C. Scandellari

Assessment of testicular cytology by fine needle aspiration as a diagnostic parameter in the evaluation of the azoospermic subject

OBJECTIVE To investigate whether testicular cytology by fine needle aspiration (FNA) may be considered a diagnostic parameter in the evaluation of the azoospermic subject. DESIGN Cytologic smears were obtained using a 23-G needle, stained with May-Grünwald-Giemsa stain and examined under a light Orthoplan microscope (Wild, Leitz, Germany) for qualitative and quantitative analysis. PATIENTS Fifty-four azoospermic patients were analyzed, and the findings were compared with those obtained from 40 normozoospermic infertile subjects used as controls. MAIN OUTCOME MEASURE(S) Two hundred spermatogenic cells were counted and classified at the various steps of spermatogenesis. Spermatic index and Sertoli index provided further elucidations and more comprehensible results. RESULTS No sign of traumatization was observed. Cytologic analysis was proved to have high statistical reproducibility (P less than 0.01 for spermatogonia and secondary spermatocytes and P less than 0.001 for the other cell types, when compared between differential counts) and permitted identification of different situations associated with azoospermia: Sertoli cell-only syndrome, germ depopulation (hypospermatogenesis), spermatogonial arrest, spermatidic arrest, and obstructive azoospermia. These findings agreed with clinical and hormonal parameters and with the results of bilateral surgical biopsies, when performed. CONCLUSIONS The results support use of FNA of the testis as a noninvasive diagnostic parameter for the assessment of azoospermic subjects.

Effect of chlorpromazine on blood glucose and plasma insulin in man

SummaryIn three groups of normal subjects and in one group of patients with latent diabetes mellitus a study has been made of the effects of chlorpromazine (CPZ) on blood glucose and plasma insulin. CPZ 75 mg/day for 7 days did not alter the plasma insulin response after oral glucose; nor did CPZ 50 mg/day for 7 days affect the glucose assimilation rate or insulin response to glucose injection. Infusion of CPZ 50 mg in 60 min slightly increased the basal blood glucose level but had no significant effect on basal plasma insulin. The insulin/glucose ratio after the end of the infusion was significantly higher than during the period of infusion of the drug. In latent diabetic patients CPZ infusion significantly diminished the insulin/glucose ratio during an intravenous glucose tolerance test. These results suggest that, whereas prolonged treatment with low doses of CPZ did not modify glucose tolerance and glucose-stimulated pancreatic response, higher acute doses of the drug may induce hyperglycaemia and can inhibit insulin secretion both in normal man and in patients with latent diabetes mellitus.

Testosterone and calcitonin plasma levels in hypogonadal osteoporotic young men

The aim of this study was to ascertain whether there was an interrelationship between male osteoporosis, calcitonin and androgens. Ten young hypogonadal osteoporotic men were studied: testosterone and calcitonin plasma levels were measured before and after therapy with testosterone enanthate (200 mg im every three weeks for four months). In these patients testosterone and calcitonin plasma levels were significantly lower than controls, before therapy (p < 0.001 and p < 0.01 respectively). Testosterone treatment significantly increased (p < 0.05) serum calcitonin. The conclusion was that androgen deficiency may cause osteoporosis also by decreasing calcitonin secretion.

Gonadal steroids and opioid control of gonadotropin secretion in man

The aim of this study was to ascertain whether there was an interrelationship between gonadal steroids and endogenous opioid peptides. The effects of naloxone (20 mg, intravenously) and of a met-enkephalin analog (DAMME) (250 micrograms, intravenously) on gonadotropin secretion in three castrated men (18 to 23 years of age) and in five age-matched normal men were studied. Normal subjects were studied before and after treatment with a specific nonsteroidal estrogen receptor antagonist, clomiphene. Naloxone caused a significant increase in luteinizing hormone (LH) (P less than 0.05); in these subjects, clomiphene treatment significantly increased LH and follicle-stimulating hormone plasma levels but totally suppressed the naloxone-induced rise in LH. In castrated men, naloxone failed to increase plasma LH levels. However, DAMME significantly reduced plasma LH levels in normal, in castrated, and in clomiphene-treated normal subjects. The results demonstrate that in castrated subjects who lack gonadal steroids and in normal subjects with blocked estrogen receptors there is a reduced opioid inhibitory tone on gonadotropin secretion. The effect of DAMME on gonadotropin secretion, however, is not influenced by the gonadal steroid environment.

Calcitonin in Human Seminal Plasma and its Localization on Human Spermatozoa

Summary:  We determined the calcitonin (CT) levels in peripheral plasma and in seminal fluid of 15 normal human subjects: the concentration of the hormone in seminal fluid was about 30 times higher than the concentration found in peripheral plasma. We also studied the localization of calcitonin on human spermatozoa by means of an indirect immunofluorescent technique, using an anti‐human CT rabbit serum and a fluo‐rescein‐isothiocyanate conjugated goat anti‐rabbit immunoglobulins serum. A bright fluorescence was observed at the middle piece and neck, while the tails principal piece was weakly stained.

MRI in insulinomas: preliminary findings

After establishing the diagnosis of an insulinoma, most surgeons prefer preoperative localization. Selective arteriography is usually considered the gold standard for this purpose. Recently, computed tomography (CT) and preoperative US have contended the role to angiography. MRI has been used in few cases of endocrine pancreatic tumors, and its role in this particular field has to be defined. Between November 1988 and September 1990 we evaluated 7 adult patients who had had surgery in our Surgical Department. Eight tumors were resected in 6 patients who were cured; in an 18-year-old woman surgical treatment was unsuccessful. Arteriography, CT, preoperative US, MRI and intraoperative US detected 2, 6, 6, 5 and 6 tumors, respectively. Two insulinomas (0.2 and 0.7 cm) were found at histologic examination in resected specimen. The ability of intraoperative US and careful surgical exploration to resolve more than 90% of cases makes the preoperative use of arteriography and CT of questionable value. If further experience confirms these findings, US and MRI may suffice.

In vivo studies on 5-hydroxytryptamine and insulin secretion in dogs and in man

Summary5-Hydroxytryptamine (5-HT) effects on the insulin secretion of anaesthetized dogs and of humans were studied. From our investigations the following conclusions can be drawn: 5-HT when injected at a dose of 4.30 mg into the pancreatic artery, elicits a sharp rise of insulin concentration in pancreatico-duodenal vein; on the contrary, 21.50 mg of 5-HT is unable to modify insulin release. The infusion in fasting man of small amounts of 5-HT (∼ 0.50 μg/kg/min) during 1 h, does not alter blood glucose nor plasma insulin levels; a similar infusion, however, increases insulin response after oral glucose load. The results obtained in dogs are in agreement with the idea that 5-HT may modulate insulin release from the pancreas. The results in man suggest that enteramine released by the intestine may increase insulin secretion induced by the ingestion of glucose, through a fine interplay with other gut-factors.

Epidermal Growth Factor Receptors (EGFR) Localization in Human Testis

An indirect immunofluorescence technique was used to detect and localize epidermal growth factor receptors (EGFR) in human testicular biopsies in different testicular diseases. Monolateral biopsies from twelve infertile subjects were studied from qualitative/quantitative points of view and were examined by immunofluorescence study with anti-EGFR monoclonal antibody. Two different patterns of EGFR expression were observed: a very weak presence of EGFR was detectable on Sertoli cells, peritubular basal structures, and interstitial compartment in testicular biopsies showing a normal spermatogenic status; and an important increase in EGFR expression was observed on the cytoplasm of Sertoli cells and on peritubular basal structures in biopsies exhibiting various degrees of hypospermatogenesis and in a case of Sertoli cells only syndrome. Germ cells did not show EGFR immunolocalization. EGFR seems to be present on different testicular target cells. EGFR expression increases on peritubular and Sertoli cells in the presence of significant tubular damage.

Endothelin-1 and endothelin-3 stimulate insulin release by isolated rat pancreatic islets

Endothelins (ETs) are potent vasoconstrictive peptides released from the endothelium and other tissues, which act on target cells by receptorial calcium-mediated mechanisms. ET-1 levels are increased in diabetes, and observations suggest the involvement of ETs in the pathogenesis of diabetic angiopathy. However, it is not possible to exclude that ETs might also influence insulin secretion or function. In vivo infusion of ET-1 in rats induces hypoglycaemia and hyperinsulinemia and in vitro incubation with ET-1 stimulates insulin release by mouse islets. Therefore, ETs might be involved in a circulus vitiosus, resulting in hyperinsulinemia and diabetic angiopathy. The purpose of our study was to verify the effect of ET-1 on rat islets, in both the presence and absence of physiological glucose concentration. Moreover, we tested the effect of another isoform of endothelins, ET-3, and verified the involvement of extracellular calcium in such events. Islets were incubated with increasing ET-1 or ET-3, with or without glucose 5.6 mM. Other samples were prepared using calcium- free medium. Incubation in medium containing ET-1 and ET-3, in the presence of glucose and calcium, induced an increase in insulin release. When ET-1 and ET-3 were incubated without glucose and calcium, insulin release was not modified. Our studies demonstrate that: 1) ET-3, like ET-1, stimulates insulin release by rat isolated islets; 2) direct insulin stimulating effect on islets of both ET-1 and ET-3 is evident with physiological glucose concentrations and is calcium mediated. These results support the hypothesis of ET involvement in the regulation of insulin secretion.

Effects of a met-enkephalin analogue on motility, O2 consumption, and ATP content of human spermatozoa.

Opioid narcotics are present in seminal plasma, although their physiological effect on spermatozoa is still unknown. This study reports data on metabolic parameters of human spermatozoa in the presence of a met-enkephalin analogue: D-Ala2-Mephe4-Met-(o)-ol-Enkephalin, FK 33824, Sandoz, Basel, Switzerland (DAMME), and its receptor antagonist naloxone hydrochloride, Endo Laboratories, Garden City, New York. Our findings indicate that the metenkephalin analogue reduces sperm motility and cellular O2 consumption without affecting cellular ATP content and viability. The hypothesis that DAMME acts on adenylate-cyclase is briefly discussed.