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The aim of this study was to evaluate postoperative changes in sperm chromatin heterogeneity in varicocele patients. In 15 infertile patients with varicocele, sperm parameters including concentration, motility, and morphology were evaluated before and after surgical correction of varicocele. Sperm motion analysis using computer-assisted semen analyzer (CASA) was also performed. To analyze the sperm nuclear proteins, the acridine orange staining method was used. On semen analysis, sperm concentration and motility significantly increased after surgery (p = 0.002, p = 0.003, respectively), although sperm morphology was unaltered postoperatively. CASA parameters, including velocity, linearity, amplitude of lateral head displacement and beat cross frequency were unaltered postoperatively. On the other hand, acridine orange staining significantly increased postoperatively (p = 0.002). Varicocele influences the sperm chromatin condition, as well as sperm concentration and motility.

Fifteen patients 60 to 80 years old (a mean of 72 years) with hormone-refractory prostate cancer were treated with low dose prednisolone. All patients had previously undergone hormone therapy. Prostate specific antigen (PSA) values decreased in 11 cases (73%), of which 4 had PSA decreases of 50% or greater. Serum levels of DHEAS significantly decreased at 4 and 8 weeks after treatment (both intervals were p < 0.05 vs pretreatment). Of 8 patients with bone metastasis evaluation, 2 (25%) showed improvement of the lesion. In 5 patients (33%), relief of pain was observed one month after starting prednisolone. The one-year survival rate was 58%. The side effects were mild and manageable in an outpatient clinic.

The aim of this study was to evaluate the correlation of new of Sperm Quality Analyzer (SQA-V) with the computer-assisted sperm analysis (CASA) and manual semen analysis estimates. One hundred five fresh semen samples were analyzed using SQA-V and CASA and manual semen analysis. Significant correlations of sperm concentration (p < 0.0001), sperm motility (p < 0.0001), and normal morphology (p < 0.0001) were observed between SQA-V variables and manual semen analysis estimates. There also were significant correlations of sperm concentration (p < 0.0001), sperm motility (p < 0.0001), and sperm velocity (p = 0.0235) between SQA-V variables and CASA estimates. Meanwhile, it did not correlate with amplitude of lateral head displacement, beat cross frequency, lineality assessed by CASA. The value of the sperm concentration and the sperm motility measured by SQA-V showed high correlations with the value of those measured by CASA and manual semen analysis. In addition, velocity and sperm morphology may also be evaluated to some extent using SQA-V.

Twenty-two idiopathic infertile patients were treated with Oriental herbal medicine, Bu-zhong-yi-qi-tang (Hochu-ekki-to). Seminal plasma sFas level elevated significantly after herb administration. There was an inverse correlation between seminal plasma IL-6 level and sperm concentration before treatment. After the administration of herb seminal plasma, sFas levels significantly correlated with sperm concentration. Seminal plasma IL-8 level did not change. Certain kinds of cytokine in the seminal plasma might play some role in improving semen quality with treatment.

Laparoscopy revealed a left inguinal testis and a right abdominal testis. Surgery revealed uterus-like structures. The bilateral testes showed primitive testis without ovarian tissue. Physical examination showed a normal and an empty scrotum with a nonpalpable gonad. Chromosome analysis revealed 46,XY. Pathological findings demonstrated the immature testis and the immature uterus.

The seminal plasma levels of soluble Fas (sFas) and interleukins IL-6 and IL-8 were measured and their relationship with semen qualities was examined. The seminal plasma sFas level in fertile males was significantly higher than that in the infertile group. On the other hand, seminal plasma level of IL-6 was significantly lower in fertile males than in the infertile group. In the infertile group, patients with oligozoospermia had a lower seminal plasma sFas and a higher IL-6 level than those with normal sperm concentration. There was an inverse correlation between IL-6 and sperm concentration in infertile patients. Seminal plasma IL-8 was not correlated with sperm parameters. It would appear that certain kinds of cytokine in the seminal plasma might play an important role in improving semen quality.

Hematospermia is supposed to be derived from pathological conditions in the seminal vesicle, prostate, testis, epididymis, or urethra. A recent advance in diagnostic procedures has demonstrated the seminal vesicle, the prostate, and midline cyst as potential sources of hematospermia. The authors describe a case of hematospermia caused by ejaculatory duct obstruction, in which a transurethral technique was successful. A 51-year-old male was referred to the authors' clinic with a chief complaint of hematospermia. Transurethral ultrasonography showed a cystic lesion surrounded with hyperechoic area in the middle of the prostate. Vasography demonstrated the distal dilation of the ejaculatory duct. Magnetic resonance imaging demonstrated a high signal intensity area in the middle of the prostate. Urethrocystoscopy showed an enlarged cystic lesion with an orifice at the prostatic urethra, which was incised endoscopically. There was no complication observed postoperatively. Seven months after the technique, hematospermia resolved completely. A midline cyst should be considered a cause of hematospermia and the incidence of such cysts may be higher than that previously recognized. The transurethral technique is expected to be a successful treatment approach.

The Acrobeads test was performed on semen samples from 43 patients with varicocele before and after varicocelectomy. Sperm motility significantly increased after surgery ( p <.05), while sperm concentration and motile sperm concentration did not alter postoperatively. Sperm motion analysis using CellSoft 3000 did not demonstrate a significant change after treatment. Acrobeads score significantly increased after the procedure ( p <.005). Pregnancy was achieved in 10 patients (28%). Acrobeads score in cases that achieved pregnancy was increased postoperatively ( p <.005). The percentage of patients with a postoperative increase in Acrobeads score in the group that achieved pregnancy was significantly higher than that observed in the unsuccessful group ( p <.05). Sperm parameters other than the Acrobeads score did not show a significant difference between the successful and unsuccessful patients. The Acrobeads test assessed postoperatively can be useful in precisely evaluating fertility potential after varicocele repair.

A Leydig cell line, TTE1, was established from the temperature-sensitive simian virus 40 large T-antigen transgenic mice. The cells showed temperature-sensitive growth characteristics and a differentiated phenotype at a nonpermissive temperature. To identify differentially expressed genes in the process of Leydig cell differentiation, the authors carried out microarray analysis of TTE1 cells cultured at permissive and nonpermissive temperatures. The resulting fluorescence-labeled cDNAs synthesized from mRNAs were hybridized with Clontech's Atlas glass mouse 1.0 microarrays. Of the 1081 genes analyzed, the levels of 31 genes were changed, with 24 genes showing increased levels of expression and the remaining 7 genes showing decreased levels. Tie2 was the most changed transcript, with a 13.5-fold upregulation under the differentiated condition. The authors believe this to be the first report of broadscale gene expression in Leydig cell differentiation using the microarray technology. The ability to analyze broadscale gene expression in this manner provides a powerful tool for investigating the molecular mechanisms of Leydig cell functions.

A Leydig cell line, TTE1, has been established from transgenic mice harboring a temperature-sensitive simian virus 40 (tsSV40) large T-antigen gene. The cells grew at a permissive temperature (33°C), but growth was markedly prevented at a nonpermissive temperature (39°C). T-antigen was expressed in the nuclei at 33°C but disappeared at 39°C, indicating that the cells show a temperature-sensitive growth phenotype reflected by the tsSV40 large T-antigen. TTE1 cells did not show any colony-forming activity in soft agar and form tumors in subcutaneous tissue in nude mice, indicating that the cells were not transformed. Alkaline phosphatase and 3 -hydroxysteroid dehydrogenase (HSD) activities or expression of cytokeratin and vimentin were observed. Reverse transcription-polymerase chain reaction (RT-PCR) analysis indicated that TTE1 cells expressed mRNAs encoding 17 -HSD types 1 and 3, and inhibin- . The cells with unique characteristics, therefore, should serve as a useful model to study the function of Leydig cell.

The ability of pentoxifylline to stimulate sperm motility characteristics was assessed. The effect of pentoxifylline was immediate and lasted for 240 min. The percent motility was increased 1.5-fold when compared with the control at 120,180, and 240 min after pentoxifylline treatment. Significant increases in velocity and amplitude of lateral head displacement by the agent were observed at 120 min after the start of incubation. Conversely, linearity was reduced by pentoxifylline. Beat-cross frequency did not show any significant change by the agent at any time point. Sperm swelling was not influenced by pentoxifylline throughout the experiment. It would appear that pentoxifylline stimulates sperm motion in vitro with no change of the sperm membrane.

The hypoosmotic swelling test is a simple test for measuring the functional competence of human sperm membrane. Thirty-five patients with varicocele were assessed by hypoosmotic swelling test and the results were compared with those in patients with idiopathic infertility. Percentage of swollen sperm in varicocele tended to be lower than that in idiopathic infertility, especially in sperm concentration between 30 × 106/mL and 40 × 106/mL. Varicocele with sperm motility of 40% or more revealed lower percentage of swollen sperm than idiopathic infertility did. The results indicate that varicocele may particularly injure sperm membrane function because hypoosmotic swelling test is a test for measuring functional ability of human sperm membrane. The percentage of swollen sperm recovered after the operation earlier than did the other sperm parameters such as sperm concentration or motility, which indicates that impaired sperm membrane injury by varicocele is reversible.

The hypoosmotic swelling test is a simple test for measuring the functional competence of the human sperm membrane. Fifty-four patients with idiopathic infertility were assessed by hypoosmotic swelling test and the results were compared with those of routine semen analysis and zona-free hamster ovum human sperm penetration test (ZSPT). Semen samples with abnormal semen parameters had lower percentage of swollen sperm in comparison with those with normal semen parameters. A positive correlation was observed between sperm concentration and sperm swelling (r - .50, p < .05). A strong positive correlation was observed between the percentage of sperm motility and the percentage of swollen sperm (r - 0.60, p < .01), and between motile sperm concentration and sperm swelling (r - .62, p < .01). On the other hand, sperm swelling correlated only weakly with the percentage of sperm penetration. The results indicate that the hypoosmotic swelling test appears to evaluate different functional qualities of sperm than ZSPT.

Epidermal growth factor (EGF), first identified in extracts from submaxillary salivary glands of adult male mice, acts as a potent mitogen in a wide variety of cells and tissues in culture. Human EGF, a polypeptide of 53 amino acids isolated from human urine, has been identified in several biological fluids, including prostatic fluid and seminal plasma. Epidermal growth factor content in seminal plasma was measured by RIA. The EGF content in seminal fluid did not change after bilateral vasectomy and the first fraction of sample obtained by split ejaculation contained a significantly larger amount of EGF than the second fraction. Seminal EGF originates from the prostate. There was a close correlation between EGF and zinc contents in seminal fluid. The seminal fluid EGF content was lowered in patients with prostatitis and systemic androgen deficiency. The EGF content in seminal fluid seems to be a reliable indicator of prostatic function.

To investigate whether there is a relationship between seminal plasma transfer' concentration and hypoosmotic swelling of the sperm, semen samples from 46 infertile patients were examined. Seminal plasma transferrin concentration in oligozoospermic subjects (sperm concentration <20 × 106/mL) was significantly lower than that in normozoospermic subjects (sperm concentration ≥20×106/mL) (p < .05). Patients with ≥50% swollen sperm showed significantly higher transferrin concentration in seminal plasma than those with <50% swollen sperm (p < .05), while in oligozoospermic patients no difference was observed between seminal plasma transferrin concentration and hypoosmotic swelling. No relationship between seminal plasma transferrin concentration and serum gonadotropin levels was demonstrated. The results indicate that transferrin synthesis is important to sperm membrane integrity and functional competence. However, subsequent fertility must be examined to determine whether seminal plasma transferrin levels are predictive of fertilizing capacity.

Sixty patients with varicocele, complaining of infertility, underwent a corrective operation. Eighteen (30%) of the 60 patients impregnated their mates (impregnating group). Sperm concentration significantly increased after the operation in the impregnating group (p < .05), but not in the patients who failed to impregnate their mates (nonimpregnating group). Sperm motility was not altered after the operation in these two groups. Sperm velocity significantly increased postoperatively in the impregnating group (p < .05), while linearity was not altered in either group. Sperm swelling significantly increased postoperatively in the impregnating group (p < .05), but not in the nonimpregnating group. Preoperative sperm parameters were not different between the two groups. Varicocele may disturb sperm function including sperm motion besides spermatogenesis and may impair the fertility potential. However, a prospective large-scale controlled study is required to obtain a definitive conclusion.

Acrosome-reacted sperm was examined in infertile and fertile males using the Acrobeads test. The Acrobeads score was significantly higher in fertile males than in infertile males with normal or abnormal seminal findings (p < .005 and p < .001, respectively). The Acrobeads score was 2 or more in all the fertile males, but 62% of the infertile males with abnormal seminal findings (p < .02). Therefore, a disturbance in the acrosome reaction is suggested to be one of the causes of decreased fertility potential. A high correlation was found between Acrobeads score and sperm motility (r = .46,p < .001) or motile sperm concentration (r = .51,p < .0001). The Acrobeads test, the results of which reflect the acrosome condition of the sperm, is useful in the assessment of sperm function related to fertility.

The functional competence of the human sperm membrane is assessed by studying the swelling reaction of sperm when suspended in a medium of distilled water (water test). Eighty-seven patients with idiopathic infertility were investigated by the water test and the results were compared with various semen parameters. High correlations with the percentage of b-g type swollen sperm in the water test were observed for sperm concentration (r = .53, p < .05) and percent motility (r = .62, p < .01). The sperm swelling values obtained by the water test correlated well with those obtained by the hypoosmotic swelling test (HOST). Correlation coefficients in b-g and g swelling pattern were 0.89 and 0.71, respectively. The percentage of g-type swelling obtained by the water test was significantly larger than that obtained by the HOST (p < .05), although the two hypoosmotic procedures gave similar percentages of b-g swelling pattern. The percentage of g swelling pattern obtained by the water test correlated well with percent motility (r = .70, p < .001). These findings suggest that the water test is more useful for assessing the integrity of the sperm membrane than the HOST. The relationship between this test and subsequent fertility, as well as to other sperm function tests, needs further investigation.

By means of a triple-stain technique, the acrosome reaction in infertile and fertile males was investigated. The highest correlations with the percentage of acrosome-reacted sperm were found for motile sperm concentration (r - .60, p < .01) and percent motility (r = .58, p < .05). Significant correlations were also demonstrated between acrosome reactivity and both sperm concentration (r - .50, p < .05) and velocity (r = .40, p < .05). There was only a weak correlation between the percentage of acrosome-reacted sperm and that of swollen sperm. The ratio of acrosome-reacted sperm demonstrated in oligoasthenozoospermic patients was significantly lower than that observed in normozoospermic or fertile males (both, p < .05). There was no significant difference in the ratio of acrosome-reacted sperm between normozoospermic and fertile males. However, all the cases in the latter group had 15% or more acrosome-reacted sperm, whereas the parameter was widely distributed in the former group and some in this group had a decreased ratio. It would appear that a disturbance of the acrosome reaction is one of the causes of reduced fertility potential in normozoospermic males.

This study was designed to investigate the functional changes in Sertoli cells following clomiphene citrate administration to patients with idiopathic infertility. The agent was administered to 44 oligozoospermic patients. Patients with improvement in sperm concentration after treatment (improvement group) showed significantly lower pretreatment follicle-stimulating hormone (FSH) levels in serum. Serum FSH and testosterone levels significantly increased in the improvement group after treatment (both p < 0.05). Seminal transferrin concentration significantly increased in the improvement group after treatment (p < 0.05), although there was no significant difference between pretreatment seminal transferrin concentration in the improvement group and that in patients with no improvement in sperm concentration. Seminal plasma transferrin concentration in patients in whom pretreatment luteinizing hormone level in serum was below 10 mlU/mL, and in those in whom the ratio of post- to pretreatment values was 1.5 or more, tended to increase after treatment. This group also contained a few more patients with improvement in sperm concentration than the other groups. The patients showing low pretreatment FSH levels and a high ratio of post- to pretreatment values demonstrated a significant increase in seminal plasma transferrin concentration after treatment (p < 0.01), and this group contained more patients with improvement than the other groups. It would appear that Sertoli cell stimulation may induce an increase in sperm concentration after clomiphene citrate administration, and the elevated transferrin secretion seems to be associated with the increase of serum FSH level after treatment.

The Resazurin Reduction Test was performed on semen specimens from 27 patients with varicocele before and aftervaricocelectomy. The increases in both sperm concentration and motility were slight 3 months after surgery, but sperm concentration significantly improved 6 months after surgery (P < 0.01). The positive rate in the Resazurin Test significantly increased 3 and 6 months after surgery (each, P < 0.05) and the resazurin grade also increased at these times (each, P < 0.01). Of 13 patients with improved seminal findings, 7 had negative reactions during the preoperative Resazurin Test and 3 of these 7 patients continued to have negative reactions, while the other 4 had positive reaction after surgery. Of 14 patients with no improvement of semen characteristics, 6 continued to have negative reactions after surgery, but 4 with negative reactions before treatment showed positive reactions postoperatively. The Resazurin Test seems to assess fertility potential accurately after varicocelectomy.

Two hundred and seven patients with male infertility were investigated. Total sperm concentration and percent progressive motility by SQA IIB showed high correlations with those of conventional manual method. Percent of normal morphology showed a significant correlation among these techniques. The sperm motility index (SMI) and total functional sperm concentration (TFSC) demonstrated high correlations with any variables of manual analysis. Only velocity and amplitude of lateral head displacement showed significant correlations with the variables obtained by SQA IIB, especially with SMI and TFSC. It was suggested that SQA IIB could be a useful instrument in the clinical practice of infertility as a screening test for semen quality.