6 and 20 months after surgery. Physical examination and standardized photographs were used for assessment. Ectropion developed in 2 lids (4%), and 10 lids (20%) had increased scleral show. Thirteen of the 51 lids (25%) revealed lateral canthal displacement; all 13 lids underwent canthal stripping. Cheek pad displacement developed in 8 patients (22%), all of whom had complete maxillary degloving without soft-tissue resuspension. No patient had frontal nerve palsy. Depression in the temporal area was noted in all patients in whom the temporalis was mobilized. Remote incisions and soft-tissue degloving used for extended open reduction and internal fixation are associated with morbidity that can be minimized by meticulous technique and soft-tissue repositioning at closure.     

Role and regulation of interleukin-1 molecules in pro-asthmatic sensitised airway smooth muscle.

Interleukin (IL)-1beta is a pleiotropic, pro-inflammatory cytokine that has been importantly implicated in driving the inflammatory response and resultant changes in airway smooth muscle (ASM) responsiveness in asthma. IL-1beta belongs to a family of molecules, known as the IL-1 axis, which exert both pro- and anti-inflammatory effects. Since dysregulation of IL-1 axis molecules may be critical in the pathobiology of asthma, the present study examined the expression and activation of both the inhibitory and stimulatory IL-1 axis molecules in human ASM cells and their roles in modulating cytokine and immunoglobulin (Ig)E immune complex (IgE cx)-mediated changes in rabbit ASM constrictor and relaxant responsiveness. The results demonstrate the following. 1) Pre-treatment of isolated rabbit tracheal rings with the inhibitory IL-1 axis members, IL-1 receptor antagonist and IL-1 type-II receptor abrogated both IL-5- and IgE cx-induced changes in ASM responsiveness. 2) Administration of IL-5, IL-1beta and IgE cxs to human ASM cells increased mRNA and protein expressions of both stimulatory and inhibitory IL-1 axis molecules. 3) The time course of IL-5-induced IL-1 axis molecule expression preceded that of both IL-1beta and IgE immune cxs. Collectively, these findings suggest that modulation at the level of the interleukin-1 axis of molecules may have significant therapeutic potential in the treatment of asthma.     

Multiple internal resorptions in deciduous teeth: a case report

We report a case of rare multiple internal resorptions. Etiology of multiple internal resorptions is unknown. Interestingly, the patient had an atopic dermatitis, which is possibly related to multiple and rapid internal resorptions.     

Laparoscopic mobilization of the inferior epigastric artery for penile revascularization in vasculogenic impotence.

A laparoscopic approach was used for penile revascularization in a patient with vasculogenic impotence to avoid the long abdominal incision which was traditionally required to harvest the inferior epigastric artery as a neoarterial source. Despite the time-consuming nature of laparoscopy, this procedure was as efficacious but less morbid and required less convalescence than open revascularization. Whether more patients may benefit from this procedure must be evaluated in further studies.     

The nucleotide: DNA sequencing and its clinical application.

Information determining cellular structure and function is contained in chromosomal DNA. Genes, regions of DNA encoding this information, are composed of specific sequences of nucleotides. DNA sequencing methods have been developed to identify these sequences. Even subtle alteration (or mutation) of these sequences can lead to many human syndromes and diseases. This article reviews 1) the structure of the nucleotide, 2) the methods of DNA sequencing, and 3) its recent clinical application in analysis of the nevoid basal cell carcinoma syndrome.