To compare biochemically active with immunoreactive sperm acrosin in fertile and infertile men. T... more To compare biochemically active with immunoreactive sperm acrosin in fertile and infertile men. This study was conducted in a tertiary care center, the Andrology Clinic, Department of Internal Medicine, University of L'Aquila. We evaluated the males in 40 infertile couples with no recognized cause of female infertility and 20 fertile men. Ejaculates were collected under standardized conditions of abstinence. Total sperm acrosin activity was measured on a spectrophotometer in washed sperm stored at -80 degrees C for 1 to 6 days. The percent of spermatozoa immunostained by an antiserum against proacrosin/acrosin by indirect immunofluorescence (IFL) was determined on methanol fixed sperm smears. Biochemically active acrosin was correlated to immunoreactive acrosin (P = 0.0028), and both were inversely correlated to the percent of spermatozoa with an abnormal head (P = 0.00024 for acrosin activity and P = 0.0013 for IFL). Biochemically active and immunoreactive acrosin were lower in...
Eighty-six couples with long-standing infertility and poor postcoital test, due to oligozoospermi... more Eighty-six couples with long-standing infertility and poor postcoital test, due to oligozoospermia and/or asthenozoospermia (68 cases) or mucus hostility (18 cases), were treated by 411 intrauterine inseminations (IUI) with motile sperm suspensions from the husband's semen. The pregnancy rate per couple in the group with abnormal semen was lower than in the group with mucus hostility (22% versus 38.9%). Influence of seminal and other parameters on outcome of IUI was assessed by discriminant analysis, and a significant correlation with pregnancy rate was found for motile sperm count and sperm morphology. Teratozoospermia (normal morphology less than 50%) affected the outcome of IUI both when associated with moderate oligozoospermia and/or asthenozoospermia (motile sperm count greater than or equal to 5 X 10(6)/mL) (success rate per couple: 11.1%), and, even more, when associated with severe oligozoospermia and/or asthenozoospermia (motile sperm count less than 5 X 10(6)/mL), wher...
Background The aim of the present study was to verify whether BNP might detect pre-clinical diast... more Background The aim of the present study was to verify whether BNP might detect pre-clinical diastolic dysfunction (LVDD) in type-2 diabetic patients. Methods One-hundred and twenty-seven consecutive outpatients with type-2 diabetes mellitus were enrolled into the study. Subjects with overt heart failure or NYHA class > 1, history of coronary artery disease, severe valvulopathy or chronic atrial fibrillation were excluded from the study. All patients underwent clinical evaluation, laboratory assessment of brain natriuretic peptide (BNP) and echocardiographic examination. Results No patients showed systolic impairment of left ventricular function, whereas diastolic dysfunction was detected in 53 (42%) cases (all impaired relaxation). Median BNP was 27 pg/ml without any significant difference between 76 patients with normal left ventricular function and 53 with diastolic dysfunction; in 54 (43%) patients showing HBA1C≥8 (uncontrolled diabetes) normal function was found in 32 and diastolic dysfunction in 22, with a significant difference of BNP at multivariate analysis (OR = 1.02, 95%CI = 1.05-1.09, p = 0.003). In uncontrolled diabetic cohort, BNP was a strong predictor for LVDD (OR = 2.7, 95%CI = 1.3-5.6, p = 0.006) along with the duration of diabetes (OR = 1.6, 95%CI = 1.1-2.9, p = 0.046). BNP > 25 pg/ml was a cut-off value with high accuracy to detect a LVDD. Discussion Early screening of high-risk patients for diabetic cardiomyopathy development might be useful to better control glycemic profile in order to reduce heart disease progression or even to reverse it Conclusions BNP could be a cheap, easy and useful tool to screen those ones with preclinical ventricular diastolic dysfunction in a subset of patients particularly prone to develop cardiovascular complications, like uncontrolled diabetic patients.
Summary: The immunoreaction for acrosin in different morphological types of human spermatozoa was... more Summary: The immunoreaction for acrosin in different morphological types of human spermatozoa was evaluated by light microscopy in the semen of 68 male partners of infertile couples. The antigen had a cup-shaped distribution in the anterior region of the head in normal spermatozoa, and in those with an isolated abnormal mid-piece or tail. On the contrary acrosin was absent, or it did not show a cup-shaped immunostaining, in most spermatozoa with malformed heads with the exception of those with a large oval form. The assessment of immunoreaction for acrosin and of vitality of different morphological types of spermatozoa in the same ejaculates, suggested that the antigen was intrinsically absent in abnormal-headed but vital spermatozoa. It is concluded that an inherent lack, or an abnormal synthesis of acrosin during spermatogenesis is associated to the abnormal development of the spermatozoa head.Zusammenfassung: Mittels der Lichtmikroskopie wurde die Immunreaktion für Akrosin bei verschiedenen Formen menschlicher Spermatozoen im Sperma von 68 Männern aus einer infertilen Ehe untersucht. Es zeigte sich eine kappenförmige Verteilung des Antigens in der vorderen Region des normalen Spermatozotenkopfes und zwar bei einer isolierten Abnormalität des Mittelteils oder des Schwanzes. Im Gegensatz dazu fehlte Akrosin bzw. zeigte keine kappenförmige Immunfärbung bei den meisten Spermatozoen mit Fehlbildungen des Kopfes jedoch nicht bei den großen ovalen Formen. Die Beurteilung der Immunreaktion für Akrosin und der Vitalität bei den verschiedenen morphologischen Formen der Spermatozoen in den gleichen Ejakulaten legt es nahe, daß das Antigen wirklich abwesend war bei abnormalen Kopfformen, die jedoch vitalen Spermatozoen angehörten. Hieraus wird die Schlußfolgerung gezogen, daß ein angeborener Mangel oder eine abnormale Synthese des Akrosins während der Spermatogenese mit der abnormalen Entwicklung des Spermatozoenkopfes vergesellschaftet ist.
The objective was to evaluate HLA DR/DQ alleles and their risk factor for type 1 diabetes in the ... more The objective was to evaluate HLA DR/DQ alleles and their risk factor for type 1 diabetes in the Abruzzo region (central Italy). Sixty incident cases from the Abruzzo region were studied together with 120 unrelated control subjects living in the same administrative areas. The relative risk of diabetes associated with the alleles under study was calculated by deriving the odds ratio (OR) maximum likelihood estimates and their 95% confidence intervals (CI) by the exponentiation of the logistic regression beta–parameter. The combination DRB1*03/DQA1*0501/DQB1*0201 was found in 20.0% of patients and 7.1% of the control subjects, conferring an OR of 4.04 and a CI of 1.97–8.49. The combination DRB1*04/DQA1*0301/DQB1*0302 was found in 23.3% of diabetic patients and 6.7% of controls, giving an OR of 5.69 and a CI of 2.77–12.05. DRB1*11/DQA1*0505/DQB1*0301 and DQA1*0505/DQB1*0301 were negatively associated with type 1 diabetes (OR=0.27, CI 0.11–0.57; OR=0.07, CI 0.02–0.19). The DQA1 genotype at risk was found to be DQA1*0301/DQA1*0501: OR=23.80, CI 2.97–190.89, as it occurred with the highest frequency in the patient group. The DQB1 genotype at risk was found to be DQB1*0201/DQB1*0302, which occurred in 13.3% of patients but in only 1.1% of the control group (OR=29.75, CI 5.36–549.25). Our results shed further light on the risk of development of this disease during a specific time period in an area where the overall incidence of type 1 diabetes is known.
We report the case of a 22 year old woman with congenital generalized lipodystrophy who presented... more We report the case of a 22 year old woman with congenital generalized lipodystrophy who presented a left brachiocrural pyramidal hemisyndrome, bilateral cerebellar signs and a left cranial nerve VI deficit. The clinical pattern had a tendency to regress. MRI brainscan, CSF examination and clinical features led to the diagnosis of “probable demyelinating syndrome”. Published data on CNS involvement in patients with congenital generalized lipodystrophy are few and we have found no cases in which a demyelinating syndrome is associated. In the case we report it is tempting to see the disorder of the lipid metabolism underlying the congenital generalized lipodystrophy as underlying the myelin disorder as well. Descriviamo il caso di una paziente di 22 anni, affetta da Lipodistrofia Congenita Generalizzata, che ha presentato una sintomatologia caratterizzata da emisindrome piramidale brachiocrurale sinistra, segni cerebellari bilaterali e deficit del VI nervo cranico di sinistra. Il quadro clinico ha avuto una tendenza alla regressione. La RMN encefalo, l'esame del liquor e la clinica hanno fatto porre diagnosi di “probabile sindrome demielinizzante”. I dati della letteratura relativi al coinvolgimento del SNC in pazienti con Lipodistrofia Congenita Generalizzata sono scarsi ed in particolare non abbiamo rilevato casi di associazione con sindrome demielinizzante. Nel caso descritto è suggestivo che la turba del metabolismo lipidico alla base della Lipodistrofia Congenita Generalizzata possa essere in rapporto all'interessamento della mielina.
Summary: Four hundred not preselected male partners of infertile marriages were screened for the... more Summary: Four hundred not preselected male partners of infertile marriages were screened for the presence of anti-sperm antibodies. Serum and seminal plasma specimens from each patient were tested by the modified slide agglutination test (MSAT) and by the sperm-immobilization test. In addition, the IgG MAR test was performed on fresh ejaculates.Thirteen per cent of patients showed sperm agglutinating activity in serum and 5.7% also in seminal plasma. Sperm-immobilizing activity was found in 4.7% of serum and 1% of seminal plasma specimens, always associated with a high titre of sperm agglutinating activity. A highly significant linear correlation was found between the results of the MAR test and serum sperm-agglutinating activity; the presence of sperm-agglutinating activity in seminal plasma was always associated with MAR test positivity > 50%. The incidence of anti-sperm antibodies was not significantly different in patients with normo-, oligo- and azoospermia.The effectiveness and the easiness of both the MAR test and the MSAT do not justify, in our opinion, the utilization of more complex and expensive techniques for the detection of anti-sperm antibodies.Zusammenfassung: Immunologische Screening-Untersuchungen einer männlichen Population aus sterilen EhenVierhundert nicht ausgewählte männliche Partner steriler Ehen wurden auf das Vorhandensein von Spermaantikörpern untersucht. Serum- und Spermaplasmaproben eines jeden Patienten wurden anhand des modifizierten Slide-Agglutinationstests (MSAT) und Sperma-Immobilisationstests untersucht. Zusätzlich wurde der IgG MAR Test am frischen Ejakulat vorgenommen.13% der Patienten wiesen Spermaagglutinations-Aktivitát im Serum und 5,7% ebenso im Spermaplasma auf. Spermaimmobilisierungsaktivität wurde in 4,7% der Serum- und in 1% der Spermaplasmaproben gefunden, jeweils in Verbindung mit einem hohen Sperma-Agglutinations-Aktivitäts-Titer. Zwischen den Ergebnissen des MAR-Tests und der Spermaagglutinationsaktivität wurde eine hochsignifikante lineare Korrelation gefunden. Das Vorhandensein spermaagglutinierender Aktivität im Spermaplasma trat immer in Verbindung mit einem positiven MAR Test von über 50% auf. Das Auftreten der Antisperma-Antikörper war nicht signifikant unterschiedlich bei Patienten mit Normo-, Oligo- und Asthenozoospermie.Die Effektivität und Leichtigkeit sowohl des MAR-Tests als auch des MSAT rechtfer-tigen unserer Meinung nach nicht die Benutzung komplexerer und teurerer Techniken, urn Antisperma-Antikorper nachzuweisen.
Introduction. Sexual dysfunction in diabetic women has received less attention in clinical resea... more Introduction. Sexual dysfunction in diabetic women has received less attention in clinical research than the sexual symptoms of diabetic men. Although conflicting results have been reported, several studies suggest an increased prevalence of deficient vaginal lubrication in women with diabetes mellitus. As support to the hypothesis of a potential diabetes-related arousal dysfunction caused by a decrease in vaginal lubrication of women with Type 1 diabetes mellitus, we describe the following case report.Methods. A 29-year-old white woman was found with a sexual arousal disorder of sudden onset, complicated by loss of orgasm and sexual desire, in absence of any marital, relational, psychological, or gynecological cause.Results. One month later she was diagnosed with severe Type 1 diabetes. With the correction of diabetes and without other treatment of the sexual dysfunction, she experienced a full recovery of her sexual complaints.Conclusions. The case illustrates the importance of being aware of female sexual dysfunction as an early symptom of diabetes mellitus and suggests that a good glycemic control would be fundamental to restore a normal sexual activity in diabetic women. It also demonstrates the need to take into account, not only in males, a sexual history in the management of diabetes mellitus.
Endothelin-1 (ET-1) is a vasoconstrictor peptide which is produced by endothelial cells. The subc... more Endothelin-1 (ET-1) is a vasoconstrictor peptide which is produced by endothelial cells. The subcellular distribution of ET-1 in human skin and the variation of immunostaining for ET-1 by light microscopy in skin biopsies of diabetic patients have been analysed using immunohistochemistry and image analysis quantification. Skin biopsies were collected from 17 patients with type 1 diabetes of different durations and with presence or absence of microangiopathy in the retina; skin biopsies of healthy subjects were utilized as controls. The distribution of ET-1 immunoreactivity (IR) at both light and electron microscopy was compared to that of von Willebrand factor (vWf), a general marker of total cutaneous microvessels. Immunohistochemistry revealed that in controls the distribution of immunostaining was similar for ET-1 and vWf, being localized to microvessels in all areas of the skin. However, at the electron microscopical level ET-1-IR was localized in the endothelial cytoplasm rather than in specific organelles, while vWf immunostaining was associated with Weibel-Palade bodies. ET-1-IR was observed in 4/8 (50 per cent) biopsies from healthy subjects; this increased to 81.8 per cent in biopsies of patients affected by diabetes for less than 10 years and decreased to 16.6 per cent in patients with diabetes for more than 10 years. Quantification of ET-1 staining showed a significant decrease of ET-1-IR in patients affected by diabetes for more than 10 years compared with those affected by diabetes for less than 10 years (P<0.05). Also, the percentage of biopsies showing positive ET-1 staining was lower in patients with retinopathy than in patients without retinopathy. On the contrary, vWf-IR was observed in all skin specimens and its quantification showed no differences between diabetic patients and controls. These changes are not related to variations in the number of blood vessels, and it is suggested that they reflect a possible functional alteration of the endothelial cells during diabetes.
Diabetic neuropathy affects both sensory and autonomic peripheral nerve fibres. Vasoactive intest... more Diabetic neuropathy affects both sensory and autonomic peripheral nerve fibres. Vasoactive intestinal polypeptide (VIP) is present in autonomic fibres which modulate sweat secretion, while calcitonin gene-related peptide (CGRP) is localized to cutaneous sensory fibres. In this study, immunohistochemistry and image analysis were used to assess changes of VIP and CGRP, and of the pan-neuronal marker protein gene-product (PGP)-9.5, in skin biopsies of 18 patients affected by type 1 diabetes (age range 18–46 years) and from seven aged-matched controls. Patients were divided into three groups: group 1 (n=6), with diabetes for 6 months to 3 years; group 2 (n=5), with the disease for 5–10 years; and group 3 (n=7), with diabetes for more than 10 years. VIP immunoreactivity (IR) and PGP-9.5-IR were significantly reduced around sweat glands (P <0.005) in groups 2 and 3. Epidermal CGRP-IR and PGP-9.5-IR were significantly reduced in group 3 (P <0.05). Twenty-eight per cent (5/18) of all patients showed high VIP-IR around sweat glands (>95 per cent confidence limits of controls) and all of these patients had diabetes for less than 3 years. Conversely, 55 per cent (10/18) of patients had low VIP-IR (<5 per cent confidence limit of controls). The latter, compared with the former, showed a significantly longer duration of diabetes (Fisher exact test P=0·002), presence of clinical autonomic neuropathy (Fisher exact test P=0.04), and a reduced sural nerve conduction velocity (Fisher exact test P=0.04). These results suggest that quantitative immunohistochemical analysis of peptide-containing cutaneous nerves allows an objective evaluation of nerve fibre alterations at early stages of diabetes than is currently possible with neurophysiological functional tests.
To compare biochemically active with immunoreactive sperm acrosin in fertile and infertile men. T... more To compare biochemically active with immunoreactive sperm acrosin in fertile and infertile men. This study was conducted in a tertiary care center, the Andrology Clinic, Department of Internal Medicine, University of L'Aquila. We evaluated the males in 40 infertile couples with no recognized cause of female infertility and 20 fertile men. Ejaculates were collected under standardized conditions of abstinence. Total sperm acrosin activity was measured on a spectrophotometer in washed sperm stored at -80 degrees C for 1 to 6 days. The percent of spermatozoa immunostained by an antiserum against proacrosin/acrosin by indirect immunofluorescence (IFL) was determined on methanol fixed sperm smears. Biochemically active acrosin was correlated to immunoreactive acrosin (P = 0.0028), and both were inversely correlated to the percent of spermatozoa with an abnormal head (P = 0.00024 for acrosin activity and P = 0.0013 for IFL). Biochemically active and immunoreactive acrosin were lower in...
Eighty-six couples with long-standing infertility and poor postcoital test, due to oligozoospermi... more Eighty-six couples with long-standing infertility and poor postcoital test, due to oligozoospermia and/or asthenozoospermia (68 cases) or mucus hostility (18 cases), were treated by 411 intrauterine inseminations (IUI) with motile sperm suspensions from the husband's semen. The pregnancy rate per couple in the group with abnormal semen was lower than in the group with mucus hostility (22% versus 38.9%). Influence of seminal and other parameters on outcome of IUI was assessed by discriminant analysis, and a significant correlation with pregnancy rate was found for motile sperm count and sperm morphology. Teratozoospermia (normal morphology less than 50%) affected the outcome of IUI both when associated with moderate oligozoospermia and/or asthenozoospermia (motile sperm count greater than or equal to 5 X 10(6)/mL) (success rate per couple: 11.1%), and, even more, when associated with severe oligozoospermia and/or asthenozoospermia (motile sperm count less than 5 X 10(6)/mL), wher...
Background The aim of the present study was to verify whether BNP might detect pre-clinical diast... more Background The aim of the present study was to verify whether BNP might detect pre-clinical diastolic dysfunction (LVDD) in type-2 diabetic patients. Methods One-hundred and twenty-seven consecutive outpatients with type-2 diabetes mellitus were enrolled into the study. Subjects with overt heart failure or NYHA class > 1, history of coronary artery disease, severe valvulopathy or chronic atrial fibrillation were excluded from the study. All patients underwent clinical evaluation, laboratory assessment of brain natriuretic peptide (BNP) and echocardiographic examination. Results No patients showed systolic impairment of left ventricular function, whereas diastolic dysfunction was detected in 53 (42%) cases (all impaired relaxation). Median BNP was 27 pg/ml without any significant difference between 76 patients with normal left ventricular function and 53 with diastolic dysfunction; in 54 (43%) patients showing HBA1C≥8 (uncontrolled diabetes) normal function was found in 32 and diastolic dysfunction in 22, with a significant difference of BNP at multivariate analysis (OR = 1.02, 95%CI = 1.05-1.09, p = 0.003). In uncontrolled diabetic cohort, BNP was a strong predictor for LVDD (OR = 2.7, 95%CI = 1.3-5.6, p = 0.006) along with the duration of diabetes (OR = 1.6, 95%CI = 1.1-2.9, p = 0.046). BNP > 25 pg/ml was a cut-off value with high accuracy to detect a LVDD. Discussion Early screening of high-risk patients for diabetic cardiomyopathy development might be useful to better control glycemic profile in order to reduce heart disease progression or even to reverse it Conclusions BNP could be a cheap, easy and useful tool to screen those ones with preclinical ventricular diastolic dysfunction in a subset of patients particularly prone to develop cardiovascular complications, like uncontrolled diabetic patients.
Summary: The immunoreaction for acrosin in different morphological types of human spermatozoa was... more Summary: The immunoreaction for acrosin in different morphological types of human spermatozoa was evaluated by light microscopy in the semen of 68 male partners of infertile couples. The antigen had a cup-shaped distribution in the anterior region of the head in normal spermatozoa, and in those with an isolated abnormal mid-piece or tail. On the contrary acrosin was absent, or it did not show a cup-shaped immunostaining, in most spermatozoa with malformed heads with the exception of those with a large oval form. The assessment of immunoreaction for acrosin and of vitality of different morphological types of spermatozoa in the same ejaculates, suggested that the antigen was intrinsically absent in abnormal-headed but vital spermatozoa. It is concluded that an inherent lack, or an abnormal synthesis of acrosin during spermatogenesis is associated to the abnormal development of the spermatozoa head.Zusammenfassung: Mittels der Lichtmikroskopie wurde die Immunreaktion für Akrosin bei verschiedenen Formen menschlicher Spermatozoen im Sperma von 68 Männern aus einer infertilen Ehe untersucht. Es zeigte sich eine kappenförmige Verteilung des Antigens in der vorderen Region des normalen Spermatozotenkopfes und zwar bei einer isolierten Abnormalität des Mittelteils oder des Schwanzes. Im Gegensatz dazu fehlte Akrosin bzw. zeigte keine kappenförmige Immunfärbung bei den meisten Spermatozoen mit Fehlbildungen des Kopfes jedoch nicht bei den großen ovalen Formen. Die Beurteilung der Immunreaktion für Akrosin und der Vitalität bei den verschiedenen morphologischen Formen der Spermatozoen in den gleichen Ejakulaten legt es nahe, daß das Antigen wirklich abwesend war bei abnormalen Kopfformen, die jedoch vitalen Spermatozoen angehörten. Hieraus wird die Schlußfolgerung gezogen, daß ein angeborener Mangel oder eine abnormale Synthese des Akrosins während der Spermatogenese mit der abnormalen Entwicklung des Spermatozoenkopfes vergesellschaftet ist.
The objective was to evaluate HLA DR/DQ alleles and their risk factor for type 1 diabetes in the ... more The objective was to evaluate HLA DR/DQ alleles and their risk factor for type 1 diabetes in the Abruzzo region (central Italy). Sixty incident cases from the Abruzzo region were studied together with 120 unrelated control subjects living in the same administrative areas. The relative risk of diabetes associated with the alleles under study was calculated by deriving the odds ratio (OR) maximum likelihood estimates and their 95% confidence intervals (CI) by the exponentiation of the logistic regression beta–parameter. The combination DRB1*03/DQA1*0501/DQB1*0201 was found in 20.0% of patients and 7.1% of the control subjects, conferring an OR of 4.04 and a CI of 1.97–8.49. The combination DRB1*04/DQA1*0301/DQB1*0302 was found in 23.3% of diabetic patients and 6.7% of controls, giving an OR of 5.69 and a CI of 2.77–12.05. DRB1*11/DQA1*0505/DQB1*0301 and DQA1*0505/DQB1*0301 were negatively associated with type 1 diabetes (OR=0.27, CI 0.11–0.57; OR=0.07, CI 0.02–0.19). The DQA1 genotype at risk was found to be DQA1*0301/DQA1*0501: OR=23.80, CI 2.97–190.89, as it occurred with the highest frequency in the patient group. The DQB1 genotype at risk was found to be DQB1*0201/DQB1*0302, which occurred in 13.3% of patients but in only 1.1% of the control group (OR=29.75, CI 5.36–549.25). Our results shed further light on the risk of development of this disease during a specific time period in an area where the overall incidence of type 1 diabetes is known.
We report the case of a 22 year old woman with congenital generalized lipodystrophy who presented... more We report the case of a 22 year old woman with congenital generalized lipodystrophy who presented a left brachiocrural pyramidal hemisyndrome, bilateral cerebellar signs and a left cranial nerve VI deficit. The clinical pattern had a tendency to regress. MRI brainscan, CSF examination and clinical features led to the diagnosis of “probable demyelinating syndrome”. Published data on CNS involvement in patients with congenital generalized lipodystrophy are few and we have found no cases in which a demyelinating syndrome is associated. In the case we report it is tempting to see the disorder of the lipid metabolism underlying the congenital generalized lipodystrophy as underlying the myelin disorder as well. Descriviamo il caso di una paziente di 22 anni, affetta da Lipodistrofia Congenita Generalizzata, che ha presentato una sintomatologia caratterizzata da emisindrome piramidale brachiocrurale sinistra, segni cerebellari bilaterali e deficit del VI nervo cranico di sinistra. Il quadro clinico ha avuto una tendenza alla regressione. La RMN encefalo, l'esame del liquor e la clinica hanno fatto porre diagnosi di “probabile sindrome demielinizzante”. I dati della letteratura relativi al coinvolgimento del SNC in pazienti con Lipodistrofia Congenita Generalizzata sono scarsi ed in particolare non abbiamo rilevato casi di associazione con sindrome demielinizzante. Nel caso descritto è suggestivo che la turba del metabolismo lipidico alla base della Lipodistrofia Congenita Generalizzata possa essere in rapporto all'interessamento della mielina.
Summary: Four hundred not preselected male partners of infertile marriages were screened for the... more Summary: Four hundred not preselected male partners of infertile marriages were screened for the presence of anti-sperm antibodies. Serum and seminal plasma specimens from each patient were tested by the modified slide agglutination test (MSAT) and by the sperm-immobilization test. In addition, the IgG MAR test was performed on fresh ejaculates.Thirteen per cent of patients showed sperm agglutinating activity in serum and 5.7% also in seminal plasma. Sperm-immobilizing activity was found in 4.7% of serum and 1% of seminal plasma specimens, always associated with a high titre of sperm agglutinating activity. A highly significant linear correlation was found between the results of the MAR test and serum sperm-agglutinating activity; the presence of sperm-agglutinating activity in seminal plasma was always associated with MAR test positivity > 50%. The incidence of anti-sperm antibodies was not significantly different in patients with normo-, oligo- and azoospermia.The effectiveness and the easiness of both the MAR test and the MSAT do not justify, in our opinion, the utilization of more complex and expensive techniques for the detection of anti-sperm antibodies.Zusammenfassung: Immunologische Screening-Untersuchungen einer männlichen Population aus sterilen EhenVierhundert nicht ausgewählte männliche Partner steriler Ehen wurden auf das Vorhandensein von Spermaantikörpern untersucht. Serum- und Spermaplasmaproben eines jeden Patienten wurden anhand des modifizierten Slide-Agglutinationstests (MSAT) und Sperma-Immobilisationstests untersucht. Zusätzlich wurde der IgG MAR Test am frischen Ejakulat vorgenommen.13% der Patienten wiesen Spermaagglutinations-Aktivitát im Serum und 5,7% ebenso im Spermaplasma auf. Spermaimmobilisierungsaktivität wurde in 4,7% der Serum- und in 1% der Spermaplasmaproben gefunden, jeweils in Verbindung mit einem hohen Sperma-Agglutinations-Aktivitäts-Titer. Zwischen den Ergebnissen des MAR-Tests und der Spermaagglutinationsaktivität wurde eine hochsignifikante lineare Korrelation gefunden. Das Vorhandensein spermaagglutinierender Aktivität im Spermaplasma trat immer in Verbindung mit einem positiven MAR Test von über 50% auf. Das Auftreten der Antisperma-Antikörper war nicht signifikant unterschiedlich bei Patienten mit Normo-, Oligo- und Asthenozoospermie.Die Effektivität und Leichtigkeit sowohl des MAR-Tests als auch des MSAT rechtfer-tigen unserer Meinung nach nicht die Benutzung komplexerer und teurerer Techniken, urn Antisperma-Antikorper nachzuweisen.
Introduction. Sexual dysfunction in diabetic women has received less attention in clinical resea... more Introduction. Sexual dysfunction in diabetic women has received less attention in clinical research than the sexual symptoms of diabetic men. Although conflicting results have been reported, several studies suggest an increased prevalence of deficient vaginal lubrication in women with diabetes mellitus. As support to the hypothesis of a potential diabetes-related arousal dysfunction caused by a decrease in vaginal lubrication of women with Type 1 diabetes mellitus, we describe the following case report.Methods. A 29-year-old white woman was found with a sexual arousal disorder of sudden onset, complicated by loss of orgasm and sexual desire, in absence of any marital, relational, psychological, or gynecological cause.Results. One month later she was diagnosed with severe Type 1 diabetes. With the correction of diabetes and without other treatment of the sexual dysfunction, she experienced a full recovery of her sexual complaints.Conclusions. The case illustrates the importance of being aware of female sexual dysfunction as an early symptom of diabetes mellitus and suggests that a good glycemic control would be fundamental to restore a normal sexual activity in diabetic women. It also demonstrates the need to take into account, not only in males, a sexual history in the management of diabetes mellitus.
Endothelin-1 (ET-1) is a vasoconstrictor peptide which is produced by endothelial cells. The subc... more Endothelin-1 (ET-1) is a vasoconstrictor peptide which is produced by endothelial cells. The subcellular distribution of ET-1 in human skin and the variation of immunostaining for ET-1 by light microscopy in skin biopsies of diabetic patients have been analysed using immunohistochemistry and image analysis quantification. Skin biopsies were collected from 17 patients with type 1 diabetes of different durations and with presence or absence of microangiopathy in the retina; skin biopsies of healthy subjects were utilized as controls. The distribution of ET-1 immunoreactivity (IR) at both light and electron microscopy was compared to that of von Willebrand factor (vWf), a general marker of total cutaneous microvessels. Immunohistochemistry revealed that in controls the distribution of immunostaining was similar for ET-1 and vWf, being localized to microvessels in all areas of the skin. However, at the electron microscopical level ET-1-IR was localized in the endothelial cytoplasm rather than in specific organelles, while vWf immunostaining was associated with Weibel-Palade bodies. ET-1-IR was observed in 4/8 (50 per cent) biopsies from healthy subjects; this increased to 81.8 per cent in biopsies of patients affected by diabetes for less than 10 years and decreased to 16.6 per cent in patients with diabetes for more than 10 years. Quantification of ET-1 staining showed a significant decrease of ET-1-IR in patients affected by diabetes for more than 10 years compared with those affected by diabetes for less than 10 years (P<0.05). Also, the percentage of biopsies showing positive ET-1 staining was lower in patients with retinopathy than in patients without retinopathy. On the contrary, vWf-IR was observed in all skin specimens and its quantification showed no differences between diabetic patients and controls. These changes are not related to variations in the number of blood vessels, and it is suggested that they reflect a possible functional alteration of the endothelial cells during diabetes.
Diabetic neuropathy affects both sensory and autonomic peripheral nerve fibres. Vasoactive intest... more Diabetic neuropathy affects both sensory and autonomic peripheral nerve fibres. Vasoactive intestinal polypeptide (VIP) is present in autonomic fibres which modulate sweat secretion, while calcitonin gene-related peptide (CGRP) is localized to cutaneous sensory fibres. In this study, immunohistochemistry and image analysis were used to assess changes of VIP and CGRP, and of the pan-neuronal marker protein gene-product (PGP)-9.5, in skin biopsies of 18 patients affected by type 1 diabetes (age range 18–46 years) and from seven aged-matched controls. Patients were divided into three groups: group 1 (n=6), with diabetes for 6 months to 3 years; group 2 (n=5), with the disease for 5–10 years; and group 3 (n=7), with diabetes for more than 10 years. VIP immunoreactivity (IR) and PGP-9.5-IR were significantly reduced around sweat glands (P <0.005) in groups 2 and 3. Epidermal CGRP-IR and PGP-9.5-IR were significantly reduced in group 3 (P <0.05). Twenty-eight per cent (5/18) of all patients showed high VIP-IR around sweat glands (>95 per cent confidence limits of controls) and all of these patients had diabetes for less than 3 years. Conversely, 55 per cent (10/18) of patients had low VIP-IR (<5 per cent confidence limit of controls). The latter, compared with the former, showed a significantly longer duration of diabetes (Fisher exact test P=0·002), presence of clinical autonomic neuropathy (Fisher exact test P=0.04), and a reduced sural nerve conduction velocity (Fisher exact test P=0.04). These results suggest that quantitative immunohistochemical analysis of peptide-containing cutaneous nerves allows an objective evaluation of nerve fibre alterations at early stages of diabetes than is currently possible with neurophysiological functional tests.
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Papers by Gianfranco Poccia