Biomedical subjects
Publications and source records attributed to C Tantini.
A rare case of male internal pseudohermaphroditism is described. The patient had normal external male sexual characteristics but unilateral cryptorchidism. Three of his brothers had also cryptorchidism. The patient's parents were cousins. The patient's karyotype was normal.
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The therapeutic value of Direct Intraperitoneal Insemination (DIPI) is of particular interest in cases of unexplained infertility and failed AID. The same technique is less likely to be successful where functional or morphological semen abnormalities or multifactorial infertility exist. The Authors report their own experience with DIPI as a treatment on 76 couples with a long-standing infertility.
A number of experimental data indicate that hyperprolactinemia inhibits the activity of 5-alpha-reductase; however, no information is available about the time required for this enzyme to re-activate after prolactinemia has returned to normal values. In the present study, five normal caucasian men, whose fertility had previously been proven, were given HCG (5000 IU/day by intramuscular route for three days) both in basal conditions and after sulpiride-induced hyperprolactinemia (dosage = 200 mg/day for ten days). In both conditions, the plasma levels of prolactin (PRL), testosterone (T), dihydro-testosterone (DHT), 17-beta-estradiol (E2), and dehydroepiandrosterone sulfate (DHAS) were monitored during the treatment with HCG and for an additional 24 hrs after HCG discontinuation. All hormones were assayed by RIA. Our results demonstrate that hyperprolactinemia causes a marked decrease (58%) of DHT, a less marked decrease (39%) of T, an increase (43%) of DHAS whereas only a small increase (2%) of E2 was observed. Steroids were shown to behave differently after the HCG tests performed in the two experimental conditions. In particular, the levels of DHT had a much more pronounced increased after HCG in the second test than in the first; in contrast, both DHAS and E2 had a less marked response after the second test. Our data, on the one hand, confirm that 5-alpha-reductase is inhibited by hyperprolactinemia; on the other hand, the hyperprolactinemia-induced block of this enzyme appears to be rapidly reversible because the enzyme is reactivated within 48-72 hrs after normalization of prolactin levels. (Normal values of prolactin were on the average achieved on the 4th day after sulpiride discontinuation).(ABSTRACT TRUNCATED AT 250 WORDS)
A prospective multicentre study was designed to ascertain the value of hysteroscopy in the evaluation of female infertility. The study comprises 619 CO2 hysteroscopies in women complaining of infertility. Four hundred and ninety nine examinations (80%) were performed without anaesthesia or cervical dilatation. Twenty eight cases of malformation were diagnosed. Adhesions were found in 68 patients (11%), polypi in 56 (9.1%) and submucous fibroids in 51 (8.2%). Endometrial hyperplasia was diagnosed by hysteroscopy in 67 patients, but there was only 42% histological correlation. Examination of the tubal ostia by hysteroscopy revealed 26 patients (4%) with unilateral tubocornual polyps and one with bilateral polyps. The correlation with hysterosalpingography (HSG) in 185 patients was poor. In 20% where the HSG was reported as normal there were hysteroscopically demonstrable lesions whereas there were false positive findings at HSG in 35% of cases. Hysteroscopy is the only technique which provides an accurate clinical evaluation of the uterine cavity although it does not provide significant information about the cervical canal or fallopian tubes.
The role of hysteroscopy for a complete evaluation of luteal phase is discussed by the authors. They affirm that for a thorough evaluation a hysteroscopy may be usefully performed simultaneously to the endometrial biopsy.
A comparison between hysterosalpingography and hysteroscopy in the evaluation of tubal ostium pathology is presented by the authors. They stress in particular the role of hysteroscopy in this evaluation.
We studied the statistical distribution of the plasma concentrations of FSH and testosterone in patients with oligoazoospermia as compared with normospermic subjects. The plasma concentration of FSH was determined in 429 patients with oligoazoospermia and 282 normospermic subjects ("controls"). In 118 out of these 429 patients and in 47 of the 282 controls, the plasma concentration of testosterone was also measured. The plasma concentrations of FSH differed significantly depending on the patients' values of spermatic concentration. The most significant difference was observed between azoospermic patients and controls, whereas the difference between patients with mild oligospermia and controls was not significant. Conversely, the plasma concentrations of testosterone did not correlate with the values of spermatic concentration and even the difference between azoospermic patients and controls did not reach the significance level. In addition, testosterone plasma concentrations did not differ between two sub-groups of patients who were defined depending on whether the plasma concentration of FSH was normal or high. Our findings confirm the inverse relation between plasma FSH levels and spermatic concentration which had already been observed in previous studies. However, a considerable overlap in the plasma concentrations of FSH has been found between sub-groups of patients with different spermatic concentrations. This overlap limits the clinical usefulness of the measurement of FSH concentration inasmuch as normal FSH plasma levels may often be associated with any value of spermatic concentration. Also, our data confirm that the measurement of testosterone plasma levels provides little clinical usefulness in male infertile patients.
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Intrauterine Progesterone Contraceptive System has been used in twenty patients aged 45 to 52, affected by dysfunctional uterine bleeding due to glandular hyperplasia (6 cases), focal glandular hyperplasia (8 cases), cystic hyperplasia (4 cases) and adenomatous hyperplasia (2 cases). Hysteroscopy and endometrial biopsy were performed every two months after insertion of IPCS. Complete regression or clear improvement were observed in all cases. The question if regression may be considered permanent or temporary remains to be answered.
Dynamic echohysteroscopy is a new diagnostic method which can be applied to the clinical problems of infertility, providing informations on the morphology of the internal genitals. The Authors underline the clinical validity of this diagnostic technique, even though more experience is required in order to define a better standardization of the method.
This is a report of the variations of cervical mucus of women wearing different kinds of IUDs, before and after the insertion. We could not find significant variations of the clinical patterns in women wearing copper IUDs, but noticeable variations were found in progesterone releasing device users.
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Septate uterus is the intracavitary pathology which is most associated with infertility and/or preterm labor; therefore, it is primary indication for hysteroscopic metroplasty. By the introductio of the resectoscope in gynaecological endoscopy the surgical technique has been revolutioned. GnRHa therapy before surgery has showed some advantages related to surgical results, surgery time, intraoperative bleeding and endometrial detachment, and amount of fluids used for uterine cavity distention. The treatment before hysteroscopic metroplasty for partial septus has not influenced positive results, while for uterine septus that reached the inferior third of the cavity or moreover, it provided better condition for this procedure.
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