Difficult intravenous access in a paediatric intensive care unit.

INTRODUCTION: Multiple attempts during peripheral cannulation can have major consequences for patients, relatives, and healthcare professionals, therefore we set out to determine the extent of this problem in a paediatric intensive care unit (PICU). OBJECTIVES: The main aim was to describe peripheral venous catheter (PVC) and peripherally inserted central catheter (PICC) cannulation in children in the PICU. Secondary objectives were to determine the success rate of the first cannulation attempt, to quantify patients with difficult venous access (DVA), and to explore the association between DVA and sociodemographic, technique and nursing-related characteristics. METHOD: A cross-sectional descriptive study. Consecutive sampling was used to recruit patients aged 0-18 years admitted to the PICU who required peripheral venous cannulation. An ad hoc questionnaire was used for this purpose, including the presence of DVA as an independent variable. RESULTS: A total of 163 venous cannulations were reported. A total of 55.8% (91) were performed in patients under 1 year of age. Of these, 38.7% (63) were successful on the first attempt and 36.8% (60) had DVA. When there was DVA, 85% (51) of patients had complications, median time to cannulation by short CVP was 30 minutes [15-53] and 2 or more nurses were required on 80% (48) of occasions. CONCLUSIONS: We found a low success rate at first attempt and a high proportion of DVA. More nurses and time were employed during cannulation and complications increased if the patient had DVA. A statistically significant association was found between DVA and age, weight, poor perfusion, veins that were neither visible nor palpable, DIVA score ≥ 4, history of difficult intravenous access, complications, number of nurses and time spent.

Long term mortality and morbidity of Italian soldiers after deployment in Iraq as related to biomarkers assessment: Results of the SIGNUM study.

INTRODUCTION: The health profile of military veterans deployed in foreign operative theatres was assessed by several international studies because of potential exposure to depleted uranium and other pollutants. Here we reported results of 15-year epidemiological surveillance assessing long-term health effects in a cohort of Italian soldiers deployed in Iraq in 2004-2005 and participating in a biomonitoring campaign to identify potential genotoxic exposure to environmental xenobiotics before and after deployment (n = 981, SIGNUM cohort). METHODS: We evaluated mortality and hospitalization risks of the SIGNUM cohort retrospectively until 2016 and 2018 respectively. A wide cohort of military personnel never deployed abroad (n = 114,260) and the general Italian population were used as control populations in risk assessment. Causes of death and diagnoses of hospitalization were derived through deterministic record linkage with official national databases of mortality and hospital discharge. Standardized Mortality Ratio (SMR) and Standardized Hospitalization Ratio (SHR) were computed adjusting according to sex, age, area of birth, and calendar year. Differential pre-post deployment in xenobiotics concentrations and early effect biomarkers (oxidative DNA alterations and micronuclei) measured in blood serum were analysed in relation to cancer hospitalization. RESULTS: Mortality risk due to pathologies was more than halved compared to the general population (SMR = 0.41, 95% CI 0.11-1.05) and not significantly different compared to soldiers never deployed abroad (SMR = 0.69, 95% CI 0.19-1.68). Similarly overall hospitalization risk due to pathologies was decreased with respect to the general population (SHR = 0.86, 95% CI 0.80-0.92) and comparable to the control military group (SHR = 0.99, 95% CI: 0.93-1.06). For haematological cancers a decreased hospitalization risk compared to the Italian general population was observed (SHR = 0.38, 95% CI 0-0.92). No statistically significant differences emerged in the patterns of biomarkers in association with cancer hospitalization. CONCLUSION: The study confirms the so called 'healthy warrior' effect for the SIGNUM veterans and showed no correlation between cancer occurrence and biomonitoring markers measured on field.

[Implementation of simplified diagnostic method Apnealink™Air® to diagnose sleep apnea by general practioners of primary care]. / Implementación del método simplificado Apnealink™Air® por médicos de atención primaria para el diagnóstico del síndrome de apnea-hipopnea durante el sueño.

OBJECTIVES: To assess diagnosis and therapeutic decisions-making by General Practitioners (GP) using ApnealinkTM® (AL) in patients with high suspicion of obstructive sleep apnea (OSA), in comparison with conclusions of Hospital Sleep Unit (HSU) specialists based on home respiratory polygraphy (PGR) results. METHODS: This study involved patients previously selected by HSU for sleep testing by PGR. After it, patients were offered to complete AL test. PGR was checked at HSU; AL was checked by hemoglobin desaturation index of 4% (4% ODI), (4% AL) and 3% (3% ODI) patients with positive test to proceed with CPAP; and those with negative test for further testing. Automatically adjusted 4% AL, was considered valid as it was demonstrated to be equivalent to manual AL. Results were compared by automatically adjusted 3%AL against PGR results. RESULTS: 48 patients were collected. 43 had AL valid test, 45 had PGR valid study, and 41 had both valid test. 27 patients (62,8%) had positive 4% AL (OR 5,51, p < 0,05), that showed AHI ≥ 15/h at 3% AL test; and 19 patients (42,2%) had a positive PGR test. 31 (72%) patients had a positive 3% AL. AL had shown to be a good screening method of SAHS. CONCLUSIONS: There is equivalence between the decisions of GP and HSU. AL is a good diagnostic tool and screening method for OSA in primary care when it is used in patients with high suspicion of moderate-severe OSA.

Difficult intravenous access in a paediatric intensive care unit. / Vía venosa difícil en una unidad de cuidados intensivos pediátricos.

INTRODUCTION: Multiple attempts during peripheral cannulation can have major consequences for patients, relatives, and healthcare professionals, therefore we set out to determine the extent of this problem in a paediatric intensive care unit (PICU). OBJECTIVES: The main aim was to describe peripheral venous catheter (PVC) and peripherally inserted central catheter (PICC) cannulation in children in the PICU. Secondary objectives were to determine the success rate of the first cannulation attempt, to quantify patients with difficult venous access (DVA), and to explore the association between DVA and sociodemographic, technique and nursing-related characteristics. METHOD: A cross-sectional descriptive study. Consecutive sampling was used to recruit patients aged 0-18 years admitted to the PICU who required peripheral venous cannulation. An ad hoc questionnaire was used for this purpose, including the presence of DVA as an independent variable. RESULTS: A total of 163 venous cannulations were reported. A total of 55.8% (91) were performed in patients under 1 year of age. Of these, 38.7% (63) were successful on the first attempt and 36.8% (60) had DVA. When there was DVA, 85% (51) of patients had complications, median time to cannulation by short CVP was 30minutes [15-53] and 2 or more nurses were required on 80% (48) of occasions. CONCLUSIONS: We found a low success rate at first attempt and a high proportion of DVA. More nurses and time were employed during cannulation and complications increased if the patient had DVA. A statistically significant association was found between DVA and age, weight, poor perfusion, veins that were neither visible nor palpable, DIVA score≥4, history of difficult intravenous access, complications, number of nurses and time spent.

Virtual bronchoscopy for evaluating cervical tumors of the fetus.

We report on four cases of fetal cervical tumor, comprising three lymphangiomas and one teratoma, evaluated by ultrasound and magnetic resonance imaging (MRI) between 26 and 37 weeks' gestation. The aim was to investigate the use of virtual bronchoscopy to evaluate fetal airway patency in each case. A three-dimensional (3D) model of the airway was created from overlapping image layers generated by MRI. The files obtained were manipulated using 3D modeling software, allowing the virtual positioning of observation cameras, adjustment of lighting parameters and creation of simulated 3D movies for analysis of a virtual path through the model. In all fetuses, fetal airway patency was clearly demonstrated by virtual bronchoscopy and this was confirmed postnatally. MRI with virtual bronchoscopy could become a useful tool for studying fetal airway patency in cases of cervical tumor.

[Experience with continuous levodopa enteral infusion (Duodopa(®)) in patients with advanced Parkinson's disease in a secondary level hospital]. / Experiencia con la infusión continua de levodopa intraduodenal (Duodopa(®)) en pacientes con enfermedad de Parkinson avanzada en un hospital de segundo nivel asistencial.

INTRODUCTION: Continuous levodopa delivery by enteral infusion (Duodopa(®)) is an alternative to deep brain stimulation and subcutaneous apomorphine to control motor fluctuations and dyskinesias in advanced Parkinson's disease (PD). We report our experience with Duodopa(®) therapy in 11 patients with advanced PD. METHODS: We retrospectively assessed clinical and quality of life changes in all patients with PD with severe motor fluctuations and dyskinesias who started continuous daily levodopa duodenal infusion through percutaneous endoscopic gastrostomy from September 2006 (Duodopa(®) was approved for advanced PD treatment in Spain at that date) until April 2010 at the A. Marcide Hospital of Spain. RESULTS: Nine patients received Duodopa(®) [62.7±10.6 (44-74) years, 63.6% male)]. Pre-Duodopa(®) clinical characteristics of patients were: disease duration 14.5±8.9 (3-34) years, oral levodopa dose 918.2±277.7 (450-1300) mg/day, and Hoehn and Yahr staging 3.7±0.5 (3-4). Nine patients are still receiving Duodopa(®). Patients improved motor fluctuations (72.7% significant improvement), dyskinesia (55.5% significant improvement), daily off-time (90.9%) and daily duration dyskinesia (66.6%) after total infusion time of 170.5 months (3-31). The improvement in Parkinson's Disease Quality of Life Questionnaire-39 (PDQ-39) and Schwab&England Capacity for Daily Living Scale were 38.5±19.8 and 24±12.5 respectively (P<0.05). Equivalent daily dose of levodopa (April 2010) was 1683.4±295.8 (1234-2216) mg/day. CONCLUSIONS: Intraduodenal infusion of levodopa offers an important alternative in treating patients with advanced Parkinson disease.

Acute effects of coffee on endothelial function in healthy subjects.

BACKGROUND/OBJECTIVES: Coffee is the most widely consumed beverage in the world, but its effect on the cardiovascular system has not been fully understood. Coffee contains caffeine and antioxidants, which may influence endothelial function, both of which have not yet been investigated. The objective of this study was to investigate the acute effects of coffee on endothelial function measured by brachial artery flow-mediated dilation (FMD). SUBJECTS/METHODS: A total of 20 (10 males and 10 females) healthy non-obese subjects underwent a double-blind, crossover study. Subjects ingested one cup of caffeinated (CC) and one cup of decaffeinated (DC) Italian espresso coffee in random order at 5- to 7-day intervals. RESULTS: Following CC ingestion, FMD decreased progressively and significantly (mean+/-s.e.m.: 0 min, 7.7+/-0.6; 30 min, 6.3+/-0.7; 60 min, 6.0+/-0.8%; ANOVA (analysis of variance), P<0.05), but it did not significantly increase after DC ingestion (0 min, 6.9+/-0.6; 30 min, 8.1+/-0.9; 60 min, 8.5+/-0.9%; P=0.115). Similarly, CC significantly increased both systolic and diastolic blood pressure; this effect was not observed after DC ingestion. Blood glucose concentrations remained unchanged after ingestion of both CC and DC, but insulin (0 min, 15.8+/-0.9; 60 min, 15.0+/-0.8 muU/ml; P<0.05) and C-peptide (0 min, 1.25+/-0.09; 60 min, 1.18+/-0.09 ng/ml; P<0.01) blood concentrations decreased significantly only after CC ingestion. CONCLUSIONS: CC acutely induced unfavorable cardiovascular effects, especially on endothelial function. In the fasting state, insulin secretion is also likely reduced after CC ingestion. Future studies will determine whether CC has detrimental clinically relevant effects, especially in unhealthy subjects.

Dose-dependent effects of decaffeinated coffee on endothelial function in healthy subjects.

BACKGROUND/OBJECTIVES: Coffee is known to contain antioxidant substances whose effects may be blunted because of caffeine that may unfavorably affect the cardiovascular system. This study was designed to investigate the acute dose-dependent effects of decaffeinated coffee (DC) on endothelial function measured by the brachial artery flow-mediated dilation (FMD). SUBJECTS/METHODS: A total of 15 (8 men and 7 women) healthy nonobese subjects underwent a single-blind, crossover study. Subjects ingested one and two cups of decaffeinated Italian espresso coffee in random order at 5- to 7-day intervals. RESULTS: In the hour following the ingestion of two cups of DC, FMD increased (mean+/-s.e.m.): 0 min, 7.4+/-0.7%; 30 min, 8.0+/-0.6%; 60 min, 10.8+/-0.8%; P<0.001) as compared to consumption of one cup of DC (0 min, 6.9+/-0.7%; 30 min, 8.4+/-1.2%; 60 min, 8.5+/-1.1%; 3 x 2 repeated-measures analysis of variance: P=0.037 for time x treatment effect). Blood pressure did not differ between groups, and basal heart rate was lower in the two-cup group at baseline and 60 min. CONCLUSIONS: The present study demonstrated a significant acute favorable dose-dependent effect of decaffeinated espresso coffee on endothelial function. Further studies are needed to investigate the effects of chronic use of DC especially with respect to caffeinated coffee and in subjects with cardiovascular diseases.

[Identification and early nutritional support in hospitalized malnourished patients]. / Reconocimiento y soporte nutricional precoz en pacientes hospitalizados desnutridos.

INTRODUCTION: The prevalence of hyponutrition in hospitalized patients in our setting is 53%. The therapeutic approach is controversial. OBJECTIVES: To determine whether an early nutritional intervention in hospitalized patients by means of oral nutritional support can improve their prognosis regarding decreased morbimortality and hospital stay. MATERIAL AND METHODS: Randomized prospective study comprised by a treatment group and a control group of malnourished patients hospitalized at the Internal Medicine and Respiratory Medicine Departments. The nutritional diagnosis was made by using the Subjective Global Assessment. Groups B and C were assigned to receive the hospital diet according to their needs and pathology (control group) and the treatment group also received a standard nutritional supplement. We recorded the development of infections, pressure ulcers, hospitalization days, mortality, and weight. RESULTS: We performed more than 1,700 Subjective Global Assessments. Five hundred and thirty seven patients (264 treated and 273 controls) were followed-up until hospital discharge or death. We did not find statistically significant differences in mortality, hospital stay, or occurrence of complications between the treatment group and the control group. The treatment group presented statistically significant weight increase as compared with the control group. CONCLUSIONS: We could not demonstrate benefits when using the oral nutritional supplement in terms of mortality, hospital stay, infectious complications, or pressure ulcers. The significant weight increase in the treatment group allowed us concluding that the supplement effectively treated hyponutrition in this group. This new clinical status implies a better prognosis, as it has already been shown. However, this could not be observed by means of the study parameters. Long-term studies are required to determine for how long this nutritional improvement can be sustained, implying a better prognosis in the long run.

Cholesterol content regulates acrosomal exocytosis by enhancing Rab3A plasma membrane association.

The acrosome is an exocytic granule that overlies the spermatozoan nucleus. In response to different stimuli, it undergoes calcium-regulated exocytosis. Freshly ejaculated mammalian sperm are not immediately capable of undergoing acrosome reaction. The acquisition of this ability is called capacitation and involves a series of still not well-characterized changes in the sperm physiology. Plasma membrane cholesterol removal is one of the sperm modifications that are associated with capacitation. However, how sterols affect acrosomal exocytosis is unknown. Here, we show that short incubations with cyclodextrin, a cholesterol removal agent, just before stimulation promote acrosomal exocytosis. Moreover, the effect was also observed in permeabilized cells stimulated with calcium, indicating that cholesterol plays a direct role in the calcium-dependent exocytosis associated with acrosome reaction. Using a photo-inhibitable calcium chelator, we show that cholesterol affects an early event of the exocytic cascade rather than the lipid bilayers mixing. Functional data indicate that one target for the cholesterol effect is Rab3A. The sterol content does not affect the Rab3A activation-deactivation cycle but regulates its membrane anchoring. Western blot analysis and immunoelectron microscopy confirmed that cholesterol efflux facilitates Rab3A association to sperm plasma membrane. Our data indicate that the cholesterol efflux occurring during capacitation optimizes the conditions for the productive assembly of the fusion machinery required for acrosome reaction.

Compartmentalization of lysosomal enzymes in cauda epididymis of normal and castrated rats.

The mammalian epididymis is an organ particularly rich in acid hydrolases, consistent with a developed lysosomal apparatus. However, some of these enzymes could also play a role in an extracellular environment, since they are actively secreted by the epithelium. In this study the authors measured the activity of five acid hydrolases distributed between the epithelium, fluid, small vesicles, and spermatozoa of the rat cauda epididymis in adult rats, and compared with that distribution under conditions of deprivation of luminal testosterone and testicular compounds (hemicastration). Lysosomal enzymes are differently compartmentalized in rat cauda epididymis. Most of beta-galactosidase (beta-GAL) and aryl sulfatase (approximately 70%) were found in soluble form within the fluid. Some 60% of N-acetyl-beta-D-glucosaminidase (beta-NAG) and alpha-mannosidase (alpha-MAN) become transiently bound to sperm, and beta-glucuronidase (beta-GLU) was mostly concentrated in the epithelium. After remotion of testis this distribution changed, as the retention of alpha-MAN, beta-GAL, beta-GLU, and beta-NAG by the epididiymal tissue increased. The increase of beta-GLU followed an increase of synthesis of the enzyme. The distribution of enzymes in the epididymis from the contralateral side was similar to that in normal rats. The different roles for each enzyme in the epididymis are discussed.

Mannose-6-phosphate receptors as a molecular indicator of maturation of epididymal sperm.

This review discusses some of the changes in sperm during maturation within the context of current concepts of membrane structure and fertilization. Mammalian sperm are surrounded by a limiting plasma membrane that undergoes remodeling during passage through the epididymis. This process confers on the gamete vigorous motility and the ability to fertilize the egg. The repositioning of some surface proteins may follow redistribution of lipids in the plasmalemma, and thus represent a critical step in the maturation of the gametes. Among the various affected proteins of the sperm plasmalemma, mannose-6-phosphate receptors undergo redistribution as the gametes transit through the epididymal duct. The authors summarize their studies of the redistribution of phosphomannosyl receptors during maturation of sperm and discuss possible roles of these glycoproteins in the fertilizing capability of sperm.

Stable methane hydrate above 2 GPa and the source of Titan's atmospheric methane.

Methane hydrate is thought to have been the dominant methane-containing phase in the nebula from which Saturn, Uranus, Neptune and their major moons formed. It accordingly plays an important role in formation models of Titan, Saturn's largest moon. Current understanding assumes that methane hydrate dissociates into ice and free methane in the pressure range 1-2 GPa (10-20 kbar), consistent with some theoretical and experimental studies. But such pressure-induced dissociation would have led to the early loss of methane from Titan's interior to its atmosphere, where it would rapidly have been destroyed by photochemical processes. This is difficult to reconcile with the observed presence of significant amounts of methane in Titan's present atmosphere. Here we report neutron and synchrotron X-ray diffraction studies that determine the thermodynamic behaviour of methane hydrate at pressures up to 10 GPa. We find structural transitions at about 1 and 2 GPa to new hydrate phases which remain stable to at least 10 GPa. This implies that the methane in the primordial core of Titan remained in stable hydrate phases throughout differentiation, eventually forming a layer of methane clathrate approximately 100 km thick within the ice mantle. This layer is a plausible source for the continuing replenishment of Titan's atmospheric methane.

Changes in distribution of phosphomannosyl receptors during maturation of rat spermatozoa.

The aim of the present work was to study the distribution of the cation-independent (CI) and cation-dependent (CD) mannose-6-phosphate receptors (MPRs) in spermatozoa obtained from either rete testis or three regions of rat epididymis. We observed that both receptors underwent changes in distribution as spermatozoa passed from rete testis to cauda epididymis. CI-MPR was concentrated in the dorsal region of the head in rete testis sperm and that this labeling extended to the equatorial segment of epididymal spermatozoa. CD-MPR, however, changed from a dorsal distribution in rete testis, caput, and corpus to a double labeling on the dorsal and ventral regions in cauda spermatozoa. The percentages of spermatozoa that showed staining for either CI-MPR or CD-MPR increased from rete testis to epididymis. The observed changes were probably the result of a redistribution during transit rather than an unmasking of receptors. The fluorescence corresponding to CD-MPR and CI-MPR on the dorsal region disappeared when caudal spermatozoa underwent the acrosomal reaction. Receptors were localized on the plasmalemma of spermatozoa, as observed by immunoelectron microscopy. Changes in distribution may be related to a maturation process, which suggests new roles for the phosphomannosyl receptors.

The sesquiterpene lactone dehydroleucodine (DhL) affects the growth of cultured epimastigotes of Trypanosoma cruzi.

Here, we report an inhibitory effect of a sesquiterpene lactone dehydroleucodine (DhL) on the growth of Trypanosoma cruzi in culture. At concentrations of the drug between 5 and 10 microg/ml in the medium,the parasites remained alive for at least 4 days. Higher concentrations of DhL were lethal for the parasites within a few hours. The effect of DhL is irreversible. Morphological changes induced by DhL were also observed in the parasites. The effect of DhL was blocked by the presence of reducing substrates such as glutathione or dithiothreitol, but these agents were not able to reverse the effect of DhL if added 2 days after the start of drug exposure.

Trabeculectomy with mitomycin-C in the treatment of pediatric glaucomas.

PURPOSE: To evaluate the effectiveness and safety of trabeculectomy with mitomycin-C (MMC) in the management of childhood glaucomas. DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: All patients less than 18 years of age who underwent trabeculectomy with MMC from June 1991 through October 1997 were included. METHODS: The medical records of 29 consecutive patients (29 eyes) were reviewed. Data collected during routine patient follow-up were analyzed. Surgical outcome was evaluated using Kaplan-Meier life-table analysis. MAIN OUTCOME MEASURES: Clinical outcome assessment included intraocular pressure (IOP) control, visual acuity, and identification of complications. Successful IOP control was defined as 5 mmHg < or = final IOP < or = 21 mmHg, with or without antiglaucoma medications and without further glaucoma surgery or loss of light perception. Outcomes for the group of patients with primary infantile glaucoma were compared with those for the group with secondary glaucomas. RESULTS: Mean patient age was 6.4 +/- 4.4 years (range, 0.2-15.3 years). A variety of primary and secondary glaucomas were represented. Mitomycin-C (0.5 mg/ml) on a surgical sponge was applied to the episcleral surface for an average of 3.8 +/- 1.0 minutes (range, 1.5-5.0 minutes). Mean follow-up time for patients categorized as successes was 25.1 +/- 16.0 months (range, 5.5-59.7 months). The 12-, 24-, and 36-month life-table success rates for IOP control were 82%, 59%, and 59% respectively. There was no difference between the primary infantile glaucoma group and the secondary glaucoma group with respect to length of follow-up, rate of successful IOP control, and incidence of complications. Five patients (17%) experienced late bleb-related infection (BRI) at an average of 27.9 +/- 18.1 months (range, 5.4-55.5 months) after surgery. Other complications included hyphema, retinal detachment, late-onset bleb leak, flat anterior chamber, chronic hypotony, decompression retinopathy, suture abscess, and phthisis. CONCLUSIONS: Trabeculectomy with MMC may be useful in the management of childhood glaucomas in which goniotomy, trabeculotomy, or both have failed. However, the high incidence of BRI in this series over an extended follow-up interval dictates caution in using MMC as an adjunct in pediatric trabeculectomy.

Purification of proteins from rat sperm membranes that interact with ligands other than phosphomannosyl residues.

In this study proteins were purified from rat sperm membranes which might be the high affinity sites for ligands of epididymal fluid other than the mannose-6-phosphate receptors. The sperm membrane proteins were solubilized and passed over an affinity column containing epididymal fluid proteins coupled to a matrix. Two bands in the range of 45-55 kDa were eluted from the column with fructose-6-phosphate but not with mannose-6-phosphate. Although the molecular weight of these proteins are similar to those of the cation-dependent phosphomannosyl receptors they are not related. These two proteins may correspond either to two different receptors or to forms of the same receptor that recognize ligands from rat epididymal fluid. Sequencing and identification of these proteins will be the aim of future studies.

A cluster of ABA-regulated genes on Arabidopsis thaliana BAC T07M07.

Arabidopsis thaliana BAC T07M07 encoding the abscisic acid-insensitive 4 (ABI4) locus has been sequenced completely. It contains a 95,713-bp insert and 24 predicted genes. Most putative genes were confirmed by gel-based RNA profiling and a cluster of ABA-regulated genes was identified. One of the 24 genes, designated PP2C5, encodes a putative protein phosphatase 2C. The encoded protein was expressed in Escherichia coli, and its enzyme activity in vitro was confirmed.

Changes in the content of rat epididymal fluid induced by prolonged treatment with tamoxifen.

Prolonged treatment with tamoxifen induces changes in the male reproductive tract in rats. In this study changes in the protein content of the rat epididymal fluid as a consequence of prolonged treatment with tamoxifen are reported. Among five lysosomal enzymes measured in the epididymal fluid, alpha-mannosidase (alpha-MAN) significantly diminished, but other enzymes did not. Electrophoretic analysis of fluids showed that proteins of estimated molecular weight 25, 60, 80-85 and 180 kDa decreased in the treated rats. We also detected an increase in the binding of beta-galactosidase (beta-GAL) to caudal spermatozoa in treated rats. These changes may be related in part to the loss of fertilizing capacity of spermatozoa after tamoxifen treatment.