Robert C. Eyre
Beth Israel Deaconess Medical Center
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Featured researches published by Robert C. Eyre.
The Lancet | 1997
Randal Byrn; Dezhen Zhang; Robert C. Eyre; Katherine McGowan; Ann A. Kiessling
/L, no known infected, andnormal genitourological examination at the time ofspecimen donation. Protease-gene sequences weredetermined for 11 blood and eight semen virus clones frompatient A who had not received antiretroviral therapy, andfrom nine blood and nine semen virus clones from patient Bwho had been on antiretroviral therapy for several years,including a protease inhibitor for 4 months. The sequenceswere aligned for maximum homology and phylogeneticanalysis were done (figure).Protease-gene sequences of all clones contained severalmutations relative to the reference virus, hxb2. Thephylogenetic analyses of the sequences from each patientrevealed two distinct families of viruses, one in the bloodand one in the semen. The differences between the familiesranged from four to seven or from four to eight aminoacidsubstitutions for patients A and B, respectively. Bloodclones from patient B contained mutations at aminoacidresidues 36(I), 54(V), 63(P), and 82(A), characteristic ofemerging resistance to the protease inhibitor. By contrast,protease resistance conferring mutations were not found inthe semen virus clones from patient B.These findings support the concept that semen HIV-1arises from a distinct reservoir of HIV-1 infection whichmay be isolated from antiretroviral therapy and mayfunction independently in the pathobiology of HIV-1disease. This suggests that consideration of the specialisedfeatures of the semen compartment needs to be included indisease monitoring and the design of treatment strategies.
Fertility and Sterility | 1995
Ann A. Kiessling; Nicholas Lamparelli; Hui-Zhong Yin; Machelle M. Seibel; Robert C. Eyre
OBJECTIVE To test the hypothesis that male reproductive tract leukocytes function in the elimination of abnormal spermatozoa from ejaculated semen. DESIGN Semen specimens with > or = 2 x 10(6) nonspermatozoal cells/mL were examined for leukocytes and for mature sperm with ideal morphology. SETTING Andrology laboratory of a Center of Assisted Reproductive Technology. RESULTS Semen specimens with elevated concentrations of leukocytes contained a significantly higher frequency of sperm with ideal morphology than semen specimens with elevated numbers of immature germ cells and low numbers of leukocytes. CONCLUSIONS The direct correlation between leukocyte density and sperm with ideal morphology supports the concept that sperm surveillance is a normal function of male reproductive tract leukocytes. Understanding such germ cell-leukocyte interactions may provide valuable new insights into immunologic control mechanisms in male reproductive tract tissues.
Urology | 2003
Elroy D. Kursh; Raoul Concepcion; Seck Chan; Perry B. Hudson; Mark Ratner; Robert C. Eyre
OBJECTIVES To investigate whether interstitial laser coagulation (ILC) is as effective and as safe as transurethral resection of the prostate (TURP). The treatment of choice for bladder outflow obstruction secondary to benign prostatic hyperplasia is TURP. However, ILC is a less invasive outpatient procedure that may be as effective and safe as TURP. METHODS In a multicenter randomized trial at six U.S. tertiary care hospitals, we treated 72 men with bladder outflow obstruction secondary to benign prostatic hyperplasia with either TURP (n = 35) or ILC (n = 37). The outcome measures were peak flow rate, postvoid residual urine volume, prostate volume, prostate-specific antigen levels, symptom and quality-of-life indexes, sexual function, and adverse event rates. Measurements were taken at baseline and at 3, 6, 12, and 24 months. RESULTS At 2 years, the TURP patients had better median peak flow rates, but not significantly so (range 16.5 to 13.9 mL/s, 95% confidence interval for the 2.6 mL/s difference of -0.4 to 7.6). The median scores on the symptom indexes and quality-of-life measures were similarly improved in both groups. Of 37 ILC patients, 6 (16%) were retreated with TURP in the first year. Sexual function declined in the TURP group but remained stable in the ILC group. The adverse event rates were similar, although the events were more serious in the TURP group. CONCLUSIONS ILC compares respectably with TURP. Given the advantages of an outpatient procedure, similar results in symptom reduction and quality-of-life measures, and less severe adverse effects, ILC can be an acceptable alternative to TURP.
The Journal of Urology | 1995
Jeffrey Steinberg; Robert C. Eyre
A case of recurrent priapism in a young black man without sickle cell anemia is reported. Due to almost daily episodes of prolonged painful erections, the patient was instructed in intracorporeal injection using an epinephrine self-injection kit, which provided complete detumescence on 31 occasions. The patient refused surgical intervention and was treated with monthly intra-muscular gonadotropin-releasing hormone analogue. Priapism episodes completely abated by the second and final monthly gonadotropin-releasing hormone analogue injection without recurrence during 4 months of followup. Normal erectile function was maintained during and after gonadotropin-releasing hormone analogue therapy. Epinephrine self-injection and gonadotropin-releasing priapism.
Urology | 2000
Robert C. Eyre; Gang Zheng; Ann A. Kiessling
The concept that the male reproductive tract harbors isolated reservoirs of human immunodeficiency virus (HIV) infection has now been widely accepted. The significance of semen viral burden to sexual transmission of HIV is obvious; however, its contribution to disease progression is unknown. We report a case study that demonstrates the emergence of resistance-conferring mutations to antiviral therapy in infected seminal leukocytes from a man with asymptomatic prostatitis associated with leukospermia. This finding demonstrates the potential importance of male reproductive tract organs to the development of therapy resistance in HIV-infected men.
Cancer | 1990
Abraham Mittelman; Mark S. Huberman; Carmelo Puccio; B. Fallon; J. Tessitore; S. Savona; Robert C. Eyre; Elizabeth Gafney; M. Wick; A. Skelos; P. Arnold; Tauseef Ahmed; Jerome E. Groopman; Zalmen A. Arlin; J. Zeffren; D. Levitt
Preclinical data suggest synergy of interleukin‐2 (IL‐2) combined with alpha‐interferon (IFN). In addition, toxicities of IL‐2 may be decreased by intermittent continuous infusion. The purpose of this trial was to determine the maximum tolerated dose (MTD) of recombinant IL‐2 combined with alpha‐IFN in patients with renal cancer, colon cancer, melanoma, and malignant B‐cell disease. IL‐2 was given by continuous i.v. infusion at an initial dose of 5 × 105 units (U)/m2/d for 4 days plus IFN at 6 × 106 U/m2/d intramuscularly days 1 and 4 weekly for 4 weeks. Patients who achieved a response or stable disease received an additional 4 weeks of therapy. IL‐2 doses were increased to 1, 2, 3, 5, and 7 × 106 U/m2/d with three to eight patients at each dose level, at each of the two participating institutions. The dose of IFN was 6 × 106 U/m2 days 1 and 4 for all but five patients whose IFN dose was doubled to 12 × 106 U/m2/d. Forty‐three patients were entered on this study with 34 completing at least 4 weeks of therapy. Six patients were taken off study because of Grades III or IV pulmonary, neurologic, or cardiac toxicity; one for progressive disease; one for CNS metastases, and one for personal reasons. All of the toxicities were reversible. Chills and fever were universal, especially on days 1 and 4. Mild and moderate nausea, vomiting, diarrhea, anorexia, malaise, and cutaneous erythema were present in most patients. Fluid retention and occasional pleural effusions were observed at the higher IL‐2 doses but were not dose‐limiting. Significant hypotension associated with oliguria was seen, and these patients were treated with vasopressors and colloids. None of the patients required ICU admission. Thirty‐four patients were evaluable for response. There were 4/18 (22%) renal cell patients who experienced a partial response. No responses were seen in patients with melanoma, lymphoma, or colorectal cancer. The combined debilitating symptoms of fatigue, diarrhea, hypotension, fluid retention, and anorexia defined the MTD as 5 × 106 U/m2/d of IL‐2 and 6 × 106 U/m2 of alpha‐IFN.
Fertility and Sterility | 2008
Ann A. Kiessling; B. Desmarais; Hui-Zhong Yin; Joseph Loverde; Robert C. Eyre
OBJECTIVE To detect and identify bacteria in semen by sequencing polymerase chain reaction (PCR)-amplified ribosomal RNA gene regions (rDNAs). DESIGN Bacterial rDNAs were detected by PCR amplification of semen DNA. Conditions were adjusted to detect only abundant organisms, no fewer than 20,000 bacteria/mL of semen. SETTING Clinical andrology laboratory and academic research laboratories. PATIENT(S) Men undergoing fertility evaluation (n = 29) or vasectomy (n = 5). INTERVENTION(S) None. MAIN OUTCOME MEAURE(S): Frequency of bacterial rDNA-positive specimens, relationship of rDNAs to bacteria in GenBank, and correlation with semen cells. RESULT(S) Twenty-five (56%) of the specimens from 22 (65%) of the men were positive. A total of 141 bacterial rDNA sequences were compared with GenBank data for identification. The largest group matched gram-positive anaerobic cocci (Peptoniphilis, Anaerococcus, Finegoldia, Peptostreptococcus spp.) in 13 specimens, followed by Corynebacterium spp. in 10 specimens, Staphylococcus, Lactobacillus, and Streptococcus spp. in 7 specimens each, Pseudomonas spp. in 4 specimens, and Haemophilus and Acinetobacter spp. in 2 specimens each. The rDNA-positive specimens averaged 59 +/- 13 million sperm/mL, 46 +/- 5% of which were motile, not statistically different from the rDNA-negative specimens (77 +/- 16 million/mL, 47 +/- 5% motile). Normal sperm forms were lower in the rDNA-positive (10 +/- 1.1%) than in the rDNA-negative specimens (22 +/- 2%), and lymphocytes/monocytes were fivefold lower in the rDNA-positive specimens (0.4 +/- 0.2 million/mL) than in the negative specimens (1.9 +/- 0.7 million/mL). CONCLUSION(S) Abundant bacteria in semen are not commensal, arise from infection in the male genitourinary tract, may influence fertility, and may reflect an inadequate cellular immune response.
AIDS Research and Human Retroviruses | 2002
Mari Okamoto; Randall Byrn; Robert C. Eyre; Thomas E. Mullen; Paul Church; Ann A. Kiessling
Immunosuppressive properties of seminal plasma inhibit the recovery of infectious HIV from semen, and led to the view early in the pandemic that semen HIV was transmitted principally by infected semen cells. More recent studies have revealed significant titers of HIV RNA in seminal plasma, however, even from men receiving successful antiviral therapy. Thus, studies of infectious HIV in seminal plasma are important to understanding sexual transmission and response to therapy. The present studies were undertaken to determine whether seminal plasma immunosuppression is mediated by the induction of programmed cell death (PCD). Peripheral blood mononuclear cells (PBMCs) were cultured without or with phytohemagglutinin and seminal plasma from normal donors, or men postvasectomy, or seminal vesicle protein collected at surgery. PBMC survival was measured at 3, 6, and 18 hr of culture; cells were examined for evidence of PCD by uptake of the fluorescent dye YO-PRO, and for fragmented nuclear DNA by the TUNEL assay. Approximately 90% of PBMCs cultured with seminal plasma from intact or vasectomized men were lost during 18 hr of culture; seminal vesicle protein did not induce cell loss. PCD assays were positive for PBMCs exposed to the seminal plasma, and negative for PBMCs cultured with seminal vesicle protein. Serum was not required for PCD induction. A 3-hr pulse with seminal plasma was sufficient to initiate PCD. These findings indicate that PCD induction accounts for the cytotoxic properties of semen, that the PCD is not the result of semen amine oxidases, and either that substances produced by seminal vesicles only at ejaculation, or by the prostate, are responsible for PCD induction.
The Journal of Urology | 1986
Robert C. Eyre; Arthur G. Aaronson; Barbara J. Weinstein
We report a case of a unique granulomatous lesion of the prostate and recurrent bladder neck obstruction. The lesion was histologically identical to a rheumatoid nodule and it has only been seen in patients who have undergone prior prostatic surgery. There appears to be no clinical correlation with connective tissue disease, and the lesion differs clinically and morphologically from other types of granulomatous prostatitis.
Cancer | 1981
Mark L. Silverman; Robert C. Eyre; Leonard A. Zinman; Ann W. Crosson
The case of a patient with primary adenocarcinoma involving the urethra is described. Morphologic evidence supporting an origin in the periurethral glands is presented. The urologist and pathologist must maintain a high index of suspicion in evaluating patients with urethral structure or urethrocutaneous fistulae because superficial transurethral biopsy may fail to obtain adequate depth to demonstrate malignancy.