Vasectomy techniques for male sterilization: systematic Cochrane review of randomized controlled trials and controlled clinical trials

BACKGROUND: The review aimed to compare the effectiveness, safety and acceptability of vasectomy techniques for male sterilization. METHODS: We searched five computerized databases and reference lists of relevant articles and book chapters for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) comparing vasectomy techniques. Two reviewers independently extracted data from eligible articles. RESULTS: Two poor-quality trials compared vas occlusion with clips versus a conventional technique, and four poor-quality trials examined vas irrigation with water versus no irrigation or irrigation with euflavine. No significant differences regarding the primary outcome of time to azoospermia were found. However, one trial reported fewer median number of ejaculations to azoospermia with euflavine rather than water irrigation. An interim report of a high-quality trial comparing vasectomy with and without fascial interposition found more azoospermia with fascial interposition but also more surgical difficulties. CONCLUSIONS: No conclusions can be reached regarding the effectiveness, safety and acceptability of vas occlusion techniques or vas irrigation since only low-quality, underpowered studies were available. Fascial interposition had improved vasectomy success but also increased surgical difficulty. High-quality, adequately reported RCTs are required. More work is also needed in the standardization of follow-up protocols, evaluation of vasectomy success and failure, recanalization and analytical methods.     

Recirculating and germinal center B cells differentiate into cells responsive to polysaccharide antigens

Antibodies against bacterial capsular polysaccharides play a critical protective role. Responses to these antigens can occur without the help or control of T cells and are associated with marginal zone (MZ) B cells. Capsular antigens are diverse and some cross-react with self-carbohydrate epitopes. This diversity may explain the recruitment of non-autoreactive recirculating B cells and memory B cells to the MZ in addition to other B cells, some of which are weakly autoreactive cells, that are recruited to the MZ without entering the recirculating pool. To test whether memory B cells respond to polysaccharide-based antigens, mice with hapten-specific memory B cells were challenged with hapten-polysaccharide. Hapten-specific plasma cells producing high affinity antibody with Ig V-region mutations were induced. To test whether naive recirculating B cells can form MZ cells that respond to polysaccharide, recirculating B cells from lymph nodes were transferred into Rag-1-deficient mice. MZ cells differentiated from the donor cells without proliferation or T cell help and responded to polysaccharide-based antigen. The differentiation of B cells both from germinal centers and the recirculating pool to the MZ phenotype is likely to make an important contribution to the repertoire of B cells that respond to polysaccharide antigens.     

Effect of amiloride on electrolyte transport parameters of the main duct of the rabbit mandibular salivary gland

We have studied the response of the rabbit mandibular main duct perfused in vitro to luminally administered amiloride. The half-maximal inhibitory concentrations (K_I) when the duct was bathed in Cl solutions were: for net Na⁺ transport, 3×10^–6 mol l^–1; for transepithelial potential difference, 6×10^–6 mol l^–1; and for transepithelial conductance, 3×10^–7 mol l^–1. Substitution of the impermeant SO ₄ ^2– anion for Cl^– changed the K_I for conductance to 3×10^–6 mol l^–1. Within Cl^–-containing media, the time course of the amiloride effect on potential difference showed an early rapid fall of 10 mV with a half-time 2 s, followed by a slower depolarization of 9 mV, and the conductance change followed the slower component of the potential change. In SO ₄ ^2– -containing media, the potential difference and conductance changes followed time courses similar to one another. Finally, experiments on the effect of serosal applications of ouabain revealed that, although, in general, ouabain reduced resistance, it caused an increase in resistance in those ducts where the initial resistance was low. We conclude that: i) luminal Na⁺ transport occurs via amiloride-sensitive, conductive Na⁺ channels; ii) the Cl^– conductance is the major determinant of transepithelial conductance; iii) the first phase of the potential response is due to blocking of the Na⁺ conductive channels, whilst the slow phase reflects secondary inhibition of an electrogenic Na⁺ pump; and iv) duct resistance changes are secondary to alterations in intracellular Cl^– concentration.     

Antibodies to low-incidence antigens and elimination of the antihuman globulin phase of the crossmatch-case report: anti-Wra

An antibody to a low-incidence antigen was identified in the serum of a nontransfused male patient. The antibody was subsequently identified as anti-Wra and was only detectable at the antihuman globulin (AHG) phase of the crossmatch. Instances of severe hemolytic transfusion reactions have been reported following the transfusion of red blood cells containing low-incidence antigens in patients with antibodies directed toward these antigens (e.g., anti- Wra, -Cob, -Jsa, etc.). Elimination of the AHG phase of the crossmatch can result in either risks or benefits. Since patients seen at this facility primarily have been multitransfused or are multiparous females, the AHG phase of the crossmatch has been maintained.     

Infection of chicken erythrocytes with influenza and other viruses.

Chicken erythrocytes can be infected by the fowl plague (Rostock) strain (FP/R) of influenza type A, Newcastle disease virus (NDV), and Semliki Forest virus (SFV). Only NDV and SFV produced infectious progeny, albeit at low levels. Infection by FP/R was monitored by de novo synthesis of viral proteins, and the proteins synthesized could be identified by comparison with infected chicken fibroblast cells. FP/R synthesized far greater amounts of viral protein than did NDV or SFV.     

Pathogenesis of Herpetic Neuritis and Ganglionitis in Mice: Evidence for Intra-Axonal Transport of Infection

The pathogenesis of acute herpetic infection in the nervous system has been studied following rear footpad inoculation of mice. Viral assays performed on appropriate tissues at various time intervals indicated that the infection progressed sequentially from peripheral to the central nervous system, with infectious virus reaching the sacrosciatic spinal ganglia in 20 to 24 hr. The infection also progressed to ganglia in mice given high levels of anti-viral antibody. Immunofluorescent techniques demonstrated that both neurons and supporting cells produced virus-specific antigens. By electron microscopy, neurons were found to produce morphologically complete virions, but supporting cells replicated principally nucleocapsids. These results are discussed in the context of possible mechanisms by which herpes simplex virus might travel in nerve trunks. They are considered to offer strong support for centripetal transport in axons.     

Detection of turkey rhinotracheitis virus in turkeys using the polymerase chain reaction

Six-week-old turkey poults were infected with the virulent UK/3B/85 strain of TRTV. Tracheal and oesophageal swabs were made every 2 to 3 days from groups of five poults and the RNA extracted. The TRTV RNA was then reverse-transcribed into complementary DNA (cDNA) using an oligonucleotide complementary to the 3' end of the fusion protein (F) mRNA. The cDNA was then used in a polymerase chain reaction (PCR) with an upstream primer to generate a product of approximately 0.5 kbp which was detected by ethidium bromide staining after electrophoresis. In this way, TRTV was detected in both types of swab for 17 to 19 days post-infection, nearly 2 weeks after the peak titres of infectious virus. Swabs which were allowed to dry completely before RNA extraction were as successful as swabs kept wet and extracted almost immediately, useful for when samples are collected in the field. The oligonucleotides amplified the 0.5 kbp product from TRTV strains isolated in six countries over a 13-year period, indicating that they might be usable as 'universal' oligonucleotides for TRTV detection.