Biomedical subjects
Publications and source records attributed to H W Baker.
A case is presented of secondary infertility due to the concurrence of sperm autoimmunity and hyperprolactinemia. Treatment of his hyperprolactinemia with bromocriptine did not improve his fertility; however, concurrent treatment of both conditions resulted in improved semen quality, conception, and the birth of a healthy baby girl.
OBJECTIVE: To review recent studies on the development of new tests of human sperm function and evaluation of which sperm characteristics are most important for fertilization in vitro by logistic regression analysis. STUDY SELECTION: Recent studies on the relationship between putative and new tests of human sperm function and fertility in vitro or in vivo are discussed in this review. Some physiological and technical aspects are included. MAIN OUTCOME MEASURES: Fertilization rates in vitro and sperm tests including standard semen analysis, improved morphology assessment, objective assessment of sperm motility and movement characteristics, nuclear maturity, hypo-osmotic swelling, the acrosome and the acrosome reaction, acrosin activity, human sperm-hamster oocyte penetration assay, and sperm-zona pellucida (ZP) and sperm-oolemma binding. RESULTS: The percentages of sperm with normal morphology and a normal intact acrosome, mean linearity, and the number of sperm binding to the ZP were highly significant related to fertilization rates in vitro. Other sperm tests evaluated usually provided no additional information about fertilization rates. The human ZP is highly selective for binding of morphologically normal sperm. Acrosome-reacted human sperm have little or no ability to bind to the ZP. CONCLUSION: Results of in vitro fertilization can be used to evaluate tests of human sperm function. Logistic regression analysis is a powerful method for determining which groups of sperm characteristics are independently related to fertilization rates. Normal morphology, linearity, acrosome status, and sperm-ZP binding are the most important characteristics for fertilization in vitro.
OBJECTIVE: To study whether the results of tests of sperm chromatin and deoxyribonucleic acid (DNA) normality are related to fertilization rates in vitro. DESIGN: Normal morphology, nuclear maturity determined by acidic aniline blue stain, and DNA normality determined by acridine orange fluorescence of sperm in insemination medium and the number of sperm bound to the zona pellucida (ZP) of the oocytes that had failed to fertilize in vitro were determined. The relationship between sperm test results and fertilization rates were analyzed by logistic regression. SETTING: Samples were obtained from patients undergoing in vitro fertilization (IVF) treatment. RESULTS: The number of sperm bound to the ZP, the percentage of sperm with normal morphology, and the percentage of sperm with normal DNA were the most significant factors related to fertilization rates in vitro. In patients with normal morphology > or = 15% or with > 10 sperm bound per ZP, the percentage of sperm with normal DNA, the number of sperm bound to the ZP, and motility grade were significantly related to IVF rates. CONCLUSION: In patients with normal morphology > or = 15%, failure of fertilization may be because of defects of sperm-ZP binding or abnormal DNA. Assessment of DNA normality of motile sperm in the insemination medium may aid prediction of fertilization rates in addition to normal morphology and sperm-ZP binding.
Two methods of density gradient centrifugation, Percoll (P) and mini-Percoll (MP), were compared with the swim-up technique for preparing spermatozoa from each of 40 abnormal semen samples. P and MP produced similar results with a mean recovery of spermatozoa with progressive motility which was significantly higher (18-19%) than that achieved with swim-up (5%). However, the swim-up method resulted in the recovery of spermatozoa with a higher mean motility (89 versus 58%), velocity (69 versus 56 microns/s), percentage with normal morphology (22 versus 16%) and intact acrosomes (61 versus 36%) than P and MP. The mean amplitude of lateral head displacement was the only characteristic of spermatozoa in semen which correlated with the recoveries of motile spermatozoa. Combining MP and swim-up methods for 10 samples produced a higher recovery (11 versus 6.9%) of spermatozoa with significantly better mean motility (94 versus 87%) than did swim-up alone. Although P and MP resulted in greater yields of motile spermatozoa than the swim-up preparation, the latter procedure selected higher proportions of spermatozoa with improved characteristics (velocity, intact acrosomes and normal morphology) which correlate with fertilization rates in vitro. It is concluded that P and MP are not superior to swim-up. However, sequential MP and swim-up preparation improves yields of high quality spermatozoa from some abnormal semen samples and therefore has potential for improving fertilization rates.
The morphology of spermatozoa bound to the zona pellucida (ZP) of 264 oocytes that had failed to fertilize in 58 in vitro fertilization procedures was studied by light microscopy. The percentage of spermatozoa with normal morphology bound to the ZP (mean 77, range 8-100) was significantly higher than in the insemination medium (mean 42, range 2-80). The abnormal spermatozoa bound to the ZP had small oval (47%), pyriform (46%), amorphous (5%) and tapering (2%) heads. Other abnormalities of morphology were not observed in ZP-bound spermatozoa. The mean rates of binding to the ZP of spermatozoa with normal morphology (44, 95% confidence limits 42-46, number bound/ZP/10(5)/ml inseminated) were much higher than for abnormal spermatozoa with small oval 6.5 (5.5-7.6), pyriform 5.9 (4.8-7.3), amorphous 1.0 (0.5-2.0) and tapering 2.5 (1.2-5.3) heads. The morphologically abnormal forms not found on the ZP were infrequent in the insemination medium (tail defects, large oval, round, pin and duplicate heads and cytoplasmic droplets) but upper 95% confidence limits for standardized binding ratios of less than 60% indicated that these were unlikely to bind to the zona with rates approaching those of normal spermatozoa (standardized binding ratio 180%). A large number of uniformly normal spermatozoa bound to the ZP when the percentage normal morphology in the insemination medium was greater than 40%. The proportions of abnormal spermatozoa in the insemination medium. Spermatozoon head dimensions were measured with a micrometer in samples from 14 patients. While there were no consistent changes in all samples, the means for head width and area were significantly larger and the ratio of the length to width was smaller for spermatozoa on the ZP than for those in the insemination medium. The head length and ratio of length to width of spermatozoa in samples with good morphology were significantly less than in samples with poor morphology. The percentage of spermatozoa with normal morphology, motility and the ratio of head length to width in the insemination medium were positively correlated with the percentage of spermatozoa with normal morphology bound to the ZP. Logistic regression analysis showed that the diagnosis of tubal infertility and the rate of binding of spermatozoa with normal morphology to the ZP were positively related to fertilization rates in vitro while the rate of binding of spermatozoa with pyriform heads was negatively related. In conclusion. human ZP are highly selective for spermatozoa with normal morphology. The frequency of binding of abnormal spermatozoa to the ZP was mainly dependent on semen quality.(ABSTRACT TRUNCATED AT 400 WORDS)
Explore the source record for details and available documents.
As part of the national survey on the tumorigenesis of oral contraceptive drugs conducted by the American College of Surgeons' Commission on Cancer, a histologic study was made of 94 cases of liver tumors in users and non-users of oral contraceptives. Pathologic criteria were established and then the slides were studied; the results were tabulated to determine the significance of each of the criteria as related to the use of contraceptives. These criteria included tumor size, peliosis hepatis, hemorrhage, necrosis, fibrosis, thrombosis, and vascular alterations of the intima and media. Cases of focal nodular hyperplasia in pill users exhibited greater vascular alterations, fibrosis, peliosis, and tumor size as compared to focal nodular hyperplasia observed in non-pill users. In addition, hemorrhage, necrosis, and peliosis were much more common in hepatic cell adenoma than in focal nodular hyperplasia. In the material reported in this series there were no hepatic cell adenoma cases observed in non-pill users. Focal nodular hyperplasia cases exhibited an overwhelmingly greater degree of vascular intimal and medial alterations than hepatic cell adenoma. The results suggest that the effects of oral contraceptives on the liver may be primarily upon the vasculature.
A bioassay for inhibin based on the suppression of gonadotrophin releasing hormone (Gn-RH)-stimulated secretion of FSH by primary monolayer cultures of rat anterior pituitary cells is described. The cultures were exposed to standard or test materials for 3 days. The levels of FSH in the media were measured by radioimmunoassay after exposure for 6 h to a maximally stimulating concentration of Gn-RH (10 nmol/l). The standard was prepared from ovine testicular lymph. Several preparations of proteins from gonadal tissues or secretions suppressed the levels of FSH in parallel with the standard. The levels of LH were also reduced but higher doses of active material were required. Non-specificity from cell damage and inactivation of Gn-RH have been excluded. The secretion of gonadotrophins by the pituitary cells was also inhibited by androgens, but not in parallel with the standard and secretion of LH was affected more than that of FSH. Control lymph protein preparations from castrated sheep had no detectable activity. The assay was sensitive and had adequate precision and practicability. It has proved useful for monitoring preliminary steps in the purification of inhibin.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A clinical trial of danazol was undertaken in 30 patients with severe fibrocystic disease of the breasts. Twenty-three of the patients continued the drug for five or six months to allow adequate evaluation. Partial or complete relief of breast pain, tenderness, and nodularity occurred in all patients studied. One previously unsuspected carcinoma of the breast was discovered after three months of therapy. Side effects from the drug were generally mild. Recurrence of symptoms and physical findings occurred in most patients after the drug was discontinued but have not been as severe as prior to therapy.
To determine if preoperative irradiation should be abandoned in favor of post-hysterectomy irradiation, 65 cases of stage I endometrial carcinomas were analyzed. When no residual tumor or no myometrial invasion was found in the irradiated uterus (38 cases), a 5-year cure rate of 97.3% was obtained. When residual tumor or myometrial invasion was found, there was a 5-year cure rate of 100% in grades 1 and 2 (7 cases) but only a 20% cure rate in grade 3 lesions (5 cases). On the basis of these data there appears to be no reason to abandon preoperative irradiation in stage 1 cases. More extensive irradiation and surgery should be considered, however, in grade 3 lesions invading the myometrium.
Explore the source record for details and available documents.
Survey results of long- and short-term outcome audits of colon cancer in participating hospitals with cancer programs conducted during 1976-7 by the American College of Surgeons are presented. In the long-term audit of 38,621 cases reported by 327 hospitals in 46 states, the overall percentage of cases in localized stage (29.3%) is significantly lower than in the recent series from the National Cancer Institute. The observed survival was substantially lower than the survival rates published in recent smaller series; however, survival approaches the end results for the period 1967-1973. In the short-term audit, the analysis of 11,655 cases diagnosed in 1976 and reported by 491 hospitals from fifty states showed that while 41% of patients had symptoms for less than a month, only 29.5% were diagnosed in the localized stage. Surgery was the predominant treatment modality with an overall resectable rate of 83%. No difference was observed in the stage at diagnosis when the short-term audit (1976) was compared with that found in the long-term audit (1971). The results suggest that the early diagnosis of symptomatic patients may not always substantially improve the cure and survival rate. The screening of asymptomatic patients is suggested as the more promising approach to the substantial improvement of presently less than ideal end results.
Medium from cultures of mature rat seminiferous tubules contained a substance which suppressed, in a dose-related manner, the luteinizing hormone releasing hormone (LH-RH)-stimulated secretion of FSH by cultured rat pituitary cells. The secretion of LH was suppressed to a lesser extent and the basal secretion of both LH and FSH was inconsistently affected. Gel filtration on Sephadex G-100 did not fractionate the activity. The active material did not inhibit the secretion of TSH or destroy LH-RH and the activity was not due to testosterone or oestradiol in the medium. Control media from liver cultures were inactive. It is concluded that inhibin is present in media from cultures of rat seminiferous tubules.
Explore the source record for details and available documents.
Data on 378 (in females) and 165 (in males) cases of primary liver tumors reported by 477 hospitals in the United States during 1970 to 1975 show that in males, 91.5% of the tumors were malignant, and in females, 43.9% were malignant and 59.1% were benign. Of the 212 benign tumors in females, 96 were hepatic cell adenomas and 58 were focal nodular hyperplasias. A history of oral contraceptive use was found in nearly half of all women: 65% with benign tumors, 74% with hepatic cell adenomas, and 74% with focal nodular hyperplasias. Symptoms were more severe among users. No case of intraperitoneal bleeding was observed in nonusers. The findings confirm the suggested association between oral contraceptive use and hepatic cell adenomas and focal nodular hyperplasias.
Rat testes and accessory sex organs were perfused in situ by recirculating an artificial medium through the hemicorpus preparation previously developed for studies of skeletal muscle. The advantages and limitations of this system for studying the male productive tract were examined. The electrolyte and gas composition of the perfusate remained constant and glucose levels did not fall below normal during 3 h of perfusion. Testicular water content, temperature, and ATP and GTP levels were normal at 90 min. The mean arterial pressure was 40 mm Hg and the flow rates, measured with microspheres, were normal to high to the caput epididymides, ventral prostate and seminal vesicles and approximately half normal to the testes in preparations from 90 day old rats perfused at 35 ml/min. Administration of vasodilators indicated the absence of significant vasoconstriction in the hemicorpus. There was appreciable testosterone metabolism by the preparation and in addition, there was absorption of testosterone by the plastic tubing of the perfusion apparatus. Testosterone levels in the perfusate rose for 90 min in response to hCG. There was a dose-response relationship between hCG (20-1000 mIU/ml of medium) and testosterone levels at 90 min. FSH, prolactin, insulin and vitamins had no significant effect on hCG-stimulated testosterone levels. This perfusion system should prove useful for studies of hormone action.