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Biomedical subjects

R Hauser

Publications and source records attributed to R Hauser.

At least 19 recordsLinked to original sources

Intrauterine insemination in male factor subfertility: significance of sperm motility and morphology assessed by strict criteria.

The study was conducted to evaluate the results of IUI treatment in a homogenous group with male factor infertility, and to assess the correlation of sperm variables, including sperm morphology by strict criteria, with pregnancy achievement after IUI. A total of 108 couples with no apparent female aetiology for infertility underwent 264 intrauterine insemination treatment cycles. A comparison was made between the sperm variables in two groups in which the achievement of pregnancy differed. The percentage of motile spermatozoa, degree of motility and normal morphology (by strict criteria) were significantly higher in the pregnant group compared with that of the nonpregnant group. A significant difference in pregnancy rates per couple after intrauterine insemination was demonstrated among three groups according to the percentage of sperm morphology, i.e. poor (< 4%), fair (4-14%) or good (> 14%) (11.1%; 36.1% and 50.0%, respectively). Intrauterine insemination is a valid mode of treatment in cases with male infertility, provided that normal morphology by strict criteria is higher than 4%.

Adult↗

The contribution of RNA-binding motif (RBM) antibody to the histopathologic evaluation of testicular biopsies from infertile men.

Testicular biopsies of infertile men are often characterized by mixed histologic patterns, with different types of spermatogenic impairments being found in adjacent seminiferous tubules. RNA-binding motif (RBM) is a nuclear protein expressed exclusively in the male germ cell line. We reasoned that RBM might be a useful marker to identify germ cells in testicular sections, particularly in biopsies with mixed histologic phenotype and small focal concentrations of spermatogenesis. Testicular biopsies from azoospermic men were immunohistochemically evaluated for RBM expression. RBM expression was detectable in spermatogonia, spermatocytes, and round spermatids in biopsies of men with obstructive azoospermia and normal spermatogenesis. No specific cell staining was shown in cases of Sertoli-cell-only (SCO) syndrome. In biopsies of patients with spermatogenic disorders, all the germ cells were stained up to and including the stage level of the arrest in spermatogenesis. This approach enabled identification of small focal concentrations of spermatogenesis in a biopsy previously classified as being SCO by hematoxylin and eosin staining. Thus, RBM can be a useful immunohistochemical marker for the specific identification of germ cells and provide greater accuracy in the histopathologic evaluation of testicular biopsies.

Antibodies↗

Behaviour and leg injuries in dairy cows kept in cubicle systems with straw bedding or soft lying mats.

In order to reduce straw input, soft lying mats are used increasingly instead of straw bedding in cubicle systems for dairy cows. This study aimed at comparing different types of soft lying mats with straw bedding regarding cow behaviour and leg injuries. Data were collected on five farms with straw bedding and on 13 farms using four types of soft lying mats consisting of different materials. On each farm, lying behaviour of 10 cows was recorded automatically during 3 days by means of a pneumatically operated resting sensor fitted in a belt. In addition, standing up and lying down behaviour of cows was quantified by direct observations, and all cows on a given farm were checked once for leg injuries.There were no significant differences between cows kept in cubicle systems with soft lying mats and straw bedding regarding the total time spent lying per day and the number of lying bouts per day. Standing up and lying down behaviour also did not differ between cows with access to soft lying mats and straw bedding. Leg injuries were most frequent in the tarsal and carpal joints. Cows kept in cubicle systems with soft lying mats had a significantly higher incidence of both hairless patches more than 2 cm in diameter (P<0.001) and scabs or wounds less than 2 cm in diameter (P<0.001) located in the tarsal joints than cows in cubicle systems with straw bedding. With the carpal joints, on the other hand, the incidence of leg injuries did not differ significantly between these two housing conditions. In conclusion, the results of this study indicate that soft lying mats are equivalent to straw bedding in terms of cow behaviour but less favourable with respect to leg injuries located in the tarsal joints.

Journal Article↗

[Psychological comorbidity and quality of life of patients with morbid obesity and requesting gastric banding].

Bariatric surgical operations are well established in the treatment of morbid obesity. In this study, 79 consecutive applicants for laparoscopic gastric banding (60 females with a mean BMI of 47.4 kg/m2 and 19 males with a mean BMI of 48.9 kg/m2, mean age 39.6 years) were examined preoperatively by structured psychiatric interview and questionnaire. GOAL AND QUESTIONS: The aim of the study was to determine physical and psychological symptoms, specific eating problems, life satisfaction and incidence of psychiatric comorbidity, as well as the relations between psychological and psychosocial markers on the one hand, and demographic and somatic parameters on the other. RESULTS: Most patients displayed multiple somatic symptoms and diseases, in particular orthopaedic problems, exertion dyspnoea, hyperlipidaemia, hypertension, diabetes mellitus or sleep apnoea. The averages of all psychometric scales (General Symptomatic Index of Symptom Checklist [SCL-90-R], anxiety and depression states of the Hospital Anxiety and Depression Scale [HADS]) were higher than normal. General life satisfaction and satisfaction with health (FLZM) were low. Eating behaviour in both sexes was characterised by marked irritability, disinhibition and ravenousness. Binge eating was common, 27% reporting binges at least weekly and only 37% no binges at all. 46% were found to suffer from at least one psychiatric disorder, while half had an eating disorder with frequent bingeing and loss of control. 6.3% were diagnosed with atypical bulimia, 15.2% had an adaptational disorder and 10% a personality disorder. The HADS scales did not correlate with BMI or other somatic factors and the correlation between the SCL-90-R and BMI was low (r = 0.36, p = 0.01). However, patients with psychiatric disorders had significantly higher BMIs and higher averages on all scales except overall life satisfaction. There was no direct relation between psychosocial and sociodemographic variables (educational level, living alone). CONCLUSION: Morbidly obese patients desiring laparoscopic gastric banding display many physical and psychological symptoms with a higher preference for psychiatric (especially eating) disorders. Since there is no close relationship between psychosocial and somatic aspects in this group of patients, routine psychiatric evaluation appears to be of importance.

Adult↗

Acute respiratory symptoms in workers exposed to vanadium-rich fuel-oil ash.

BACKGROUND: Occupational exposure to fuel-oil ash, with its high vanadium content, may cause respiratory illness. It is unclear, however, what early acute health effects may occur on the pathway from normal to compromised respiratory function. METHODS: Using a repeated measures design, we studied prospectively 18 boilermakers overhauling an oil-fired boiler and 11 utility worker controls. Subjects completed a respiratory symptom diary five times per day by using a 0-3 scale where 0=symptom not present, 1=mild symptom, 2=moderate symptom, and 3=severe symptom. Daily symptom severity was calculated by using the highest reported score each day for upper and lower respiratory symptoms. Daily symptom frequency was calculated by summing all upper or lower airway symptom reports, then dividing by number of reporting times. Respiratory symptom frequency and severity were analyzed for dose-response relationships with estimated vanadium and PM(10) doses to the lung and upper airway by using robust regression. RESULTS: During the overhaul, 72% of boilermakers reported lower airway symptoms, and 67% reported upper airway symptoms. These percentages were 27 and 36 for controls. Boilermakers had more frequent and more severe upper and lower respiratory symptoms compared to utility workers, and this difference was greatest during interior boiler work. A statistically significant dose-response pattern for frequency and severity of both upper and lower respiratory symptoms was seen with vanadium and PM(10) in the three lower exposure quartiles. However, there was a reversal in the dose-response trend in the highest exposure quartile, reflecting a possible healthy worker effect. CONCLUSIONS: Boilermakers experience more frequent and more severe respiratory symptoms than utility workers. This is most statistically significant during boiler work and is associated with increasing dose estimates of lung and nasal vanadium and PM(10).

Adult↗

Online head motion tracking applied to the patient registration problem.

Image-guided systems for surgical procedures in the region of the head require a method to correlate the diagnostic image data with the corresponding site of pathology in the patient. Considering that patient movement can occur, detection and correction of such movement errors during the acquisition of images is a basic prerequisite for accurate treatment. For this reason, we developed a new registration method based upon on-line tracking of the patient's head to solve the problem of registration in the presence of head motion. The method provides non-invasive active patient registration for correction of movements during imaging and continuous update of the patient's head position during surgery. The patient motion correction applies the rigid body model to register the images using feature correspondence. The new registration method is described, and results of experiments that were performed to evaluate its accuracy and reliability in a plastic skull model and in patients are presented. The error analysis resulted in a final target registration error of 0.90 mm +/- 0.16 mm using experimental model data and 1.58 mm +/- 0.26 mm using clinical patient data. In addition, the residual registration error is modeled as a function of the measured and predicted head motion in order to determine the error that is introduced by motion tracking during image data acquisition. Furthermore, the clinical application of the method is demonstrated for oto-, rhino-, and neurosurgical procedures in the region of the head.

Algorithms↗

Zona pellucida binding improvement effect of different sperm preparation techniques is not related to changes in sperm motility characterizations.

OBJECTIVE: To study the relation between changes in sperm motion characteristics and sperm binding capacity to the zona pellucida (ZP) after different sperm preparation techniques. DESIGN: Prospective study. SETTING: Andrology laboratory at the Lis Maternity Hospital. PATIENT(S): Sixty-three infertile men. INTERVENTION(S): In vitro preparation of 57 sperm samples by pentoxifylline (PTX), 38 samples by SpermPrep I (SP1), and 27 samples by mini-Percoll (mPER). Sperm preparation was evaluated in comparison with the control washing technique. MAIN OUTCOME MEASURE(S): Motility variables and binding capacity. RESULT(S): Binding capacity after PTX, SP1, and mPER preparation methods was significantly higher compared with the control medium preparation. Computer-assisted sperm analysis (CASA) of sperm motility revealed a significant increase in a number of variables after the different treatments. A statistically significant but low correlation was observed between sperm binding capacity after control swim-up preparation and VAP (r = 0.27) as well as with VSL (r = 0.30). No significant correlations were found between the changes in the CASA and the improved sperm binding to the ZP. CONCLUSION(S): The two biologic effects of binding capacity enhancement and motility features improvement are not related. Furthermore, because the binding assay is highly correlated with fertilization capacity, these alterations in motility, as evidenced by CASA, probably have a minor effect on fertilization in vitro.

Electronic Data Processing↗

Evaluation of meiotic impairment of azoospermic men by fluorescence in situ hybridization.

OBJECTIVE: To identify predictive criteria for the existence of spermatogenesis in nonobstructive azoospermic men. DESIGN: Prospective study. SETTING: Andrology laboratory at a teaching hospital. PATIENT(S): Twenty-two azoospermic men were divided into three groups by qualitative testicular histopathology and the presence of spermatozoa in minced biopsies. INTERVENTION(S): Testicular biopsies evaluation. MAIN OUTCOME MEASURE(S): The presence of spermatozoa and/or mature spermatids, the percentage of sex vesicle formation (X and Y chromosomes in proximity), and the pairing of the two 18 homologous chromosomes. RESULT(S): Spermatozoa and mature spermatids were found in 17 study patients. Whenever few mature spermatids and/or spermatozoa were found, the rates of X-Y and 18 bivalents were significantly higher (mean +/- SD, 73% +/- 13. 3% and 91% +/- 7.1%) than those in cases of spermatocyte maturation arrest (23% +/- 8.0% and 60% +/- 11.8%, respectively). CONCLUSION(S): Pairing of chromosomes during meiosis is apparently related to the progression of spermatogenesis. Consequently, high rates of bivalent formation increase the prospect of focal spermatogenesis in the testis, despite the failure to identify mature spermatids in the specific testicular biopsy under examination.

Adult↗

Maturation phenotype of Sertoli cells in testicular biopsies of azoospermic men.

The involvement of Sertoli cells in different spermatogenic impairments has been studied by an immunohistomorphometric technique using cytokeratin-18 (CK-18) as a marker for immature Sertoli cells. CK-18 is known to be expressed in Sertoli cells during prenatal and prepubertal differentiation and is normally lost at puberty. Forty-nine azoospermic men were included in the current study. Quantitative measurements on testicular biopsies revealed the highest CK-18 expression in the mixed atrophy biopsies (22 men), a lower expression in the Sertoli cell-only (SCO) biopsies (12 men), and minimal residual staining in the group considered as representing normal spermatogenesis (six obstructive azoospermia patients). The cytokeratin immunopositive-stained tubules were associated either with arrest in spermatogenesis or with SCO. Examination of sections from nine men with microdeletions in the AZF region of the Y chromosome revealed that these men were either negative for CK-18 expression or showed only weak residual staining. This may suggest that the spermatogenic defect in the AZF-deleted men originates in the germ cell and has no impact on Sertoli cell maturation. The cause that determined the spermatogenic defect in the other cases of male infertility with high CK-18 expression may have damaged both the Sertoli and the germ cells.

Adult↗

Follow-up of sperm concentration and motility in patients with lymphoma.

Lymphomas are a group of diseases, prevalent at reproductive age. Fertility is notoriously reduced among lymphoma patients. This study evaluates pre- and post-treatment semen concentration and motility, and factors associated with semen quality deterioration. We followed-up 33 patients with non-Hodgkin's lymphoma or with Hodgkin's disease during the years 1987-1997 who were referred for semen cryopreservation. Pretreatment semen analysis, and hormonal profile were recorded at diagnosis and at least 1 year after completion of the treatment, and compared. Medical records for disease type, disease stage and treatment protocols were related to long-term sperm outcome. Hormonal concentrations were not predictive of post-treatment sperm concentration. In patients with localized disease, initial sperm concentration and motility tended to be preserved, compared with patients with widespread disease (P: = 0. 016). In Hodgkin's disease patients, treatment with the adriamycin, bleomycin, vinblastine and dacarbazine (ABVD) protocol was superior to the mechloretamine, vincristine, procarbazine and prednisone with ABV protocol regarding germinal toxicity (P: = 0.0008). The post-treatment sperm outcome was better in patients treated with local irradiation than in those who did not undergo irradiation (P: = 0.0027). No predictive tools for post-treatment fertility were found and, therefore, every patient with a lymphoma should have his semen cryopreserved at diagnosis.

Adolescent↗

Varicocele and the testicular-renal venous route: hemodynamic Doppler sonographic investigation.

The aim of this study was to quantify the anatomic and hemodynamic components of the testicular venous drainage for the purpose of understanding their mechanisms of interacting in producing mutual effects, such as "nutcracker" phenomenon, reflux, and varicoceles. Seventy-five male subjects were studied at rest and during Valsalva maneuver. Aortomesenteric distance and angle, flow velocity in different segments of the renal veins, testicular vein diameter, and flow inversion were evaluated using standard ultrasound equipment with spectral and color Doppler capabilities. The velocity of flow in the proximal segment of the left renal vein (17.5 cm/s) was found to be significantly lower than that in both the distal left renal vein (121 cm/s) and the right renal vein (37 cm/s). The flow velocity in the proximal left renal vein decreased with decrease in the aortomesenteric distance and angle. Testicular vein diameters greater than 3 mm were statistically associated with decreased superior mesenteric artery angle. A significant association also was found between the left testicular vein diameter (in Valsalva maneuver) and inversion of flow. The decrease in flow velocity in the left renal vein proximal to the bifurcation of the superior mesenteric artery from the aorta supports the "nutcracker" theory. An association was found between the decrease of superior mesenteric artery angle and the increase in testicular vein diameter. Another association exists between the presence of reflux during Valsalva maneuver and increased testicular vein diameter. These finding were significant only for testicular vein diameter values greater than 3 mm.

Adolescent↗

[Immunohistochemical identification of testicular germ cells--preliminary report].

The use of testicular spermatozoa for intracytoplasmic sperm injection introduced a new treatment modality for management of male infertility. Since testicular biopsies of non-obstructive azoospermic men are not homogenous in their histological patterns, identification with certainty of focal spermatogenesis might be difficult, particularly in those with small foci of spermatogenesis. We used an immunohistochemical marker of the male germ line, an antibody generated against RBM (RNA-binding-motif), to recognize with high precision the presence of germ cells in the biopsy. Biopsies of 30 men with azoospermia, most with non-obstructive azoospermia and a few with obstruction of the vas deferens, were evaluated. Immunohistochemical staining for RBM protein contributed to the detection and accuracy of the identification of germ cells. Furthermore, this immunohistochemical technique aided the histopathologist to focus on even small foci of spermatogenesis. Absence of the protein expression confirmed the diagnosis of Sertoli-cell-only syndrome. The results indicate that expression of RBM can be a diagnostic marker for identifying the germ cells of small concentrations of spermatogenesis. This method can enhance the accuracy of histopathological evaluation of testicular biopsies that had formerly relied mainly on hematoxylin-and-eosin staining.

Biopsy↗

[Acute toxoplasmosis in coexistent non-Hodgkin lymphoma].

There are many reasons for cervical lymph node enlargement. In particular, the large group of infectious diseases must be considered along with malignant diseases. The coexistence of an uncommon infectious disease with malignant disease is a rare event. We report the case of an otherwise healthy 69-year-old man with marked enlargement of his cervical lymph nodes. A diagnosis of a recent toxoplasmosis infection was made based on positive IgG and IgM toxoplasma titers and the results of fine-needle aspiration from a lymph node. Since the enlarged lymph nodes persisted for more than weeks, the lymph node was excised. Histological examination revealed a non-Hodgkin's lymphoma. IgM titers in toxoplasmosis can persist up to 1 year. In cases with rare infectious diseases like toxoplasmosis in immunocompromised patients, swollen lymph nodes that persist or grow should lead to the suspicion of additional disease. A diagnosis can be confirmed by removing a lymph node for histology.

Aged↗

The concentration of glutamate in cerebral tissue as a factor for the assessment of the emotional state before death. A preliminary report.

In this paper the concentration of glutamate in the hemispheres of the brain, the cerebellum and the brain stems of rats exposed to sensory stimulation before death and of control rats are presented. Statistically significant differences in the concentration of this neurotransmitter were found in the hemispheres of the brain in the cases of stress lasting 10 min and 1 min and in the cerebellum after a stress of 10 min. This suggests that it may be possible to diagnose the post-mortem state of emotional tension related to sensoric aversive input which takes place directly before death.

Acoustic Stimulation↗

Pre-freezing sperm preparation does not impair thawed spermatozoa binding to the zona pellucida.

The present study was conducted to assess the fertilizing potential of frozen-thawed spermatozoa, which were cryopreserved after separation on a Percoll gradient, or washed out of seminal plasma. For this purpose, binding to the zona pellucida and other characteristics of the treated sperm cells were compared with those of cryopreserved spermatozoa from the same original sample which were not manipulated before freezing. Semen specimens were obtained from 80 candidates for sperm donation. Percoll-treated sperm samples compared with the sibling, unprocessed controls had significantly higher values of sperm motility characteristics and per cent of cells with normal morphology after freezing and thawing. Sperm binding ability to the zona pellucida was not statistically different (109 +/- 8.1% and 94 +/- 6.7% in unprocessed and Percoll-treated samples respectively). Sperm specimens processed by washing had significantly higher values for motility characteristics than untreated sibling samples, but no differences were found between the treated and untreated samples for morphology and binding to the zona pellucida (hemizona index of 75 +/- 7.0% and 76 +/- 6.7% in unprocessed and washed samples respectively). These findings suggest that, judged by the binding assay, the aforementioned pre-freezing separation processes have no adverse effect upon the fertilizing potential of the thawed sperm cells. These procedures make it possible to optimize the progressive motile sperm cell concentration of the frozen specimen, which facilitates the storage of samples with good quality, even when the features of the original semen are sub-optimal.

Cell Separation↗

Genetic evaluation of infertile men.

Recently, microdeletions in the azoospermic factor region of the Y chromosome, in addition to chromosomal anomalies, have been detected in men with azoospermia or severe oligozoospermia. In this study we evaluated the molecular and cytogenetic defects of infertile men. The frequency of Y microdeletions among 105 azoospermic, 28 oligozoospermic and 32 fertile men was tested on lymphocyte DNA using a series of 20 sequence-tagged sites. In addition, microdeletions were evaluated on testicular-derived DNA among 26 azoospermic patients who underwent testicular biopsy and in whom no sperm cells could be identified. Karyotype analysis was performed on 72 of the infertile patients. Deletions were detected in 6.7% azoospermic and 3.6% oligozoospermic men. No deletions were identified among the fertile men. Identical results were obtained with DNA derived either from lymphocytes or testicular tissue. The frequency of chromosomal aberrations in the 72 infertile patients tested (62 azoospermic, 10 oligozoospermic) was 16.6%, with a high percentage of gonosome anomalies. Additional andrological parameters (hormone values, cryptorchidism) failed to identify men at risk for having microdeletions before the test. Our findings support the recommendation to perform genetic defect screening among infertile men before their enrollment in an intracytoplasmic injection/in-vitro fertilization programme.

Adult↗