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Biomedical subjects

D J Kay

Publications and source records attributed to D J Kay.

At least 19 recordsLinked to original sources
PubMed2002

Porcine zonae pellucidae immunization of tammar wallabies (Macropus eugenii): fertility and immune responses.

This study looked at the feasibility of targeting the zona pellucida for a contraceptive vaccine as a possible alternative method of control for overabundant macropods. Tammar wallabies, as a model for other macropods, were immunized with porcine zonae pellucidae (PZP) and were found to achieve significant concentrations of antibody to PZP in sera and reproductive tract fluids. Wallabies immunized with PZP exhibited lower ovarian weight with reduced numbers of antral follicles when compared with control animals. Wallabies were placed in a natural mating trial followed by an artificial insemination trial. None of the PZP-immunized wallabies produced offspring in the natural mating trial compared with 67% of control animals. To further assess fertility, a sub-sample of the wallabies were superovulated and artificially inseminated. This resulted in all control wallabies producing fertilized ova and all PZP-immunized wallabies failing to ovulate. These results suggest that immunocontraception based on targeting antigens of the zona pellucida may be an effective strategy for fertility reduction in macropods.

Animals↗
PubMed2001

Meta-analysis of tympanostomy tube sequelae.

OBJECTIVE: To estimate the incidence of tympanostomy tube sequelae based on systematic review of published case series and randomized studies. DATA SOURCES: English-language MEDLINE search from 1966 through April 1999 with manual reference search of proceedings, articles, reports, and guidelines. STUDY SELECTION: Cohort studies with otitis media as the primary indication for tube placement. DATA EXTRACTION: Two reviewers independently extracted data from 134 articles. DATA SYNTHESIS: Transient otorrhea occurred in 16% of patients in the postoperative period and later in 26%; recurrent otorrhea occurred in 7.4% of patients and chronic otorrhea in 3.8%. Sequelae of indwelling tubes included obstruction (7% of ears), granulation tissue (5%), premature extrusion (3.9%), and medial displacement (0.5%). Sequelae after tube extrusion included tympanosclerosis (32%), focal atrophy (25%), retraction pocket (3.1%), cholesteatoma (0.7%), and perforation (2.2% with short-term tubes, 16.6% with long-term tubes). Meta-analysis showed that long-term tubes increased the relative risk of perforation by 3.5 (95% CI, 1.5 to 7.1) and cholesteatoma by 2.6 (95% CI, 1.5 to 4.4). Similarly, intubation increased the relative risk of tympanosclerosis by 3.5 (95% CI, 2.6 to 4.9) and focal atrophy by 1.7 (95% CI, 1.1 to 2.7) over nonintubated control ears (baseline tympanosclerosis and atrophy rates of 10% and 14%, respectively). CONCLUSIONS: Sequelae of tympanostomy tubes are common but are generally transient (otorrhea) or cosmetic (tympanosclerosis, focal atrophy). Nonetheless, the high incidence suggests a need for ongoing otologic surveillance of all patients with indwelling tubes and for a reasonable time period after tube extrusion. Long-term tubes should be used on a selective and individualized basis.

Atrophy↗
PubMed1998

Facial nerve stimulation from cochlear implants.

OBJECTIVE: To evaluate the incidence of facial nerve stimulation from cochlear implants and to better define the segment of nerve being stimulated and the causes of stimulation. STUDY DESIGN: Retrospective patient case review and a temporal bone dissection study. SETTING: A tertiary care setting. PATIENTS: All patients given a cochlear implant at the Hospital of the University of Pennsylvania. This encompassed only adult patients. INTERVENTION: All patients had surgical insertion of either a 3M single channel, Nucleus 22-channel, or CLARION multichannel cochlear implant. MAIN OUTCOME MEASURES: Demonstration of facial nerve stimulation with a cochlear implant and determination of affected electrodes; measurement of electrode location and distances between the labyrinthine segment of the facial nerve and the cochlea in temporal bone dissections: and determination of the relationship between the labyrinthine facial nerve and the cochlea using computed tomography evaluation. RESULTS: The overall incidence of facial nerve stimulation using all three devices was 14% (8 of 58). Otosclerosis and otosyphilis appear to be predisposing conditions to stimulation. The mid-cochlear electrodes, located near the labyrinthine facial nerve, appear to cause stimulation of the VIIth nerve most commonly. Computed tomographic evaluation of the bone between the labyrinthine fallopian canal and the cochlea may provide some indication of potential facial nerve problems. CONCLUSION: Facial nerve stimulation from the use of cochlear implants is more prevalent in patients with otosclerosis and otosyphilis. The labyrinthine segment of the facial nerve is the most likely area being stimulated in most patients. Preoperative computed tomographic evaluation may be beneficial in determining the possibility of this problem.

Adult↗
PubMed1996

Diagnosis and management of complications of self-injection injuries of the neck.

When IVDUs who lose peripheral access turn to their necks, they invite a spectrum of unique complications that require particular management and treatment. While many of these complications are infectious, other possibilities include vocal cord paralysis and needle fragment foreign bodies. Work-up of these patients must include a very thorough history and physical exam, particularly of the head and neck, complete with a laryngeal exam. All patients should undergo imaging studies, including plain films, CT or MRI of the neck, and other studies as appropriate. Laboratory studies should include HIV and hepatitis serologies. Because of the risks to the surgical team, neck explorations, when indicated, should be performed under general anesthesia with strict adherence to universal precautions. Further management includes early referrals to methadone clinics, although unfortunately poor patient compliance is usual. Public campaigns aimed at prevention are useful, although limited, and should be encouraged.

Adult↗
PubMed1993

Sperm antibodies in a patient with obstructive azoospermia.

An artificial spermatocoele was constructed at the level of the caput epididymis in a patient with obstructive azoospermia. Morphologically normal spermatozoa were harvested but motility and progression were inadequate for intra-uterine insemination or in vitro fertilisation. In addition, there was an antispermatozoal antibody response which transuded back into the reproductive tract and coated spermatozoa with antibody. It is recommended that if harvesting of epididymal spermatozoa is contemplated, the serum should initially be assessed for spermatozoal antibody.

Adult↗
PubMed1993

Anti-sperm antibodies and semen profiles in re-anastomosed men.

A group of 29 re-anastomosed men were examined with respect to semen quality, anti-sperm antibody titres in serum and seminal plasma, presence of anti-sperm antibodies on sperm, and success rate in inducing pregnancy. Results indicated no association between pre-reversal serum anti-sperm antibody titres and post-reversal semen quality, but a pregnancy induction rate of zero was associated with serum anti-sperm antibody titres greater than 160. It is recommended that men considering reversal, with anti-sperm antibody titres of this level, should receive counselling about the possibility of post-reversal infertility.

Adult↗
PubMed1992

Local immunity in the male reproductive tract.

In previous studies we have demonstrated that the male urinary tract forms part of the common mucosal immune system, and that the gut contributes to local defences at this site. The question arises as to the extent to which the reproductive tract also forms part of the common mucosal immune system. Rats were immunized by a variety of routes designed to stimulate a local response in the intestine and/or the reproductive tract. Rats immunized only by the intratesticular (i.t.) route yielded no antibody-containing (ACC) response in any of the tissues examined. Intestinal immunization using intraperitoneal priming followed by intraduodenal challenge (i.p./i.d.) yielded a substantial IgA-specific ACC response in the jejunum, but no ACC were detectable in any of the reproductive tract tissues. However, when intestinal and testicular immunizations were combined, large numbers of IgA-specific antibodies were detected in all tissues examined. Chronic drainage of the thoracic lymphatic duct throughout the post-challenge period abrogated the ACC response in all tissues of the reproductive tract, indicating that the ACC appearing at these sites after immunization were of gut origin. The IgA-specific anti-OVA antibody detectable in serum, saliva and testis homogenate reflected the ACC counts in histological sections. The studies reported here confirm that the male reproductive tract does form part of a common mucosal immune system and that gut-associated lymphoid tissues may contribute cellular precursors for ACC, particularly those of IgA specificity, appearing in the tract after local challenge.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Comparison of the SpermMar test with currently accepted procedures for detecting human sperm antibodies.

To eliminate the possibility of immunological infertility in spontaneously infertile and re-anastomosed men, a screening test that can be applied directly to semen is desirable. The SpermMar test is one such possibility. In this study, indirect tests for sperm antibodies using the commercial SpermMar test have been applied to a panel of sera whose reactions in the tube slide agglutination test (TSAT), gelatin agglutination test (GAT) and sperm immobilization test (SIT) for sperm antibodies are well characterized. The results from the SpermMar tests are compared directly with those obtained from Immunobead tests carried out at the same time. Results from screening tests performed on 30 sera confirmed complete correspondence between the GAT, SpermMar and Immunobead tests. When sera were titrated, the Immunobead test proved slightly more sensitive than the GAT and the SpermMar test was slightly more sensitive than the Immunobead test. The SpermMar test proved easier to use and to assess than the Immunobead test and it is recommended for consideration as a screening procedure for sperm antibodies despite the fact that at this stage only IgG antibodies can be detected.

Autoantibodies↗
PubMed1988

Antispermatozoal antibodies in three men with infertility due to congenital aplasia of the vasa deferentia.

Men presenting with azoospermia due to aplasia of the vas deferens have commonly been considered to be infertile without hope of treatment. With improved methods of artificial insemination however, and more particularly with the advent of in vitro fertilization, it has been suggested that unusable spermatozoa may be able to be drawn from the epididymes of such men so that fertilization is achieved. The clinical situation of such men is analogous to that of long term vasectomised patients, 60% of whom are known to produce antibodies to spermatozoa which would interfere with the fertilization process. It was therefore decided to attempt to draw fluid from the epididymes of three such patients and at the same time conduct immunological studies on their sera, seminal fluid and, where available, epididymal fluid. Unfortunately, the spermatozoa obtained from all three men lacked sufficient progressive motility for use in in vitro fertilization. In addition, all men had antispermatozoal antibodies in their sera. Two of them also had antispermatozoal antibodies in their epididymal fluid and on their sperm, one at the same titer as in his serum. Since it is known that antibodies coating sperm reduce the changes of fertilization it is suggested that their presence should be assessed in all such men being considered for treatment. In addition, these studies demonstrate that antispermatozoal antibodies can enter the male tract at the level of the epididymis or higher and there were strong suggestions of local antibody production at this level in the tract.

Adult↗
PubMed1985

Antispermatozoal antibodies in human follicular fluid.

The possibility of antispermatozoal antibodies in women having significant effects in the higher regions of the female reproductive tract has been investigated. Follicular fluids (FF) and sera taken at the time of oocyte recovery from women undergoing in vitro fertilisation and embryo transfer (IVF-ET) were tested for the presence of antispermatozoal antibodies, and the concentrations of IgM, IgG, IgA, and complement C3 were determined. The concentrations of immunoglobulins and C3 in FF were consistent with transudation from serum inversely proportional to molecular weight. Titres of agglutinating and immobilizing antibodies in FF were usually one or two dilution steps below those of serum except where immobilizing activity was associated with IgM. IgG:IgA ratios were lower in FF from women with antispermatozoal antibodies, suggesting local production or enhanced transudation of IgA; however, a secretory component could not be detected in any of the follicular fluids in this study. Two women with antispermatozoal antibodies and infertility in excess of 5 years had successful IVF-ET and have delivered healthy infants.

Antibody Specificity↗
PubMed1985

Common specificities of auto- and iso-antibodies to human spermatozoa.

The specificities of antispermatozoal antibodies in humans were compared using the ability of F(ab')2 fragments prepared from sera containing spermatozoal antibodies to block access to antigenic sites on spermatozoa. Reciprocal blocking experiments were carried out on a panel of 13 sera which came from both men and women, had different modes of agglutination, and came from widely separated population centers. The blocking experiments confirmed that specificities of antispermatozoal antibodies bear little relation to those suggested by observed modes of agglutination. F(ab')2 fragments from head-agglutinating sera could inhibit the immobilizing activity of a tail-agglutinating sera and vice versa. Similarly, the sera from men and women could inhibit each other, as could sera collected from patients living in widely separated localities. It is concluded that there are more than one, but a limited number, of antigens on the spermatozoal surface capable of generating antibodies with antifertility effects. It is also concluded that these antigens occur all over the sperm surface but may be concentrated in certain areas and that the observed modes of agglutination depend at least as much on the characteristics of the antibodies as on their specificities.

Antibody Specificity↗
PubMed1982

Successful treatment of male infertility caused by antispermatozoal antibodies.

Spermatozoa in the ejaculate of a man with antispermatozoal antibodies in the serum (gelatin agglutination technique (GAT) titre, 640) and the seminal plasma (GAT titre, 80) were shown to have IgG and IgA bound to them. In preparation for intrauterine artificial insemination, the ejaculate was collected in Tyrode's medium. Then spermatozoa were washed, resuspended in Tyrode's medium, and 0.2 mL of the suspension was injected in the uterus. A successful pregnancy resulted. Reasons are given for considering that the successful pregnancy resulted from the manipulation of the semen.

Adult↗
PubMed1981

The binding of sex steroids to human spermatozoa. An autoradiographic study.

The locations of steroid binding sites with specificities for 17 beta-oestradiol, progesterone and testosterone have been examined on human spermatozoa by autoradiography. The binding sites were not evenly distributed over the entire surface of human spermatozoa. They were more densely located on the midpiece of the tail, less on the head and neck, and least on the principal- and end pieces of the tail. The binding sites for 17 beta-oestradiol were specific, with 3H-17 beta-oestradiol being displayed by unlabelled 17 beta-oestradiol, but less readily displaced by either progesterone or testosterone. The binding sites for testosterone were less specific than those for 17 beta-oestradiol or those for progesterone. Both 17 beta-oestradiol and progesterone were good competitors for testosterone binding sites, while the binding of 3H-progesterone was easily displaced by 17 beta-oestradiol, but less readily displayed by testosterone. Since there was preferential binding of these steroids to the mid-piece, and strong competition for binding between 17 beta-oestradiol and progesterone, these studies appear to provide information on the sites of action for the reported effects of these and related steroids on spermatozoal motility, migration and metabolism.

Autoradiography↗
PubMed1980

Mouse uterine alkaline phosphatase: improved purification by affinity chromatography and further characterization of the enzyme.

An improved procedure for the purification of alkaline phosphatase from about 10 g of day 7 pregnant mouse uterine tissue is described. Following homogenization, the procedure involved solubilization and extraction with 0.8% (v/v) Triton X-100 and 20% (v/v) n-butanol, ammonium sulfate precipitation, concanavalin A-Sepharose 4B affinity chromatography, DEAE-cellulose anion-exchange chromatography and Sephacryl S200 gel filtration. On subjecting 2162-fold purified enzyme preparations to polyacrylamide-gel electrophoresis, a single band of protein coincident with the zone of enzyme activity and having an apparent molecular weight of 205 000 +/- 10 000 was identified. Affinity chromatography yielded the largest increase in purity of any step in the procedure and established the glycoprotein nature of the uterine enzyme. Some metalloenzyme properties of the phosphatase were also studied and it was demonstrated that both Mg2+ and Zn2+ ions are necessary for hydrolytic activity. Treatment with neuraminidases retarded the anodal migration of the enzyme during electrophoresis on cellulose acetate membranes but did not influence its activity or catalytic properties. These results suggest that the uterine alkaline phosphatase is a sialoglycoprotein. The sialic acid residues, however, do not appear to constitute part of the active centre of the enzyme. In addition, the optimum pH for activity depended on substrate concentration and decreased with decreasing substrate concentration. Apparent Km values also depended on variations in pH and decreased with decreasing pH. Plots of pKm versus pH revealed a functional group with a pK value of 9.45. The enzyme also hydrolysed a variety of compounds having either phosphomonoester or pyrophosphate linkages and was inactivated after heating at 60 degrees C for 15 min. The activation energy, determined from a linear Arrhenius plot, was 50.1 kJ mol-1.

Alkaline Phosphatase↗
PubMed1980

Further characterization of the nonimmunoglobulin sperm-agglutinin found in some human sera.

A comparison is made between some properties of immunoglobulin and nonimmunoglobulin sperm-agglutinins. It is found that antisperm antibodies are directed against spermatozoal components and bind equally well to viable and nonviable spermatozoa. On the other hand nonimmunoglobulin sperm-agglutinins are directed at both spermatozoal and seminal plasma components and bind to viable sperm. beta-lipoprotein may not be involved in the nonimmunoglobulin sperm-agglutinin found in human sera.

Humans↗
PubMed1979

Extraction and partial purification of mouse uterine alkaline phosphatase.

Alkaline phosphatase in uterine homogenates from day 7 pregnant mice was solubilized using 0.2% (v/v) Triton X-100 and extracted wtih 20% (v/v) n-butanol. The procedure, which resulted in 182-fold purification, included ammonium sulfate precipitation, DEAE-cellulose anion exchange chromatography and Sephadex G200 gel filtration. Solubilization with Triton X-100 was an important step in the procedure since extraction with n-butanol alone only partially solubilized the enzyme and gave low extraction yields, much of the enzyme activity remaining in association with negatively charged residues. However, butanol extraction of Triton X-100-treated homogenates gave high yields of enzyme and eliminated p-nitrophenyl phosphatases which displayed activity in the pH range 3.0--7.5, together with a large proportion of inactive protein. The activity of the purified enzyme preparations was electrophoretically homogeneous on cellulose acetate membranes, suggesting that the alkaline phosphatase in the mouse uterus exists in a single isozymic form. Polyacrylamide-gel electrophoresis revealed that the purified preparations contained at least one protein as an impurity. Attempts to further purify the alkaline phosphatase by isoelectric focusing were unsuccessful since the enzyme was found to have an isoelectric point of about 5.0 and at this pH it was rapidly inactivated.

Alkaline Phosphatase↗