Testicular sperm extraction with intracytoplasmic sperm injection for nonobstructive azoospermia: testicular histology can predict success of sperm retrieval.

Purpose: We present treatment results of testicular sperm extraction with intracytoplasmic sperm injection for men with nonobstructive azoospermia and reevaluate the role of testicular histology on open diagnostic testicular biopsy as a predictor of sperm retrieval success.

Materials And Methods: We evaluated 75 men diagnosed with nonobstructive azoospermia. Cases were categorized into 3 groups of hypospermatogenesis, maturation arrest or Sertoli-cell-only based on the most advanced pattern of spermatogenesis seen on histology.

Modification of the genetic program of human alveolar macrophages by adenovirus vectors in vitro is feasible but inefficient, limited in part by the low level of expression of the coxsackie/adenovirus receptor.

Robust expression of genes transferred by adenovirus (Ad) vectors depends upon efficient entry of vectors into target cells. Cells deficient in the coxsackie/adenovirus receptor (CAR) are difficult targets for Ad-mediated gene transfer. We hypothesized that low levels of CAR expression may be responsible, in part, for the relative inefficiency of Ad-mediated gene transfer to human alveolar macrophages (AMs).

Antibacterial skin preparation decreases the incidence of false-positive semen culture results.

Purpose: Antibacterial skin preparation was used before obtaining semen cultures to assess whether true seminal pathogens could be isolated with greater specificity.

Materials And Methods: A total of 14 paired semen cultures were obtained from men evaluated for infertility. The first set (group 1) was obtained without preparation and the second set (group 2) was obtained after using an antibacterial skin preparation consisting of a shower followed by perineal, penile and hand wash with 4% chlorhexidine and 10% povidone-iodine.

Abdominal hysterectomy practice patterns in the United States.

Objective: To describe nationwide practice trends for two principal techniques of abdominal hysterectomy in the United States, numbers and rates of total (TAH) and supracervical (SCH) hysterectomy were reviewed with charges for each operation.

Methods: Practice patterns for all inpatient TAH and SCH discharges in the US from 1991 to 1994 were studied using HCUP-3 NIS, a nationwide hospital discharge database. Hysterectomies performed for malignant disease, vaginally or with laparoscopic assistance were not sampled.

Double immunolabeling with cytokeratin and smooth-muscle actin in confirming early invasive carcinoma of breast.

Histopathological identification of invasive breast carcinoma in its earliest phases is fraught with pitfalls. Preinvasive malignant lesions complicated by radial scar, sclerosing adenosis, and lobular cancerization, among other lesions, may simulate invasive carcinoma. Fibrosis, inflammatory reaction, and other stromal changes around in situ carcinoma may mask microinvasive foci on routine stains.

Human endometrial stromal cells improve embryo quality by enhancing the expression of insulin-like growth factors and their receptors in cocultured human preimplantation embryos.

Objective: To demonstrate the mechanism by which human endometrial stromal cells improve embryo quality in coculture.

Design: Randomized study.

Setting: Academic research center.

Determinants of precordial QT dispersion in normal subjects.

Dispersion of precordial QT intervals has been attributed to delay in the recovery process in the myocardium under the exploring electrode, a local effect. However, the phenomenon also could be explained by different projections of the heart vector, in which case the 12-lead electrocardiogram (ECG) derived from the heart vector would show similar dispersion that could not be local in nature because the electrical activity of the heart is represented by a single dipole. Using an analog device that switched between the two, conventional and derived ECGs were obtained from 129 normal subjects.

Oocyte donation: insights into implantation.

Objective: To ascertain whether obstetric, gynecologic, or congenital variables affect implantation efficiency or eventual delivery in donor oocyte recipients.

Design: Clinical study.

Setting: Academic tertiary care infertility clinic.

Changes in survival of twins delivered after twin-twin transfusion syndrome versus preterm singletons over the calendar years 1970-1994.

Objective: The use of serial amniotic fluid volume reduction for the treatment of twin-twin transfusion syndrome (TTTS) became available about 1986 and may account for a recent increase in survival of TTTS twins. To determine whether the increase in survival has been due to advances in neonatal care rather than the advent of amnioreduction, the current study evaluated whether increases in survival of preterm TTTS twins were greater than increases in survival of preterm singletons from studies before 1986 compared to studies after 1986.

Methods: Medline literature search identified all reported cases of TTTS and all reports of severely preterm neonatal survival.

Thick loop transurethral resection of the prostate.

Objectives: To evaluate the safety and efficacy of the new resection loops for transurethral resection of the prostate (TURP). These loops, which are both thicker and have a modified shape, allow simultaneous resection, increased tissue vaporization, and improved hemostasis.

Methods: Two open studies have been performed with the thick resection loop.

Giant prosthetic reinforcement of the visceral sac. The Stoppa groin hernia repair.

GPRVS is a properitoneal hernioplasty with a prosthesis composed of the polyester Dacron. The repair is anatomic, sutureless, tension-free, and the absolute weapon to eliminate all types of groin hernias. No other technique produces better results for the repair of recurrent and re-recurrent groin hernias.

Genotype-phenotype correlation in murine Apc mutation: differences in enterocyte migration and response to sulindac.

The adenomatous polyposis coli (APC) gene product mediates coordinated cell growth in the intestinal mucosa. In humans, germ-line mutations of APC are associated with colorectal carcinogenesis, a process that varies in severity depending on the length of the protein resulting from the mutant allele. In a previous study of the C57BL/6J-Min/+ (Min/+) mouse, we found that the protein fragment resulting from truncation at codon 850 of murine Apc was associated with changes in enterocyte migration, proliferation, apoptosis, and beta-catenin expression.

End-of-life decision-making in the hospital: current practice and future prospects.

Chart review of patients who died in the hospital was used to describe the pattern of end-of-life decision-making and care for hospitalized dying patients and to propose a structured process of assessing the suitability of patients for palliative care. The setting was a large urban academic medical center, and the sample comprised 200 of 205 consecutive adult deaths during the first 4 months of 1996. The main outcome measures were identification of the patient as dying, do-not-resuscitate (DNR) orders, and comfort care plans.

Some new developments in the understanding of oropharyngeal and postingestional controls of meal size.

This review focuses on new developments in the understanding of how oropharyngeal and postingestional stimulation control the ingestive behavior of the rat ingesting liquids. With the development of the computer-controlled lickometer it is now possible to measure and analyze in fine detail the impact these two variables have on the rat's licking behavior. Because variations in this behavior are responsible for variations in intake this methodology is beginning to provide a clearer picture of how oropharyngeal and postingestional stimulation control ingestive behavior and interact to control meal size.

The effect of genital prolapse on voiding.

Purpose: We determined whether genital prolapse causes obstruction that may be relieved by a vaginal pessary as well as the degree to which voiding difficulty, urethral hypermobility, bladder outlet obstruction, occult stress incontinence, detrusor instability and impaired detrusor contractility are associated with prolapse.

Materials And Methods: We prospectively evaluated 60 women with a mean age of 52 years who had genital prolapse, including 35 (58%) with grade 1 or 2 and 25 (42%) with grade 3 or 4 cystocele, using pressure-flow video urodynamics and cotton swab testing. Leak point pressure and uroflowmetry were repeated in patients with severe prolapse after insertion of a ring pessary.

Pectoralis major rupture during gait training: case report.

Rupture of the pectoralis major muscle is rare. The majority of cases have been reported in young, healthy athletes during strenuous activities such as weight-lifting, wind surfing, and football. The injury is thought to result from either a forceful contraction of the muscle applied to an immovable object or a sudden stretching force applied to the contracting muscle.

Effect of methylene blue, indigo carmine, and Renografin on human sperm motility.

Objectives: To evaluate the effect of commonly used intraoperative vasography and tissue staining agents, indigo carmine, methylene blue, and Renografin, on sperm motility.

Methods: Semen from 20 healthy men was obtained after 2 to 4 days of abstinence. Sperm motility was initially evaluated in each specimen.

Selective expansion of alveolar macrophages in vivo by adenovirus-mediated transfer of the murine granulocyte-macrophage colony-stimulating factor cDNA.

Based on the hypothesis that genetic modification of freshly isolated alveolar macrophages (AM) with the granulocyte-macrophage colony-stimulating factor (GM-CSF) cDNA would induce AM to proliferate, this study focuses on the ability of adenoviral (Ad) vectors to transfer and efficiently express the murine (m) GM-CSF cDNA in murine AM with consequent expansion in the number of AM in vitro and in vivo. To demonstrate that an Ad vector can effectively transfer and express genes in AM, murine AM recovered by bronchoalveolar lavage from the lung of Balb/c mice were infected with an Ad vector coding for green fluorescent protein (GFP) in vitro and expressed GFP in a dose-dependent fashion. Infection of AM with an Ad vector containing an expression cassette coding for mGM-CSF led to GM-CSF expression and to AM proliferation in vitro.

Behaviorally specific inhibition of sham feeding by amylin.

To further characterize amylin's inhibitory action on feeding, we examined the effects of intraperitoneal injections of amylin on sham feeding of sucrose in food-deprived male rats with chronic gastric cannulas. Thirty and 100 microg/kg amylin reduced sham feeding, but did not terminate it or elicit the behavioral sequence of satiety. Real feeding of sucrose, but not sham feeding, was reduced after injection of 10 microg/kg amylin.

Optimization of contrast delivery for pulmonary CT angiography.

Pulmonary CT angiography is becoming an increasingly important tool for diagnosing Pulmonary Emboli. An important aspect in optimizing the quality of these studies is achieving maximum levels of enhancement of the pulmonary arteries. In this study we reviewed the current literature to see if there was any standardization of protocols to achieve this purpose, and found that there was no consensus.

Outcome analysis of 245 CarboMedics and St. Jude valves implanted at the same institution.

Background: Thromboembolism and valve-related death are major complications associated with prosthetic valve implants, but it is difficult to evaluate the relative incidence of these complications based on studies in which the implantation of only one valve is reported from any given institution. We therefore report the outcome of patients implanted at our institution during the same time period with either the recently released CarboMedics (CM) or the St. Jude Medical (SJ) valve prostheses.

Lesbians and the internalization of societal standards of weight and appearance.

ABSTRACT Findings from a study of body image, weight concern, and disordered eating in lesbians are presented. While lesbians were more critical of traditional social norms regarding the rights and roles of women in general than heterosexual controls, this difference disappeared in regard to norms concerning women's weight and appearance. Dieting was frequent, almost half of the participants were dissatisfied with their weight, and self-esteem was strongly influenced by body esteem.

A microendoscopic test card for ophthalmic endoscopes.

Ophthalmic endoscopes allow examination of intraocular structures when traditional surgical microscopic visualization is limited or impossible. Periodic evaluation of the optical precision of these instruments is essential to ensure optimal intraoperative performance. A test card has been developed to aid in the calibration of ophthalmic endoscopes.

Dietary modulation of carcinoma development in a mouse model for human familial adenomatous polyposis.

Familial adenomatous polyposis (FAP) is caused by a dominant mutation in the adenomatous polyposis coli (APC) gene. Individuals with FAP progressively develop adenomas and carcinomas of the colon and rectum. We developed a mouse model for this disorder by genetically modifying the Apc gene.