Physical Mechanisms Providing Clinical Information From Ultrasound Lung Images: Hypotheses and Early Confirmations

In standard B mode imaging, a set of ultrasound pulses is used to reconstruct a 2-D image even though some of the assumptions needed to do this are not fully satisfied. For this reason, ultrasound medical images show numerous artifacts which physicians recognize and evaluate as part of their diagnosis since even one artifact can provide clinical information. Understanding the physical mechanisms at the basis of the formation of an artifact is important to identify the physiopathological state of the biological medium which generated the artifact. Ultrasound lung images are a significant example of this challenge since everything that is represented beyond the thickness of the chest wall ( ≈ 2 cm) is artifactual information. A convincing physical explanation of the genesis of important ultrasound lung artifacts does not exist yet. Physicians simply base their diagnosis on a correlation observed over the years between the manifestation of some artifacts and the occurrence of particular lung pathologies. In this article, a plausible genesis of some important lung artifacts is suggested.

Detection of Mycobacteria and Chlamydiae in Granulomatous Inflammation of Reptiles: A Retrospective Study

A retrospective study on reptile tissues presenting with granulomatous inflammation was performed to detect the possible presence of mycobacteria and chlamydiae in these lesions. Ninety cases including 48 snakes, 27 chelonians, and 15 lizards were selected. Mycobacteria were detected by Ziehl-Neelsen (ZN) staining and a broad-range polymerase chain reaction (PCR) followed by DNA sequencing. To detect chlamydiae, immunohistochemistry with monoclonal antibodies against chlamydial lipopolysaccharide (LPS) and a Chlamydiales order-specific PCR and sequencing were applied. Acid-fast bacilli were found in 14 cases (15.6%) by ZN staining and in 23 cases (25.6%) by PCR. Sequence analysis revealed the presence of Mycobacteria other than Mycobacterium tuberculosis complex (MOTT). Chlamydial LPS antigen was observed within granulomas from five samples (5.6%), whereas the PCR screen revealed 58 positive cases (64.4%). Of these, 9 cases (10%) showed 98–99% similarity to Chlamydophila ( Cp.) pneumoniae and 49 cases (54.4%) displayed a high similarity (88–97%) to the newly described “Chlamydia-like” microorganisms Parachlamydia acanthamoebae and Simkania negevensis. Results from this study confirm, on the one hand, that MOTT are probably the most important infectious etiology for granulomatous inflammation in reptiles. On the other hand, they indicate that chlamydia infects reptiles and that Cp. pneumoniae should be considered an etiological agent of granulomatous lesions of reptiles. Because both MOTT and Cp. pneumoniae are human pathogens, the potential of zoonotic transmission from reptiles to humans has to be considered. In contrast, the significance of Chlamydia-like isolates remains completely open, and further studies are needed to evaluate their role.

Lung and ultrasound: time to "reflect"

BACKGROUND

Literature concerning lung ultrasonography is largely growing and opening new diagnostic opportunities. The clinical value of the ultrasonographic interstitio-alveolar syndrome, based on artifactual (lung comets or B-lines) rather than real images, in the detection of lung contusion, pneumonia and pulmonary edema, is clearly demonstrated. As clinical echographists, though, we are living the paradox of relying our experience in lung pathology on images whose biophysical and genetic nature is not fully understood.

OBJECTIVE AND PERSPECTIVES

A detailed review of the ultimate findings with an analysis of recent and past literature regarding the formation of ultrasonographic artifacts was undertaken with the aim of clarifying what we know and where we are heading in this field. It is important for us to underline how lung ultrasonography is not morphological, as this, along with the study of artifact formation, will be the base for the development of a novel 'view' able to take us from artifact to reality in terms of 'quantification' of lung disease and damage.

CONCLUSIONS

Lung ultrasonographic artifacts need to be read in a new light which will privilege biophysical knowledge and research. In this field a gap of basic knowledge clearly exists. A greater understanding of the formation of acoustic artifacts from ultrasound interference on discretely aerated tissues of variable density, would place the practice of lung "ultrasonography" in the correct technological and clinical position.

Bedside lung ultrasound in critical care practice

Ultrasonographic scanning of the lung is gaining ever-growing recognition as a diagnostic and monitoring imaging technique. Its role in trauma assessment has already been established as an extension of the focused assessment of trauma with sonography for the diagnosis of pneumothorax. As more centers are discovering the advantages of ultrasound and conducting experimental and comparative studies, its use for diagnosing many other lung pathologies is becoming even more important. In-depth studies and innovative ideas are needed to explore the possibilities of this technology. We believe that, ultimately, the advantages for the patient will far outweigh the disadvantages of ultrasonography. Here, we review all possible applications of lung ultrasonography used thus far in Intensive Care Units, where a readily available and biologically non-invasive imaging technique may make the difference in diagnosis. In addition, we describe how the non-invasive nature of ultrasonography allows it to be used as a monitoring device of disease progression vs the healing process. We also provide a detailed explanation of the methods and materials necessary and a few indications towards unanswered questions in this field of research.

Sonographic findings in pulmonary diseases

Lung sonography, generally not thought to be diagnostic, is currently being reconsidered and is developing into an interesting clinical possibility. The principal sonographic signs of lung disease are described in light of our personal experience and the current literature.

Prolonged practice is of scarce benefit in improving motor performance in Parkinson's disease

Many studies have addressed practice effects in motor sequences in Parkinson's disease (PD). Most studied short-term practice and showed that treated patients with mild-to-moderate disease achieve normal or slightly abnormal improvement. Less attention has focused on practice effects after prolonged training (days), and the results are inconclusive. Here, we studied the kinematic changes induced by prolonged practice in a group of medicated patients with mild-to-moderate PD and a healthy control group. We did so by analyzing an internally determined sequential arm movement performed as fast and accurately as possible before and after a 2-week training period. After 1-day's practice, movement duration, pause duration, and movement accuracy improved similarly in patients and controls, indicating that patients benefitted normally from short-term practice. After 1-week's practice, movement and pause duration improved further in both groups, whereas movement accuracy remained unchanged. After 2-weeks' practice, healthy controls continued to improve but patients did not, indicating reduced prolonged practice benefit in PD. Because short-term practice benefit on motor performance is thought to be mediated predominantly by cerebellar activation, whereas long-term practice benefit relies predominantly on the basal ganglia, we attribute our findings to the underlying basal ganglia dysfunction in PD. Our study may be relevant for planning and executing rehabilitation programs in these patients.

Clinical and pathological characterisation of primary pulmonary hypertension in a dog

Primary pulmonary hypertension was diagnosed in an eight-year-old labrador retriever on the basis of echocardiographic findings of severe right ventricular eccentric hypertrophy, abnormally high systolic and diastolic pulmonary arterial pressures calculated by applying the modified Bernoulli equation to the tricuspid and pulmonary insufficiency peak velocities, and the absence of any underlying disease known to cause secondary pulmonary hypertension. The clinical abnormalities developed gradually, from exercise intolerance starting early in life to terminal right-sided congestive heart failure. Consistent histopathological findings were severe intimal and medial thickening of small arteries and arterioles that led to vascular obliteration.

Charcot-Marie-Tooth disease in Molise, a central-southern region of Italy: an epidemiological study

An epidemiological survey of Charcot-Marie-Tooth disease (CMT) was conducted in Molise, a central-southern region of Italy, from March 1998 to June 2000. Fifty-eight cases of CMT in 13 unrelated families were identified within the selected area. The prevalence of all subtypes of CMT was 17.5/100,000. All families underwent a bio-molecular analysis to disclose the duplication at gene locus 17p11.2 in order to ascertain the diagnosis of CMT type 1A. Our data revealed that 64% of all the observed patients had CMT1A, thus confirming the high prevalence of duplication of the 17p11.2 locus.

Homocysteine, vitamins and gene mutations in peripheral arterial disease

A case-control study was undertaken involving 51 consecutive patients with peripheral artery obstructive disease (PAOD) scheduled for angioplasty. Blood samples of these patients were analysed for plasma homocysteine (tHcy) and levels of vitamin B12 and folate, and the MTHFR gene was assessed for mutation. Patients were compared with age- and sex-matched controls who did not present with cardiovascular risk factors. Mean tHcy did not differ between cases and controls (13.3 +/- 5.7 and 12.6 +/- 4.9 micromol/l, P = 0.49). More patients were above the 95th percentile as determined from the data in the control group with an odds ratio (OR) that almost reached statistical significance [OR, 2.8; 95% confidence interval (CI), 0.9-8.7], but on separate analyses only female patients showed higher tHcy than female controls (15.6 versus 12.0 micromol/l, P = 0.05), with an odds ratio for tHcy above the 95th percentile of 10.5 (95% CI, 1.1-96.6). The TT genotype of the MTHFR gene was found in 24% of the patients and in 12% of the controls (OR, 2.3; 95% CI, 0.8-6.7). Our findings point to a modest association between tHcy and PAOD, with a difference between cases and controls restricted to the highest percentile in female patients. A weak but not significant association was also found for the TT genotype of the MTHFR gene.

[Boerhaave syndrome. A case report and review of the literature]

Spontaneous esophageal perforation (Boerhaave's syndrome) remains a difficult diagnostic and management problem with controversial recommendations regarding its treatment. The clinical manifestations of the disease are variable, and may be misleading, thus delaying accurate recognition. On the other hand, in view of the rapid onset of severe complications, particularly mediastinitis, a prompt diagnosis is essential to a better prognosis, successful operative outcome and potential survival. A case of spontaneous perforation of the thoracic esophagus penetrating the left pleural space treated within 4 hours from admission to the Emergency Room, with minimal surgical intervention is presented. Despite negative chest X-ray, a thoracic TC showed a small right sided effusion with left sided hydropneumothorax, and the definitive diagnosis was obtained by contrast study with a water soluble medium which showed the leak communicating freely with the left pleural space. The patient underwent repair by thoracic approach, the rupture was closed with a primary suture without flap reinforcement and the pleural space drained with the placement of single chest thoracostomy tube. The recovery was uneventful. The analysis of this case report and of the appropriate literature reveals that a poor prognosis is correlated with the time elapsed between the perforation and treatment. In conclusion the importance of an early aggressive surgical treatment for the Boerhaave's syndrome is emphasized, because any perforation treated more than 24 hours after the onset of symptoms, irrespective of the procedure used, is associated with a significantly higher morbility and mortality.

Preprogramming and control activity of bimanual self-paced motor task in Parkinson's disease

OBJECTIVE

The authors investigated programming (Bereitschaftspotential or BP) and control activity (Skilled Performance Positivity or SPP) of a bimanual, sequential, skilled motor act in off-therapy Parkinson's disease (PD) patients.

METHODS

We recorded Movement Related Potentials (MRPs) in 12, non-demented, off-therapy parkinsonian patients and in 17 control subjects who were performing a skilled, time-locked motor act, which was not routine in their everyday life but had to be learned: the Skilled Performance Task (SPT). BP, SPP and correct performances were evaluated in grand average waveforms and in sequential blocks.

RESULTS

The analysis of correct performances showed that accuracy in PD patients was significantly lower than in the control group and this accuracy did not improve throughout the blocks. A significantly low level of performances was associated with an increased BP amplitude (P<0.05) and decreased SPP amplitude (P<0.05) in PD patients.

CONCLUSION

Our findings suggest that skill motor learning is impaired in non-demented unmedicated PD patients. We discuss the view that PD patients may allocate more attentional resources, as suggested by the increased BP amplitude, the decreased SPP amplitude and the low correct performances, in order to perform a new skilled motor act.

Flow cytometric detection of p53 protein after incubation of a pre-B cell line with antitumor agents

BACKGROUND

The study of new substances capable of counteracting tumor development has focused, in recent years, on several of the steps in a cell's initiation of the process of apoptosis. One of the crucial events is the activation of p53, leading to a cell cycle G1/S block or to programmed cell death.

METHODS

We report here a parallel flow cytometric method for semiquantitative detection of p53 protein and apoptosis (percent of apoptotic cells) in a pre-B leukemic cell line (NALM-6) exposed to various antitumor agents (2.35 microg/ml etoposide; 0.175 microg/ml FCE296; 0.4 microg/ml FCE624; and 1.5 microg/ml L-PAM).

RESULTS

All of the substances proved to be capable of inducing an increase of p53 after 16 or 24 h of incubation. In all experiments with antitumor agents we also found an onset of apoptosis after 24 h of incubation with the substance, as determined by the annexin V flow cytometric assay and by DNA fragmentation.

CONCLUSIONS

This technique, based on flow cytometric data of both p53 intracellular content and percentage of apoptotic cells, is suitable to determine the amount of antitumor agent needed to induce p53, and thus to dose the drug in relation to the sensitivity of a defined tumor as well as choose the more efficacious drug, depending on cell responsiveness. The study of antitumor substances that induce apoptosis, bypassing p53, could also be evaluated by this method, in view of the development of substances for the treatment of p53-mutated tumors.

Follicular fluid proteins stimulate nitric oxide (NO) synthesis in human sperm: a possible role for NO in acrosomal reaction

Nitric oxide (NO) is a free radical involved in the regulation of several functions of the male genitourinary system. It is produced by neurons and the endothelium and epithelia of reproductive system; it mediates penile erection and regulates sperm motility, viability, and metabolism. Here we show that human spermatozoa exhibit a detectable NO synthase (NOS) activity, measured both as ability of the intact sperm and cell lysate to convert L-[3H]arginine into L-[3H]citrulline and as 24 h accumulation of extracellular nitrite in intact sperm suspensions. NOS activity (identified as an endothelial isoform) was inhibited by L-canavanine and N(G)-monomethyl-L-arginine, and nitrite accumulation was inhibited by the NO scavenger hemoglobin; both enzyme activity and nitrite production were increased by a 24 h incubation of spermatozoa with protein-enriched extracts of human follicular fluid (PFF); a significant increase of citrulline synthesis was observed only after a 4 h incubation with 40% PFF, a time period during which acrosomal reactivity was significantly increased. PFF-induced acrosomal reaction was inhibited by L-canavanine and hemoglobin, and the NO donors sodium nitroprusside (SNP), S-nitroso-N-acetyl-penicillamine (SNAP), and DETA NONOate were able to increase the percentage of reacted spermatozoa. Our results suggest that NO synthesized by human sperm may play a role in follicular fluid-induced acrosomal reaction.

Follicular fluid proteins stimulate nitric oxide (NO) synthesis in human sperm: a possible role for NO in acrosomal reaction

Nitric oxide (NO) is a free radical involved in the regulation of several functions of the male genitourinary system. It is produced by neurons and the endothelium and epithelia of reproductive system; it mediates penile erection and regulates sperm motility, viability, and metabolism. Here we show that human spermatozoa exhibit a detectable NO synthase (NOS) activity, measured both as ability of the intact sperm and cell lysate to convert L-[3H]arginine into L-[3H]citrulline and as 24 h accumulation of extracellular nitrite in intact sperm suspensions. NOS activity (identified as an endothelial isoform) was inhibited by L-canavanine and N(G)-monomethyl-L-arginine, and nitrite accumulation was inhibited by the NO scavenger hemoglobin; both enzyme activity and nitrite production were increased by a 24 h incubation of spermatozoa with protein-enriched extracts of human follicular fluid (PFF); a significant increase of citrulline synthesis was observed only after a 4 h incubation with 40% PFF, a time period during which acrosomal reactivity was significantly increased. PFF-induced acrosomal reaction was inhibited by L-canavanine and hemoglobin, and the NO donors sodium nitroprusside (SNP), S-nitroso-N-acetyl-penicillamine (SNAP), and DETA NONOate were able to increase the percentage of reacted spermatozoa. Our results suggest that NO synthesized by human sperm may play a role in follicular fluid-induced acrosomal reaction.

Resveratrol arrests the cell division cycle at S/G2 phase transition

Resveratrol (3,5,4'-trihydroxystilbene) is a naturally occurring phytoalexin, found in grapes and wine, which has been reported to exert a variety of important pharmacological effects. We have investigated the activity of resveratrol on proliferation and differentiation of the promyelocitic cell line HL-60. A concentration as low as 30 microM causes a complete arrest of proliferation and a rapid induction of differentiation towards a myelo-monocytic phenotype. Analyses by flow cytometry showed the absence of the G2/M peak and the accumulation of cells in G1 and S phases. Moreover, at the concentrations employed, a very low amount of apoptotic cells was evidenced. A detailed biochemical analysis demonstrated that the G1 phase of the cell division cycle engine was completely unmodified by resveratrol addition, thus indicating that the G1 --> S transition occurs normally. Conversely, after only 24 h treatment, a significant increase of cyclins A and E could be observed along with the accumulation of cdc2 in the inactive phosphorylated form. These data demonstrate that resveratrol causes a complete and reversible cell cycle arrest at the S phase checkpoint.

Low dosage clozapine effects on L-dopa induced dyskinesias in parkinsonian patients

OBJECTIVES

The aim of this study was to investigate the clinical efficacy of clozapine, an atypical neuroleptic, on L-dopa induced dyskinesias of Parkinson's disease.

MATERIAL AND METHODS

In an open study, a group of 10 PD patients was treated with low dosage clozapine (mean 30 mg/day) for a 4-month period and L-dopa dyskinesias were evaluated in basal conditions and during clozapine treatment after the usual morning dose of clozapine. We utilized the AIMS for evaluation of dyskinesias and UPDRS for the assessment of motor performances.

RESULTS

Clozapine produced a significant (P<0.05) reduction of dyskinesias 1 week after the therapy onset. This effect was more pronounced at the end of the 2nd week and remained stable through the following months. We did not observe significant variations of motor performances.

CONCLUSION

A low dose of clozapine appears to be beneficial for patients with L-dopa induced dyskinesias that do not respond to other drugs and therapeutic measures.

A novel flow cytometric method for the quantification of p53 gene expression

We describe a rapid and simple flow cytometry technique for the detection and quantification of p53 in several human cell lines, including an adenocarcinoma cell line (SW 626) having a mutant (m) p53, and a pre-B leukemia cell line (NALM-6) having wild-type (wt) p53. By introducing a second antibody coupled to RPE-fluorescence, the discrimination between control and specific peaks was improved over that achieved with methods used previously. To quantify the content of p53 molecules in the cells, we used a series of beads with the capability to bind mouse monoclonal IgG antibodies. p53 cell content, expressed as antibody binding capacity (ABC), was directly quantified from logarithmic scattergrams; the results were reproducible in all cell lines tested. Flow cytometric results were compared with those of a standard immunocytochemistry method routinely used for the detection of p53 in cells, and found to be in correlation. Furthermore, cytometric data also reflect ELISA determinations. In summary, we showed for the first time that (i) p53 can be clearly detected by flow cytometry in various cell lines, (ii) p53 can be quantitated in terms of number of molecules per cell, and (iii) it can be easily monitored as a function of time after stimulation.

Effects of spontaneous chronic hypoglycemia on central and peripheral nervous system in insulinoma patients before and after surgery: a neurophysiological follow-up

To investigate the effects of spontaneous chronic hypoglycemia on the peripheral and central nervous system, a multimodal neurophysiological evaluation [median somatosensory (mSEP), brain stem auditory (BAEP), and visual (VEP) evoked potentials recordings] was performed in seven insulinoma patients before and 3 and 6 months after surgical removal of tumor. Before surgery, mSEP findings showed abnormal reduction in peripheral wrist-Erb conduction velocity in three patients as well as a pathological increase in Erb-N13, N13-N20, and Erb-N20 conduction times in five cases. BAEP and VEP recordings gave pathological results in two patients. Moreover, during hypoglycemia, the III-V and I-V interpeak latencies of BAEPs were significantly prolonged (P < 0.01 and P < 0.005, respectively) compared to recordings in euglycemia. After 6 months, a mSEP recovery, even if partial was noted in four patients, BAEPs were normalized in one case, and VEPs were unmodified. Compared to presurgery data, these recordings showed a significant (P < 0.05), but incomplete, shortening of BAEPs (III-V and I-V interpeak latencies) and mSEPs (Erb-N13 and Erb-N20 conduction times). Our findings demonstrate that multiple and selective neurophysiological abnormalities are present in insulinoma patients, confirm that hypoglycemia impairs suddenly brain stem function, and show that after tumor removal, long recovery times for improvement of some neurophysiological anomalies are requested.

Nature's motility blockers: controlling human sperm motility machinery from the outside. Chemical characterization of a peritoneal fluid lipid that induces sperm immobilization

A molecule isolated from the peritoneal fluids of women undergoing laparoscopy for in-vitro fertilization techniques has been chemically characterized and identified as 1-palmitic-3-phosphorylcholine (lysophosphatidylcholine, LPC). This lipid is able, at physiological concentrations, to completely inhibit sperm motility in vitro in a dose-dependent way. Synthetic LPC induced rapid and complete arrest of sperm motility when added to sperm suspensions at physiological concentrations without any damage to cell membranes. Taken together, these results suggest that LPC may represent a previously unrecognized in-vivo modulator of human sperm motility.

Multimodal evoked potentials in HIV-1-seropositive patients: relationship between the immune impairment and the neurophysiological function

Multimodal evoked potentials (PRVEP, BAEP, mSEP) were recorded in 56 HIV-1 seropositive outpatients free from opportunistic CNS pathologies and/or overt HIV-1 encephalopathy. EPs were altered in 17 of 39 (43.6%) seropositive subjects without AIDS (group A) and in 13 of 17 (76.5%) patients with AIDS (group B). A high incidence of subclinical alterations (30.8%) were found in group A patients. Significant BAEP (I-III, III-V, I-V) interpeak latency and mSEP (N9-N13, N9-N20) conduction time prolongations were found in group A and B patients. PRVEP P100 was significantly prolonged only in group B. An inverse relationship between BAEP interpeak latencies and CD4 count was found. Our findings support the hypothesis of an important role of immunodepression in the development of neurophysiologic abnormalities, together with a preferential involvement of acoustic pathways, in the course of HIV-1 infection.

Detection of chromosome 11 alterations in blood and bone marrow by interphase cytogenetics in mantle cell lymphoma

The t(11;14)(q13;q32) translocation is a consistent chromosome change in mantle cell lymphomas. This study investigates the application of fluorescent in situ hybridization (FISH) with chromosome painting probes for interphase cytogenetic analysis in patients with mantle cell lymphomas. Chromosome 11 paints have been able to show splitting of the chromosome signal consistent with the t(11;14) translocation in interphase cells from bone marrow and blood of patients with mantle cell lymphomas. These include some in clinical remission. The chromosome probes conjugated with fluorescent molecules are hybridized with patient's DNA allowing the easy detection of chromosome 11 abnormalities with fluorescent-light microscopes. Interphase FISH has a higher sensitivity and is quicker than standard metaphase cytogenetics. This may be beneficial in rapid detection of chromosome 11 abnormalities, assisting in the diagnosis of mantle cell lymphomas. In addition, detection of a clonal population of cells is possible.

Predictive value of neurological abnormalities in HIV 1 patients in the early stages of the infection

A longitudinal clinical neurological and electrophysiological follow-up study was carried out on 31 HIV1 seropositive outpatients in the asymptomatic or LAS stages of the infection (CDC II-III). The results of clinical examination and multimodal evoked potentials (EP) recording showed a high percentage of abnormalities (42% and 39% of cases respectively); in a statistically significant number of subjects these abnormalities were predictive of subsequent immunological deterioration, thus demonstrating the close relationship between neurological and immunological functions in HIV1 infection.

Influence of peritoneal fluid from spontaneous and stimulated cycles on sperm motility in vitro

Peritoneal fluids (PFs) from spontaneous (n = 14) and gonadotrophin-stimulated cycles (n = 20) were obtained during diagnostic laparoscopy and gamete intrafallopian transfer (GIFT) procedures, respectively. The effects of these fluids on the linear component of sperm motility and on the percentage of motile spermatozoa were studied in vitro by objective motility assessments and compared to a control medium (B2-Ménézo). Overall, the two types of PFs were found to have rather similar effects on the motility parameters studied. However, the fluids from hormonally-stimulated cycles sustained motility better (i.e., sperm velocity and percentage of motile sperm) and in a rather constant manner as a function of time (narrower range distributions of the motility measurements). Furthermore, it was observed that under identical experimental conditions motility measurements depended not only on the type of PF used but also on the sperm sample. These results suggest that assisted reproduction procedures in which PF is the medium where the gametes eventually meet and interact, such as direct peritoneal insemination (DIPI) or peritoneal oocyte and sperm transfer (POST), could have different success rates if performed in spontaneous rather than in stimulated cycles. At the same time, our results may help to explain why different pregnancy rates were reported in different studies using DIP or POST.

Effect of volumetric mixtures of peritoneal and follicular fluid from the same woman on sperm motility and acrosomal reactivity in vitro

OBJECTIVE

To study the effect of peritoneal (PF) and follicular fluids (FF from the same woman) as well as of given volumetric combinations thereof on sperm motility and acrosomal reactivity.

DESIGN

Prospective. Peritoneal fluid and FF were incubated separately or in given volumetric combinations (PF/FF = 100/0, 75/25, 50/50, 25/75, 0/100; vol/vol) with swim-up sperm suspensions.

SETTING

In vitro fertilization and general infertility clinic and laboratories.

PATIENTS, PARTICIPANTS

Women participants of the gamete intrafallopian transfer program (motility study, n = 20; acrosomal reaction study, n = 14). Sperm donors of the artificial insemination program and men with given sperm parameters.

INTERVENTIONS

Hormonal stimulation. Laparoscopy.

MAIN OUTCOME MEASURES

Progressive velocity and percentage of motile gametes measured with multiple-exposure photography. Acrosomal reactivity measured by an immunofluorescent technique.

RESULTS

Follicular fluid always influenced progressive motility and also sustained the number of motile gametes, as function of time, better than PF or the PF/FF mixtures (P less than 0.05). The acrosomal reactivity of sperm incubated in the various PF/FF combinations was low; after 5 hours only the FF-sperm suspensions showed a significant enhancement of acrosomally reacted gametes.

CONCLUSION

At ovulation, FF transmit positive (motility- and acrosomal reactivity-enhancing) signals to sperm, whereas PF may transmit positive, neutral, or negative signals (noise signals). The volumetric combination of FF and PF in the tubal environment, which may differ from cycle to cycle and from woman to woman, could therefore result in synergic (or antagonistic) effects on the sperm fertility potential.

Removal of sperm-coat from human spermatozoa by interaction with cervical mucus or a capacitating medium

Human spermatozoa were labelled with cationized ferritin and their interaction with cervical mucus or a capacitating medium enriched with 3% bovine serum albumin (BSA) was investigated by transmission electron microscopy. It was found that the sperm-coat was removed from the surface of spermatozoa after incubation in the BSA-enriched capacitating medium, as well as after crossing a column filled with cervical mucus. These results suggest that both media have a quantitatively similar action in removing the sperm-coat.

Monitoring of somatosensory evoked potentials in cerebral ischemia: an experimental model

We have studied Mongolian gerbils using somatosensory evoked potentials (SEP) recordings before, during and after an ischemic event. In six experimental animals, cerebral ischemia was reproduced by clamping both carotid arteries for ten minutes. Two recordings were made during this period at 4' and 8'. An additional four recordings were made after removal of the clamp at 4', 8', 12' and 20'. Four animals were utilized as a control group, and were subjected to the identical experimental protocol, with the exclusion of carotid artery clamping. During ischemia we observed an evident alteration of the SEP recordings in the experimental animals, and a more or less rapid recovery during the post-ischemic period. This experimental model may be useful for the monitoring and the evaluation of the evolution of cerebro-vascular damage during the post-ischemic period.

Effect of peritoneal fluid on sperm motility and velocity distribution using objective measurements

The aim of this study was to analyze in vitro the effect(s) of peritoneal fluid (PF) on sperm motility. Seventy PFs obtained during laparoscopy were tested on motile-rich sperm suspensions. Proportion of motile sperm and velocity distribution were evaluated by multiple-exposure photography technique. At time (t) = 0, PFs increased both sperm parameters as compared with control (P less than 0.01). Maximum effect was observed at t = 5 hours: 32 (45%) PFs increased and 5 (7%) decreased the proportion of motile sperm, while 8 (11%) PFs increased and 4 (6%) decreased sperm velocity. No correlation was found between a particular infertile group and a definite negative effect. However, 70% of PFs from fertile women maintained or increased the proportion of motile sperm at t = 5 hours, compared with 36% in the total infertile group. Comparison of the sperm motility effect(s) of a given PF on different ejaculates revealed that the effects observed also were influenced by the sperm sample tested. In conclusion, PFs can maintain or increase the motility of spermatozoa as function of time. However, some PFs can inhibit sperm motility and these effect(s) can be influenced by the sperm sample.

[Evaluation of cerebral circulation in the presence of carotid vessel changes]

The importance of transcranial Doppler sonography (TCD) use in the presence of extracranial carotid artery diseases (occlusions, stenosis, parietal irregularities) is discussed. The preliminary data, obtained from 25 patients and as many normal subjects, show a significant correlation in the two groups, between blood flow velocities in the middle (MCA) and anterior cerebral arteries (ACA).

Short-latency sinusoidal wavelets to bright flashed stimuli: studies with corneal lens, nasopharyngeal, retrobulbar and scalp recordings

Short-latency flash visual evoked potentials (VEPs) and electroretinograms (ERGs) were recorded in 30 healthy volunteers and 14 patients (7 with retrobulbar neuritis and 7 with retinitis pigmentosa). Simultaneous recordings were performed by corneal, scalp, nasopharyngeal and retrobulbar (5 patients) electrodes. In 18 out of 30 healthy controls a brief sequence of oscillating wavelets was recorded between 15 and 40 ms on the scalp sites behind the vertex. In retrobulbar neuritis (RBN) patients normal responses were recorded by lens, retrobulbar, nasopharyngeal and frontal scalp electrodes. On the contrary none of these patients displayed short-latency activity behind the Cz scalp position. In 5 out of the 7 patients with retinitis pigmentosa, corneal, nasopharyngeal and scalp electrodes failed to detect any reliable waveform time-locked to the flash onset. In the remaining 2, a small lens ERG was recorded, while all other electrodes recorded a sequence of low-volted wavelets initiating 30 ms after the stimulus onset. In these patients an occipital VEP reduced in amplitude and with prolonged latency was also recorded. It is concluded that in presence of a normal corneal ERG because of the presence of volume spread oscillating retinal activity, it is hard to define while part of the scalp recorded, short latency, oscillating potentials is generated in subcortical visual structures.

Partial purification of lymphoblasts after in vitro immunization increases the yield in Ig-producing hybridomas

Using in vitro immunization with a human plasma protein (apolipoprotein-A1) as antigen, we have shown that it is possible to prepare more monoclonal antibodies using a ten-fold lower concentration of antigen compared to in vivo immunization procedures (Weech et al., 1985). In addition, we can increase the number of Ig-producing hybridomas after in vitro immunization by a simple one-step separation of the lymphoblasts on a Percoll gradient before the fusion procedure. In order to apply this procedure to in vivo immunization techniques, it is necessary to expand the B-blast/plasma cell population by culturing the spleen cells for 4-6 days before fusion. Only antibodies of the IgM class were produced with the in vitro technique. However, by combining in vivo priming with in vitro immunization, it is possible to produce specific antibodies to both IgG and IgM classes.

Synthesis of anticholinergic agents: N-methyl-4-piperidinyl alpha-benzoyloxy-alpha-cyclopentylphenylacetate salts

The synthesis of a new anticholinergic agent, N-methyl-4-piperidinyl alpha-benzoyloxy-alpha-cyclopentylphenylacetate, obtained by reacting N-methyl-4-piperidinyl alpha-cyclopentylmandelate with benzoyl chloride in the presence of methyllithium, is reported. This material may be useful as an antiperspirant.

New compounds: addition products of heterocyclic chalcones

Michael-type adducts, 1,3-heterocyclic-3-mercaptopropan-1-ones, were prepared by the base-catalyzed reaction of heterocyclic chalcones with thiols. These new compounds were found to be active as fungicides.