The routine assessment of sperm motility at room temperature and 37°C

The World Health Organization (WHO) laboratory manual (1992) states that assessment of sperm motility can be performed at either 37^OC or room temperature (20–24^OC). The motility of spermatozoa in 44 semen samples (22 fresh samples and 22 frozen-thawed samples) was assessed at both of these temperatures and a significant difference in the motility profiles was noted, specifically an increase at 37^OC in the percentage (expressed here as median and ranges) of spermatozoa with excellent progressive motility and an overall increase in the percentage with total progressive motility. With fresh samples the excellent progressive motility increased from 41 (19–53) to 54 (30–66) and the overall motility from 58.5 (39–74) to 65.0 (40–79). With the frozen—thawed samples the excellent motility increased from 14 (1–33) to 25 (6–45) and the overall motility from 30.5 (14–51) to 33.0 (16–52). As the WHO laboratory manual was published. 'In response to a growing need for the standardisation of procedures for the examination of human spermatozoa' it is proposed that only one temperature for routine analysis should be used, namely 37^OC, which may have more physiological relevance and eliminate effects of fluctuations in ambient laboratory temperature.     

BIOACTIVE FORMS OF SERUM LACTOGENS: EFFECTS OF TREATMENT OF PROLACTINOMA PATIENTS WITH BROMOCRIPTINE

An in vitro bioassay for lactogenic hormones, based on the specific mitogenic effects of lactogens on cultured Nb2 node rat lymphoma cells, was used to measure the levels of lactogens in whole serum and in fractionated serum samples from three patients with prolactin (PRL) secreting pituitary adenomas. Under basal conditions, after pituitary stimulation, and following treatment with bromocriptine which greatly decreased the serum PRL levels, the bioassay (BA) results closely paralleled fluctuations in the sum of radioimmunoassay (RIA) estimates of serum PRL and growth hormone concentrations. The extreme sensitivity (10 pg/ml) of the BA facilitated measurement of PRL in fractions obtained after Sephadex G-100 chromatography of only 0.1 to 0.3 ml of sera from both untreated and bromocriptine-treated prolactinoma patients. In both types of samples, similar heterogenous patterns of bioactive PRL were observed, although most of the recovered activity appeared to be due to monomeric PRL. BA and RIA of fractions obtained after DEAE cellulose chromatography of sera from untreated prolactinoma patients revealed two PRL peaks, the first one containing 75% of the activity. Therapy with bromocriptine led to a reduction in the total serum PRL activity and, in particular, in the activity of the second peak.     

GONADOTROPHIN-SECRETING PITUITARY TUMOUR: REPORT AND REVIEW

A 34-year-old male with a pituitary adenoma was investigated and demonstrated to have hypersecretion of both gonadotrophins in the basal state. Immunocytochemical staining and electron microscopic examination were positive for tumour cells secreting FSH and LH. Presenting symptoms included visual disturbances, loss of libido, impotence, cold intolerance, frontal headaches, change in skin pigmentation and excessive weight gain. The patient denied alteration in hair distribution, had no acral features, galactorrhoea or gynaecomastia. Surgical extirpation resulted in complete amelioration of his symptoms over a three year follow-up period. Basal and stimulated pituitary function testing results returned to normal post-operatively. A review of the literature documents six other cases of pituitary tumour secreting both LH and FSH in the basal state. More commonly, the pituitary adenoma secretes FSH only. The literature is reviewed with regard to both types of tumour.     

The effects of a 16-N-homopiperidino analogue of vecuronium on neuromuscular transmission in anaesthetized cats, pigs, dogs and monkeys, and in isolated preparations

Org 9991, a 16-N-homopiperidinium substituted vecuronium analogue, has been tested for neuromuscular blocking activity in anaesthetized cats, pigs, dogs and monkeys, and in isolated nerve-muscle preparations. Org 9991 exhibited non-depolarizing neuromuscular blocking activity of the competitive type, being reversible by neostigmine and showing no endplate channel blocking action in isolated preparations. In cats, 50% vagal block was observed at doses of Org 9991 approximately 10 times those producing 50% neuromuscular block; no ganglion block was seen at these doses. Effects on blood pressure or heart rate at 90% twitch blocking doses were either minor or absent. The potency and time course of action of Org 9991 remained similar in all four species: i.e. 90% block at ca 200-300 micrograms kg-1; onset time ca 1.2-1.9 min; duration 90% ca 4.5-8.9 min. This study suggests that 16-N-homopiperidinium analogues of vecuronium may provide leads in the quest for a potent non-depolarizing replacement for suxamethonium.     

Beliefs about constipation in old age psychiatry

A questionnaire survey of opinions about the influence of constipation on the mental state of older people was sent to RMN and RGN nursing staff and psychiatrists in the South-East Thames Region. The response rate for trusts was 62.5%, and just over 50% of individuals from participating services returned questionnaires. Constipation was thought to be an important cause of deterioration in patients with dementia by 86.6% of respondents, and although it was the least favourite mechanism, 54.9% felt that reabsorption of toxic substances contributed to this. Of respondents, 86.6% believed that delirium could be caused de novo by constipation. There was little difference between doctors and nurses in their responses. These results from experienced clinicians suggest that further investigation of the role of constipation in deterioration in the elderly with dementia is warranted.     

The UK National External Quality Assessment Scheme in Blood Group Serology. ABO and D grouping,antibody screening,direct antiglobulin test and antibody identification 1984–1985

Summary In seven exercises of blood grouping the overall rates of major error were 0.19% and 0.25% in ABO and D grouping respectively. In ABO grouping this represents an increase in error rate over that observed in 1982–1983 but the increase was due to an unusually high error rate with one particular group A₂B cell. An improvement in performance was observed in simple D grouping and was largely due to a lower incidence of false positive grouping of D-negative cells in the antiglobulin test. An improvement in performance observed in D grouping IgG-coated D-negative cells appeared to be due to a better understanding of the problem rather than to any change in serological practice. Error rates in antibody screening were somewhat lower than in 1982–1983 but this may or may not represent an improvement in performance as the test materials were not the same in the two periods. The direct antiglobulin test with IgG-coated cells was reliably performed with polyspccific and with anti-IgG reagents but an excess of false positive results was obtained with anti-C3d. Error rates in antibody identification varied from 0.6% for anti-D to 74% for anti-c + E.     

Biochemical and Cytologic Alterations in the Respiratory Tract of Rats Exposed for 4 Hours to Hydrogen Sulfide

Fischer-344 rats were killed by exsanguination 1, 20, and 44hr after a single 4-hr exposure to an atmosphere of 0, 10, 200,and 400 ppm of hydrogen sulfide (H₂S) Alterations in the activitiesof lactate dehydrogenase and alkaline phosphatase, and cytomorphologyof epithelial cells in fluids obtained by nasal and bronchoalveolarlavage were used as indicators of cell injury. Changes in thenumber of leukocytes were used as indicators of inflammatoryresponse, and changes in the concentration of protein were usedas indicators of altered vascular permeability. Inhalation ofH₂S resulted in 139, 483, and 817% increased cellularity inthe nasal cavity of rats exposed to 10, 200, and 400 ppm, respectively.This was due to marked exfoliation of degenerated epithelialcells and exudation of neutrophils. The high dose of H₂S resultedin a moderate increase in lactate dehydrogenase and proteinin nasal passages; values returned to baseline levels 20 hrlater. Bronchoalveolar cell counts were decreased in rats exposedto 400 ppm and unchanged in those exposed to 10 and 200 ppm.Enzymatic activities in lung lavage fluid were moderately elevated(up to 90%), yet protein concentrations were increased by morethan 3000% and remained significantly elevated up to 44 hr afterexposure to 400 ppm. It was concluded that inhalation of H₂Shas a severe cytotoxic effect on the nasal epithelium and asevere edematogenic effect on lung parenchyma. These resultsare in agreement with autopsy findings of individuals killedby accidental exposure to H₂S-containing sour gas.     

REVERSIBLE REPRODUCTIVE DYSFUNCTION IN MEN WITH OBSTRUCTIVE SLEEP APNOEA

A central, reversible decrease in male sexual function appears related to some aspect of obstructive sleep apnoea (OSA). Lower serum testosterone (T) levels were documented in 15 men with OSA versus nine snorers (no OSA), (9.18 ± 0.92 vs 11.55 ± 0.90 nmol/l, mean ± SEM), P < 0.05 in a consecutive case series of 24 men referred for diagnostic overnight sleep studies. Gonadotrophins did not differ between the two groups. Although the men with OSA did not differ in body mass index (BMI) or weight from the snorers, they were older (51 ± 3.9 vs 44 ± 3.1 years), P < 0.02. Serum T did not correlate with age, but was correlated with minimum nocturnal arterial oxygen saturation (Min SaO₂) ( r =0.589), P < 0.02. A prospective controlled trial of uvulopalatopharyngo-plasty therapy (UPP) for OSA in 12 subsequent subjects showed reproductive improvement which was parallel with improved apnoea at 3 months post-surgery. T increased (13.31 ± 1.07 to 16.59 ± 0.72 nmol/l), P <0.02, without significant changes in BMI, serum PRL, LH or FSH. All seven of the men who reported decreased sexual interest prior to surgery felt their libido and sexual functioning had returned to normal 3 months following UPP. Some aspect of OSA in men appears to produce a reversible hypothalamic-pituitary reproductive dysfunction.