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Biomedical subjects

E Vicari

Publications and source records attributed to E Vicari.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Clinical and sperm follow-up after subinguinal varicocelectomy].

In order to evaluate the sperm output and the adverse-side-effects after subinguinal varicoceloctomy, a follow-up study of 16 months was performed on 196 selected patients (aged from 22 to 43 years) affected by left varicocele (VR). In the pre-treatment, both Doppler ultrasonography and didymo-epididymal ultrasonography allowed to distinguish two homogeneous patient groups: group A (no. = 136), including patients affected by VR alone and, group B (n. = 60), including patients with VR combined to coincidental didymo-epididymal morphological abnormalities, DEMA). These DEMA lesions (testis size < 12 ml, epididymides abnormalities: increased head- > or = 12 mm- and/or tail- > or = 6 mm-diameter, multiple microcysts, large idrocele) were omolaterally to VR in 30/60 (50%), eterolaterally in 19/60 (31.7%) or bilaterally in 11/60 (18.3%). During sperm follow-up, group A patients showed both a significant temporal change (p < 0.01 ANOVA) of all sperm parameters studied (sperm density, total sperm count, motility and morphology) from month 8 onward and sperm values significantly higher than found in group B patients. On the contrary, the sperm parameters of group B patients did not change significantly during the follow-up observations. As far as the varicocelectomy-mediated clinical symptoms, some patients complained early and transiently (on 1-2-4 weeks following varicocelectomy) the following symptoms: didymal pain (1.5%), didymo-epididymal pain (4.1%) and parasthesiaes on the anterior-medial side of the left thigh (4.1%) or scrotal (3.1%); only four patients (2%) complained permanent paresthesiaes on the anterior-medial side of the left thigh. Furthermore, the clinical follow-up also revealed a low rate of complications: persistent VR (3.6%), hydrocele (1.5%), intrascrotal venous ecstasies (6.1%), epididymitis (0.5%). Some morpho-structural abnormalities at US scans were transient (1-2 weeks): scrotal oedema (6.1%), orchitis (2%), orchi-epididymitis (1%). Subinguinal varicocelectomy performed on large population demonstrated a significant improvement of the sperm output from month 8th onward in patients with VR alone, while sperm parameters did not show any significant change in patients with VR plus coincidental DEMA. This surgical technique also demonstrated safety since both low rates of symptoms and (transient) complications were registered.

Adult↗
PubMed1999

Seminal leukocyte concentration and related specific reactive oxygen species production in patients with male accessory gland infections.

The aim of this study was to determine whether differences occur in seminal concentrations of white blood corpuscles (sWBC) and whether WBC production of reactive oxygen species (ROS) is related to the infiltration of one or more male sexual glands. We studied 70 infertile patients affected by bacterial male accessory gland infections (MAGI) who were divided clinically and, by ultrasound (US), into four well-characterized, aged-matched groups. Three of the groups presented an abnormal US scan (MAGI US+ groups): group P with prostatitis alone (n = 15), group PV with prostato-vesiculitis (n = 19), and group PVE with prostato-vesiculo-epididymitis (n = 22). The fourth group presented with a normal US scan (MAGI US- group) and was diagnosed with presumptive MAGI according to laboratory criteria (n = 14). In addition, 20 fertile males acted as controls. All patients underwent seminal and microbiological analyses as well as US scans. In addition, the WBC concentrations of whole semen and the WBC-rich 45% Percoll fraction (Pf45) as well as WBC-specific ROS production in the same sperm fraction were analysed. Semen samples from the PVE patient group exhibited significantly (P < 0.01) lower values of sperm parameters than those obtained from P, PV, MAGI US- and the control groups. The sWBC and Pf45 WBC concentration as well as baseline and fMLP-stimulated ROS counts in each MAGI US+ group were significantly (P < 0.01) higher than those found in the MAGI US- group and controls.

Adult↗
PubMed1999

Improved high-temperature expansion and critical equation of state of three-dimensional Ising-like systems.

High-temperature series are computed for a generalized three-dimensional Ising model with arbitrary potential. Three specific "improved" potentials (suppressing leading scaling corrections) are selected by Monte Carlo computation. Critical exponents are extracted from high-temperature series specialized to improved potentials, achieving high accuracy; our best estimates are gamma=1.2371(4), nu=0.630 02(23), alpha=0.1099(7), eta=0.0364(4), beta=0.326 48(18). By the same technique, the coefficients of the small-field expansion for the effective potential (Helmholtz free energy) are computed. These results are applied to the construction of parametric representations of the critical equation of state. A systematic approximation scheme, based on a global stationarity condition, is introduced (the lowest-order approximation reproduces the linear parametric model). This scheme is used for an accurate determination of universal ratios of amplitudes. A comparison with other theoretical and experimental determinations of universal quantities is presented.

Journal Article↗
PubMed1999

[Diagnostic approach and therapeutic strategy in 133 infertile patients with astheno-necrozoospermia].

One-hundred thirty-three patients (aged 22 to 48, median 27 years) found affected by repetitive severe astheno-necrozoospermia (ASNE) (forward sperm motility < 10%; viable forms < 25%) in their ejaculates detected by both conventional viability tests (eosin Y exclusion and HOS tests) associated with oligo (51.1%), poly (3.7%), terato- (82.7%), -zoospermia, hyperdesfoliation of seminal spermatids (36.8%), hypospermia (11.3%), a comprehensive (history analysis; physical examination; lab: hormonal, microbiological, hemato-chemical blood screening, ultrasound scans at didymo-epididymal and prostato-vesicular glands, genital venous doppler) work-up allowed to recognize the following possible causes of ASNE: infectious (24.1%), spermiotoxyc (16.5%), hormonal (15.0%), iatrogenic (12.8%), chronic extratesticular diseases (CETD) (10.9%), varicocele (6.8%), idiopathic (14.3%). Overall population, except CETD patients gave their written informed consent about trial options for a three month period: a. rational, evidence-based treatment, group-standardised for doses and lenght (treated patients = subgroups T: total number = 71); b. short-term treatment/no treatment, (matched-control = subgroups Co: total number = 47). Follow-up semen data performed after completion of the assigned trial, together detected a conventionally normal percentage (> 25%) of viable sperm (necrozoospermic-responders (NR) in 37 (52.1%) out of subgroup-T patients. All subgroups-T patient, excepted subgroup-T patient affected by idiophathic ASNE (NR = 0%), exhibited NR rate (range 50-69.2%) values always significantly higher than subgroups-Co (NR = 0%, in all subgroups). Moreover, in each subgroup-T patients the percentages of viable and forward motile sperms values were significantly higher than matched-controls. The results of this study indicate that in patients affected by ASNE an andrological comprehensive work-up is mandatory because ASNE has a heterogeneous pathogenesis and a favourable prognosis, in terms of viable forms sperm improvement is possible after evidence-based therapeutic strategy.

Adult↗
PubMed1999

[Male urogenital amicrobial phlogosis: effects of the treatment with amtolmetin guacyl on some sperm parameters].

To examine if some inflammation-related sperm abnormalities were influenced by leucocytospermia (sWBC) alone, WBC-specific Radical oxygen species (WBC-ROS) over-production, and/or by different infected sexual gland sites and if these abnormalities were possibly reversible following treatment with an antiphlogistic drug, a total of 43 infertile male patients with amicrobial male accessory gland infections (MAGI) associated with prostatitis (P, n = 16), prostato-vesiculitis (PV, n = 14) or prostato-vesiculo-epididymitis (PVE, n = 13) as confirmed by ultrasound, were studied. The patients were then further subdivided into two subsets: one of the subsets (P, n = 10; PV, n = 8; PVE, n = 7) was administered amtolmetina guacyl (Eufans) 600 mg once daily for 14 consecutive days per month, for a 2-months period. The second subset (six patients for each category) received no treatment (matched-control). Mean outcome measures included a follow-up of sperm analysis with assessment of sperm forward motility (M), sperm viability (V). In addition, sWBC as well as basal and maximal fMLP-mediated WBC-ROS production were also carried out by conventional immunocytochemistry staining and chemiluminescence analysis respectively. In the pre-treatment, in all patients (treated and not treated subsets) median values of the sperm M and V were significantly different among categories (P > PV > PVE), and necrozoospermia (sperm viability < 25%) were present in the 70% out of group P patients and in all (100%) patients from groups PV and PVE. Median sWBC concentrations, elevated (values > 1 mil/ml) in all groups, in the PV and PVE groups were significantly higher compared to those found in the group P. Furthermore, PVE group generated baseline and fMLP-stimulated ROS productions from low density 45% Percoll fraction (Pc45), significantly higher than those found in P or PV groups. Sperm outcome measures were significantly different compared with the matched-controls (exhibiting 0% case-responders), in a time- and infected gland site-dependent manner. Thus, either in terms of median values and percentages of responders (defined as parameters ensued within the conventional normal range) sperm M and V percentages, as well as sWBC improved after the first (T1) antiphlogistic course in the group P only, but after the second (T2) antiphlogistic course in the other groups (PV or PVE). Moreover, treated patients of each group had amounts of generated basal and fMLP-stimulated ROS signals significantly reduced, with values ensued within a fertile control range at T2, in 80, 62.5 and 42.8% out of the P, PV and PVE groups respectively. We concluded that long-term amtolmetina-guacyl administration demonstrated efficacy and safety in the treatment of amicrobial MAGI, exhibiting a positive impact on all sperm parameters studied and no side-effects.

Adult↗
PubMed1998

Correlation between intracellular cAMP content, kinematic parameters and hyperactivation of human spermatozoa after incubation with pentoxifylline.

Various compounds have been used in the attempt to improve sperm motility, including pentoxifylline (PF), a methylxanthine derivative. It has been postulated that PF, being a phosphodiesterase inhibitor, increases sperm kinematic parameters and the number of spermatozoa exhibiting hyperactivated motility by raising the intracellular content of cAMP, a molecule involved in the generation of sperm energy. However, it has not been clarified whether the biological effects of PF on sperm motility correlate with its ability to increase intracellular cAMP levels. To examine this relationship, the kinematic parameters, hyperactivation, and intracellular cAMP content were evaluated in motile spermatozoa, obtained by discontinuous Percoll gradient and swim-up from 21 normozoospermic semen samples, incubated without and with PF for 0, 1, 2, and 4 h. PF increased beat cross frequency after 1 and 2 h of incubation, curvilinear velocity and lateral head displacement (ALH) after 4 h, and hyperactivation after 1, 2, and 4 h, and decreased linearity (LIN) after 1 h of incubation. The intracellular cAMP content of spermatozoa incubated with PF increased at all time-points examined. Both intracellular cAMP content and increase in hyperactivation in response to PF decreased with the length of incubation. In the absence of PF, cAMP content was unchanged and was correlated significantly only with ALH and the percentage of spermatozoa with hyperactivated motility. Following incubation with PF, cAMP content correlated with hyperactivation and all sperm kinematic parameters, with the exception of LIN and straightness. These findings suggest that the beneficial effects of PF on sperm kinematic parameters and hyperactivation are related to its ability to increase intracellular cAMP content.

Cyclic AMP↗
PubMed1997

[The negative effect in patients with varicocele of coincidental didymo-epididymal morpho-pathology on sperm response before and after surgical correction].

In order to assess the relative incidence of varicocele (V) alone and V+ coincidental didymo-epididymal morphological abnormalities (DEMA) and the role of these pathologies on the pre- and post-surgical sperm outcome, 151 selected (previous exclusion of cases with bilateral V, seminal infections, antisperm autoAb) patients (aged 20-41 yrs) affected by left V at Doppler ultrasonography, underwent both ultrasound scrotal content examinations and semen analyses (sperm density, total sperm count, forward motility and normal morphology employing as frequency distribution) before and after varicocelectomy (on months 4-8-12, taking for statistical comparison the maximal post-surgical sperm value registered vs. mean correspective pre-treatment value). One-hundred two (67.5%) patients exhibited V alone (group A), whilst 49 (32.5%) patients showed V+DEMA (group B). As regards V, DEMA lesions (testis size < 12 ml; epididymides abnormalities: increased head (> 11 mm) and/or tail (> 6 mm) diameter, multiple microcysts; large idrocele) were omolaterally in 21/49 (42.8%) eterolaterally in 11/49 (22.5%) or bilaterally in 17/49 (34.7%). An additional group of 25 patients, exhibiting the above ultrasonic DEMA lesions alone without V, served as controls (group C) for semen statistical analysis in the pre-surgical period only. In this phase among groups A vs B, A vs C, B vs C, frequency distributions of all sperm parameters studied (excepted for density not significative only between B and C group patients) were significantly different. The following data were registered from A, B and C patient groups respectively: a) azoospermia was present in 12.7%, 34.8% and 24%; b) oligozoospermia (< 20 mil/ml) in 39.2%, 49% and 48%; c) normozoospermia in 48.1%, 16.3% and 8%; d) total sperm count was < 40 millions/ejaculate in 44.1%, 91.9% and 76%; e) asthenozoospermia (forward motility < 25%) was present in 32.3%, 71.4% e 72%; f) teratozoospermia (oval form <30%) was present in 34.3%, 62.3% and 48%. In the post-surgical follow-up examinations, significative changes with ameliorated frequency distributions of all semen parameters were observed within group A only, while these same parameters remained unmodified within group B patients, thus being together a significative difference between groups A vs B higher than that observed in the pretreatment. The coexistence of DEMA+V seems to determine two important effects on sperm output: a) in the pre-treatment, this selection judgement allowed to distinguish a different frequency distribution of semen parameters between patients affected by V alone and V+DEMA; b) since patients with V alone in comparison with V+DEMA patients groups had a favourable sperm outcome, the assessment of DEMA in patients with V seems to be mandatory for a better sperm prognostic judice.

Adult↗
PubMed1996

[A possible therapeutic improvement of the antibacterial effect by monitoring the production of leukocyte free oxygen radicals during antibiotic treatment of infertile patients with chronic bacterial prostatitis].

In the male chronic accessory gland bacterial infections (AGBI), antibiotic treatment (AT) efficacy usually evaluates the antimicrobial outcome through one or more spermiocolture (SC) become negative. Recently, bacterial olipeptide fMPL has been used to detect a specific Radical Oxygen Species production by leukocytes (L-RLO), even when they are present at low concentrations in sperm fractions specimens. In the male AGBI could be present endogenous fMLP at sufficient levels to produce L chemiotaxis in the semen, and secondly active their specific L-RLO production, till when bacteriospermia remained positive. In the Percoll 50% (Pc50%) fraction, at higher L concentrations, from 22 infertile patients affected by chronic bacterial prostatitis (BP) and enrolled to a randomly AT treatment with a Quinolone (n = 12) or a Macrolide (n = 10), through two secondary milestones (possible elevated basal L-RLO in the pre-treatment, T0; significant changes in the basal and fMLP-stimulated L-RLO production within each treatment group and between groups), we would verify if a normalized L-RLO production could be taken as break-point for the AT withdrawal before checking SC for control. Indeed, in T0 all patients had positive SC and exhibited both basal and fMLP-stimulated L-RLO levels higher than those observed in 2 control groups (group cA = 10 fertile men, without chronic BP; group cB = 10 patients affected by chronic abacterial prostatitis (AP). On the 3rd AT cycle for 14 days, together in 20/22 AT-treated patients, basal and fMLP-stimulated L-RLO levels become low or normal, as well as their SCs become negative (CFU/ml = 0), whilst in a third control group (group cC) of 10 not-AT-treated BP patients, through matched-follow-up observations, these L-RLO values were always elevated and their SC remained positive (CFU/ml > or = 10(5)). In chronic BP patients, AT seems to demonstrate both antimicrobial effectiveness and reduction of L-RLO production with values similar to those of control group cA. The monitored L-RLO values during AT could be useful in order to ottimize antimicrobial effect: this tool being able to previse SC outcome, could be assumed to define clearly AT break-point and/or cycle numbers.

4-Quinolones↗
PubMed1995

Effectiveness of long-acting gonadotrophin-releasing hormone agonist treatment in combination with conventional therapy on testicular outcome in human orchitis/epididymo-orchitis.

A group of 24 patients suffering from acute post-pubertal orchitis/epididymo-orchitis were prospectively randomized to treatment over a total period of 3 months with a combined conventional plus long-acting gonadotrophin-releasing hormone analogue (GnRHa) (leuprolide, 3.75 mg every 27 days) therapy (n = 13, group A) or conventional therapy alone (n = 11, group B) respectively, in order to verify any differences in clinical and sperm outcome during treatment and follow-up. Seven patients affected by uncomplicated mumps (group C), receiving GnRHa for 3 months, served as an additional control group. Combined leuprolide plus conventional therapy provided better outcomes than conventional therapy alone in terms of scrotal ultrasound scans and serum antisperm antibodies (ASA) at time of presentation and monthly thereafter throughout the study: the most solid data relate to testicular atrophy in three out of 11 patients from group B and their sAb positivity persisting, as opposed to zero out of 13 in group A. Moreover, semen analyses performed at 3-6 months after therapy withdrawal revealed in groups A and C mean total sperm counts and percentages of oval forms significantly higher than those observed in group B. It is concluded that GnRHa treatment is a promising pharmacological tool with no side-effects, effective in reducing testicular vascular leakages in male orchitis.

Adult↗