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1.
Int Urol Nephrol ; 42(4): 991-7, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20405207

RESUMO

AIM: Our aim was to investigate the changes in testicular tissue histology associated with six different types of commonly used suture material. MATERIALS AND METHODS: Twenty-one adult male New Zealand White rabbits were randomly assigned to seven groups of three animals each: sham-operated controls; polyglyconate suture; chromic catgut suture; polypropylene suture; polyglactin-910 suture; silk suture; and poliglecaprone-25 suture. All the materials tested were 6-0 caliber. In each suture-group rabbit, bilateral vertical paramedian incisions were made in the scrotal skin. Three interrupted transparenchymal sutures were then passed through the upper pole, middle, and lower pole of each testis and then fixed to the tunica albuginea using small tapered atraumatic needles. The control group underwent the same procedures but the needle was passed without suture attached. Bilateral orchiectomies were performed 30 days after suture placement, and the tissues were histologically scored. The parameters evaluated were the numbers of foreign-body giant cells and the proportion of the area that histiocytes infiltrated nearby the suture material; severity of fibrosis in the surrounding tissue; the proportion of tubules affected by the material; and spermatogenetic activity in the seminiferous tubules surrounding the suture material. RESULTS: The control tissues showed no inflammatory reaction and no changes in spermatogenesis. All tissue samples from all suture groups showed foreign-body reaction. In addition, all the suture-group specimens exhibited reduced spermatogenesis. Polypropylene suture had highest numbers of tubules with normal spermatogenesis and lowest numbers of maturation arrest. CONCLUSION: All the suture materials had a negative impact on spermatogenesis. Polypropylene suture caused less reaction and damage than the other five materials tested.


Assuntos
Teste de Materiais , Técnicas de Sutura , Suturas , Testículo/patologia , Testículo/cirurgia , Animais , Masculino , Coelhos
2.
J Endourol ; 21(1): 108-11, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17263621

RESUMO

PURPOSE: To evaluate the effect of artificial CO2 pneumoretroperitoneum on bacterial translocation in an experimental retroperitoneoscopy model. MATERIALS AND METHODS: Eighteen adult male New Zealand White rabbits weighing 2.5 to 3 kg were divided into two groups. Group 1 (control group) consisted of 6 rabbits, while the remaining 12 served as the pneumoretroperitoneum group (group 2). In group 1, the left retroperitoneal space was dissected with a 50-mL balloon without CO2 insufflation, and the animals were kept under anesthesia for 3 hours with the balloons inflated. In group 2, after balloon dissection as in group 1, CO2 insufflation was applied at 1 L/min to achieve a pressure of 10 to 12 mm Hg for 3 hours. Afterward, all animals were sacrificed, and samples were taken from the blood, retroperitoneal area, lungs, liver, mesentery, heart, kidneys, ureters, bladder, colon, small intestine, and spleen and carried to the microbiology laboratory in Carry-Blair medium. Bacterial growth was evaluated using standard techniques. RESULTS: All animals survived the experimental procedures. None of the rabbits in the control group demonstrated any bacterial translocation in the sampled tissues. In the pneumoretroperitoneum group, one rabbit was found to have 10(2) colony-forming units of E. coli in the kidney, but this was considered to be the result of contamination, not translocation. CONCLUSION: Carbon dioxide pneumoretroperitoneum does not seem to cause bacteremia or bacterial translocation in this experimental model. Retroperitoneoscopy probably does not create any additional risk of septic complications.


Assuntos
Translocação Bacteriana/efeitos dos fármacos , Dióxido de Carbono/farmacologia , Escherichia coli/fisiologia , Retropneumoperitônio/induzido quimicamente , Retropneumoperitônio/microbiologia , Animais , Modelos Animais de Doenças , Masculino , Coelhos
3.
Arch Androl ; 52(6): 427-31, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17028090

RESUMO

In male infertility, the frequency of genetic factors is high. Klinefelter's Syndrome is the most frequent sex chromosomal abnormality detected in male infertility. In this study we report a patient diagnosed with Klinefelter's Syndrome with a deletion of the Yq interval. The patient was 24-years old with primary infertility. Semen analyses carried out in triplicate indicated azoospermia. The plasma leutenizing hormone (LH) and follicle stimulating hormone (FSH) levels were abnormally high and the testosterone level was lower than the usual range. Each of his testes had a volume of 3 cc. Peripheral blood karyotype analysis showed Klinefelter's Syndrome (47, XXY) pattern. Polymerase chain reaction amplification of DNA was performed using the following primers; AZFa (sY81, sY82, sY84), AZFb (sY127, sY142, sY164, RBM1), AZFc (CDY, BPY, sY254, sY255, sY277), AZFd (sY152, sY145, sY153). Analysis revealed a single deletion of AZFa region (sY84). Deletion of the AZFa region may be an additional factor for absolute azoospermia in men with Klinefelter's Syndrome. For individuals with Klinefelter's Syndrome who plan to undergo assisted reproduction techniques, Y chromosome microdeletion screening can diagnostically be convenient.


Assuntos
Deleção Cromossômica , Cromossomos Humanos Y/genética , Síndrome de Klinefelter/genética , Adulto , Humanos , Masculino , Reação em Cadeia da Polimerase
4.
Arch Androl ; 52(6): 423-6, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17050323

RESUMO

Microdeletions of the so-called azoospermia factor (AZF) locus of the Y chromosome long arm (Yq) are an etiological factor of severe oligozoospermia or azoospermia. Patients affected are infertile unless assisted reproductive techniques are used. We report the case of an azoospermic patient (proband) and three brothers who inherited a Yq microdeletion from their father through a spontaneous pregnancy. Leukocyte DNA was extracted using a commercially available kit. A total of 15 pairs of sequence-tagged site (STSs) based primers, spanning the AZFa, b and c regions, were used for screening. All brothers and their father carried a Yq microdeletion of the AZFb subregion where the RNA-binding motif (RBM) gene is located. The proband carried additional deletions of the AZFa and AZFb subregions. RBM deletion can be associated with oligozoospermia allowing natural conception and therefore natural transmission of this genetic anomaly.


Assuntos
Azoospermia/genética , Deleção Cromossômica , Cromossomos Humanos Y/genética , Proteínas de Plasma Seminal/genética , Adulto , Loci Gênicos , Humanos , Masculino , Pessoa de Meia-Idade
5.
Arch Androl ; 52(6): 471-7, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17050329

RESUMO

Congenital bilateral absence of the vas deferens (CBAVD) is a form of infertility with an autosomal recessive genetic background in otherwise healthy males. In this study, we examined the clinical and cystic fibrosis transmembrane-conductance regulator (CFTR) gene mutations in sixty patients with bilateral absence of vas deferens that applied to andrology clinic due to male factor infertility. Urogenital anomalies of vas deferens, seminal vesicle and epididymis were detected in our patient group. CFTR gene mutations, which are known to be frequent among cystic fibrosis patients, could not be detected in our patient group with that high frequency. Delta F508 mutations were detected in only 6% of patients. IVS8 polyT alleles were positive in 68% of patients. No 1677delTA mutations and M470V variants were detected in our patient group. However, sperm retrieval is almost always possible from CBAVD patients; secondary pathologies may also result defective spermatogenesis.


Assuntos
Anormalidades Múltiplas/genética , Infertilidade Masculina/genética , Ducto Deferente/anormalidades , Adulto , Regulador de Condutância Transmembrana em Fibrose Cística/genética , Epididimo/anormalidades , Humanos , Infertilidade Masculina/etiologia , Masculino , Pessoa de Meia-Idade , Glândulas Seminais/anormalidades , Recuperação Espermática , Espermatogênese
6.
Arch Androl ; 52(4): 263-7, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16728341

RESUMO

Genetic factors have a major importance in male infertility etiology. Numerical and structural chromosomal abnormalities seem to be frequent inoligospermia and azoospermia cases with unknown etiology. In this study, 819 patients with azoospermia (383) and oligospermia (436) who attended the infertility department between 1995-2005 were evaluated. Spermogram and basic hormone proties (FSH-testosterone) were studied two times in a one month interval from each patient, and all the cases were evaluated cytogenetically. The 47 (12%) of 383 azoospermia patients and the 20 (4%) of 436 oligospermia patients were found to have chromosomal abnormalities. The 9 (19%) of the chromosomal abnormalities found in azoospermia patients were autosomal and the 38 (80%) were gonosomal. In oligospermia cases, the 8 (40%) of the chromosomal abnormalities were autosomal and 12 (60%) were gonosomal. Cytogenetic analysis and genetic counseling would be helpful in infertile males with azoospermia and oligospermia by determining the genetic factors causing infertility and by assessing the genetic risks of the offsprigs provided by assisted reproductive techniques.


Assuntos
Aberrações Cromossômicas , Anormalidades Congênitas/genética , Mosaicismo , Oligospermia/genética , Humanos , Infertilidade Masculina/etiologia , Infertilidade Masculina/genética , Síndrome de Klinefelter/genética , Masculino , Estudos Retrospectivos
7.
Surg Endosc ; 18(8): 1272-5, 2004 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-15457386

RESUMO

BACKGROUND: This study investigated the effect of intravenous administration of verapamil in prevention of the injury caused by free oxygen radicals generated in a rabbit retroperitoneoscopic donor nephrectomy model. METHODS: Twenty-four adult New Zealand rabbits were divided into four groups. In group I, balloon dissection of the left retroperitoneal space was performed. In group II, CO2 at 10 mmHg was applied for 3 hours after the balloon dissection. In group III, laparotomy was performed, the left renal pedicle was clamped for 3 min, and the clamp was removed 5 min before nephrectomy. In group IV, 2 min before the attempt 0.2 mg/kg verapamil was given intravenously, and the same procedure was employed as in group III. Nephrectomy was performed after each experiment. The concentrations of malonyl dialdehyde (MDA), reduced glutathione (GSH), and protein carbonyl content were measured in renal tissue samples as markers of oxidative stress. RESULTS: Pneumoretroperitoneum (Prp) promoted oxidative stress in renal tissues, with an increase of MDA and protein carbonyl content. The verapamil- pretreated group (group IV) showed statistical significantly lower values of MDA and protein carbonyl content when compared with group II and III (p < 0.05), whereas tissue GSH concentrations were unchanged in all groups. CONCLUSIONS: Our study showed that Prp causes increased oxidative stress in renal tissue. Warm ischemia lasting 3 min did not exert an additive effect on Prp-associated oxidative stress. Verapamil reduces the oxidative stress markers caused by Prp.


Assuntos
Laparoscopia/efeitos adversos , Nefrectomia/métodos , Estresse Oxidativo , Traumatismo por Reperfusão/prevenção & controle , Vasodilatadores/uso terapêutico , Verapamil/uso terapêutico , Animais , Glutationa/análise , Laparoscopia/métodos , Masculino , Malondialdeído/análise , Modelos Animais , Coelhos , Traumatismo por Reperfusão/etiologia
8.
Surg Laparosc Endosc Percutan Tech ; 14(3): 153-6, 2004 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15471022

RESUMO

The aim of this study was to investigate the possible effects of carbon dioxide (CO2) pneumoretroperitoneum on free oxygen radicals in the kidney. Twelve male New Zealand rabbits were divided into 2 equal groups; group 1; control operation group (retroperitoneal space preparation without CO2 insufflation) and group 2; study group (10-12 mm Hg pneumoretroperitoneum for 3 hours with CO2). At the end of the procedure, laparotomy was performed to harvest ipsilateral and contralateral kidney in both groups after three hours. Kidney tissues were homogenized and were assayed for malondialdehyde (MDA), protein carbonyls (for protein oxidation), and reduced glutathione (GSH). Ipsilateral and contralateral kidney tissue levels of the MDA, protein carbonyls and GSH were not different in both the study and the control group (P > 0.05 for all comparisions). Corresponding ipsilateral and contralateral tissue levels of the markers, MDA and protein carbonyls were found to be significantly different in the study group as compared with the control group (P < 0.05 for the four comparisons mentioned). However, neither the ipsilateral nor the contralateral tissue levels of the marker GSH showed statistically relevant difference when the study group was compared with the control group. Oxidative stress was identified as a component of CO2 pneumoretroperitoneum-induced kidney injury using an animal model of retroperitoneoscopy. Oxidative stress is likely to contribute to the impairment of renal function after retroperitoneoscopy using a 10 mm-12 mm Hg CO2 pneumoretroperitoneum.


Assuntos
Dióxido de Carbono/farmacologia , Gases/farmacologia , Rim/metabolismo , Laparoscopia , Espécies Reativas de Oxigênio/metabolismo , Animais , Radicais Livres/metabolismo , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Modelos Animais , Estresse Oxidativo/fisiologia , Pneumoperitônio/metabolismo , Proteínas/metabolismo , Coelhos , Espaço Retroperitoneal
9.
Urol Int ; 73(2): 125-9, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15331896

RESUMO

OBJECTIVE: To compare the effects of the doxazosin and terazosin on total International Prostate Symptom Score (IPSS) and maximum urinary flow rate (Qmax) in treating patients with lower urinary tract symptoms (LUTS) and compare this effectivity by switching the drugs in the patients who did not benefit from either the first or the second drug. METHODS: This is a prospective randomized study of the patients with LUTS suggestive of benign prostatic hyperplasia (BPH). Fifty male patients (mean age 59.4 +/- 7.6 years) received either doxazosin (n = 25) or terazosin (n = 25) once daily every night. The patients were evaluated in the 1st, 2nd and 3rd months of treatment. Minimum 20% improvement in IPSS and Qmax in the 3rd month was considered as improvement. The patients with no improvement in any of the parameters switched the drugs, and they were followed up in the next 3 months. The patients whose only one parameter improved were excluded from the study. RESULTS: Eleven (44%) out of 25 patients using doxazosin and 10 (40%) out of 25 patients using terazosin showed improvement in both IPSS and Qmax at the end of the 3rd month and continued using the drug. After 3 months of treatment, increase in Qmax (p < 0.001) and decrease in IPSS (p < 0.01) was significant for both doxazosin and terazosin. Nineteen patients, who did not show improvement in any of the parameters, switched the drug. Of the patients who switched the drug, 2 (4%) showed improvement both in IPSS and in Qmax, while 2 (4%) showed improvement only in IPSS but not in Qmax. The remaining 15 (30%) patients did not show improvement in any of the parameters. CONCLUSION: The results of the study suggest that alpha-blockade with either doxazosin or terazosin is effective in males with LUTS. The two alpha-blocking drugs showed equal effectiveness in the treatment of LUTS. If one of the drugs is ineffective in the treatment of LUTS, then the other drug will probably be ineffective.


Assuntos
Antagonistas Adrenérgicos alfa/uso terapêutico , Doxazossina/uso terapêutico , Prazosina/análogos & derivados , Prazosina/uso terapêutico , Hiperplasia Prostática/tratamento farmacológico , Idoso , Estudos Cross-Over , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
10.
J Endourol ; 18(3): 293-8, 2004 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15225397

RESUMO

PURPOSE: We evaluated our results with bipolar plasma kinetic electrovaporization in the treatment of benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: Twenty-one patients with infravesical obstruction by BPH have been treated with bipolar plasma kinetic electrovaporization. International Prostate Symptom Score (IPSS) with a quality of life (QOL) scoring questionnaire, uroflowmetry (maximum flow rate; Qmax), transrectal ultrasonography (TRUS), and residual urine volume and prostate specific antigen (PSA) measurements had been performed before surgery. The IPSS scores, prostate volumes, and residual urine volumes were reevaluated during the third postoperative month. Uroflowmetry was repeated on postoperative days 7, 15, 30, and 90. Total PSA and free PSA measurements were repeated on postoperative days 3, 5, 7, 15, 30, and 90. RESULTS: The results of 20 patients could be evaluated. The median age of these patients was 61 years. The median volume of the prostates was 42 cc (95% CI 56-53). The median operation time and postoperative hospitalization were 55 minutes (95% CI 40-65) and 3 days (95% CI 3-5), respectively. The mean period of time needed for vaporizing 1 g of tissue was calculated as 2.8 +/- 1.3 minutes. Postoperative day 90 values of IPSS, QOL, prostate volume, residual urine volume, and Qmax showed significant improvement compared with preoperative values (p < 0.05). The median preoperative PSA value was 1.64 mg/mL (95% CI 1-3.6). The value showed a statistically significant increase 24 hours after the intervention (p < 0.0001), but the PSA values on the 30th (p = 0.041) and 90th (p = 0.025) days were below preoperative values. CONCLUSION: The IPSS with QOL scores, prostate volumes, and residual urine volumes showed significant decreases and Qmax values showed a significant increase after bipolar plasma kinetic electrovaporization. This treatment modality causes a temporary increase in the PSA concentration, as do other interventional treatment methods, but the measurements on the 30th and 90th days were below preoperative values.


Assuntos
Hiperplasia Prostática/cirurgia , Ressecção Transuretral da Próstata/métodos , Obstrução do Colo da Bexiga Urinária/cirurgia , Eletrocoagulação/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Hiperplasia Prostática/complicações , Resultado do Tratamento , Obstrução do Colo da Bexiga Urinária/etiologia , Volatilização
11.
Arch Androl ; 50(4): 267-71, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15277005

RESUMO

We investigated the treatment results in 6 azoospermic idiopathic hypogonadotropic hypogonadism (IHH) cases that remained untreated 41-47 years of age. Medical history, physical examination, hormone profile measurements, peripheral blood karyotype, skull X-ray and/or magnetic resonance imaging were performed. Patients received 1,000 to 5,000 IU hCG, 2-3 times per week, and 75 to 150 IU hMG, 2-3 times per week for 24 months. Serum testosterone levels were assessed every month for maximum 6 months to evaluate optimal dose of treatment and then every 3 months thereafter. Sperm counts were assessed every 3 months. Testosterone level increased from 2.7 +/- 0.9 mIU/L to 22 +/- 7.04 mIU/L with treatment; testicular volume increased by 4.6 ml during the treatment. Sperm were detected in the ejaculate in 3 out of 6 patients on the 22nd, 18th, and 15th month of treatment. 3 patients underwent testicular biopsy; histopathology revealed tubular hyalinization. Spermatogenesis in older men with IHH was restored by exogenous gonadotropins.


Assuntos
Hipogonadismo/fisiopatologia , Espermatogênese/fisiologia , Ejaculação , Feminino , Humanos , Cariotipagem , Masculino , Pessoa de Meia-Idade , Sêmen/química , Sêmen/fisiologia , Comportamento Sexual , Testículo/anatomia & histologia
12.
Scand J Urol Nephrol ; 38(1): 38-41, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15204425

RESUMO

OBJECTIVE: To investigate the effects of extracorporeal shock-wave lithotripsy (ESWL) applied to the pelvic region on testicular histology and spermatogenesis. MATERIAL AND METHODS: ESWL (2000 shock waves over a 20-min period at 18 kV) was applied to 12 adult New Zealand male rabbits. The rabbits were divided into three equal groups: those in Group 1 were sacrificed 1 h after the intervention, those in Group 2 were sacrificed on the 3rd day and those in Group 3 were sacrificed on the 7th day. Both testicles were removed for histopathological examination to investigate the effects of ESWL. Transmission electron microscopy (TEM) was used to detect ultrastructural changes. Epididymal and testicular touch-print preparations were stained with SperMac stain in order to evaluate the morphology of the spermatozoa. RESULTS: There were no significant differences between the groups in terms of sperm morphology (p = 0.386). TEM revealed only huge vacuolation of Sertoli cells and diffuse edema in the mitochondria of Sertoli cells. CONCLUSION: No detrimental effect of ESWL on sperm morphology was detected in this study. We conclude that shock waves do not cause severe permanent effects but only transient disorders in testes.


Assuntos
Litotripsia/métodos , Testículo/ultraestrutura , Cálculos Urinários/terapia , Animais , Modelos Animais de Doenças , Litotripsia/efeitos adversos , Masculino , Microscopia Eletrônica de Varredura , Coelhos , Distribuição Aleatória , Valores de Referência , Risco , Contagem de Espermatozoides , Motilidade dos Espermatozoides , Espermatogênese , Testículo/fisiologia , Bexiga Urinária
13.
J Urol ; 171(6 Pt 1): 2354-7, 2004 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15126820

RESUMO

PURPOSE: We developed an artificial neural network (ANN) for predicting spermatozoa prior to testicular biopsy in men with nonobstructive azoospermia. The performance of this ANN was compared to that of the standard logistic regression (LR) model. MATERIALS AND METHODS: Data were retrospectively collected from the physical examination and laboratory records of 303 patients who presented with infertility due to nonobstructive azoospermia. Input factors were patient age, duration of infertility, serum follicle-stimulating hormone, luteinizing hormone, total testosterone and prolactin, and left and right testicular volume. The ANN and LR models were constructed based on data on cases in which spermatozoa were and were not detected on testicular sperm extraction. The ANN was trained and validated with the data in the training (200 cases) and validation (30 cases) sets, and the model was then used to predict findings in the test set (73 cases). The LR model was constructed using the same data on the 230 training and validation cases. The same 73 patients served as the test set. RESULTS: The sensitivity of the ANN model was significantly higher than that of the LR model (68% vs 28%, p < 0.0001). The neural network correctly predicted the outcome in 59 of the 73 test set patients (80.8%), whereas LR correctly predicted the outcome in 48 (65.7%, p = 0.07). CONCLUSIONS: This ANN model, which is based on age, duration of infertility, serum hormone levels and testicular volumes, has clinically acceptable sensitivity. It may be of value for predicting spermatozoa in men with nonobstructive azoospermia.


Assuntos
Redes Neurais de Computação , Oligospermia , Espermatozoides , Testículo/citologia , Adulto , Humanos , Modelos Logísticos , Masculino , Estudos Retrospectivos
14.
BJU Int ; 93(4): 617-21, 2004 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15008742

RESUMO

OBJECTIVES: To investigate bladder tissue reactions to three types of implanted mesh material, i.e. polypropylene, polyglactin and polypropylene-polyglactin combined. MATERIALS AND METHODS: Forty-eight adult female Wistar albino rats were randomized to four equal groups, i.e. group 1 (sham-operated controls), group 2 (polypropylene mesh), group 3 (polyglactin mesh) and group 4 (polypropylene-polyglactin mesh). A laparotomy incision was made to access the bladder and fix a 0.5 x 1 cm piece of mesh directly on the bladder wall. Each group was randomly divided into two subgroups of six animals, killed at 7 and 14 days after mesh implantation, respectively, to study mesh and tissue features with time. Bladders were harvested for histological and immunohistochemical investigation. Microvessels that developed around the mesh were detected with the avidin-biotin peroxidase system, using antibody to Factor VIII-related antigen as an endothelial marker. Vessels were counted in the most intensely stained area of one section from each animal's bladder. RESULTS: Compared with the other groups, group 4 had more inflammatory reaction at 7 days but the tissue reactions to all mesh materials were similar at 14 days; the mesh penetrated the bladder muscularis propria at 14 days in all six rats in group 2, in one in group 3, and two in group 4. Group 4 tended to have a greater microvessel density at 14 than at 7 days. In contrast, groups 2 and 3 had lower microvessel densities at 14 than at 7 days. CONCLUSION: The rat bladder wall had a similar early response to all three types of mesh materials. Penetration was more marked with polypropylene mesh than with the other materials. This nonabsorbable material persists in tissue and is currently widely used for clinical applications. These results for penetration suggest that the use of polypropylene mesh risks serious postoperative complications, e.g. urethral tissue erosion.


Assuntos
Cistite/patologia , Telas Cirúrgicas/efeitos adversos , Animais , Cistite/etiologia , Feminino , Imuno-Histoquímica , Poliglactina 910/efeitos adversos , Polipropilenos/efeitos adversos , Ratos , Ratos Wistar , Bexiga Urinária/cirurgia
15.
J Assist Reprod Genet ; 18(7): 357-63, 2001 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-11499318

RESUMO

PURPOSE: The aim of this study is to evaluate the efficacy of simultaneous testicular touch-print cytology, testicular histopathology, and wet preparation in nonobstructive azoospermic (NOA) males. METHODS: Three hundred and sixty-three males with NOA underwent a multiple testicular sampling prior to ICSI for histopathologic evaluation, diagnostic testicular sperm extraction, and simultaneous touch-print cytology to evaluate sperm presence or absence. A total of 979 testicular samples were taken. RESULTS: Sperm recovery was achieved in 106 cases (29.2%). Patients with hypospermatogenesis and focal spermatogenesis needed 2.8 and 5.9 biopsies, respectively, to retrieve spermatozoa, while in patients with germ cell aplasia and maturation arrest, even after eight to nine samples no spermatozoa were recovered. Neither the FSH levels nor the testicular volume was found to be significant in the prediction of sperm recovery. If only a single testis was to be biopsied, 25% of the cases with sperm recovery would have been missed. The combination of touch-print cytology with histopathology and wet preparation increased the accuracy of spermatozoa identification. CONCLUSION: Touch-print cytology was found to be more predictive than wet preparation in the diagnosis of spermatogenesis; moreover, it was found to be a quick and easy technique providing an accurate diagnosis in prediction of sperm recovery.


Assuntos
Separação Celular/métodos , Técnicas Citológicas/métodos , Espermatozoides , Testículo/patologia , Adulto , Feminino , Humanos , Infertilidade Masculina , Masculino , Oligospermia
16.
Hum Reprod ; 15(11): 2390-3, 2000 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11056140

RESUMO

Couples undergoing intracytoplasmic sperm injection (ICSI) for male infertility using oocytes with centrally located granular cytoplasm (CLCG) were evaluated for fertilization, embryo development, implantation and pregnancy rate. CLCG is a rare morphological feature of the oocyte, that is diagnosed as a larger, dark, spongy granular area in the cytoplasm. Severity is based on both the diameter of granular area and the depth of the lesion. Twenty-seven couples with 39 cycles presenting CLCG in >50% of retrieved oocytes were evaluated. A total of 489 oocytes was retrieved, out of which 392 were at MII. CLCG was observed in 258 of the MII oocytes (65. 8%); 66.7% of these oocytes had slight and 33.3% had severe CLCG. The overall fertilization rate was 72.2% and no statistical significant difference was found between normal and CLCG oocytes and between the oocytes representing slight and severe CLCG. The development and quality of embryos was the same in normal and CLCG oocytes. In nine cycles, preimplantation genetic diagnosis was executed to evaluate a possible accompanying chromosomal abnormality. Out of 44 blastomeres biopsied, 23 had chromosomal abnormality (52. 3%). Eleven pregnancies were achieved in 39 cycles (28.2%), six pregnancies resulted in abortion (54.5%). The implantation rate was found to be 4.2%. Only five ongoing pregnancies were achieved in 39 cycles (12.8%). Couples with CLCG oocytes should be informed about poor on-going pregnancy rates even if fertilization, embryo quality and total pregnancy rates are normal. Furthermore, a high aneuploidy rate may be linked to a high abortion rate.


Assuntos
Grânulos Citoplasmáticos/ultraestrutura , Infertilidade Masculina/terapia , Oócitos/ultraestrutura , Resultado da Gravidez , Injeções de Esperma Intracitoplásmicas , Aborto Espontâneo/epidemiologia , Aborto Espontâneo/genética , Adulto , Aneuploidia , Coeficiente de Natalidade , Aberrações Cromossômicas/epidemiologia , Transtornos Cromossômicos , Transferência Embrionária , Embrião de Mamíferos/fisiologia , Feminino , Fertilização , Humanos , Incidência , Masculino , Gravidez , Estudos Retrospectivos , Turquia
17.
Hum Reprod ; 13(1): 104-10, 1998 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9512238

RESUMO

Recent studies have shown that the injection of spermatid cells into the human oocyte can result in normal fertilization, embryo development and even delivery of live, healthy offspring. In our study, 23 azoospermic cases with severe spermatogenetic defects in their testicular biopsy are presented. The serum follicle stimulating hormone (FSH) concentrations and histopathological results of these males have been documented and compared in terms of fertilization and embryo development. The mean FSH value of the azoospermic males was 15.8 +/- 2.3 mIU/l, ranging from 1.6 to 39 mIU/l. Elongated spermatids were used in three cases only, as these more mature forms were mostly present in the testicular sample. In the remaining 20 cases, only round spermatids were found for use in intracytoplasmic sperm injection (ICSI). The fertilization rate with two pronuclei was 31.3%. The fertilization rate was found to be as high as 71% in three patients in the elongating and elongated spermatids group and as low as 25.6% in the round spermatid group. A few immature, non-motile spermatozoa were seen in only two cases from the elongated spermatid group. However, in the remaining cases, no spermatozoa were observed. The number of pronuclear (PN) arrest was quite high when only round spermatids were used (36.1%). Total fertilization failure was observed in two cases from the round spermatid group with Sertoli cell only and germ cell aplasia. A total of three pregnancies was achieved in 23 cases (13.0%), two from the elongated spermatid group and one from the round spermatid group. One biochemical pregnancy with a round spermatid resulted in an early spontaneous abortion and surprisingly, the remaining pregnancies were achieved with elongated spermatids resulting in multiple pregnancies. One twin and one triplet pregnancy were established following four embryo transfers in each patient. The twin pregnancy resulted in a live birth with two healthy babies; unfortunately, the triplet pregnancy ended in an abortion at 11 weeks. The use of testicular spermatids in the treatment of non-obstructive azoospermia may give hope by offering a novel treatment model. In cases with very severe spermatogenetic defect, even multiple pregnancies can be achieved with elongated spermatid cells by yielding a high implantation rate. However, the efficiency of round spermatids in achieving fertilization and pregnancy was disappointing.


Assuntos
Oligospermia , Gravidez Múltipla , Técnicas Reprodutivas , Interações Espermatozoide-Óvulo , Espermátides , Testículo/patologia , Adulto , Biópsia , Citoplasma , Feminino , Humanos , Masculino , Microinjeções , Micromanipulação , Gravidez , Espermatogênese/fisiologia , Resultado do Tratamento
18.
Int Urol Nephrol ; 25(5): 445-53, 1993.
Artigo em Inglês | MEDLINE | ID: mdl-8270372

RESUMO

We present an alternative technique of ureterocolonic anastomosis which has been standardized at our Department since 1981. Early and late postoperative complications of 82 patients who underwent ureterosigmoidostomy are reviewed. Urinary leakage was observed in 3 patients (3.7%) in the early postoperative period. Late complication rate in 38 patients, whose data concerning postoperative course could be obtained, was found to be 15.8%. Mean follow-up was 38.5 +/- 10.2 months. Long-term results were comparable with those in the literature and it has been proved to be a simple and satisfactory technique of ureterocolonic anastomosis.


Assuntos
Colo Sigmoide/cirurgia , Derivação Urinária/métodos , Anastomose Cirúrgica/métodos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Fatores de Tempo , Neoplasias da Bexiga Urinária/cirurgia , Doenças Urológicas/cirurgia
19.
Proc Soc Exp Biol Med ; 149(2): 511-4, 1975 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-807918

RESUMO

The interaction of thyrotropin-releasing hormone (TRH) and ergocryptine or apomorphine in affecting prolactin secretion was examined. Ergocryptine and apomorphine inhibited the release of 3H-prolactin labeled in an in vitro incubation of the rat anterior pituitary and led to a retention within the gland of 3H-prolactin. TRH (1.4 X 10(-8) M) partially blocked the inhibitory effect of 4 x 10(10) M ergocryptine on 3H-prolactin release and totally blocked the effect on radioimmunoassayable prolactin release. TRH also completely blocked the inhibitory effects of 5 x 10(-8) M apomorphine on both 3H-prolactin and radioimmunoassayable prolactin release. Since TRH can also completely block the inhibitory effects of dopamine upon prolactin secretion, these results are consistent with apomorphine and ergocryptine stimulating "dopaminergic" sites and also further support the role of TRH as a prolactin-releasing factor.


Assuntos
Apomorfina/farmacologia , Ergolinas/farmacologia , Prolactina/fisiologia , Hormônio Liberador de Tireotropina/fisiologia , Animais , Interações Medicamentosas , Eritrócitos/imunologia , Feminino , Hormônio do Crescimento/fisiologia , Hipofisectomia , Imunoglobulina G , Técnicas In Vitro , Radioisótopos do Iodo , Leucina/metabolismo , Adeno-Hipófise/fisiologia , Prolactina/antagonistas & inibidores , Radioimunoensaio , Ratos , Ovinos/sangue , Hormônio Liberador de Tireotropina/farmacologia , Trítio
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