No abstract

A prerequisite for the success of intracytoplasmic sperm injection (ICSI) is the use of viable sperm that will support oocyte activation and embryo development. Usually, spermatozoa are selected according to motility, which is a clear indication for viability. However, in cases with complete asthenozoospermia, it is impossible to select viable sperm by morphological means. Here we report for the first time on the use of a laser to discriminate between viable and dead immotile spermatozoa. The application of a single laser shot to the far end of the sperm tail causes a curling of the sperm tail only in viable sperm, similar to the reaction observed in the hypo-osmotic swelling test. Using this method for sperm selection prior to ICSI we achieved high fertilization and cleavage rates in cases with immotile sperm in fresh testicular biopsy material as well in cases with ejaculated immotile sperm. It is concluded that laser sperm interaction allows for the identification of viable but immotile spermatozoa.

A study of 84 patients who were diagnosed with epididymo-orchitis between July 1987 and September 1993 is presented. Brucellosis was a complication in 14 cases (17%). All 14 cases had elevated agglutination titers. Brucella blood culture was found to be positive in 4 of 14 cases (28.5%). Standard therapy regime (streptomycin plus tetracycline) was effective in 13 of 14 (93%) cases.

Ischemia-reperfusion injury in rat kidneys most probably comes from oxidative stress, but the possible preventive effect of alpha-tocopherol (AT) treatment on this injury has not yet been established. Forty male Wistar rats were randomly divided into four groups. The left renal arteries of all rats except the controls were clamped to induce renal ischemia. The left kidneys of the rats in the ischemia group were removed following 40 min ischemia. The rats in the ischemia-reperfusion and ischemia-reperfusion-AT groups were treated similarly, but in these groups the renal arteries were re-perfused for 1 h following ischemia. The rats in the ischemia-reperfusion-AT group also received 10 mg/kg AT 3 h prior to ischemia. The specimens were examined histopathologically and ultrastructurally, and the tissue calcium levels were measured. Light microscope and ultrastructural examination showed that the greatest damage occurred in the ischemia-reperfusion group. The highest level of tissue calcium was also found in this group. In the ischemia-reperfusion-AT-treated group, less tissue damage and a lower tissue calcium concentration was found compared to both the ischemia and ischemia-reperfusion groups. Our results indicate that AT can reduce tissue damage after ischemia-reperfusion injury.

Objective: To determine the efficacy of intrarectal lidocaine gel alone and a combination of lidocaine gel with 2 different longer-acting local anesthetic (LA) agents that were injected into the periprostatic area before transrectal ultrasound-guided prostate biopsy. Patients and Methods: One hundred patients undergoing transrectal prostate biopsy were randomized into 4 groups of 25 patients each. Before the biopsy, group 1 received no local anesthesia, group 2 received 2% lidocaine gel intrarectally, group 3 received intrarectal lidocaine gel and 5 ml bupivacaine (0.25%) injected into periprostatic area, and group 4 received lidocaine gel intrarectally and a 5-ml ropivacaine injection (0.25%) in the same location as group 3. Pain levels during and after the biopsy were assessed by using a 10-point linear visual analog scale (VAS). Results: Patients in groups 3 and 4 had significantly lower VAS scores than those in groups 1 and 2, both during and 1 h after biopsy. There were no differences in the pain scores between groups 1 and 2. Conclusion: The combination of intrarectal lidocaine gel and periprostatic longer-acting LA agents significantly reduces the pain related to prostate biopsy, whereas intrarectal lidocaine gel administration alone does not reduce pain. Thus, administration of the periprostatic longer-acting LA agents alone is adequate.