The distribution of androgen and estrogen binding sites in the mouse epididymis was assessed by autoradiography with 3H dihydrotestosterone (3H DHT) and 3H estradiol (3H E2). Nuclear labeling with 3H DHT in principal cells of the epithelium is high in the caput, low in the corpus, and high again in the cauda. 3H E2 also binds to the nuclei of principal cells. The pattern is distinct from 3H DHT: nuclear labeling is highest in the ductulus efferens and high in the caput, but low or absent in corpus and cauda. Apical cells in caput and clear cells in corpus and cauda are moderately labeled with 3H DHT but heavily labeled with 3H E2. Connective tissue cells show variable labeling with both hormones, being more pronounced with 3H E2. Smooth muscle cells are also labeled to varying degrees with both hormones. The different binding patterns of 3H DHT and 3H E2 and the results of the competition studies with unlabeled compounds demonstrate that in the epididymis besides the specific nuclear receptors for androgen also estrogen receptors are present.

Testicular biopsy specimens from oligozoospermic infertile patients are characterized by different types of spermatogenic impairment in adjacent seminiferous tubules, a phenomenon called mixed atrophy. In order to evaluate possible involvement of the state of Sertoli cell differentiation, the distribution pattern of anti-Müllerian hormone (AMH), vimentin and cytokeratin intermediate filament proteins was investigated by means of immunohistochemistry. AMH immunoactivity occurs in Sertoli cells of the normal postnatal prepubertal testis, but it is absent in the adult testis with normal spermatogenesis. In the case of mixed atrophy, AMH immunoactivity was found in Sertoli cells of tubules showing spermatogenic arrest at the level of spermatogonia and in tubules showing Sertoli-cell-only (SCO) syndrome. Vimentin was expressed regularly in Sertoli cells independent of spermatogenic impairment or the state of Sertoli cell differentiation. Cytokeratin immunoactivity occurs in Sertoli cells of the normal postnatal prepubertal testis. Furthermore, cytokeratin expression was found in Sertoli cells of tubules showing spermatogenic arrest at the level of spermatogonia and in some SCO tubules. Co-expression of AMH and cytokeratin suggests that spermatogenic impairment such as spermatogenic arrest and SCO syndrome in human seminiferous tubules is associated with a population of Sertoli cells showing a prepubertal stage of development. The different pattern of AMH and cytokeratin expression in SCO tubules indicates that Sertoli cells in SCO syndrome show a mosaic pattern of differentiation.

Pulmonary tuberculosis (PTB) and pneumococcal community-acquired pneumonia (PCAP) are common causes of lower respiratory tract infections in HIV-seropositive patients and may have similar clinical and radiological features. This study aimed to assess the value of serum procalcitonin (PCT) and C-reactive protein (CRP) levels in HIV-seropositive patients with pneumonia, and to investigate their potential role in differentiating pneumococcal from mycobacterial infections.HIV-seropositive patients admitted with pneumonia were evaluated prospectively, 34 with PTB and 33 with PCAP.All 33 patients in the PCAP group and 20 of 34 patients in the PTB group had elevated PCT levels (.0.1 ng?mL -1 ). All patients in both groups had elevated CRP levels (.10 mg?L -1). The PTB group had significantly lower CD4 T-lymphocyte counts, lower CRP levels, lower white cell counts, and lower PCT levels than the PCAP group. Receiver operating characteristic analysis showed that optimal discrimination between PTB and PCAP could be performed at a cut-off point of 3 ng?mL -1 for PCT (sensitivity 81.8%; specificity 82.35%) and 246 mg?L -1 for CRP (sensitivity 78.8%; specificity 82.3%).In conclusion, HIV-seropositive patients with pneumococcal community-acquired pneumonia had significantly higher procalcitonin and C-reactive protein levels than those with pulmonary tuberculosis. A procalcitonin level .3 ng?mL -1 and a C-reactive protein level .246 mg?L -1 were both highly predictive of pneumococcal infection.

In an effort to evaluate the effect of hCG/human menopausal gonadotropin (hMG) treatment on semen parameters in normogonadotropic men suffering from oligospermia, a double blind, placebo-controlled study was conducted. After 2 basal examinations of seminal parameters and reproductive hormones, 39 men were recruited for the trial. Nineteen men, allocated randomly to the active drug group, received im injections of 2500 IU hCG twice a week in combination with 150 IU hMG three times a week for 13 weeks, while 20 men were treated, following the same injection schedule, with NaCl only. After the 13-week treatment period, follow-up examination was performed, followed by 3 additional examinations at 4-week intervals. Of those men receiving hCG-hMG, 2 induced pregnancies in their wives, while no pregnancies were reported in the placebo group. Sperm concentrations, the percentages of motile sperm, and the proportions of normally formed spermatozoa, however, were similar in the 2 groups at all times. It was not possible to predict the outcome of treatment based on results of GnRH and hCG tests performed before the treatment phase.

After injection of [3H]-1,25(OH)2-vitamin D3 (soltriol), nuclear labeling is found in Sertoli cells of testes, being highest at the stage of spermiosis, in epithelium of efferent ductules and caput epididymidis and in connective tissue cells of epididymis, in lamina propria and muscular sheath of deferent duct, and in epithelium and muscular sheath of dorsal and ventral prostate of the mouse. This labeling pattern is characteristic for [3H]-soltriol and differs from that for [3H]-dihydrotestosterone and [3H]-estradiol, although with overlap. The nuclear labeling with [3H]-soltriol suggests an action of the hormone on certain processes during spermatogenesis, on sperm maturation, on epididymal fluid resorption, and on secretion and transport of spermatozoa.

No abstract

A true hermaphrodite with a 46 XX/47 XXY karyotype, gynaecomastia, hypospadia and scrotal gonads was investigated. Gonadectomy performed at 14 years of age revealed bilateral ovotestes. The ovarian portion contained follicles of all developmental stages. The testicular portion was immature consisting of seminiferous cords with Sertoli cells at various steps of differentiation and few germ cells within massive aggregates of collagenous connective tissue. Leydig cells as well as germ cells remained in an embryonic stage of development. Sections of a differentiated Wolffian duct (ductuli efferentes, epididymis, vas deferens) as well as of a Müllerian duct (hypoplastic fallopian tube) were found adjacent to both gonads. Postoperative treatment consisted of androgen substitution therapy leading to progression of puberty.

Background and aims: Data in critically ill patients on the effect of intravenous lipid emulsions (LEs), containing omega-3 polyunsaturated fatty acids (PUFAs), in parenteral nutrition (PN) are scarce and conflicting. This study compared the effects of a four-oil LE (30% soybean oil, 30% medium-chain triglycerides, 25% olive oil and 15% fish oil (FO)) (SMOFlipid®) to those of a 100% soybean oil-based LE in critically ill adult intensive care unit (ICU) patients. Methods: In this double-blind, randomised study, patients (n ¼ 75) predicted to need PN for more than 5 days were randomised to receive either a four-oil LE (Study Group (SG)) or a 100% soybean oil LE (Control Group (CG)). Isocaloric, isonitrogenous PN was administered continuously for 5 days. FO was provided at a dose of 0.09e0.22 g/kg body weight. Measurements included biochemical parameters and sequential organ failure assessment (SOFA) score daily and plasma total phospholipid fatty acids (FAs) and cytokine levels on days 1, 3, 6. Days on mechanical ventilation, length of stay and mortality were also recorded. ANOVA was used to compare response variables between the two groups over the time and Pearson correlation was used to measure relationships between continuous variables. Results: 68 patients completed the study (n ¼ 35 SG, n ¼ 33 CG), with male predominance (66% SG, 56% CG). Average age was 60.8 ± 13.9 years (SG) versus 55.7 ± 14.8 (CG) (p ¼ 0.143). The majority were surgical admissions (85% SG versus 91% CG) followed by medical. Plasma phospholipid oleic acid (p ¼ 0.022) and alpha-linolenic acid (p<0.0005) increased in both groups. In the SG, plasma phospholipid EPA and DHA increased (both p<0.001), whereas the omega-6:omega-3 PUFA (n-6:n-3 PUFA) ratio decreased (p < 0.001). Aspartate aminotransferase (AST), alanine aminotransferase (ALT) and bilirubin decreased in both treatment groups. Considering only the change from day 1 to day 6 there was a bigger decrease in AST, ALT and bilirubin levels in the SG. Concentrations of TNF-a decreased from day 1 to day 6 in the SG, whereas they increased in the CG, but the change was not statistically significant (p ¼ 0.112). A significant negative correlation was found between EPA provision on day 3 and the SOFA score (r ¼ À0.4047, p ¼ 0.018). Days on mechanical ventilation (1.24 ± 0.83 days in SG versus 0.88 ± 1.63 days in CG, p ¼ 0.385) and ICU LOS (9.5 ± 7.09 days in SG versus 10.7 ± 7.6 days in CG, p ¼ 0.490) were not different between groups. Conclusion: PN containing a four-oil LE increased plasma EPA and DHA, decreased n-6:n-3 PUFA ratio, and was safe and well tolerated. The negative relationship between day 3 EPA and SOFA score seems promising, but EPA intake and effects may have been diluted by enteral nutrition which was started in more than half of patients on day 4. There was no significant difference in terms of other biochemical