Biomedical subjects

H Hibi

Publications and source records attributed to H Hibi.

At least 55 records · Page 3Linked to original sources

PubMed1995

Management of chronic orchialgia of unknown etiology.

The treatment of patients with chronic unilateral or bilateral orchialgia, defined as intermittent or constant testicular pain of greater than 3 months and of unclear cause, is difficult. This pain significantly interferes with the daily activities of the patient. We have seen 12 patients with chronic orchialgia of unknown etiology and each had a normal history, physical examination and normal scrotal sonogram. Three patients were treated with nonsteroidal anti-inflammatory drugs and obtained partial pain relief. Three patients underwent spermatic cord nerve blockade using a combination of 1% lidocaine and 40 mg methylprednisolone and experienced partial pain relief. Four patients underwent inguinal orchiectomy after failing conservative management: three reported complete relief of pain, and the other partial relief. Two patients had bilateral transrectal injections of local anesthetic (5 ml bupivacaine) and methylprednisolone into the region of the pelvic plexus under transrectal ultrasound guidance. They were successfully treated with this injection technique. On the basis of our results, we recommend transrectal blockade of nerves from the pelvic plexus or inguinal orchiectomy as the procedure of choice for patients in whom medical treatment fails.

Adult↗

PubMed1995

Successful pregnancy after microfertilization with epididymal sperm retrieved by micropuncture technique in the patient with congenital absence of the vas deferens.

A case report describes successful microfertilization of oocytes of a 27-year-old woman with epididymal sperm retrieved by micropuncture technique from the patient with congenital absence of the vas deferens. Microfertilization treatment resulted in a singleton pregnancy; the child has since been born. Treatment of couples involving men with surgically unreconstructible obstruction is now possible. Our experience indicates that sperm retrieved with this new technique, when combined with assisted reproductive technologies, permits fertilization for the men with surgically irreparable vasal obstruction.

Adult↗

PubMed1995

Effects of alpha-blocker on daily testicular sperm production and sperm concentration, motility, intraluminal pressure and fluid movement in the rat epididymis.

This study was undertaken to investigate whether alpha-blocker has an effect on daily testicular sperm production and epididymal sperm parameters, intraluminal pressure and fluid movement in the rat cauda epididymal tubules. Sprague-Dawley rats were given daily oral doses 1 mg/kg, 2 mg/kg, or 10 mg/kg of Bunazosin, which was a selective alpha-blocker, for three months. Intraluminal fluids were collected from the cauda epididymidis using a micropuncture technique. Sperm concentration was determined with a sperm concentration microassay. Motility estimates were made by measurements of linear distance traveled by sperm in the diluent. Epididymal intraluminal pressure was measured through a micropunctured pipette connected to a micropressure transducer. Intraluminal fluid movement was examined by measurement of the distance which Sudan Black stained mineral oil moved along the epididymal tubules. Outside diameters of seminiferous and epididymal tubules were measured by light microscopy. Epididymal sperm concentrations were significantly increased after administration of alpha-blocker. Progressive motility of spermatozoa was not significantly altered by alpha-blocker. Intraluminal pressures were significantly reduced and intraluminal fluid movement rates were significantly increased by alpha-blocker. Daily sperm production was significantly increased by alpha-blocker. Outside diameters of seminiferous and epididymal tubules were significantly distended when treated with alpha-blocker. These results demonstrate that alpha-blocker has an effect on spermatogenesis and sperm transport in the rat testis and epididymis.

Adrenergic alpha-Antagonists↗

PubMed1995

Serum estradiol levels in normal men and men with idiopathic infertility.

Serum estradiol levels were measured in 360 men attending an infertility clinic and 68 proven fertile men to determine whether estradiol measurements are clinically useful. The normal range of estradiol levels found in fertile men was 10-82 pg/ml. Serum concentrations of estradiol in azoospermic or oligozoospermic patients were significantly lower than those in normozoospermic men (p < 0.021). Serum concentrations of testosterone were also significantly decreased in infertile patients (p < 0.025). This decrease in serum estradiol may be partly due to reduced testosterone levels in these men because estradiol is mainly formed by peripheral aromatization of testosterone in fatty and muscle tissues. However, the exact mechanism for the decrease in the serum estradiol levels remains undetermined. It is concluded that serum estradiol levels are significantly low in the men with various testicular disorders.

Adult↗

PubMed1995

[Clinical evaluation of a new polymerase chain reaction assay for detection of Chlamydia trachomatis in young patients with acute epididymitis].

Specimens from 15 young patients presenting with acute epididymitis were tested for the presence of Chlamydia trachomatis by an enzyme immunoassay (EIA), polymerase chain reaction (PCR), and for other bacteria by standard laboratory techniques. C. trachomatis urethral infection was detected in 3 patients by an EIA test of the urethral swabs (20%) and in 13 patients by the PCR (87%). This difference in detection rate was statistically significant (p < 0.005). Thirteen specimens were positive by the PCR, but only three of them were positive by the EIA method. These findings indicate that the PCR assay is a highly sensitive assay for the detection of C. trachomatis in male urine specimens and provides a noninvasive technique for routine screening of chlamydia infection in the patient with acute epididymitis.

Acute Disease↗

PubMed1995

Serum inhibin levels in normal men and men with idiopathic infertility.

In vitro studies have shown that the Sertoli cell is the primary source of inhibin in the male. To assess the regulation of inhibin production we measured serum inhibin, FSH, LH and testosterone in 21 normal men and 104 men with various testicular disorders resulting in infertility. The infertile men were subdivided into groups on the basis of their mean sperm count, FSH and LH levels. The mean serum concentrations of inhibin in the normal men were 602 +/- 29 U/L and were significantly decreased in those groups with severe oligozoospermia (p < 0.01) or azoospermia (p < 0.01; p < 0.001). The FSH concentrations correlated inversely with serum inhibin concentrations (p < 0.001) in azoospermic men. Azoospermic men with high FSH had significantly lower inhibin and testosterone levels when compared with normal men (p < 0.01; p < 0.001). Serum FSH concentrations were significantly increased in azoospermic men (p < 0.001). Our present results of serum concentrations of inhibin correlating inversely with those of FSH levels suggest that measurement of inhibin may be a useful circulating marker of Sertoli cell function.

Adult↗

PubMed1995

Antibiotic and ejaculation treatments improve resolution rate of leukocytospermia in infertile men with prostatitis.

Leukocytospermia has been associated with notable adverse effects on semen parameters and sperm function. The present study was undertaken to identify men with leukocytospermia and prostatitis in an infertility population and assess the effects of various treatments. One million white blood cells (WBC)/ml semen was defined as leukocytospermia. An expressed prostatic fluid was analyzed for the presence of white blood cells. The presence of more than 10 WBCs/high power field on expressed prostatic secretion was needed for the diagnosis of prostatitis. Those men who had more than one million WBCs in their semen and more than 10 WBCs/high power field on expressed prostatic secretion were enrolled in this study. Of two hundred sixty-three men screened for the presence of leukocytospermia and prostatitis, forty-eight men met both criteria. They were blindly and randomly assigned to one of three groups. Group 1 received no treatment. Group 2 were treated with trimethoprim 80 mg-sulfamethoxazole 400 mg (TMP-SMX) orally twice per day for one month. Group 3 were treated not only with the same antibiotic regimen as group 2 but also were instructed to ejaculate frequently (at least once every three days) for one month. Significant resolution of leukocytospermia occurred in the order of patient groups 3 > 2 > 1 at one month. The resolution rate of leukocytospermia of each group was 76% in group 3, 56% in group 2 and 6.7% in group 1. The rates in groups 2 and 3 were significantly higher than that in group 1 (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

PubMed1995

The effect of varicocelectomy on testicular volume in infertile patients with varicoceles.

The presence of a varicocele has been associated with decrease in testicular volume both in adult and pediatric patients. However, a study on the effect of varicocelectomy on testicular volume in the adult varicocele patient has never been reported. We determined the testicular volume before and after varicocelectomy in 52 patients with varicocele. A significant increase in testicular volume with the right side showing a greater increase was observed (p < 0.05). No greater increase in testicular volume was noted among the patients who achieved a pregnancy with their spouses. In addition, the age of the patient did not correlate with the observed change in testicular volume. These results suggest that varicocele is clearly related to decreased testicular volume and that varicocelectomy can increase bilateral testis volume resulting in improved testicular function.

Adult↗

PubMed1995

[Study on transepithelial movement of 3H-androgen in the rat seminiferous and epididymal tubules].

The mechanisms involved in the maintenance of the endocrinological microenvironment of the seminiferous and epididymal tubules were examined in a series of experiments utilizing in vivo microperifusion, microperfusion, and micropuncture technique. The intraluminal 3H-androgen concentration in the seminiferous tubules increased linearly as the interstitial 3H-androgen concentrations increased from 10 nM to 2,000 nM, but in the caput epididymidal tubules, the intraluminal 3H-androgen concentration increased hyperbolically across the same range of peritubular 3H-androgen concentration. Intraluminal 3H-androgen concentrations in the caput epididymidis did not rise above approximately 340 nM even when the peritubular 3H-androgen concentration exceeded 2,000 nM. Perifusion of caput tubules with 0.1 mM dinitrophenol or potassium cyanide or 100 micrograms/ml cyclohexamide significantly reduced the proluminal 3H-androgen movement, but tubules perifused with control medium did not support antigrade 3H-androgen movement in the absence of native lumen fluids which contain androgen-binding protein. Energy-requiring protein synthesis is necessary for antigrade 3H-androgen movement in the caput epididymidis, but the mechanism for the interaction of intracellular protein(s) and 3H-androgen movement remains undetermined.

Androgens↗

PubMed1995

Successful in vitro fertilization and pregnancy by the micromanipulation with sperm from efferent duct retrieved by micropuncture technique in a patient with congenital absence of the vas deferens.

A case of successful in vitro microfertilization and pregnancy of 30-year-old woman with sperm from efferent duct retrieved by a micropuncture technique combined with perivascular nerve stimulation from a patient with congenital absence of the vas deferens is reported. Treatment of couples involving men with surgically unreconstructible vasal obstruction is now possible. Our experience indicates that sperm from the efferent duct retrieved by this new technique, when combined with assisted reproductive technologies, permit fertilization and subsequent pregnancy for the men with surgically irreparable vasal obstruction.

Adult↗

PubMed1995

Strain and sex differences in kidney carcinogenesis in rats treated with N-ethyl-N-hydroxyethylnitrosamine and uracil.

We earlier demonstrated that simultaneous administration of EHEN and uracil for 3 weeks resulted in enhancement of renal carcinogenesis in F344 female rats. Therefore, to establish a model of renal carcinogenesis in rats that can induce advanced renal carcinoma at a high incidence, differences in the susceptibility to N-ethyl-N-hydroxyethylnitrosamine (EHEN) and uracil of the kidneys in male and female rats of two strains were examined. Group 1 (male Wistar rats), group 2 (female Wistar rats), group 3 (male F344 rats), and group 4 (female F344 rats) received a 3-week simultaneous administration of 0.05% EHEN in the drinking water and 3% uracil in the diet after one week's acclimation. In all the above four groups, the rats were thereafter given a basal diet and water without chemical addition for a 29-week period. Group 5 (male Wistar rats), group 6 (female Wistar rats), group 7 (male F344 rats) and group 8 (female F344 rats) received no chemicals for the entire 33 weeks. At the end of the experiment, renal adenocarcinomas were found in 85, 68, 14 and 0% of the rats in groups 1, 2, 3 and 4, respectively. The incidence of adenomas and adenocarcinomas in Wistar rats were significantly greater than in F344 rats (p < 0.0001). These findings indicate strain and possibly sex differences in kidney carcinogenesis in rats treated with EHEN and uracil, and simultaneous administration of the two agents to male Wistar rats might have an advantage for models to induce advanced renal carcinoma at a high incidence.

Adenocarcinoma↗

PubMed1995

A case of unilateral giant hydronephrosis with renal insufficiency.

Giant hydronephrosis, which is a symptomless enlargement of the abdomen, is an extremely rare condition in adults, with most cases being discovered in young-to-middle-aged people. We report a case of adult giant hydronephrosis accompanied by renal insufficiency, in which surgical repair was not performed because of the patient's poor cardiac function. Nephrostomy was performed and was followed with replacement of the nephrostomy tube every 2 weeks. For diagnostic purposes, ultrasonography and computerized tomography were preferable. A supplementary antegrade and retrograde pyelography was valuable in locating the stenosis.

Humans↗

PubMed1995

A case of sex reversal syndrome with sex-determining region (XX male).

We examined a 32-year-old man with a 4-year history of infertility. The man's sex life, male hair pattern, and penis were normal, and he had no history of erection problems. Left and right testicular volumes were 2 ml and 3 ml, respectively. Semen analysis showed no sperm. The endocrine panel revealed increased serum luteinizing hormone and follicle-stimulating hormone levels, and a normal serum testosterone level. A testicular biopsy demonstrated that both Leydig cell and Sertoli cell hyperplasia were present, and that no germ cells were found in the tubules. A chromosome analysis done on the peripheral blood lymphocytes revealed a karyotype of 46, XX. We identified the sex-determining region, Y, by polymerase chain reaction using Y-specific probes in this patient. The diagnosis was XX male.

Adult↗

PubMed1995

Effects of varicocelectomy on testis volume and semen parameters in adolescents: a randomized prospective study.

Because the treatment of a varicocele in adolescents remains controversial, we undertook a prospective study in 51 male adolescents, aged 15-21 years, who were referred for a varicocele. Twenty-nine patients were treated with high retroperitoneal ligation of the left spermatic vein, and 22 were untreated. Eighteen healthy adolescent volunteers without a varicocele were also assessed. Testicular volume was measured using an orchiometer, and semen analyses were carried out at referral and after 1 year of follow-up. In addition, serum luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone levels were estimated by radioimmunoassay. Both patient groups had significantly smaller testis volumes than the controls at the outset. In the follow-up, the treated patients had testis volumes similar to those of the controls. Both testes increased significantly in volume after treatment. Although semen parameters were comparable in all groups initially, sperm concentration increased significantly after treatment of the varicocele. We concluded that varicocele treatment in adolescents leads to increased testis volume and a higher sperm concentration; however, whether early treatment will improve testicular function remains to be elucidated.

Adolescent↗

PubMed1995

Angiomyolipoma of the kidney with extension into the inferior vena cava.

Renal angiomyolipoma is a benign, nonaggressive hamartoma which rarely invades the vascular system. A case of angiomyolipoma of the right kidney with extension into the inferior vena cava, detected by ultrasonography, computed tomography (CT scanning), and magnetic resonance imaging (MRI) is presented. This tumor was found incidentally in a 31-year-old female who underwent CT scanning for unrelated abdominal problems. To our knowledge, only eight cases of angiomyolipoma with caval involvement have been reported in the world medical literature.

Adult↗

PubMed1994

Initiation-stage enhancement by uracil of N-ethyl-N-hydroxyethylnitrosamine-induction of kidney carcinogenesis in rats.

The present study was conducted to clarify the effects of N-ethyl-N-hydroxyethylnitrosamine (EHEN) and uracil in combination on renal carcinogenesis in female F344 rats. Group 1 animals (n = 30) received a 3-week simultaneous administration of 0.05% EHEN and 3% uracil, and group 2 (n = 26) 0.05% EHEN with a lower 1.5% dose of uracil. Group 3 (n = 30) was treated with 0.05% EHEN alone and group 4 (n = 28) received only 3% uracil for 3 weeks. In all the above four groups, the rats were given basal diet and water without chemical addition for a 48-week period after the 3-week treatment period. Group 5 (n = 33) received no chemicals for the entire 52 weeks. At the end of week 52, renal adenocarcinomas were found in 53%, 31% and 13% of the rats in groups 1, 2, and 3, respectively. The present study thus demonstrated that simultaneous administration of uracil enhances the occurrence of EHEN-induced renal adenocarcinomas in rats.

Adenocarcinoma↗

PubMed1994

Successful in vitro fertilization and pregnancy by micromanipulation with epididymal sperm.

PURPOSE: To examine the effectiveness of micromanipulation on the treatment of the patients with obstructive azoospermia, subzonal insemination or partial zona dissection was performed using epididymal sperm of the 23 patients, and the in vitro fertilization and embryo transfer (IVF-ET) outcomes were analyzed. RESULTS: Fertilized oocytes were obtained in 11 cycles of the 25 treated cycles, and six pregnancies were established by the subsequent ET. Through the analysis of 13 cycles in which both the micromanipulation and usual IVF insemination were performed, the fertilization rate per oocyte with the micromanipulation [25% (28/113)] was significantly higher than that with the usual insemination method [4% (4/102)]. The micromanipulation was most useful for the treatment of the patients with congenital absence of the vas deferens. Moreover, there was no need to aspirate a large volume of the epididymal fluid, but it was essential to prepare more than 10 mature oocytes retrieved. CONCLUSIONS: These results indicate that micromanipulation with epididymal sperm is an effective treatment for obstructive azoospermia, and careful preparations of sperm and well-controlled ovarian hyperstimulation are necessary for successful IVF-ET.

Adult↗

PubMed1994

A new sclerosant therapy for testicular hydrocele with aspiration and injection of OK-432.

Twenty patients with testicular hydrocele were treated with a new sclerosing therapy consisting of intrascrotal injection of OK-432 (group A Streptococcus pyogenes of human origin). The median observation period after treatment was 6 months (range 2-13 months). Eighteen patients required only one treatment. Two patients had recurrences and received repeat injection. There have been no serious side effects except for fever of 2-3 days' duration and local inflammatory reaction. Sclerotherapy with OK-432 is an efficient and easy method which can be recommended as a primary treatment for hydrocele.

Aged↗