Treatment refractory acute necrotizing myelitis after COVID-19 vaccine injection: a case report

Introduction and importance

Post-vaccination myelitis is a rare and debilitating clinical situation. There are few reports of post-COVID-19 infection and vaccination neurological sequela.

Case presentation

A 69-year-old lady was admitted to the emergency department due to weakness and hypoesthesia in her hands 1 week after the Sinopharm vaccine injection. MRI showed a cervicothoracic cord haemorrhagic lesion that deteriorated within 48 h. The clinical course was refractory to conservative treatments. She underwent an emergency cervical laminectomy as a salvage treatment. Intraoperative samples were in favour of acute necrotizing myelitis.

Discussion

In the review of the literature, the inflammatory storm, vasculitis, and many unknown etiologies are deemed to be the possible causes of encephalopathy and myelitis after COVID-19 infection and vaccination. There are few cases of post-COVID-19 myelitis and hematomyelia, but this case was the first report of post-vaccination necrotizing myelitis.

Conclusion

Post-vaccination necrotizing myelitis is a lethal medical situation requiring intensive and emergent neurosurgical vigilance. Early clinical diagnosis in the beginning and full neurosurgical-neurological treatment armamentarium options are cornerstones of treatment paradigms. Salvage treatment options such as extensive laminectomy may play a life-saving role in treatment refractory cases of acute necrotizing myelitis.

Preservation of rooster post-thawed sperm epigenetic modifications, fertility potential and other quality parameters in different extenders using reduced glutathione

Although rooster semen cryopreservation is an efficient procedure to spread qualified semen samples for reproductive goals, some post-thawed qualified semen samples resulted in poor fertility rate that could be related to epigenetic modifications during the cryopreservation process. This research was conducted to investigate the effect of reduced glutathione (GSH) in different cryopreservation extenders (Lake and Beltsville) on preservation of epigenetic modifications, fertility potential and other quality parameters of rooster sperm after thawing. Semen samples were collected and diluted in Lake and Beltsville extenders as follows: L-0: Lake without GSH, L-G: Lake with GSH, B-0: Beltsville without GSH, and B-G: Beltsville with GSH. After freeze-thawing process, sperm motility, membrane functionality, mitochondrial activity, acrosome integrity, viability, apoptosis status, lipid peroxidation, DNA fragmentation, ROS concentration, epigenetic modifications and fertility potential were evaluated. In results, the type of extender had no effect (P > 0.05) of post-thawed sperm quality. The treatments containing GSH presented higher (P ≤ 0.05) total motility, progressive motility, membrane functionality, mitochondrial activity, acrosome integrity, viability, DNA methylation, fertility as well as lower (P ≤ 0.05) lipid peroxidation, apoptosis, DNA fragmentation and ROS concentration than other treatments. Extender supplementation with GSH had no effect (P > 0.05) on histone methylation, histone acetylation and hatching rate. In conclusion, supplementation of rooster sperm cryopreservation extender with GSH could be an effective strategy to preserve post-thawed sperm DNA methylation, fertility and other quality parameters during reproductive programs.

Spontaneous spinal epidural haematoma following COVID-19 vaccination: a case report

Introduction

COVID-19 vaccination side effects are rare but important medical situations. Spine-affecting side effects are amongst the rarest, but exceedingly important. Haemorrhagic spinal manifestations of COVID-19 and its vaccines are less reported with little knowledge about them.

Case presentation

An 80-year-old male who received his first shot of the COVID-19 vaccine had developed COVID-19 pneumonia, weakness, and sensory problems in his legs followed by sphincter incontinence within 5 days period. MRI showed a spontaneous epidural spinal epidural haematoma (SSEDH) in T10-L1. He underwent laminectomy and haematoma evacuation. One month follow-up showed no clinical improvement.

Discussion

To our knowledge, this was the first post-vaccination SSEDH and second in haemorrhagic spinal complications following COVID-19 vaccination. Considering the neuropathogenesis pathway of COVID-19 and its vaccines, there are common mechanisms of action that could potentially justify post-vaccination SSEDH such as seen in COVID-19 infection, itself. Early Neurosurgical intervention and better preoperative neurological status could be a beneficial modifier for favourable clinical outcomes.

Conclusion

SSEDH and COVID-19 vaccine coincidence is a rare clinical event, still no solid association could be scientifically explained. Further studies are required for a reliable pathophysiologic association. Early diagnosis, interdisciplinary medical approach, and faster intervention are the cornerstone of the treatment paradigm.

Surgical outcomes of calvaria reconstruction in cranial pansynostosis associated with Arnold-Chiari type 1.5 malformation, a case report

A 6-year-old girl with persistent headaches and the visual problem was diagnosed as a delayed onset cranial pansynostosis with concurrent type 1.5 Arnold-Chiari malformation. She underwent multi-sutural reconstructive surgery and followed. The headache was greatly decreased and tonsillar-brain stem herniation and syrinx were resolved.

Half-Saline Versus Normal-Saline as Irrigation Solutions in Burr Hole Craniostomy to Treat Chronic Subdural Hematomata: A Randomized Clinical Trial

OBJECTIVE

This study aimed to evaluate the efficacy and safety of half-saline (HS) serum as an irrigation solution in chronic subdural hematoma (CSDH) surgery using the burr hole craniostomy (BHC) technique.

METHODS

This randomized clinical trial was conducted in university hospital referral centers from 2020 to 2021. Sixty-three patients with CSDH eligible for BHC were primarily enrolled. Two patients were excluded because of concurrent stroke. Sixty-one patients were randomly allocated into case (HS=30) and control (normal-saline [NS]=31) groups. HS was used to irrigate the hematoma in the case group and NS was used in the control group. The patients were followed-up. Clinical variables including demographic and medical findings, postoperative computed tomography findings, postoperative complications, hospitalization period, recurrence rate, and functional status measured by the Barthel type B index were recorded.

RESULTS

Forty-six of 61 patients were male (75.4%), and the patients' mean age was 65.4±16.9 years, with equal distribution between the 2 groups. Postoperative effusion and postoperative hospital stay duration were significantly lower in the HS group than in the NS group (p=0.002 and 0.033, respectively). The postoperative recurrence within 3 months in both groups was approximately equal (6.6%). In terms of functional outcomes and postoperative complications, HS showed similar results to those of NS.

CONCLUSION

HS as an irrigation fluid in BHC effectively reduced postoperative effusion and hospital stay duration without considerable complications.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials Identifier: IRCT20200608047688N1.

Cysteamine enhances quality and fertility potential of rooster semen in cooled storage

This study investigated the effects of supplementing Lake extender with cysteamine (CYS) on rooster semen quality in cold storage and it's fertility performance. Semen samples were diluted with Lake extender supplemented with different concentrations of CYS (0, 1, 2, 4 and 8 mM) and were cooled and stored at 5 °C for a period of 46 h. Motility, membrane functionality, viability, lipid peroxidation, and mitochondria membrane potential were evaluated at 0, 23 and 46 h of storage. Fertility was assessed at 23 h of storage. Although at the beginning time (0 h), parameters were not affected, 1 mM of CYS improved (P ≤ 0.05) total motility, progressive motility and mitochondria membrane potential during 23 and 46 h storage. Moreover, 1 and 2 mM CYS improved (P ≤ 0.05) membrane functionality and viability compared to other groups. Lipid peroxidation was lower (P ≤ 0.05) in samples diluted with 1 and 2 mM CYS compared to the others. Artificial insemination with 23-hrs cooled-stored semen produced the higher (P ≤ 0.05) fertility rate in groups received 1 and 2 mM CYS compared to the control group. In conclusion, addition of 1 and 2 mM CYS to the extender could be helpful to protect rooster semen against structural and functional damages of cooling storage process.

Rooster frozen-thawed semen quality following sublethal xanthine oxidase treatments

Reactive oxygen species are associated with cryodamage and may be a factor causing or exacerbating cellular cryodamage during freezing and thawing processes. Induction of sublethal oxidative stress as a new approach for preconditioning of sperm improves the cryo-resistance of sperm. The aim of this study was to investigate effects of sublethal concentrations of xanthine oxidase (XO), which induces oxidative stress before cryopreservation on values for semen quality variables of rooster sperm post-thawing. Semen samples were collected from 15 roosters and treated with different concentrations of XO [XO-0, XO-0.005, XO-0.05, XO-0.5, XO-5, and XO-50 U/ml]; then, the effects of treatments with XO as sublethal stressors, were examined. Results indicated the XO-0.5 and XO-5 treatments resulted in a greater percentage of sperm total motility, progressive motility, viability, and membrane functionality compared to other groups. There was no difference after treatments with XO-0, XO-0.005, and XO-0.05 on sperm total motility, membrane functionality, apoptosis, mitochondria activity, and viability. There was a greater percentage of mitochondria activity in sperm of the XO-0.05, XO-0.5, and XO-5 groups. Furthermore, there was the greatest concentration of malondialdehyde (MDA) in samples of the XO-50 group. Values for sperm abnormal morphology, acrosome integrity, and DNA fragmentation were not different among samples post-thawing. Sperm treated with XO-0.5 and XO-5 had a greater fertilization capacity than those of the control group. In conclusion, treatment of sperm with 0.5 and 5 U/ml XO as inducers of mild oxidative stress before cryopreservation, improved several function quality indices of sperm post-thawing.

Supplementation of Beltsville extender with quercetin improves the quality of frozen-thawed rooster semen

1. Excessive reactive oxygen species (ROS) production during the sperm freeze-thawing process leads to membrane lipid peroxidation, DNA damage, and motility loss.2. This study examined the effect of supplementation of Beltsville poultry semen extender with different concentrations of quercetin (and antioxidants) on the cryopreservation of rooster sperm.3. Semen samples were collected from six Ross broiler breeders via abdominal massage twice a week for 4 weeks (eight replicates), and were divided into five equal aliquots to be diluted in Beltsville extenders that contained different concentrations of quercetin: 0, 5, 10, 15, and 20 mM. Motility, membrane functionality, abnormal morphology, lipid peroxidation, mitochondrial activity, viability, apoptosis status, and fertility potential were assessed post thaw.4. The addition of 10 and 15 mM quercetin to the semen extender significantly increased the total motility, straight-line velocity (VSL), and sperm membrane functionality compared with the other groups (P ≤ 0.05). Moreover, 10 mM quercetin caused higher progressive motility (34.86 ± 3.80%), curvilinear velocity (VCL; 175.11 ± 3.20 µm/s), average path velocity (VAP; 44.35 ± 11.06 µm/s), viability (59.14 ± 1.36%), mitochondrial activity (80.14 ± 2.07%), lower abnormal morphology (19.21 ± 0.45%), and lower lipid peroxidation (2.7 ± 0.13 nmol/ml) compared with the other groups (P < 0.05). The rate of fertility and hatchability after artificial insemination was not affected by experimental groups.5. In conclusion, supplementation of Beltsville extender with 10 mM quercetin could be a suitable method to improve post-thawed rooster sperm quality resulting in better freeze/thaw characteristics.

The mitochondria-targeted antioxidant Mito-TEMPO conserves rooster's cooled semen quality and fertility potential

The PUFAs content of rooster sperm cells makes them vulnerable to the thermal shocks during chilling storage, which reduces the fertility performance of cooled sperm. Extender supplementation with antioxidants is a reasonable method to conserve sperm fertility potential during cooling storage process. The aim of this study was to determine the effect of Mito-TEMPO addition to the Lake medium on rooster sperm quality and fertility potential during cooling process. Semen samples were diluted in the Lake medium and assigned into five equal aliquots and supplemented with 0, 0.5, 5, 50 and 500 μM Mito-TEMPO. Then, the samples were cooled at 5 °C and conserved up to 50 h. Total motility, progressive motility, morphology, viability, membrane integrity, lipid peroxidation and mitochondrial activity of samples were analyzed during 0, 25 and 50 h of cooling period. Artificial insemination was also conducted using 25 h-cooled semen. No significant difference was observed among different treatments during quality evaluations at 0 h storage. Extender supplementation with 5 and 50 μM Mito-TEMPO presented greater (P ≤ 0.05) total motility, progressive motility, viability, membrane integrity and lower lipid peroxidation compared to other groups during 25 and 50 h cooling storage. Mitochondrial activity was higher (P ≤ 0.05) in groups received 5, 50 and 500 μM Mito-TEMPO than others. Fertility rate of 25 h-cooled-stored samples was higher (P ≤ 0.05) in groups containing 5 and 50 μM Mito-TEMPO compared to control group. In conclusion, addition of 5 and 50 μM Mito-TEMPO as a mitochondria-targeted antioxidant to the storage medium could be a suitable method to conserve rooster semen quality against stressful conditions of cooling storage process.

Effect of Glutathione Supplementation to Semen Extender on Post-thawed Rooster Sperm Quality Indices Frozen After Different Equilibration Times

BACKGROUND

Avian sperm is susceptible to lipid peroxidation, compromising their fertility. The semen antioxidant system protects sperm plasma membrane against reactive oxygen species.

OBJECTIVE

The study evaluates the effect of glutathione (GSH) addition to semen extender during different equilibration times (ET) on rooster sperm cryopreservation.

MATERIALS AND METHODS

Semen samples are weekly collected from 60-week-old broiler breeder roosters. Collected samples were pooled and divided to six equal parts and frozen according to a randomized design (2 × 3 factorial arrangement). Treatments included adding two levels of GSH [0 (GSH-0) or 1 (GSH-1) mM] to semen extender during three ET: 0 (ET-0), 4 (ET-4) or 8 (ET-8) hours. Post-thawed motility and velocity parameters, apoptotic like changes, plasma membrane functionality, and mitochondrial membrane potential (MMP) were evaluated.

RESULTS

Post-thawed total motility is improved in the GSH-1 compared to the GSH-0 group (P<0.10). Total motility responded quadratically to increasing levels of ET such that the highest value is recorded at ET-0. Although progressive motility (PM) is not affected by GSH or ET, the highest PM is obtained in the GSH-1×ET-0 group (P<0.05). The VAP and STR is improved in the GSH-1 compared to GSH-0 group; however, VAP decreases quadratically, and STR decreases linearly as ET is advanced (P<0.05). The interactive effect of GSH by ET tends (P<0.08) to affect the wobble coefficient (WOB), such that the highest value is recorded in the GSH-1×ET-0 group. Within both GSH supplemented and control groups, the amplitude of lateral head displacement (ALH) is highest (P<0.05) in the ET-0 group. The percentage of live spermatozoa quadratically decreases and the percentage of dead sperm quadratically increases in response to graded levels of ET (P<0.01). The highest plasma membrane functionality is also noted in the GSH-1×ET-0 group (P<0.05). Mitochondrial membrane potential quadratically decreases in response to increasing levels of ET (P<0.05).

CONCLUSION

Generally, GSH supplementation to rooster sperm extender has some beneficial effects on post-thawed sperm motion characteristics, but does not positively interact with ET.

The effect of zinc oxide on rooster semen cryopreservation

1. Deleterious effects from the freeze-thawing process on post-thawed sperm quality attributes are main limiting factors in cryopreservation. The current study was conducted to determine the effect of semen extender containing zinc oxide (ZnO) on post-thaw rooster sperm quality indices.2. Semen samples from six, 60-week-old broiler breeder roosters were collected weekly during five successive weeks. The samples were mixed and divided into three equal parts and diluted with semen extender containing different levels of ZnO; 0 (ZnO-0), 1 (ZnO-1) or 2 (ZnO-2) µg/ml. After thawing, motility and velocity parameters, plasma membrane functionality, apoptotic like changes, mitochondrial membrane potential (MMP), and DNA fragmentation index (DFI) were evaluated.3. Results showed that the addition of ZnO in the extender quadratically affected (P < 0.01) total motility (TM), progressive motility (PM), and average path velocity (VAP) with the highest values were noted in the ZnO-1 group. Levels of ZnO quadratically affected percentages of live (P < 0.01), apoptotic (P < 0.03) and dead (P < 0.10) spermatozoa, where the highest percentage of live, and the lowest percentage of apoptotic or dead spermatozoa was for the ZnO-1 group. Although adding ZnO quadratically affected plasma membrane functionality and MMP (P < 0.01), it did not affect (P > 0.05) DFI.4. In conclusion, there were some beneficial effects of ZnO supplementation in semen extender on post-thawed rooster sperm quality which may result in a better freezability.

Improvement of rooster semen quality using coenzyme Q10 during cooling storage in the Lake extender

Sensitivity of rooster semen to stressful condition of cooling restricts the semen storage in commercial flocks for artificial insemination. This study was accomplished to investigate the effect of coenzyme Q10 (CoQ10) addition to the Lake extender during chilled-storage on the parameters of sperm quality and fertility performance. Roosters' pooled semen samples were assigned into equal parts and diluted with Lake extender supplemented with different concentrations of CoQ10 (0, 1, 2, 5 and 10 μM CoQ10). Then, semen samples were cooled to 5 °C and stored over 48 h. Total and progressive motilities, abnormal morphology, viability, membrane functionality, lipid peroxidation (LPO) and mitochondria active potential of diluted sperm were evaluated at 0, 24 and 48 h of cooling storage. Fertility performance of cooled stored semen was examined at 24 h of cooling storage. Although CoQ10 did not affect sperm quality at the starting time of cooling storage (0 h), extender supplementation with 5 μM of CoQ10 showed higher (P ≤ 0.05) sperm total and progressive motilities, membrane functionality, viability and mitochondria active potential at 24 h as well as total motility, viability and membrane functionality at 48 h in contrast with other groups. Moreover, lipid peroxidation was lower (P ≤ 0.05) in semen samples diluted with 5 μM CoQ10 at 24 and 48 h compared to others. After artificial insemination with 24 h chilled-stored sperm, fertility efficiency was higher (P ≤ 0.05) in treatments contained 5 μM CoQ10 compared to the control group. According to the results, using optimum dose of CoQ10 could be helpful to save rooster semen against chilled storage structural and functional damages.

Effect of tert-butyl hydroquinone on bull semen cryopreservation

BACKGROUND

Many studies have been shown that freezing induced oxidative stress has detrimental effect on post-thaw sperm quality.

OBJECTIVE

This study was conducted to investigate the effect of tert-butyl hydroquinone (tBHQ) on bull semen crtopreservation.

MATERIALS AND METHODS

In this study, four different levels of tBHQ [Optidyl containing zero (T0), 2.5 (T2.5), 5 (T5), and 7.5 µM (T7.5) tBHQ] was used to study the effect of tBHQ on freezability of bull semen. On each collection day, four ejaculates were collected (a total of 24 ejaculates from four bulls), pooled and divided to four equal parts. Each part was diluted with one of the above-mentioned extenders and frozen. After thawing, sperm motility, plasma membrane functionality and integrity, apoptosis status and mitochondrial activity were assessed.

RESULTS

The results show that total sperm motility was significantly higher in T5 compared to other groups. The value of VSL was significantly lower in T5 compared to T0. Also, T5 resulted in lower LIN and STR versus T0 and T2.5 groups. All extenders containing tBHQ resulted in a significantly higher percentage of sperm with functional membrane compared to T0 groups. Finally, Apoptosis related parameters and mitochondrial activity were not significantly difference between the groups.

CONCLUSION

adding 5 µM tBHQ to the bull semen extender can be beneficial for post-thaw sperm quality. Also, in vivo or in vitro fertility test is recommended to test fertilizing ability of tBHQ exposed sperm.

Effect of dietary fish oil supplementation on ram semen freeze ability and fertility using soybean lecithin- and egg yolk-based extenders

Ram semen cryopreservation is not efficient for artificial insemination in commercial herds. Beneficial effects of dietary fish oil have been evaluated for cryopreservation of ram semen in soybean lecithin (SL) and egg yolk (EY)-based extenders. A factorial study (two diets × two extenders) was used to analyze the effects of two diets supplemented with fish oil (n-3 fatty acid) or palm oil (saturated fatty acids; [SFAs]) to freeze ram semen in two extenders containing SL or EY. Motility characteristics, membrane integrity, abnormal morphology, mitochondria activity, acrosome integrity, apoptotic status, and fertilizing ability were assessed after freeze-thawing. Although diet had significant (P ≤ 0.05) effects on the quality parameters of frozen-thawed sperm, effects of extenders on these traits were not significant (P > 0.05). The higher significant (P ≤ 0.05) percentage of total motility and progressive motility were observed in n-3/SL (44.83 ± 1.56 and 28.33 ± 1.4) and n-3/EY (43.33 ± 1.56 and 28.50 ± 1.4) than SFA/SL (32.16 ± 1.56 and 14.00 ± 1.4) and SFA/EY (31.66 ± 1.56 and 12.66 ± 1.4) groups. Moreover, n-3/SL and n-3/EY produced the higher significant (P ≤ 0.05) percentage of membrane integrity of sperm (39.83 ± 1.4 and 37.33 ± 1.4) than SFA/SL and SFA/EY (29.83 ± 1.4 and 28.5 ± 1.4). For viability results, the higher significant percentage of live sperm was observed in n-3/SL and n-3/EY (43.16 ± 1.38 and 45.66 ± 1.38) than SFA/SL and SFA/EY (28.66 ± 1.38 and 27.5 ± 1.38). For fertility trials, n-3-based diets (n-3/SL and n-3/EY) improved significantly (P ≤ 0.05) pregnancy rate (44% and 46%), parturition rate (42% and 42%), and lambing rate (46% and 44%) compared with the SFA-based diets (SFA/SL and SFA/EY). No interaction effects have been found between diets and extenders (P > 0.05). It seems that dietary fish oil can improve the semen performance after freezing-thawing process and artificial insemination aside from type of extenders.

Fertility and flow cytometry study of frozen-thawed sperm in cryopreservation medium supplemented with soybean lecithin

Semen cryopreservation can provide genetic resources for a large number of females from a small number of superior males. Optimization of cryopreservation media to achieve the highest quality of post-thaw semen is crucial. Soybean lecithin has evaluated as a plant-based cryoprotectant for substitution of egg yolk in ram semen extender. Flow cytometric and fertility assessments were applied following cryopreservation procedure in two experimental groups (SL group: extender containing 1% w/v soybean lecithin and EY group: extender containing 20% v/v egg yolk). The higher percentage of live sperm and the lower percentage of dead sperm were obtained in SL (47.66 ± 1.38, 52.33 ± 1.69, respectively) extender compared to EY (41.16 ± 1.38, 58.83 ± 1.69). For motion characteristics, plasma membrane integrity, acrosome integrity and mitochondria activity, no significant difference was observed between SL and EY extenders. In artificial insemination experiment, there was no significant difference in pregnancy rate, lambing rate and twining rate between SL and EY extenders. It can be concluded that SL extender can be an efficient alternative extender to preserve ram sperm during cryopreservation procedure without adverse effects.

51 STRESS PRECONDITIONING OF SPERMATOZOA WITH SUBLETHAL CONCENTRATIONS OF ETHANOL IMPROVE POST-THAW SPERM QUALITY IN BULL

A variety of controlled mild stressors have been applied for activation of temporary response in oocytes, embryos, and somatic cells. So far, several stressors have been used to induce mild stress, including that of hydrostatic pressure, osmotic stress, mechanical stress, and oxidative challenges. Based on these evidences, we hypothesised that the ethanol in sublethal concentration would be capable of generating mild stress that may ultimately leads to an adaptive response in spermatozoa. To evaluate this hypothesis, semen samples (n = 24, 6 ejaculates/bull) from 4 Holstein bulls were collected and pooled for each replicate. Pooled samples were divided into 5 equal parts and each part diluted with tris-glycerol-based (Optidyl®) extender containing 0 (O-E0), 0.03 (O-E3), 0.09 (O-E9), and 0.15 (O-E15) % (vol/vol) ethanol and frozen. After thawing, sperm motility and velocity parameters (sperm class analysis), apoptosis status (Phospatidylserin Translocation Detection commercial kit), plasma membrane integrity (eosin-Nigrosin staining), malondialdehyde concentration (thiobarbituric acid reaction), and mitochondrial activity (rhodamine-123 and propidium iodide) were evaluated. The data were analysed using Proc Mixed of SAS 9.1 (version 9.1; SAS Institute Inc., 2002, Cary, NC, USA). Tukey's test was used to compare least squares means. As a result, the O-E9 group showed higher (85.2%) percentage of total motility compared with O-E0 (73.6%), O-E3 (51.9%), and O-E15 (67.5%) groups (P < 0.05). A highest (P < 0.05) percentage of live spermatozoa were observed in the O-E9 (62.9%) group as compared with O-E0 (49.4%), O-E3 (50.3%), and O-E15 (49.6%) groups, and also the proportion of apoptotic spermatozoa in the O-E9 (10.6%) group tended to be lowest as compared with those of O-E0 (15.6%), O-E3 (17.2%), O-E15 (14.1%) groups (P > 0.05). The plasma membrane integrity was higher (P < 0.05) in O-E9 (90.8%) compared with O-E3 (75%) and O-E15 (77.2%) groups; however, the difference was not significant when the O-E9 group was compared with the O-E0 group (83.2%; P > 0.05). Obtained results revealed that malondialdehyde level was lower in O-E3 (1.03%), O-E9 (0.63%), and O-E15 (0.89%) groups compared with the O-E0 (1.94%) group (P < 0.05). Furthermore, the percentage of live spermatozoa with active mitochondria was higher in O-E9 (57.7%) and O-E15 (57.5%) groups compared with O-E0 (49.1%) and O-E3 (38.2%) groups (P < 0.05). These results strongly suggest that supplementation of Optidyl® extender with sublethal concentration of ethanol influences post-thawed bull sperm quality in a dose-dependent manner. However, further studies are needed to empirically determine the effect of supplementation on fertilization and pregnancy outcome.

Protective role of glutathione in buck semen cryopreservation

The aim of this study was to determine the effect of low levels of glutathione on post-thawed buck sperm quality. In this experiment, different concentrations of glutathione [0 (LG-0), 0.5 (LG-0.5), 1 (LG-1), 1.5 (LG-1.5), and 2 (LG-2) mM] were added in a soybean lecithin-based extender. A total of 16 ejaculates from four bucks were collected and pooled. Each pooled sample was divided into five equal parts and each part was diluted by one of the above mentioned groups. After freeze-thawing process, motility and velocity, plasma membrane integrity and functionality, and apoptosis features of spermatozoa were evaluated. The results of this experiment showed that total motility (50.75 ± 2.33), plasma membrane integrity (55.75 ± 3.01) and functionality (46.75 ± 2.79) were higher in LG-1 extender compared to other extenders (P<0.05). The percentage of live spermatozoa (53.23 ± 3.26) was higher in LG-1 extender compared to other extenders, with the exception of LG-1.5 extender (P<0.05). Also, the percentage of late apoptotic spermatozoa (21.33 ± 1.63) was lower in LG-1 extender compared to other extenders (P<0.05). In conclusion, our results showed that GL-1 extender resulted in higher post-thawed buck sperm quality compared to other extenders.

Flow cytometric and microscopic evaluation of post-thawed ram semen cryopreserved in chemically defined home-made or commercial extenders

The present study was designed to determine the effect of three different extenders on ram sperm quality during a freeze–thawing procedure using flow cytometric and microscopic evaluations. Several in vitro qualitative analyses of post-thawed sperm parameters including motility and velocity parameters, plasma membrane functionality, total abnormality, capacitation status, acrosome integrity, mitochondrial activity and apoptosis features were considered. In the breeding season, seven ejaculates from each Zandi ram were collected routinely twice a week. Following semen collection, samples were pooled and equally divided into three aliquots. Each aliquot was diluted and frozen with one of the following extenders: (1) Tris-based extender containing 1.5% (w/v) soybean lecithin (TSL), as a chemically defined extender, (2) Bioxcell, a commercial soybean lecithin-based extender, and (3) Tris-based extender containing 20% (v/v) egg yolk (TEY). The results of the present study indicated no differences in total [TSL (55.8 ± 2.02%) vs TEY (50.2 ± 2.02%; P < 0.05)] and progressive motility of spermatozoa [TSL (26.2 ± 1.36%) vs Bioxcell (22.4 ± 1.36%; P < 0.05)]. Semen freezing by means of TSL resulted in a higher percentage of live spermatozoa (39.42 ± 1.81%) compared with TEY (29.17 ± 1.81%; P < 0.05), and a higher percentage of functional plasma membrane (50.8 ± 192%) compared with TEY (44 ± 1.92%) and Bioxcell (38.8 ± 1.92%; P < 0.05). The effect of extenders on sperm capacitation status showed that the percentage of post-thawed capacitated spermatozoa was higher in TEY (61.9 ± 1.48%) compared with that in TSL (56.6 ± 1.48%; P < 0.05). The evaluation of post-thawed spermatozoa indicated that the percentage of live spermatozoa with active mitochondria was higher in TSL (53.05 ± 2.31%) compared with Bioxcell (45.92 ± 2.31; P < 0.05) and the percentage of intact acrosome spermatozoa was higher in TSL (84.55 ± 2.51%) compared with TEY (74.91 ± 2.51%; P < 0.05). The use of TSL and Bioxcell extenders reduced the percentage of apoptotic spermatozoa (40.82 ± 2.07% and 42.22 ± 2.07%, respectively), compared with TEY (51.34 ± 2.07%; P < 0.05). Post-thawing dead spermatozoa were increased when semen was frozen by Bioxcell (25.69 ± 1.28%). The results of this study showed that TSL extender may provide stabile milieu and conditions for ram sperm cryopreservation compared with Bioxcell and TEY extenders. Whether TSL extender can improve the artificial insemination results remains, however, an open question.

Cryopreservation of ram semen in extenders containing soybean lecithin as cryoprotectant and hyaluronic acid as antioxidant

A soybean lecithin-based extender supplemented with hyaluronic acid (HA) was assayed for effectiveness to improve the quality of frozen-thawed ram semen. HA has not been tested yet in an extender containing soybean lecithin for freezing ram semen. Thus, the aim of this study was to analyse the effects of soybean lecithin at 1% or 1.5% along with HA at 0, 0.5 and 1 mg ml(-1) in a Tris-based extender on the motion characteristics, membrane integrity (HOST), viability, GSH peroxidase (GSH-PX) activity, lipid peroxidation and acrosomal status after freezing-thawing. Semen was collected from four Mehraban rams during the breeding season and frozen in the six lecithin×HA extenders. The extender containing 1.5% lecithin supplemented with no HA yielded higher total motility (52.5%±1.6), viability (55.8%±1.6) and membrane integrity (44.5%±1.7), but the effects of the lecithin concentration did not reach signification. Linearity-related parameters, ALH, BCF, lipid peroxidation, GSH-PX activity, morphology and acrosomal status were not affected by the extender composition. In general, adding HA significantly decreased sperm velocity (1 mg ml(-1) HA), total motility (only with 1.5% lecithin), viability (1 mg ml(-1) HA for 1% lecithin; both concentrations for 1.5% lecithin) and membrane integrity. In conclusion, adding HA to the freezing extender supplemented with soybean lecithin failed to improve quality-related variables in ram semen. Increasing the lecithin content could have a positive effect, but further studies are needed.

Impact of Supplementation with Curcuminoids on Systemic Inflammation in Patients with Knee Osteoarthritis: Findings from a Randomized Double-Blind Placebo-Controlled Trial

OBJECTIVE

Osteoarthritis (OA) is a degenerative joint disease associated with inflammation. The present study aimed to determine changes in serum levels of inflammatory biomarkers in OA patients whose clinical symptoms were improved as a result of supplementation with curcuminoids.

METHODS

This study was a randomized double-blind placebo-control parallel-group clinical trial in which 40 subjects with mild-to-moderate degree knee OA were randomly allocated to receive either pure curcuminoids (1,500 mg/day in 3 divided doses; n=19) or matched placebo (n=21) for 6 weeks. In order to enhance the bioavailability of curcuminoids, piperine (15 mg/day) was added to the treatment regimen. Serum levels of interleukins 4 (IL-4) and 6 (IL-6), tumor necrosis factor-α (TNF-α), transforming growth factor-β (TGF-β) and high-sensitivity C-reactive protein (hs-CRP), together with erythrocyte sedimentation rate (ESR) were determined at baseline as well as at the end of trial.

RESULTS

Serum concentrations of IL-4 (p=0.001), IL-6 (p=0.006) and hs-CRP (p=0.004) were significantly reduced in the curcuminoid group whilst serum levels of TNF-α and TGF-β and mean ESR remained unaltered by the end of trial (p>0.05). In the placebo group, serum concentrations of IL-4 (p=0.001), IL-6 (p=0.003), TNF-α (p=0.003) and TGF-β (p=0.005) were significantly reduced but mean hs-CRP and ESR values remained statistically unchanged (p>0.05). Comparison of the magnitude of changes in the evaluated inflammatory biomarkers did not indicate any significant difference between the study groups (p>0.05).

CONCLUSION

Significant improvement in clinical symptoms of OA in curcuminoid-treated subjects cannot be attributed to the systemic anti-inflammatory effects of these phytochemicals.

Optimization of ram semen cryopreservation using a chemically defined soybean lecithin-based extender

The purpose of the present study was to investigate the effects of a chemically defined soybean lecithin-based semen extender as a substitute for egg yolk-based extenders in ram semen cryopreservation. In this study, 28 ejaculates were collected from four Zandi rams in the breeding season and then pooled together. The pooled semen was divided into six equal aliquots and diluted with six different extenders: (i) Tris-based extender (TE) containing 0.5% (w/v) soybean lecithin (SL0.5), (ii) TE containing 1% (w/v) soybean lecithin (SL1), (iii) TE containing 1.5% (w/v) soybean lecithin (SL1.5), (iv) TE containing 2% (w/v) soybean lecithin (SL2), (v) TE containing 2.5% (w/v) soybean lecithin (SL2.5) and (vi) TE containing 20% (v/v) egg yolk (EYT). After thawing, sperm motility and motion parameters, plasma membrane and acrosome integrity, apoptosis status and mitochondrial activity were evaluated. The results shown that total and progressive motility (54.43 ± 1.33% and 25.43 ± 0.96%, respectively) were significantly higher in SL1.5 when compared to other semen extenders. Sperm motion parameters (VAP, VSL, VCL, ALH and STR) were significantly higher in SL1.5 compared to other extender, with the exception of SL1 extender. Plasma membrane integrity (48.86 ± 1.38%) was significantly higher in SL1.5 when compared to other semen extenders. Also, percentage of spermatozoa with intact acrosome in SL1.5 (85.35 ± 2.19%) extender was significantly higher than that in SL0.5, SL2.5 and EYT extenders. The results showed that the proportion of live post-thawed sperm was significantly increased in SL1.5 extender compared to SL0.5, SL2 and EYT extenders. In addition, SL1, SL1.5 and SL2.5 extenders resulted in significantly lower percentage of early-apoptotic sperm than that in EYT extender. There were no significant differences in different semen extenders for percentage of post-thawed necrotic and late-apoptotic spermatozoa. Also, the results indicated that there are slight differences for percentage of live spermatozoa with active mitochondria between extenders. In conclusion, SL1.5 extender was better than other extenders in most in vitro evaluated sperm parameters.

Clinical features of laryngeal tuberculosis in Iran

Tuberculosis is a major health problem in Iran and its laryngeal involvement is not uncommon. Laryngeal tuberculosis is so infectious and delay in diagnosis and treatment could result spread of disease and causes divesting complications. We reviewed clinical and para-clinical characteristics of patients with laryngeal tuberculosis in Iran. In a cross sectional study, patients with laryngeal tuberculosis were studied and followed. All patients admitted from May 2000 to Dec 2011 in Amir-Alam hospital, a referral center for laryngeal diseases in Tehran. We studied 19 cases of laryngeal tuberculosis with typical histopathology (chronic granulomatous inflammation with caseous necrosis and langhans-type giant cells) and 6 cases of laryngeal tuberculosis with atypical histopathology (chronic granulomatous inflammation or chronic inflammation without necrosis). They had laryngeal symptoms and signs from 2 to 12 months before definitive diagnosis. Macroscopic appearances of laryngeal lesions were exophytic in 11 cases and ulcerative in 14 cases. True vocal cords were involved in 22 cases. The primary clinical diagnosis was malignancy in 17 cases, tuberculosis in 5 cases, and nonspecific inflammation in 3 cases. The chest x-ray findings were compatible with tuberculosis in 14 patients. The response to anti-tuberculosis therapy was desirable in all patients. In endemic area, tuberculosis should be considered as an important diagnosis in patients with laryngeal lesions even when histopathology of laryngeal lesions is not typical. Association with pulmonary tuberculosis helps for diagnosis.

Is leaf dry matter content a better predictor of soil fertility than specific leaf area?

BACKGROUND AND AIMS

Specific leaf area (SLA), a key element of the 'worldwide leaf economics spectrum', is the preferred 'soft' plant trait for assessing soil fertility. SLA is a function of leaf dry matter content (LDMC) and leaf thickness (LT). The first, LDMC, defines leaf construction costs and can be used instead of SLA. However, LT identifies shade at its lowest extreme and succulence at its highest, and is not related to soil fertility. Why then is SLA more frequently used as a predictor of soil fertility than LDMC?

METHODS

SLA, LDMC and LT were measured and leaf density (LD) estimated for almost 2000 species, and the capacity of LD to predict LDMC was examined, as was the relative contribution of LDMC and LT to the expression of SLA. Subsequently, the relationships between SLA, LDMC and LT with respect to soil fertility and shade were described.

KEY RESULTS

Although LD is strongly related to LDMC, and LDMC and LT each contribute equally to the expression of SLA, the exact relationships differ between ecological groupings. LDMC predicts leaf nitrogen content and soil fertility but, because LT primarily varies with light intensity, SLA increases in response to both increased shade and increased fertility.

CONCLUSIONS

Gradients of soil fertility are frequently also gradients of biomass accumulation with reduced irradiance lower in the canopy. Therefore, SLA, which includes both fertility and shade components, may often discriminate better between communities or treatments than LDMC. However, LDMC should always be the preferred trait for assessing gradients of soil fertility uncoupled from shade. Nevertheless, because leaves multitask, individual leaf traits do not necessarily exhibit exact functional equivalence between species. In consequence, rather than using a single stand-alone predictor, multivariate analyses using several leaf traits is recommended.

Stomatal vs. genome size in angiosperms: the somatic tail wagging the genomic dog?

BACKGROUND AND AIMS

Genome size is a function, and the product, of cell volume. As such it is contingent on ecological circumstance. The nature of 'this ecological circumstance' is, however, hotly debated. Here, we investigate for angiosperms whether stomatal size may be this 'missing link': the primary determinant of genome size. Stomata are crucial for photosynthesis and their size affects functional efficiency.

METHODS

Stomatal and leaf characteristics were measured for 1442 species from Argentina, Iran, Spain and the UK and, using PCA, some emergent ecological and taxonomic patterns identified. Subsequently, an assessment of the relationship between genome-size values obtained from the Plant DNA C-values database and measurements of stomatal size was carried out.

KEY RESULTS

Stomatal size is an ecologically important attribute. It varies with life-history (woody species < herbaceous species < vernal geophytes) and contributes to ecologically and physiologically important axes of leaf specialization. Moreover, it is positively correlated with genome size across a wide range of major taxa.

CONCLUSIONS

Stomatal size predicts genome size within angiosperms. Correlation is not, however, proof of causality and here our interpretation is hampered by unexpected deficiencies in the scientific literature. Firstly, there are discrepancies between our own observations and established ideas about the ecological significance of stomatal size; very large stomata, theoretically facilitating photosynthesis in deep shade, were, in this study (and in other studies), primarily associated with vernal geophytes of unshaded habitats. Secondly, the lower size limit at which stomata can function efficiently, and the ecological circumstances under which these minute stomata might occur, have not been satisfactorally resolved. Thus, our hypothesis, that the optimization of stomatal size for functional efficiency is a major ecological determinant of genome size, remains unproven.

In vitro comparison of egg yolk-based and soybean lecithin-based extenders for cryopreservation of ram semen

Substitution of egg yolk with soybean lecithin may reduce hygienic risks in extenders. Though a few studies have been performed on the effect of soybean lecithin in bull, to date evaluation of ram semen in vitro fertility after cryopreservation with use of soybean lecithin has not been studied. This study assessed the effect of 1% or 2% (wt/vol) soybean lecithin (L1 or L2) or 15% or 20% (vol/vol) egg yolk (E15 or E20) supplemented with 5% or 7% glycerol (G5 or G7) in a Tris-based medium for cryopreservation of ram (Oviss arries) semen. Although no significant difference was observed in pattern of capacitation, the best results in terms of sperm motility, viability postthaw, and cleavage rates were observed with L1G7 (51.9+/-4.8%, 48.1+/-3.5%, and 79.6+/-3.9%, respectively) and E20G7 (51.8+/-2.9%, 46.7+/-4.0%, and 72.9+/-6.4%, respectively). Our results also showed that 1% lecithin and 20% egg yolk was superior to 2% lecithin and 15% egg yolk. In terms of cleavage rate, 7% glycerol was superior to 5% glycerol. No significant difference was obtained between groups in terms of blastocysts rate per cleaved embryo. Therefore, we concluded that the optimal concentration of lecithin and egg yolk is 1% and 20%, respectively, along with 7% glycerol. In addition, our results suggest that lecithin can be used as a substitute for egg yolk.

The impact of hepatitis B infection on outcome of kidney transplantation: a long-term study

BACKGROUND

With the success of kidney transplantation, liver disease has emerged as an important cause of morbidity and mortality in kidney recipients.

OBJECTIVE

To determine the impact of hepatitis B virus (HBV) infection on patients and graft survival in both short- and long-terms.

METHODS

99 renal transplant patients infected with HBV on follow-up in two major transplant centers were included in a retrospective study. These patients were grafted between 1986 and 2005 and divided into two groups: (1) those only positive for hepatitis B surface antigen (HBsAg) and (2) those who were also positive for hepatitis C virus antibodies (HCV Ab).

RESULTS

There were 88 patients with HBsAg(+) and 11 with both HBsAg(+) and HCV Ab(+). The mean±SD age of patients was 38.8±13.2 years, and the median follow-up after transplantation was 19 months. Although not significant, the allograft survival rate in the first group (HBV(+)) was better compared to that in the second group (HBV(+) and HCV(+)); 1, 5 and 10 years graft survival rates were 91, 77 and 62 in the first group and 70, 56 and 28 in the second group, respectively (P=0.07). The overall mortality was 5% (4 of 88) in the first and 27% (3 of 11) in the second group (P=0.02).

CONCLUSION

Renal allograft recipients with HBV and HCV infections has a poor survival rate compared to patients with only HBV infection. However, there is no significant difference in terms of renal graft survival between the two groups.

Responsivity to food stimuli in obese and lean binge eaters using functional MRI

Functional neuroimaging was employed to study 10 obese and 10 lean healthy young right-handed women, divided equally into binge and non-binge eaters. Subjects were presented with visual and auditory stimuli of binge type foods, non-binge type foods, and non-food stimuli in the fMRI scanner. Brain areas activated by both the visual and auditory stimuli across all individual subjects within a particular group was observed only for the binge food stimuli in the obese binge eaters, in the right premotor area, involved in planning of motor behavior. For four of the five obese binge eaters, the activation was in the ventral premotor cortex adjacent to the oral region, and may reflect past or concurrent motor planning about eating binge foods. Because a random effects group analysis has not yet been completed, this should be considered a preliminary report.

Comparison of Classical and Clozapine Treatment on Schizophrenia Using Positive and Negative Syndrome Scale of Schizophrenia (PANSS) and SPECT Imaging

Many neuroimaging studies of schizophrenia have shown abnormalities in the frontal cortex, limbic system, basal ganglia, temporal and parietal lobes. These findings are not specific or consistent enough to build up a coherent theory of the origin of the brain abnormality in schizophrenia. This paper describes a state-of-the-art approach of SPECT to correlate neuropsychological evaluation. PANSS scores and different brain focal abnormalities of two groups of patients receiving Clozapine and classical antipsychotic treatments were observed. A total of 20 drug-free patients, actively psychotic schizophrenic, were selected according to the DSM-IV criteria. Pre-Post-treatment was designed using PANSS and 99mTc- ECD-SPECT to assess regional Cerebral Blood Flow (rCBF). The results showed that after treatment, differences in PANSS scores were significant in both groups, with superior scores resulting from the Clozapine therapy. Results were supported by SPECT, which showed a greater improvement in the Clozapine group. Both positive and negative symptoms were improved with Clozapine as well. Before treatment, hypofrontality was the most common (85%) finding, whereas after treatment hypofrontality was mostly cleared. However, in some areas like temporal and caudate, hyperfrontality was induced. Negative symptoms showed linkage to hypofrontality in both groups before and after treatment, and both positive and negative symptoms were improved more with Clozapine therapy than with classical treatment.

NO reduces PMN adhesion to human vascular endothelial cells due to downregulation of ICAM-1 mRNA and surface expression

Reperfusion damage is largely due to the adherence of polymorphonuclear leukocytes to the endothelium initiated by adhesion molecule upregulation. The reduced endothelial nitric oxide release during ischemia may be involved in the upregulation of intercellular adhesion molecule 1. In this study, we tested if nitric oxide donors suppress polymorphonuclear leukocyte adherence to activated endothelial cells by inhibition of the intercellular adhesion molecule 1 surface expression. Confluent human umbilical vein endothelial cells were stimulated with tumor necrosis factor alpha (300 U/mL) after preincubation with increasing concentrations of the nitric oxide donors CAS 1609 (0.005-5 mM/L) and 3-(4-morpholinyl)-sydnonimine (0.01-1 mM/L). Intercellular adhesion molecule 1 surface expression was measured in a cell surface enzyme-linked immunosorbent assay, intercellular adhesion molecule 1 mRNA by Northern analysis. Human saphenous vein endothelial cells were transfected with the inducible nitric oxide synthase gene and stimulated with tumor necrosis factor alpha (300 U/mL). Fluorescein green-labeled polymorphonuclear leukocytes adhering to activated human umbilical vein endothelial cells/human saphenous vein endothelial cells were quantified by epifluorescent microscopy. The intercellular adhesion molecule 1 surface expression of activated human umbilical vein endothelial cells/human saphenous vein endothelial cells was significantly diminished to 40 to 60% of the maximum after treatment with CAS 1609, 3-(4-morpholinyl)-sydnonimine, or transfection with the inducible nitric oxide synthase gene. Intercellular adhesion molecule 1 mRNA was diminished by CAS 1609 and 3-(4-morpholinyl)-sydnonimine in the same manner. The functional relevance of our data was shown by reduction of polymorphonuclear leukocyte adherence to activated human umbilical vein endothelial cells/human saphenous vein endothelial cells following treatment with CAS 1609 and 3-(4-morpholinyl)-sydnonimine or transfection with inducible nitric oxide synthase. Tumor necrosis factor-induced polymorphonuclear leukocyte adherence was abolished by blocking antibody against intercellular adhesion molecule 1. Thus, exogenous or endogenous substitution of nitric oxide diminishes the expression of endothelial intercellular adhesion molecule 1 and its mRNA following tumor necrosis factor alpha stimulation. This results in a reduced polymorphonuclear leukocyte adherence to activated endothelium.

Substrate supply for nitric-oxide synthase in macrophages and endothelial cells: role of cationic amino acid transporters

The current study was designed to investigate the importance of cationic amino acid transporters (CATs) for the L-arginine supply to nitric oxide (NO) synthases in mouse J774A.1 macrophages and human EA.hy926 endothelial cells. CAT-1 was expressed in both cell types, whereas CAT-2B was only expressed in activated macrophages. Apparent K(M) values for transport of L-arginine in both cell types was consistent with the expression of the system y(+) carriers CAT-1 (and CAT-2B in macrophages). In addition, L-arginine transport was Na(+) independent and sensitive to trans-stimulation. A 2-h preincubation of activated macrophages in 2 mM L-lysine (which is exchanged for L-arginine by the CATs) reduced the intracellular L-arginine concentration from 2 mM to 160 microM. At the same time, nitric-oxide synthase (NOS) II activity was completely abolished. NOS II activity could be restored with extracellular L-arginine. No difference in NO production was seen between macrophages preincubated in L-arginine-containing buffer and incubated either with or without L-arginine during the 2-min NO assay. Incubation of endothelial cells in 2 mM L-lysine for up to 24 h decreased the intracellular L-arginine concentration from 3.5 mM to about 600 microM but did not reduce the NOS III activity. Our results suggest that both activated macrophages and endothelial cells have an L-arginine pool that is not freely exchangeable with the extracellular space. This pool seems to be accessible to NOS III in endothelial cells but not to NOS II in macrophages.