S. Arakawa

Decrease in apoptosis of germ cells in the testes of infertile men with varicocele

Abstract To determine whether the regulation of apoptosis in the testes of patients with varicocele testes was abnormal, affecting germ-cell differentiation and sperm production, we studied apoptosis in the testes of normal men and infertile men with varicocele. In all, 56 testicular biopsy specimens were collected from 28 varicocele patients. The specimens from the testes of five normal volunteers with informed consent were used as controls. In situ end-labeled cells were counted with a CAS 200 image analyzer, and an apoptotic index (AI) was calculated by division of the number of labeled cells by the total number of spermatocytes and spermatogonia in over 20 seminiferous tubules. The apoptosis was also examined by electron microscope. The mean AI was 9.67 ± 0.93% in normal testes (n = 5). In contrast, the mean AIs determined in the right and left testes of varicocele patients (n = 28) were 3.90 ± 2.28% and 3.78 ± 2.87%, respectively. The AIs recorded for the testes of varicocele patients were significantly lower than those noted for normal men (P < 0.05). In varicocele patients the AI obtained in the right testis was not statistically significantly different from that found in the left testis. The numbers of apoptotic cells per Sertoli cell also decreased in the testes of varicocele patients as compared with normal men (P < 0.01). Evaluation of all specimens, including the normal controls, revealed no significant correlation either between the AI and the sperm concentration on the seminogram or between the AI and Johnsens mean score. There was also no relationship between the AI and the serum level of follicle-stimulating hormone, lutenizing hormone, testosterone, or estradiol. In conclusion, apoptosis is decreased in germ cells in the testes of infertile men with varicocele as compared with normal men.

A clinicopathological study of bladder cancer associated with upper urinary tract cancer

ObjectivesTo analyse the clinicopathological features of bladder cancer associated with upper urinary tract cancer (UUTC).

Expression of endothelial nitric oxide synthase in the Sertoli cells of men with infertility of various causes

Objective To investigate how endothelial nitric oxide (eNOS) expression in the seminiferous tubules might be related to spermatogenesis, by examining eNOS expression in testicular tissue of patients infertile from various causes.

EVALUATION OF HEALTH-RELATED QUALITY OF LIFE IN PATIENTS TREATED FOR ERECTILE DYSFUNCTION WITH VIAGRA (SILDENAFIL CITRATE) USING SF-36 SCORE

The effect of sildenafil on health-related quality of life (HRQOL) was evaluated. Forty men (61 - 8 years old, mean - SD) with erectile dysfunction (ED) were studied. Sexual satisfaction as well as HRQOL according to SF-36 scales was evaluated before and after treatment with Viagra (Sildenafil citrate) at a dose of 25 or 50 mg. After treatment with Viagra, scores increased for all scales; of these, physical functioning (PF), general health (GH), and role-emotional functioning (RE) showed significant differences from baseline scores. Patients who evaluated effectiveness of the treatment as excellent showed significantly better PF, role-physical functioning (RP), and GH scale scores than those who evaluated their outcome as good or poor ( p <. 05 for RP and GH; p <. 01 in PF). In comparison with the scores at baseline, patients who considered outcome of Viagra to be excellent also showed significant improvements in PF, GH, and RE. Viagra treatment can improve HRQOL as well as sexual function in many patients.

Levels of Interferon α and γ in Seminal Plasma of Normozoospermic, Oligozoospermic, and Azoospermic Men

The functions of the interferons in the testis are unclear. We investigated the role of interferon alpha and gamma in the seminal plasma on spermatogenesis. The levels of interferon alpha and gamma were determined in the seminal plasma of 101 males including normozoospermic (n = 31), oligozoospermic (n = 57) and azoospermic men (n = 13). The correlation between such levels and clinical parameter (seminogram and serum hormone levels) was evaluated. The seminal plasma level of interferon alpha (92.0 + 110.3 ng/mL) in the normozoospermic men was significantly lower than that of oligozoospermic men (162.4 +/- 130.3 ng/mL) (p < .05). The three groups (normozoospermic, oligozoospermic, and azoospermic group) did not differ as to the level of interferon gamma. No significant correlations were observed between the levels of interferon alpha or gamma in seminal plasma and the serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone, prolactin, or estradiol. Theses results suggest that the level of interferon alpha in the seminal plasma may be related to sperm production.

Rapid detection and differentiation of Gram-negative and Gram-positive pathogenic bacteria in urine using TaqMan probe

Urinary tract infection has been shown to be quite complicated and often difficult to diagnose and treat. For appropriate diagnosis, it is very important to find the correct Gram stain classification as soon as possible, especially in severe cases where there is a possibility of severe sepsis developing. In order to solve this problem, we developed a new method to detect a Gram stain of bacteria obtained from 1 ml of urine from urinary tract infection patients using a consensus real-time PCR protocol with a TaqMan probe that allows detection of spiked bacterial 16S DNA from urine. We extracted DNA of 55 urine samples obtained from patients with complicated urinary tract infection and at the same time performed urine culture testing. After DNA extraction, they were subjected to real-time PCR using a TaqMan discrimination system. Sixteen kinds of bacteria were cultured from the urine culture testing. Of these bacteria, eight were classified as Gram-positive bacteria and the other eight were classified as Gram-negative bacteria. Of the 55 samples, the TaqMan technique result showed 27 samples that were classified as Gram-negative bacteria; 11 samples that were Gram-positive, 10 that included both Gram-negative and -positive bacteria, and 7 that showed no amplification. The classifications of all samples corresponded exactly to those determined by urine culture testing. The present genotyping method of real-time PCR using a TaqMan discrimination system could be applied to the rapid detection of Gram-positive or -negative bacteria in urine of urinary tract infection patients. This assay can differentiate those species tested, but whether the presence of other (untested) bacteria could lead to misinterpretation is unknown. For further investigation, it is important to test other (untested) bacteria in the near future.

The significance of E-cadherin in transitional-cell carcinoma of the human urinary bladder

SummaryE-cadherin is a Ca2+-dependent intracellular adhesion molecule in the epithelial tissue. The urothelium also expresses E-cadherin molecules. We determined E-cadherin expression in bladder carcinoma immunohistochemically and investigated its relationship with pathological and clinical data. The percentage of cases showing pattern B, less than 50% of which cancer cells expressed the same intensity of E-cadherin as did the normal epithelium, was higher in cases of high-grade or high-stage tumors as compared with those of low grade or low stage. Heterogeneous staining was observed in the same specimens, which suggested changes in the cell phenotype. Immunoblotting demonstrated no evidence of gross alteration of E-cadherin molecules. The decrease in E-cadherin expression was associated with the invasiveness of bladder carcinoma, as has been reported in other carcinomas.

Susceptibilities of Neisseria gonorrhoeae to fluoroquinolones and other antimicrobial agents in Hyogo and Osaka, Japan

Objectives: Decreasing susceptibility of Neisseria gonorrhoeae to fluoroquinolones has been reported in several countries. Knowledge of local N gonorrhoeae susceptibilities to various antimicrobials is important for establishing a rational treatment strategy in each region. Methods: Isolates of N gonorrhoeae from male urethritis patients attending four urological clinics in Hyogo and Osaka prefectures in Japan were collected during 2002. The MICs for nine antimicrobials: penicillin G, tetracycline, cefixime, ceftriaxone, levofloxacin, gatifloxacin, ciprofloxacin, moxifloxacin, and spectinomycin were determined for each isolate. All isolates were also tested for β lactamase producing profiles. Results: Among the 87 isolates obtained, only one isolate was revealed to produce β lactamase. MIC90 values for ciprofloxacin, levofloxacin, gatifloxacin, and moxifloxacin were over 8 μg/ml, over 8 μg/ml, 4 μg/ml, and 2 μg/ml, respectively. The proportion of isolates resistant to fluoroquinolones was over 60% (ciprofloxacin, 70.1%; levofloxacin, 65.5%; gatifloxacin, 70.1%). Chromosomally mediated penicillin and tetracycline resistance was identified in 12.6% and 33.3% of the isolates. MIC90 values for cefixime and ceftriaxone and were 0.5 μg/ml and 0.0063 μg/ml. All isolates were sensitive to ceftriaxone and 90.8% of them were sensitive to cefixime. MIC90 for spectinomycin was 32 μg/ml and all isolates were sensitive to it. Fluoroquinolone resistance correlated significantly with MICs for penicillin G but not tetracycline. Conclusion: Ceftriaxone and spectinomycin demonstrated lower MICs and so are recommended for N gonorrhoeae. Susceptibilities of N gonorrhoeae should be monitored periodically by region.

Value of the serum prostate‐specific antigen‐α1‐antichymotrypsin complex and its density as a predictor for the extent of prostate cancer

Objective To determine whether serum levels of the prostate‐specific antigen‐α1‐antichymotrypsin complex (PSA‐ACT) and its density (ACTD) in patients scheduled to undergo radical prostatectomy for clinically localized prostate cancer can predict organ‐confined vs extraprostatic disease.

Hyperprolactinaemia among infertile patients and its effect on sperm functions

Summary. The effects of hyperprolactinaemia on sperm function were investigated in 264 men with oligozoo‐, asthenozoo‐, or teratozoospermia and who were attending a male infertility clinic. None of the patients exhibited galactorrhea or complained of impotence. There was no correlation between abnormal values in spermiogram and hyperprolactinaemia. After multiple measurements of serum prolactin concentration, 15 cases (5.7%) were diagnosed as hyperprolactinaemic (≧ 10 ng ml−1). Six of these patients were taking cimetidine and six were taking anti‐anxiety drugs. Serum prolactin returned to the normal level after discontinuation of these drugs; thus these 12 cases were considered as drug‐induced hyperprolactinaemia. The other three patients were diagnosed as having pituitary microadenomas and received bromocriptine treatment; the serum prolactin levels normalized within 1 month. No changes in sperm concentration, motility or morphology were found after normalization of serum prolactin levels. Sperm fertilizing ability was monitored by the hamster test for 10 months in the three patients with pituitary microadenoma, and no improvement was observed. Results suggest that hyperprolactinaemia, which does not cause symptoms, has little effect on the impairment of sperm functions. Measurement of serum prolactin in infertile men could be justified, however, for early detection of pituitary adenomas.