Bengt Fredricsson

Morphology of Postcoital Spermatozoa in the Cervical Secretion and its Clinical Significance

Morphologic analysis of spermatozoa recovered 10 hours postcoitally from the human female genital tract and its correlation to the clinical situation have shown that (1) spermatozoa in the vagina are equivalent to those in the semen sample; (2) spermatozoa within the cervical secretion exhibit significantly better morphology than do those of the semen sample, indicating the presence of a barrier against abnormal spermatozoa at the level of the external os; (3) this barrier is significantly more effective in cases where conceptions later occur than in cases of persistent, unexplained infertility; and (4) the barrier is particularly active against spermatozoa with abnormal heads.

Morphologic Evaluation of Spermatozoa in Different Laboratories

Morphologische Auswertung von Spermatozoen in verschiedenen Laboratorien

Studies on the ultrastructure of the human oviduct epithelium in different functional states

SummaryThe ultrastructure of the ampullar epithelium of the human oviduct was studied in 9 women in different phases of the sexual cycle and in pregnancy.Both kinds of cells (secretory and ciliated) showed morphological signs of micropinocytotic activity during the follicular phase, but no such activity during the luteal phase. Thus cyclic variations were observed in both ciliated and secretory cells. The secretory cells were provided with an extraneous coat, which was most conspicuous during the follicular phase. The Golgi apparatus was large. The mitochondria had transversal cristae. The endoplasmic reticulum consisted of cisternae with partly granular membranes. The ribosomes were partly membranebound and partly free. The appearance of the endoplasmic reticulum and the distribution and frequency of the ribosomes varied with the functional states. The ciliated cells were not provided with an extraneous coat. The Golgi apparatus was small. The mitochondria were numerous and had transversal cristae. Multivesicular bodies and dense bodies occurred in the nuclear region. Cilia as well as centrioles were provided with striated rootlets.

Comparison of Oral and Vaginal Metronidazole Therapy for Nonspecific Bacterial Vaginosis

A prospective, randomized, nonblind study was performed to compare the efficacy of a 7-day vaginal regimen with 500 mg metronidazole (Flagyl) once a day and that of oral treatment with 400 mg metronidazole twice daily for 7 days in the treatment of nonspecific bacterial vaginosis. No treatment was given to the sexual partners and there was no restriction of sexual intercourse. 38 women completed the study and at follow-up after 4 weeks, women receiving vaginal therapy had a cure rate of 79% compared with 74% in the women on oral therapy. Cure rates were lower among users of an intrauterine contraceptive device (57 versus 88% among nonusers). The occurrence of lactate-producing bacteria (lactobacilli and aerobic streptococci) in the vagina was significantly higher in women after vaginal compared with oral therapy. Gardnerella vaginalis was isolated in 58% of the women after vaginal and in 44% of the women after oral treatment. It is concluded that vaginal application of 500 mg metronidazole daily for 7 days is equally effective as oral administration in the treatment of bacterial vaginosis.

The bovine oviduct epithelium and its secretory process as studied with the electron microscope and histochemical tests

SummaryThe epithelium of the bovine oviduct was studied with respect to its ultrastructural organization and histochemical features.The ciliated cells seem to undergo no changes during the sexual cycle. The nucleus is regular, the mitochondria are small and frequent. Particles resembling lysosomes are present. Except for the free surface, containing alkaline phosphatase, these cells do not present any particular histochemical characteristics.The secretory cells contain more ribonucleic acid than the ciliated cells, and the endoplasmic reticulum is better developed. This also shows changes correlated with the sexual phases, thus the cisternae are much larger during the follicular phase than during the luteal phase. The nucleus is deeply fissured, the cisternae of the ergastoplasm dipping into these fissures. The mitochondria are larger and less frequent than in the ciliated cells. Secretion granules are frequently present. They are basophilic and periodic acid-Schiff reactive. They seem not to contain glycogen. The granules undergo characteristic changes and are subsequently discharged. This process is not paralleled by any changes in the histochemical reactions studied.Tests for the demonstration of lipids, non-specific esterase, and acid phosphatase did not give information that could be correlated to the ultrastructural organization.

Bacterial Vaginosis Is Not a Simple Ecological Disorder

Eighty-four patients with bacterial vaginosis were examined in an open randomized trial, the aim of which was to define clinical results and the microbiological panorama after topical treatment for 1 week with either an acetic acid jelly (A), an estrogen cream (B), a fermented milk product (C) or metronidazole (D). After exclusion because of chlamydia infection (15 cases) or for other reasons, 61 cases remained for complete evaluation 4 weeks after the start of treatment. Clinical cure was obtained in 3 cases out of 17 on regimen A, in 1 out of 16 on regimen B, in 1 of 14 on regimen C, and in 13 out of 14 on regimen D. The patients were conclusively either symptomless or symptomatic when examined on 113 occasions. Statistically significant reduction after treatment resulting in relief of symptoms was observed in the numbers of corynebacteria and anaerobic cocci, whereas lactobacilli increased in numbers. The instillation of high numbers of Lactobacillus acidophilus (C) into the vagina cured only 1 patient and did not influence the predominance of lactobacilli in the vagina at the follow-up examination. The difference in microbiological profile of women in symptomatic and asymptomatic conditions becomes still more apparent when the results of the present and previously published studies on the subject by the present group of investigators are combined. The symptomatic woman is significantly more often harboring corynebacteria, Gardnerella vaginalis, peptostreptococci, peptococci, eubacteria and Bacteroides species. Lactobacilli are significantly reduced in numbers. However, only 51 % of our previously symptomatic, but now symptomless women show predominant growth of lactobacilli, which is less than expected for healthy women. Therefore, lactobacilli may not be the specific factor that protects against bacterial vaginosis.

Systemic concentrations of metronidazole and its main metabolites after intravenous oral and vaginal administration.

Metronidazole kinetics was studied in 5 healthy women after a single dose given intravenously, orally or vaginally, 500, 400 and 500 mg, respectively. Serum levels of the drug and of its hydroxy and acid metabolites were assessed. The results after intravenous and oral boluses were consistent with previous reports. After vaginal dose maximum serum levels of about 1 microgram/ml of the drug were obtained between 9 and 24 h after the dose. Maximum concentration of the hydroxy metabolite was about 0.3 microgram/ml after 24 h. Bioavailability of the drug was 19 +/- 3% after the vaginal dose as compared to 100 +/- 5% after the oral dose. Daily insertion into the vagina of 500 mg metronidazole resulted in a maximum serum concentration of 1.2 +/- 0.2 microgram/ml of the parent drug and of 0.6 +/- 0.1 microgram/ml of the hydroxy metabolite after about 3 days (range 2-4) after which no accumulation was noted. Urinary excretion of the metabolites was considerably lower after vaginal than after intravenous or oral administration, but the proportion between the two metabolites in the urine was constant.

On the development of different morphologic abnormalities of human spermatozoa.

Über die Entwicklung verschiedener morphologischer Fehlbildungen von menschlichen Spermatozoen

Could Bacterial Vaginosis Be Due to the Competitive Suppression of Lactobacilli by Aerobic Microorganisms

Bacterial vaginosis (BV) is characterized by lack of lactobacilli and predominance of anaerobic species. Ciprofloxacin is active against a great number of aerobic bacteria. The effect of ciprofloxacin on the vaginal microbial flora was studied both in healthy subjects and in patients with BV in order to test if BV may be due to competitive suppression of lactobacilli by aerobic species. About half of the patients were relieved of their symptoms. No adverse effects on the microbial profile or colonization by lactobacilli were produced by the drug. Lactobacilli known to be able to produce hydrogen peroxide were found to be significantly more common in healthy women than in women with BV. The species most frequently related to vaginal health were Lactobacillus jensenii and Lactobacillus rogosae.

Gardnerella-Associated Vaginitis and Anaerobic Bacteria

12 patients with mild or moderate symptoms of Gardnerella-associated vaginitis were examined clinically and microbiologically on 52 different occasions, 27 of which were asymptomatic. The symptomatic state was defined by fulfilling at least three of the following criteria: (1) subjective symptoms; (2) pH above 4.5; (3) positive amine test, and (4) clue cells in wet smear. Variation of the vaginal microflora was considerable. No causative bacterial species could be identified. Microorganisms of the genus Bacteroides were significantly (p less than 0.02) more often found in the symptomatic condition. The presence of either peptococci , peptostreptococci or anaerobic streptococci was similarly related to symptoms (p less than 0.01). Lactobacilli were significantly more often present when the patient was free of symptoms (p less than 0.05). Gardnerella vaginalis was a common isolate whether the patient suffered from symptoms or not. It is concluded that the presence of this microorganism indicates a disturbed ecologic situation within the vagina, resulting in loss of predominance of lactobacilli and hence liability to develop symptoms.