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Biomedical subjects

A Zini

Publications and source records attributed to A Zini.

At least 19 recordsLinked to original sources
PubMed2006

Bilateral posterior medullary and cervical stroke: a case report.

Spinal strokes are often localised in the anterior spinal artery territory, whereas an involvement of the posterior spinal arteries (PSA) is uncommon, and usually unilateral. Bilateral PSA stroke is exceptional. A 70-year-old woman, after a mild head trauma, presented with cervical pain, left hypoaesthesia and sensitive ataxia, which then extended to the right hemibody, including face. A Doppler ultrasound showed an only systolic flow signal in the left vertebral artery (VA). MR showed a bilateral infarction extending from the posterior medulla oblongata to C4 and a left hypoplasic VA with lack of visualisation of the V3 segment. This case was peculiar, implying a bilateral stroke in the PSA territory, possibly related to a left VA dissection, and in the presence of a dominant PSA, originating from the hypoplasic VA and of hyposupply of posterior radiculomedullary arteries and anastomoses.

Aged↗
PubMed2006

[Survey of patient satisfaction at the Yad Sarah Geriatric Dental Clinic].

OBJECTIVES: The purpose of this study is to determine the influence of a supporting professional environment, in a voluntary dental clinic, on the satisfaction among dental patients. METHODS: A sample of 109 patients who received dental care between 3/01-3/02 at the Yad Sarah dental clinic in Jerusalem were asked about : their satisfaction concerning their experience of previous visits, the frequency of their visits, how they heard about the clinic and whether they would return to the clinic in the future. RESULTS: On average, each patient visited the clinic three times. 36.7% of the patients heard about the clinic from friends or family. Most of the patients were highly satisfied (47.2%) or satisfied (36.1%) with the clinic. The two best predictors of patient satisfaction (total 83.2%) were the professionalism of the dentists (41.4%) and the good attitude of the dentists to them. On the other hand, the two best predictors of patient non-satisfaction (14%) were the low professionalism of the dentists (33.3%) and the price of the treatments at the clinic (33.3%). 89% said they would return to the clinic and 93% said they would recommend that other patients use the services of Yad Sarah dental clinic. CONCLUSIONS: Overall, the patients who were treated at the Yad Sarah dental clinic expressed high levels of satisfaction with the care they received. The professionalism and the attitude of the staff were the main contributors to the high level of satisfaction with the Yad Sarah dental clinic.

Aged↗
PubMed2006

[Gerodontology teaching program at the geriatric dental clinic in Yad Sarah].

OBJECTIVES: World demographic changes show an increase in the elderly population worldwide. Due to increase in life span, the continuously growing elderly population requires extra attention. This has a great effect on private medical practice. A long term result is the necessity of training dentists in the practice of geriatric dentistry. Geriatric patients have problems that are age dependent, general health problems and specific dental problems. These problems require special skills on the part of the dentist. Yad Sarah has undertaken responsibility for this important task and provides dentists with a geriatric dental (gerodontology) training program. Elderly patients in need of geriatric dental treatment are served in both stationary and mobile clinics. The program includes both theoretical and practical studies. For this purpose, the Hebrew University-Hadassah School of Dental Medicine and Yad Sarah have created a three-year program at the end of which the dentists, working voluntarily, receive a diploma in geriatric dentistry. The purpose of the present study is to evaluate the teaching program in the past few years. METHODS: All the lectures given in the program from 2001 to 2005, both theoretical and practical, have been summarized and categorized by subject. RESULTS: In 2001-2002, the teaching program was theoretical only. Starting from 2003 practical studies were added to the program so that now it includes both theoretical and practical studies. The results presented do not include the many clinical teaching hours during supervised treatment that are given privately to the dentists, from the preparation of the dental treatment plan until the conclusion of treatment. The result shows a steady increase in teaching hours during the years 2001-2005. Not only has the quantity increased; the content has changed too, because of the changes in the needs and the character of work in the geriatric dentistry field. The increasing activity through the mobile dental clinic for homebound patients has led to stepped up teaching in subjects that are related to this kind of treatment, such as oral medicine, systemic disease and oral rehabilitation relating to at-home treatment. The increase in implant treatments created the need to train the dentists in the surgical and rehabilitative aspects of care. The area of oral medicine (26%) and oral rehabilitation (24%) received the most teaching hours, while endodontics (4%) received the least. CONCLUSIONS: The teaching program at Yad Sarah is need-dependent--needs of the patients and of the volunteer dentists as well. At Yad Sarah the dentists come to volunteer, to give needy people quality dental treatment that they cannot afford themselves at regular clinics. An additional motive of these dentists is to advance themselves professionally. The Yad Sarah Dental Clinic offers a unique teaching program that contributes to enhancing knowledge in gerodontology. As the needs at the clinic change, so does the teaching program.

Aged↗
PubMed2004

Beneficial effect of microsurgical varicocelectomy on human sperm DNA integrity.

BACKGROUND: Human sperm DNA damage may adversely affect reproductive outcomes, and the spermatozoa of infertile men possess substantially more DNA damage than that of fertile men. To date, there is no available treatment for men with high levels of sperm DNA damage. The objective of this study was to examine the effect of varicocelectomy on sperm DNA denaturation (DD, an index of sperm DNA damage) in infertile men with a clinical varicocele. METHODS: We reviewed the reports of 37 men who underwent microsurgical varicocelectomy at our institution from September 2001 to July 2002. Standard semen parameters and the percentage of spermatozoa with DD (monitored by flow cytometry analysis of acridine orange-treated spermatozoa) were assessed before and 6 months after varicocelectomy. RESULTS: The percentage of spermatozoa with DD decreased following varicocelectomy compared with pre-operatively (27.7 versus 24.6%, respectively, P < 0.05). Sperm concentration and the percentages of motile sperm and normal forms (WHO criteria) increased following varicocelectomy, but the difference did not reach statistical significance. CONCLUSIONS: Our data suggest that varicocelectomy can improve human sperm DNA integrity in infertile men with varicocele. These data represent the first report of improved sperm DNA integrity after therapy and further support the beneficial effect of varicocelectomy on human spermatogenesis.

Adult↗
PubMed2004

[A new gel for topical use in treating severe periodontal disease--clinical observations].

Within the framework of the efforts to find non-invasive treatment methods for severe periodontitis, a topical gel was developed by an Israeli research group. The aim of the current study is to present clinical observations and X-ray measurements of alveolar bone changes following an 8 week, self-care periodontal treatment in two groups of patients with severe periodontitis. All 31 patients who participated in the study showed an improvement of the periodontal condition as expressed in all the indexes examined. The observation findings testify to the fact that through self-care using a topical gel, significant results were achieved: decrease in probing depth, decrease in bleeding, significant improvement in teeth mobility and in level of the alveolar bone height and its density. These clinical findings raise interesting research questions and hint at the potential for regeneration of supportive periodontal tissues in cases of severe periodontitis, currently achieved only through surgical means. In order to obtain more accurate data regarding the treatment potential of this gel, it is important to conduct additional controlled clinical trials on different populations and also to try and determine how it works.

Adult↗
PubMed2003

Lichen planopilaris: report of 30 cases and review of the literature.

BACKGROUND: Lichen planopilaris (LPP) affects primarily the scalp, resulting in scaling, atrophy, and alopecia with scarring. The purpose of our study was to obtain original data on LPP and to evaluate the efficacy of topical therapy in comparison with systemic therapies. METHODS: We examined 30 patients affected by LPP between 1996 and 2001, performing clinical, laboratory, histopathologic and direct immunofluorescence examinations. Twenty-one of the patients (70%) were women and nine (30%) were men. The average age at presentation was 51.5 years. The average duration of the disease was 13 months at the time of the diagnosis. All patients received topical steroids for a total of 12 weeks. RESULTS: Resolution of the inflammatory process and blocking of the cicatricial progression were observed in 66% of cases, a mild reduction of fibrosis and cicatrization in 20% of patients, and no response in 13%. CONCLUSIONS: We concluded that topical therapy may be a valid alternative to systemic therapies, especially in patients with lesions in the early phase.

Administration, Topical↗
PubMed2002

Catalase-like and superoxide dismutase-like activities in human seminal plasma.

Human spermatozoa are highly susceptible to oxidative injury but are naturally protected from such injury by the antioxidant properties of seminal plasma. We measured catalase-like and superoxide dismutase (SOD)-like activities in the seminal plasma of fertile and vasectomized men in order to gain insight into the potential source(s) and function(s) of these antioxidants in semen. Semen samples were obtained from fertile men ( n=11) and men post-vasectomy ( n=16). Catalase-like activity was measured by the decrease in hydrogen peroxide concentration after incubation with seminal plasma. SOD-like activity was measured as the inhibition of nitroblue tetrazolium reduction due to superoxide anion generation by xanthine plus xanthine oxidase. Mean seminal catalase-like activity (+/-1SD) in the fertile group was not significantly different from that of the post-vasectomy group (389+/-163 and 325+/-119 U/ml, respectively). Similarly, mean seminal SOD-like activity in the fertile group was not significantly different from that of the post-vasectomy group (37+/-10 and 36+/-10 U/ml, respectively). Our data suggest that the testis and epididymis are not an important source of catalase-like and SOD-like activities in semen. These findings indicate that antioxidants in semen are primarily of post-testicular origin and probably serve to protect ejaculated spermatozoa from oxidative stress such as that which occurs in the female reproductive tract.

Adult↗
PubMed2001

Correlations between two markers of sperm DNA integrity, DNA denaturation and DNA fragmentation, in fertile and infertile men.

OBJECTIVE: To evaluate two different assays of human sperm DNA integrity, DNA denaturation (DD) and DNA fragmentation (DF), and to correlate these with standard semen parameters. DESIGN: Prospective, observational study. SETTING: University infertility clinic. PATIENT(S): Forty consecutive semen samples from 33 nonazoospermic men presenting for infertility evaluation and 7 fertile men presenting for vasectomy. INTERVENTION(S): Assessment of sperm concentration, motility, morphology, DD and DF. MAIN OUTCOME MEASURE(S): Sperm DD and DF in fertile and infertile men. RESULT(S): The mean (+/-SE) rates of DD and DF were significantly higher in infertile subjects compared to fertile controls, respectively: 25.4 +/- 3.0 vs. 10.2 +/- 2.3 (P=.028) and 27.6 +/- 2.5 vs. 13.3 +/- 2.5% (P=.016). DF and DD correlated strongly (r = 0.71, P<.0001). Also, DD and DF correlated negatively with standard semen parameters (concentration, motility, and morphology), the strongest correlation being with sperm motility. CONCLUSION(S): The strong correlation between sperm DD and DF, and the higher levels of sperm DNA damage in infertile compared with fertile men, indicate that male infertility is associated with poor sperm DNA integrity. Although infertile men may father children with assisted conception, fertilization with DNA-damaged spermatozoa may increase the risk of genetic disease in the offspring.

Biomarkers↗
PubMed2001

Microsurgical varicocelectomy in the era of assisted reproductive technology: influence of initial semen quality on pregnancy rates.

OBJECTIVE: To evaluate the natural history of infertile couples in whom the man underwent varicocelectomy. DESIGN: Retrospective study. SETTING: University infertility clinic. PATIENT(S): 159 infertile couples. INTERVENTION(S): Microsurgical varicocelectomy. MAIN OUTCOME MEASURE(S): Standard semen parameters and pregnancy rates (assisted and unassisted). RESULT(S): Postoperative sperm concentration and motility increased significantly compared to before the varicocelectomy (28.9 +/- 3.0 vs. 22.5 +/- 2.1 x 10(6)/mL and 33.9 +/- 1.9 vs. 22.1 +/- 1.3%, respectively). Overall, 48% (76/159) of the couples achieved a spontaneous pregnancy at the mean of 30 months' follow-up. An additional 10% (16/159) and 11% (18/159) of couples achieved a pregnancy following intrauterine insemination and in vitro fertilization/intracytoplasmic sperm injection, respectively. Significantly higher spontaneous pregnancy rates were observed in couples in whom the man's initial sperm concentration was greater than or equal to 5 million sperm per milliliter compared to those in whom the man's initial sperm concentration was less than 5 million sperm per milliliter (61% vs. 8%, respectively). CONCLUSION(S): Our data demonstrate that, in couples in whom the man undergoes varicocelectomy for treatment of varicocele, close to 70% achieve a pregnancy. The initial sperm concentration is predictive of unassisted pregnancy outcome in this population.

Adult↗
PubMed2001

Free thiols in human spermatozoa: correlation with sperm DNA integrity.

OBJECTIVES: To examine the levels of sperm protamine free sulfhydryl or thiol (SH) groups and DNA denaturation (DD) in semen from fertile and infertile men.Methods. Semen samples were obtained from consecutive nonazoospermic men presenting for infertility evaluation (n = 66) and fertile men presenting for vasectomy (n = 10). The standard semen parameters (sperm concentration, motility, and morphology), sperm DD, and SH content were monitored. Sperm DNA integrity was evaluated by flow cytometry analysis of acridine orange-treated spermatozoa and expressed as the percentage of spermatozoa demonstrating denatured DNA. RESULTS: The mean (+/- SE) levels of sperm SH groups and the percentage of spermatozoa with DD were significantly higher in the infertile men than in the fertile men (SH groups 1083 +/- 97 and 570 +/- 101 nmol/10(6) spermatozoa, respectively; and DD 21% +/- 1.7% and 8.9% +/- 1.9%, respectively). The levels of sperm SH groups and DD correlated positively (r = 0.53). Also, the levels of sperm SH groups and DD correlated negatively with the standard semen parameters. CONCLUSIONS: Our data demonstrate that sperm SH content correlates positively with sperm DD and that significantly higher levels of sperm DD and SH content are found in infertile men than are found in fertile men. These data suggest that the enhanced susceptibility of sperm DNA to denaturation in infertile compared with fertile men may be associated with incomplete oxidation of the sperm SH groups.

DNA↗
PubMed2001

Nitric oxide synthase activity in human seminal plasma.

OBJECTIVES: To determine whether human seminal plasma possesses nitric oxide synthase (NOS) activity and whether, if present, this activity correlates with standard semen analysis parameters. Recent studies have demonstrated the presence of NOS in the epithelium of the male reproductive tract and have shown that nitric oxide can influence human sperm function in vitro. METHODS: Semen samples were collected from 30 men presenting for an infertility evaluation at our institution. After a standard semen analysis, the semen samples were centrifuged at 10,000g, and the seminal plasma was collected and stored at -20 degrees C for later evaluation of the arginine concentration and calcium-dependent and calcium-independent NOS activity. NOS activity was measured by the conversion of [(3)H]L-arginine to [(3)H]L-citrulline. RESULTS: NOS activity was detected in 28 of 30 seminal plasma samples tested. The mean +/- SD calcium-dependent NOS activity was 1.6 +/- 0.8 nmol/min/mL and the mean calcium-independent NOS activity was 1.0 +/- 0.7 nmol/min/mL of the seminal plasma. The mean +/- SD arginine concentration in the seminal plasma was 7.0 +/- 1.9 mM. No significant correlations were found between the NOS activity in the seminal plasma and sperm concentration, sperm motility, or leukocyte concentration. The 2 men without detectable NOS activity in their semen had documented congenital bilateral absence of the vas deferens. CONCLUSIONS: The results of this study demonstrate the presence of NOS activity in human semen and support a role of nitric oxide in sperm function in vivo. Our results also suggest that the seminal vesicles may be an important source of NOS activity in semen.

Adult↗
PubMed2001

Biologic variability of sperm DNA denaturation in infertile men.

OBJECTIVES: To examine sperm DNA denaturation (DD) in fertile and infertile men and assess the variability of conventional semen parameters and sperm DD in repeated semen samples from infertile men. METHODS: Twenty-one consecutive nonazoospermic, infertile men each submitted two semen samples, 2 to 6 weeks apart. We examined semen samples from consecutive fertile men (n = 10) presenting for vasectomy as controls. Standard semen parameters (World Health Organization criteria) and sperm chromatin structure (evaluated by flow cytometry analysis of acridine orange-treated spermatozoa and expressed as the percentage of spermatozoa with denatured DNA) were monitored. RESULTS: Fertile men had a significantly higher sperm concentration and percentage of sperm motility and a significantly lower percentage of sperm with DD than did infertile men (36 +/- 5.2 x 10(6)/mL versus 12.5 +/- 2.2 x 10(6)/mL, 60.0% +/- 5.2% versus 30.1% +/- 4.1%, and 8.9% +/- 1.9% versus 20.3% +/- 2.5%, respectively, P <0.05). The sperm concentration, sperm motility, and percentage of spermatozoa with DD were not significantly different between the first and second semen samples from the infertile men. Sperm DD showed the lowest average within-subject coefficient of variation (SD/mean), followed by motility and concentration (coefficient of variation 21%, 24%, and 35%, respectively). CONCLUSIONS: Our data demonstrate that infertile men have significantly higher sperm DD compared with fertile men and that sperm DD exhibits a low coefficient of variation ( approximately 20%) on repeated assessment. These data suggest that sperm DD has a relatively low degree of biologic variability.

DNA↗
PubMed2000

Influence of semen processing technique on human sperm DNA integrity.

OBJECTIVES: To compare the effects of density-gradient centrifugation and swim-up technique on sperm DNA integrity. METHODS: Semen samples (n = 22) were obtained from consecutive nonazoospermic men presenting for infertility evaluation. Individual samples were divided into three aliquots (whole semen, density-gradient centrifugation, and swim-up) for subsequent analysis of sperm motility and DNA integrity. Sperm DNA integrity was evaluated by flow cytometry analysis of acridine orange-treated spermatozoa and expressed as the percentage of spermatozoa demonstrating denatured DNA. RESULTS: Mean sperm motility (+/-SEM) improved significantly after processing with two-layer density-gradient and swim-up compared with whole semen (65.6% +/- 4.0% and 73.0% +/- 3.0% versus 52.0% +/- 3.6%, respectively, P <0.005), with no significant difference in motility between Percoll-treated and swim-up-treated spermatozoa. In contrast, the percentage of spermatozoa with denatured DNA was reduced significantly in swim-up-treated but not in Percoll-treated spermatozoa compared with whole semen (4.8% +/- 1. 2% and 13.6% +/- 3.6% versus 10.1% +/- 2.3%, respectively, P <0. 0001). CONCLUSIONS: Although density-gradient centrifugation is comparable to swim-up technique in recovering spermatozoa with enhanced motility, spermatozoa recovered after swim-up possess higher DNA integrity. These data urge us to reexamine our current sperm processing techniques in order to minimize sperm DNA damage.

Centrifugation, Density Gradient↗
PubMed2000

Smoking is associated with the retention of cytoplasm by human spermatozoa.

OBJECTIVES: To determine whether cigarette smoking is associated with the abnormal retention of residual sperm cytoplasm in infertile men. METHODS: Semen samples were obtained from 87 consecutive non-azoospermic men with idiopathic infertility (18 smokers and 69 nonsmokers) and from 20 men presenting for vasectomy (fertile controls). Standard semen parameters and the percentage of spermatozoa with residual cytoplasm (on Papanicolaou smears) were recorded. RESULTS: Subject age, semen volume, and sperm density, motility, and morphology were not significantly different between the two groups of infertile men. However, a significant difference was found in the mean +/- SEM percentages of sperm with cytoplasm droplets between smokers and nonsmokers (12.9% +/- 1.7% and 8.1% +/- 0.9%, respectively; P < 0.001). CONCLUSIONS: Our data suggest that cigarette smoking is associated with retention of sperm cytoplasmic droplets in infertile men, a morphologic characteristic associated with impaired sperm function.

Cytoplasm↗
PubMed2000

Varicocele is associated with abnormal retention of cytoplasmic droplets by human spermatozoa.

OBJECTIVE: To determine whether varicocele is associated with retention of sperm cytoplasmic droplets in infertile men. DESIGN: Retrospective study. SETTING: University infertility clinic. PATIENT(S): Nonazoospermic men with idiopathic (n = 69) and varicocele-associated infertility (n = 73), and 20 fertile controls presenting for vasectomy. INTERVENTION(S): None. MAIN OUTCOME MEASURES(S): Standard semen parameters and percentage of spermatozoa with cytoplasmic droplets on Papanicolaou smears. RESULT(S): No statistically significant differences were found between the fertile and infertile groups with respect to semen volume. Fertile controls had significantly greater mean percent sperm motility and normal morphology than infertile men. The mean percentage of sperm with residual cytoplasm was statistically significantly different in all three groups. Infertile men with varicocele had the highest percentage of sperm with cytoplasmic droplets, the next highest level being in men with idiopathic infertility and the lowest level in fertile controls (11.7 +/- 1.0, 8.1 +/- 0.9 and 3.2 +/- 0.4%, respectively, P<.0001). CONCLUSION(S): Our data show that idiopathic and even moreso, varicocele-related male infertility are conditions associated with impaired disposal of residual sperm cytoplasm by the testis and/or epididymis. These data provide a possible mechanism for the observed semen abnormalities and reduced fertility potential associated with varicocele and idiopathic male infertility.

Cytoplasm↗