PubMed Health⌕ Search

Biomedical subjects

D Paoli

Publications and source records attributed to D Paoli.

13 recordsLinked to original sources
PubMed2004

Full-term pregnancies achieved with ICSI despite high levels of sperm chromatin damage.

BACKGROUND: Sperm DNA integrity is essential for the accurate transmission of genetic information. The clinical significance of this assessment lies in its association with not only natural conception rates, but also the success of assisted reproduction technology (ART). It has been reported that sperm chromatin structure assay (SCSA) identified thresholds for negative pregnancy outcome after ART when the DNA fragmentation index (DFI), previously known as COMPalphat, was >30%. METHODS: In a prospective clinical study, we examined 34 male infertile patients, the husbands of women undergoing conventional IVF or ICSI. SCSA and ART were carried out on semen aliquots taken from the same ejaculate. Fertilization rate, embryo quality and pregnancy rates were correlated to SCSA parameters, DFI and highly DNA stainable (HDS) cells. RESULTS: No differences were seen in SCSA parameter values between patients initiating pregnancies and not doing so in either ICSI or conventional IVF. Pregnancies and normal delivery were obtained even with high levels of DFI. CONCLUSIONS: There is still controversy over whether analytical techniques currently in use are able to identify the level of damage to spermatozoa. Large-scale studies should be conducted in different clinical settings to determine the effects of sperm DNA damage on the outcome of ART.

Adult↗
PubMed2000

Study of apoptotic DNA fragmentation in human spermatozoa.

The aim of our work was to define and better understand apoptosis in the spermatozoa of normal subjects, infertile patients and patients affected by specific tumoral diseases employing the method of the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labelling and confirming the results by electron microscopy. We studied 23 healthy, normozoospermic subjects (group A), 29 oligoasthenoteratozoospermic patients, affected by various andrological pathologies (group B), 28 patients with Hodgkin's disease (C1) and 30 patients with testicular cancer (C2). Our data demonstrate that the percentage of apoptosis in normozoospermic subjects (group A) is significantly lower than in all the other groups (B, C1, C2) (P < 0.001). This confirms that high DNA fragmentation is one of the characteristics of spermatogenetic failure. The induction of apoptosis, which can also be a basic response to neoplastic disease, can even act right up to the mature male gamete. Our results suggest that apoptosis could be the final result of various pathologies and of a deregulation of spermatogenesis control systems.

Adult↗
PubMed1998

Retinal astrocytoma associated with hypertrophy of the retinal pigment epithelium: clinical report and follow-up.

Retinal astrocytoma is a rare and benign tumor of the retina most frequently seen in patients with tuberous sclerosis. We describe the case of a 12-year-old boy with solitary retinal astrocytoma in the right eye associated with hypertrophy of the retinal pigment epithelium in the left eye. In this work the instrumental examinations, the differential diagnosis and the follow-up of 7 years are described.

Astrocytoma↗
PubMed1998

Bilateral occlusion of the central retinal artery in a homocystinuric patient: the role of echography.

The authors describe a case presented by a homocystinuric 26-year-old male patient with bilateral occlusion of the central retinal artery. Echography carried out the same day of the occlusion and the following days identified and monitored a mass located in the orbit of the OD. Characteristics and dimension of the mass were confirmed and measured by a CT scan and NMR examination. The orbital mass of the OD appeared to be a swelling of the central retinal artery with echo-refracting opacities, which, in light of recent studies, can be interpreted as multiple arterial thrombi, composed predominantly most likely by platelets. Therapeutic possibilities are discussed.

Adult↗
PubMed1997

Antisperm antibody detection: 2. Clinical, biological, and statistical correlation between methods.

PROBLEM: In clinical andrology, the detection of antisperm antibodies (ASA) is regarded as one of the most important steps in the study of male infertility. This practice is generally accepted even though there is still some disagreement about the true meaning of antisperm immunity, and there remains a good deal of controversy about the test regarded as the most suitable for the detection of antibodies directed against sperm antigens. International Workshops have tried to standardize universally accepted protocols. A panel of three or four methods is generally advised to provide a correct and complete screening of patients with antisperm immunity. The aim of the present paper is to report our studies on the correlation between direct methods (IBT, MAR test) and indirect methods (gelatin agglutination test [GAT], and tray agglutination test [TAT]) and to establish whether biological models can explain the antibody test results. An attempt was also made to establish a "predictive threshold" to explain even apparently discordant direct and indirect results.

Agglutination Tests↗
PubMed1995

Study of antisperm antibodies bound to the sperm cell surface and their relationship to circulating ASA.

PROBLEM: Direct and indirect tests for antisperm antibody (ASA) detection are commonly used in laboratories for the diagnosis of male immunological infertility. Even though the two kinds of tests study the same immunological phenomena, frequently no perfect correlation is found even on large series of patients and with precise statistical models. The aim of the present investigation was to try to establish whether biological models can explain the antibody test results and if a predictive threshold can be established for expected positivity/negativity. METHOD: The data relate to 667 patients, who were screened using the Direct Immunobead test (d-IBT) for ASA bound to the sperm surface and with the gelatin and tray agglutination test (GAT and TAT) in sera for circulating ASA. Correlation were studied and cases of no correlation were further analyzed. RESULTS: The number of patients with a clinically significant positivity to d-IBT (binding percentage > or = 20%) was 134 (20.1% of total patients). The analysis of the results of direct and indirect tests shows that the discordances are due to differences in the Ig class of immunization or to the site of epitopes involved. In fact, as far the Ig class is concerned, if d-IBT shows a prevalent or exclusive IgG or IgA positivity, this results in a poor correlation between binding percentage to d-IBT and GAT-TAT titers. If both the Ig classes are involved, the level of positivity of the two kinds of test are strictly related. As far as the site of Ag-Ab reaction on the sperm surface is concerned, the wide immunization involving all the surface sperm antigens (mixed), shown by d-IBT, is related to higher indirect test titers. CONCLUSION: Local and systemic antisperm immunizations are strictly related and a predictive threshold of expectation can be established to explain even apparently discordant direct and indirect results.

Agglutination Tests↗
PubMed1987

[Anterior desinsertion of the transversus abdominalis in the prosthetic treatment of major eventrations].

An original procedure is suggested for the prosthetic treatment of major incisional hernias: transversus abdominalis muscle desinsertion. The aim is to create an opening between two cleavage planes which are the underperitoneal space externally and the posterior face of the rectus abdominalis muscle internally. The single space thus created allows the wide implantation of a subperitoneal Mersilene prosthesis which is isolated from the viscera as well as from the skin. A strong abdominal wall is then reconstituted. Ten patients were operated upon using this technique with excellent results in all cases.

Abdominal Muscles↗
PubMed1987

[Response to hepatic intra-arterial chemotherapy for metastases of colorectal cancer. Anatomo-pathological evaluation apropos of 3 cases of secondary hepatic excision].

Following intra-arterial chemotherapy (5-fluorouracil), wide hepatic resection was performed in three patients with metastases from colorectal cancer. These surgical procedures had been considered to be unfeasible before chemotherapy in two of the three cases because of the extension of the metastases. In contrast to the results of preoperative imaging techniques (CT scan, ultrasonography), the histologic response of tumors to chemotherapy was found to be significant (1/3) or complete (2/3). Since after chemotherapy these imaging procedures are unable to determine whether the observed lesions are tumoral, fibrotic or necrotic, a laparotomy after hepatic intra-arterial chemotherapy is proposed to obtain specimens for histopathologic examination and an assessment of resectability. This procedure should be reserved for patients in whom substantial benefit can be expected considering the extension of primary and metastatic disease.

Colonic Neoplasms↗
PubMed1982

[Drainage of the bladder by suprapubic catheterization (author's transl)].

In most cases of urine retention due to lower urinary tract obstruction, the distended bladder can be drained by suprapubic catheterization. Only large intervesical blood clots cannot be removed by this method. The technique has been simplified and made non-traumatic and safe by the advent of small-diameter, self-winding, polyrethane catheters (Cystofix) which are easy to handle and well tolerated. The urethra and possible cervico-prostatis obstacles are left undisturbed, and radiological as well as manometric explorations can be performed. Complications do not occur if bladder distention is well ascertained, if the catheter is accurately inserted and if stringent aseptic precautions are taken. In the authors' unit suprapubic catheterization has become common practice and transurethral catheterization is seldom performed.

Humans↗