Peroxidase-positive Cells Research Articles

Comparative Evaluation of Prostatic Smear and Semen Analysis in The Diagnosis of Chronic Prostatitis

Abstract Background Chronic prostatitis is one of the most common medical problems among andrology and urology patients. Besides being the primary problem in many cases, it seems to play an important contributing role “major or minor” in a significant proportion of patients whether at the level of fertility, sexology or venerology. Consequently, effective management of the prostatic pathology has a great impact on the overall successful management of such andrologic problem. Aim of the Work to provide an objective comparison between traditional prostatic discharge analysis and traditional semen analysis as regards detection of pus cells in cases of prostatitis as well as to assess the possible advantage(s) of applying some modifications to enhance the diagnostic value of the previous techniques. These would include preliminary centrifugation of expressed prostatic discharge and preliminary peroxidase staining of semen sample before microscopic examination. Patients and Methods This pilot study included 40 patients suffering from prostatitis except acute prostatitis. The patients were recruited from the outpatient clinic of Venerology and Andrology department of Ain Shams University Hospitals in the period from February 2021 to November 2021. Results The current study included 40 patients suffering from any kind of prostatitis except acute prostatitis. Their age ranged between 30 and 50 years old with a mean age of 39.60 ± 4.52 years. Duration of disease ranged from 4-18 months with a mean of 7 ± 3.1 months. Most of patients were married (38, 95%). Main symptoms presented among studied patients were groin pain (37.5%), groin pain and painful micturition (20%) and groin pain, painful micturition and sexual problems (42.5%) Conclusion prostatic smear examination revealed higher sensitivity in detection of infection compared to semen analysis especially if combined with centrifugation. In addition, peroxidase positive cell testing revealed a significant role in detection of infection if the diagnosis is made solely on semen analysis results.

Analytical validation of five diagnostic tests for the detection of polymorphonuclear cells in stallion semen.

The objectives of this study were to evaluate the ability of five diagnostic tests to detect polymorphonuclear cells (PMNs) in stallion semen, and to determine the concentration of PMNs that affects sperm motility. We hypothesized that all tests have diagnostic value, and even low concentrations of PMNs affect motility. One ejaculate was obtained from six stallions. Aliquots of 50×106 purified sperm were incubated, in triplicate, with six concentrations of purified PMNs: 1) no PMNs, 2) 0.25×106 PMN/ml, 3) 0.5×106 PMN/ml, 4) 2.5×106 PMN/ml, 5) 5×106 PMN/ml, 6) 10×106 PMN/ml. The PMNs were quantified using a hemacytometer, cytology, a leucocyte esterase dipstick test (LEDT), a peroxidase test, and CD13 immunolabeling. Sperm motility was evaluated after 4 h at 38 °C. The number of leucocytes detected with the LEDT differed among treatments (P<0.0001), from negative results in control samples to moderate or large numbers in the samples with the highest PMN concentration. The hemacytometer count and CD13 immunostaining detected differences with the control treatment at the lowest PMN concentration (2.5×106 PMN/ml; P<0.001). Sperm motion was lower in samples with ≥5×106 PMN/ml (P<0.0001). Thus, a sample was considered leucospermic if it contained ≥5×106 PMN/ml. The LEDT had the best sensitivity (100%), followed by cytology (78%), peroxidase test (60%), CD13 immunostaining (56%) and hemacytometer count (47%). The LEDT had the lowest specificity (65%), which was 95% for all other tests. In conclusion, the LEDT was a simple, economic and sensitive stall-side test to screen semen for presence of PMNs. Because of the lower specificity, positive LEDT results should be confirmed with the identification of peroxidase-positive cells or CD13-positive cells.

Diagnosis of leucospermia in the stallion

The lack of standardized tests and interpretative criteria makes the diagnosis of stallion leucospermia difficult. Our objectives were to evaluate the ability of six diagnostic tests to detect polymorphonuclear cells (PMNs) in stallion semen, and to determine the concentration of PMNs that affects sperm motility. We hypothesized that all tests have diagnostic value, and that low concentrations of PMNs affect sperm motility. One ejaculate was obtained from six stallions. Aliquots of 50 ×106 purified sperm from each stallion were incubated with six concentrations of purified PMNs: 1) no PMNs, 2) 0.25 ×106 PMN/ml, 3) 0.5 ×106 PMN/ml, 4) 2.5 ×106 PMN/ml, 5) 5 ×106 PMN/ml, and 6) 10 ×106 PMN/ml. Each treatment was performed in triplicate. The PMNs were quantified using a hemacytometer (phase contrast microscopy), cytology (light microscopy), a commercial leucocyte esterase test (dipstick), a commercial peroxidase test (light microscopy), and immunolabeling of the neutrophil marker CD13 (flow cytometry). Sperm motility was evaluated after 4 h at 38 °C. The frequency of results obtained with the esterase test differed among treatments (P<0.0001). Negative or trace results were observed only with ≤ 0.5 ×106 PMNs/ml. A small number was observed in intermediate samples. In samples with ≥ 5 ×106 PMN/ml, only moderate or large results were obtained. Among quantitative tests, the hemacytometer count and flow cytometry detected differences with the control treatment at the lowest PMN concentration (2.5 ×106 PMN/ml; P<0.001). Total and progressive sperm motility were lower in samples with ≥5 ×106 PMN/ml than in those with lower concentrations (P<0.0001). Thus, a sample was considered leucospermic with ≥ 5 ×106 PMN/ml. The leucocyte esterase dipstick test had the best sensitivity (100%), followed by cytology (78%), peroxidase test (60%), flow cytometry (56%) and hemacytometer count (47%). The esterase test had the lowest specificity (65%), whereas the specificity of all other tests was 95%. In conclusion, presence of ≥5 ×106 PMNs/ml was associated with impaired sperm motility. The leucocyte esterase dipstick test is a simple, economic and sensitive stall-side test to screen semen for presence of PMNs in quantities capable of affecting sperm motility. Because of the lower specificity, we recommend confirming positive esterase results with the identification of peroxidase-positive cells under light microscopy, or CD13-positive cells using flow cytometry.

Biological, histological and immunohistochemical studies on the toxicity of spent coffee grounds and caffeine on the larvae of Aedes aegypti (Diptera: Culicidae).

The mosquito Aedes aegypti is a primary vector for major arboviruses, and its control is mainly based on the use of insecticides. Caffeine and spent coffee grounds (CG) are potential agents in controlling Ae. aegypti by reducing survival and blocking larval development. In this study, we analyzed the effects of treatment with common CG (CCG: with caffeine), decaffeinated CG (DCG: with low caffeine), and pure caffeine on the survival, behavior, and morphology of the midgut of Ae. aegypti under laboratory conditions. Third instar larvae (L3) were exposed to different concentrations of CCG, DCG, and caffeine. All compounds significantly affected larval survival, and sublethal concentrations reduced larval locomotor activity, delayed development, and reduced adult life span. Damage to the midgut of treated larvae included changes in epithelial morphology, increased number of peroxidase-positive cells (more abundant in DCG-treated larvae), and caspase 3-positive cells (more abundant in CCG-treated larvae), suggesting that the treatments triggered cell damage, leading to activation of cell death. In addition, the treatments reduced the FMRFamide-positive enteroendocrine cells and dividing cells compared to the control. CG and caffeine have larvicidal effects on Ae. aegypti that warrant field testing for their potential to control mosquitoes.

Comparative biological assessments of endodontic root canal sealer containing surface pre-reacted glass-ionomer (S-PRG) filler or silica filler.

Surface pre-reacted glass-ionomer (S-PRG) filler releases several ions, such as fluoride, borate and strontium ions, to exert bioactive effects. We fabricated an endodontic root canal sealer containing S-PRG fillers (S-PRG sealer) and then evaluated the antibacterial and anti-inflammatory properties of S-PRG sealer compared with sealer containing conventional silica fillers (silica sealer). Antibacterial tests showed that S-PRG sealer significantly reduced the turbidity of Enterococcus faecalis compared with silica sealer. Implantation of S-PRG or silica sealer blocks in rat subcutaneous tissue showed that S-PRG sealer decreased the proinflammatory response compared with silica sealer at 10 days post-implantation. In addition, immunostaining revealed that infiltration of CD68- and peroxidase-positive cells around the S-PRG sealer was significantly lower than that in silica sealer. Therefore, it was suggested that S-PRG sealer exhibits antibacterial and anti-inflammatory effects.

Updates in protocol for human semen examination.

Currently, the WHO laboratory manual for the examination and processing of human semen (5th edition, 2010) provides updated, standardized, evidence-based procedures and recommendations for laboratory managers, scientists and technicians to follow in examining human semen in a clinical or research setting. Despite the fact, there are several gaps and limitations in the interpretation of this compendium. Mostly, the WHO-protocol of estimation of peroxidase-positive cells and spermatozoa, as well as evaluation of their viability and morphology are not so affordable and applicable in Russia due to peculiarities of laboratory market. Furthermore, most of Russian manuscripts do not reflect a unified approach to the analytical stage of semen analyses. In order to standardize the protocol for human semen examination which adopted to Russian lab it was developed packing of reagents (GEMSTANDART-SEMEN ANALYSES, LLC 'GEMSTANDART', Saint Petersburg, Russia) allowing to obtain an accuracy and completeness of the examination. In summary, this approach is a necessary step in male fertility evaluation. Together with a clinical information, it is indispensable for planning the appropriate clinical management and tacking care in male health.

Enhanced Type 2 Immune Reactions by Increased IL-22/IL-22Ra1 Signaling in Chronic Rhinosinusitis With Nasal Polyps.

PurposeRecent studies have revealed the pathogenic role of interleukin (IL)-22 in atopic dermatitis and asthma. However, little is known about the role of IL-22 in the pathophysiology of chronic rhinosinusitis with nasal polyps. We aimed to investigate the expression of IL-22 and its pathogenic function in type 2 immune reactions of nasal polyps (NP).MethodsProtein levels of inflammatory mediators were determined by multiplex immunoassay, and principal component analysis (PCA) was performed. Immunofluorescence analysis and mast cell culture were used to determine the cellular sources of IL-22. Normal human bronchial epithelial (NHBE) cells were stimulated using IL-22 in combination with diverse cytokines, and thymic stromal lymphopoietin (TSLP) was measured.ResultsIL-22 expression was not up-regulated in NP compared with control tissues, but IL-22-high NP revealed distinct features characterized by type 2 inflammatory cytokines such as chemokine (C-C motif) ligand (CCL)-11, CCL-24, and IL-5 on the PCA. Additionally, IL-22 positively correlated with type 2 immune mediators and the disease severity in NP. For the localization of the cellular sources of IL-22 in eosinophilic NP, it was expressed in cells mostly composed of eosinophil peroxidase-positive cells and partially of tryptase-positive cells. The human mast cell line, LAD2 cells, released IL-22 mediated by immunoglobulin E. Moreover, IL-22 receptor subunit alpha-1 (IL-22Ra1) expression was significantly increased in NP. IL-22Ra1 was up-regulated with poly(I:C) stimulation in NHBE cells. Furthermore, TSLP production was enhanced when stimulated with a combination of IL-13, poly(I:C), and IL-22. Treatment with anti-IL-22Ra1 also inhibited IL-22-induced enhancement of TSLP production.ConclusionIL-22 was associated with type 2 inflammatory reactions in NP. The IL-22/IL-22Ra1 axis was enhanced and might be involved in type 2 inflammatory reactions via TSLP production in NP.

Impact of age, clinical conditions, and lifestyle on routine semen parameters and sperm kinematics

To assess the impact of aging on routine semen and computer-assisted sperm analysis (CASA) motility parameters according to the current World Health Organization guidelines; and to evaluate the effect of obesity and lifestyle (alcohol consumption, cigarette smoking) in older men's semen. Blind cross-sectional study. Research laboratory and andrology and reproduction laboratory. A population of 11,706 men. None. Semen analysis: routine (semen volume, sperm concentration and count, motility, vitality, morphology, hypo-osmotic swelling test, round and peroxidase-positive cell concentration) and CASA (straight-line velocity, curvilinear velocity, average path velocity, linearity, straightness, beat cross frequency, wobble, amplitude of lateral head displacement, and mean angular displacement) parameters; and body mass index. A negative correlation was found between age and routine semen parameters: volume, sperm count, motility, vitality, total motile spermatozoa and normal-motile spermatozoa, round cell concentration, and hypo-osmotic swelling test values. Several CASA variables (straight-line velocity, curvilinear velocity, average path velocity, beat cross frequency, amplitude of lateral head displacement, and mean angular displacement) were also negatively affected. Using 40years as a cut-off value, significant differences in most parameters correlated to age. In a selected subpopulation of men unexposed to known fertility-compromising factors, the same evaluations were performed, finding some parameters still decreased. Although obesity exerted a significant deleterious effect on older patients' semen quality, alcohol consumption and cigarette smoking mildly affected it. Male aging, with the contribution of unhealthy conditions, are paramount effectors of sperm quality deterioration.

Fast and Specific Assessment of the Halogenating Peroxidase Activity in Leukocyte-enriched Blood Samples.

In this paper a protocol for the quick and standardized enrichment of leukocytes from small whole blood samples is described. This procedure is based on the hypotonic lysis of erythrocytes and can be applied to human samples as well as to blood of non-human origin. The small initial sample volume of about 50 to 100 µl makes this method applicable to recurrent blood sampling from small laboratory animals. Moreover, leukocyte enrichment is achieved within minutes and with low material efforts regarding chemicals and instrumentation, making this method applicable in multiple laboratory environments. Standardized purification of leukocytes is combined with a highly selective staining method to evaluate halogenating peroxidase activity of the heme peroxidases, myeloperoxidase (MPO) and eosinophil peroxidase (EPO), i.e., the formation of hypochlorous and hypobromous acid (HOCl and HOBr). While MPO is strongly expressed in neutrophils, the most abundant immune cell type in human blood as well as in monocytes, the related enzyme EPO is exclusively expressed in eosinophils. The halogenating activity of these enzymes is addressed by using the almost HOCl- and HOBr-specific dye aminophenyl fluorescein (APF) and the primary peroxidase substrate hydrogen peroxide. Upon subsequent flow cytometry analysis all peroxidase-positive cells (neutrophils, monocytes, eosinophils) are distinguishable and their halogenating peroxidase activity can be quantified. Since APF staining may be combined with the application of cell surface markers, this protocol can be extended to specifically address leukocyte sub-fractions. The method is applicable to detect HOCl and HOBr production both in human and in rodent leukocytes. Given the widely and diversely discussed immunological role of these enzymatic products in chronic inflammatory diseases, this protocol may contribute to a better understanding of the immunological relevance of leukocyte-derived heme peroxidases.

Seminal parameters of chronic male genital inflammation are associated with disturbed sperm DNA integrity.

Definition of chronic male genital tract inflammation and its impact on male infertility is still a matter of debate. In particular, DNA integrity has been reported to be disturbed in subfertile men. Thus, the aim of this study was to investigate an association of DNA integrity to altered standard semen parameters as well as inflammatory parameters such as peroxidase-positive cells, macrophages and seminal interleukin-6 concentration. Macrophages were detected by CD18/HLA-Dr staining, and DNA integrity was analysed by acridine orange staining using flow cytometry. Interleukin-6 was detected by ELISA. Normal DNA integrity showed a significant correlation to sperm number and progressive motility. Moreover, a significant inverse correlation of DNA integrity to Interleukin-6 and macrophages could be demonstrated. Further on, seminal interleukin-6 also significantly correlated to macrophages. No association has been observed between the number of peroxidase-positive cells and normal DNA integrity. As disturbed DNA integrity has been reported to negatively influence spermatozoon-egg interaction and even fertilisation rates following ICSI, and as early miscarriages have been associated with sperm DNA damage, it should be screened very carefully for male genital tract inflammations in couples undergoing infertility treatment. Measuring Interleukin-6 seems superior to assessment of the number of leucocytes alone and additional assessment of DNA integrity into the diagnostic work-up should be considered.

Macrophage metalloelastase-12 is detectable in human seminal plasma and represents a predictor for inflammatory processes in the male genital tract

Macrophage metalloelastase-12 (MMP-12), a protein of the matrix metalloproteinase family, is involved in the breakdown of extracellular matrix in normal physiological processes as well as in disease processes. MMP-12 is almost exclusively produced by macrophages and is associated with inflammatory disorders. Giving the fact that inflammation negatively influences ejaculate parameters, we investigated a possible presence and correlation of MMP-12 in seminal plasma with parameters of the ejaculate, especially in leucocytospermic ejaculates. Forty-two patients who presented for semen analysis were assigned into four groups depending on the result of semen analysis according to the WHO guidelines 2010: normozoospermia (n = 11), OAT (n = 10), azoospermia (n = 10) and leucocytospermia (>1 mio. peroxidase-positive cells per ml) (n = 11). MMP-12 was detected by ELISA and was measurable in nearly all seminal plasma samples. Generally, MMP-12 concentrations were significantly higher in leucocytospermic samples than in nonleucocytospermic ones (P = 0.001). The MMP-12 levels between the latter nonleucocytospermic groups did not differ. Moreover, MMP-12 levels correlated with the presence of peroxidase-positive leucocytes. No correlation with CD 14 positive monocytes/macrophages was detected. In this study, we demonstrate that MMP-12 is present in seminal plasma and is correlated with inflammatory conditions in human semen and therefore may serve as predictor of ongoing inflammatory processes.

Diagnosis of male infertility: A need of functional and chromatin evaluation

ObjectivesTo evaluate the incidence of functional and chromatin alterations on spermatozoids in patients grouped according to normality of standard semen parameters based on the 5th edition of the World Health Organization (WHO) guidelines. To identify and correlate the most frequently altered characteristics in the normal standard semen parameters sub-population. Materials and methodsA prospective study was performed. It evaluated standard semen parameters (volume, sperm concentration, motility and morphology, round cells, peroxidase-positive cells) according to WHO guidelines, as well as functional tests (24h survival, hypoosmotic swelling test, modified stress test), and additional assays (aniline blue, nitroblue-tetrazolium, TUNEL) in 110 semen samples from patients and 6 from fertile donors (control). Based on standard semen parameters values, patients were divided into two groups (A: all standard parameters normal; B: one altered standard parameter at least). ResultsAt least one of the variables analyzed was altered in 96.61% of the samples. Groups A and B showed statistically significant differences in all the complementary tests. At least one of the complementary tests were altered in 93.68% of the samples in group A, and the most frequently affected variable was sperm DNA fragmentation (16.95%). ConclusionsPerforming a more in-depth seminal study within the routine functional and chromatin assays provides a more precise diagnosis of male infertility. The WHO standards should be considered as a primary approach.

Diagnóstico de infertilidad masculina: necesidad de valoraciones funcionales y cromatínicas

ObjectivesTo evaluate the incidence of functional and chromatin alterations on spermatozoids in patients grouped according to normality of standard semen parameters based on the 5th edition of the World Health Organization (WHO) guidelines. To identify and correlate the most frequently altered characteristics in the normal standard semen parameters sub-population. Materials and MethodsA prospective study was performed. It evaluated standard semen parameters (volume, sperm concentration, motility and morphology, round cells, peroxidase-positive cells) according to WHO guidelines, as well as functional tests (24hours survival, hypoosmotic swelling test, modified stress test), and additional assays (aniline blue, nitroblue-tetrazolium, TUNEL) in 110 semen samples from patients and 6 from fertile donors (control). Based on standard semen parameters values, patients were divided into two groups (A: all standard parameters normal; B: one altered standard parameter at least). ResultsAt least one of the variables analyzed was altered in 96.61% of the samples. Groups A and B showed statistically significant differences in all the complementary tests. At least one of the complementary tests were altered in 93.68% of the samples in group A, and the most frequently affected variable was sperm DNA fragmentation (16.95%). ConclusionsPerforming a more in-depth seminal study within the routine functional and chromatin assays provides a more precise diagnosis of male infertility. The WHO standards should be considered as a primary approach.

Sperm separation in patients with urogenital infections.

A total of 196 patients attending the Center of Dermatology and Andrology, Giessen, Germany, were examined for fertility problems. Polymorphonuclear elastase, reactive oxygen species (ROS) and the number of round and peroxidase-positive cells were investigated in addition to routine semen analysis. The ejaculates were also analysed before and after sperm separation by means of swim-up or glass wool filtration. In 20 cases of leukocytospermia, sperm concentration, motility, viability, production of reactive oxygen species, and the number of peroxidase-positive cells were evaluated before and after glass wool filtration. The results show that ROS production by viable spermatozoa is highly correlated with the concentration of PMN elastase and the number of both peroxidase-positive and round cells. Multiple regression analysis with motility as dependent parameter showed the number of round cells (n = 91; r = -0.332; P = 0.0030) to be the most important parameter affecting motility, while ROS mainly affects the viability of spermatozoa (n = 69; r = 0.250; P = 0.0107). In the case of leukocytospermia, glass wool filtration significantly reduced the number of peroxidase-positive cells and ROS production (P = 0.0098 and P = 0.0005, respectively). Receiver operating characteristic (ROC) curve analysis for ROS production in the ejaculate using a concentration of 1.000 ng ml-1 PMN elastase as decisive parameter resulted in a cut-off value of 49,489.9 counts 10(-7) viable spermatozoa. The statistical parameters were: Sensitivity: 63.2%, specificity: 100%, positive predictive value: 100%, negative predictive value: 36.1%.

Mechanisms of sperm deficiency in male accessory gland infection.

The presence of 2 million or more peroxidase-positive white blood cells per ml of semen, or the diagnosis of male accessory gland infection, is associated with important biochemical and biological changes in semen plasma and in the spermatozoa, reducing their fertilizing potential in vitro and in vivo (e.g., during intra-uterine insemination). In addition to the effects of reactive oxygen species, and its influence on the essential fatty acid composition of the sperm membrane, potentially unfavourable effects can occur through the intermediate of increased concentrations of certain cytokines, and decreased activity of enzymes such as alpha-glucosidase. In contrast, lower numbers of white blood cells may exert beneficial effects on spermatozoa thanks to the increased production of hepatocyte growth factor/scatter factor (a tissue repairing substance), and the stimulation of immuno-competent cells by particular cytokines (e.g., Interleukin-6).

CD 45/67 immunobead preparation of human semen activates granulocytes.

In human semen reactive oxygen species (ROS) produced by spermatozoa or leukocytes can impair spermatozoa functions. The objective of this study was to assess the effects of CD 45- and/or CD 67 immunobead preparation on the chemiluminescence (CL) of seminal plasma free ejaculate cells (= original cell suspension), as well as of the spermatozoa and leukocyte fractions. The original cell suspensions of 68 infertile and 8 fertile men were incubated with CD 45 or CD 67 immunobeads. After separation in a magnetic field the luminol chemiluminescence of the original cell suspensions, the spermatozoa and the leukocyte fractions were recorded on a luminometer. Spermatozoa fractions did not contain any leukocytes as no increase in CL-counts occurred after addition of FMLP. The number of peroxidase-positive cells (per 10(7) spermatozoa) correlated with the CL of the original cell suspensions (r = 0.7; P < 0.0001) as well as the CL of the spermatozoa and the leukocyte fractions after CD 45 or CD 67-preparation (r = 0.64; P < 0.0001). The CL of the spermatozoa and of the leukocyte fractions after CD 45 immunobead incubation were significantly correlated (r = 0.091; P < 0.0001). According to these data contaminating leukocytes could be eliminated by immunobead preparation. However, incubation of original cell suspensions with CD 45 or CD 67 immunobeads stimulated leukocytes to release soluble products resulting in elevated CL signals both in the leukocyte and the spermatozoa fractions. These effects have to be taken into account when using immunobeads for the preparation of human semen.

Granulocyte elastase indicates silent male genital tract inflammation and appropriate anti-inflammatory treatment.

Diagnosis of male genital inflammations plays a significant role in andrology. Although genital infections are often silent, they can severely impair male fertility. In the seminal plasma of 305 patients, immunoglobulins IgG, IgA, complement factor C3C, coeruloplasmin and the number of peroxidase-positive cells were determined in addition to conventional semen parameters and microbiological investigations. A leukocyte esterase dipstick test was also carried out. All these parameters were correlated with the granulocyte elastase determined by an enzyme immunoassay. A highly significant correlation between elastase concentrations and the other parameters indicating inflammation was observed. After anti-inflammatory treatment, elastase concentrations decreased markedly. The results showed that exact quantification of granulocyte elastase is a very specific and sensitive method to distinguish inflammatory from non-inflammatory male adnexal affections, which is appropriate for control of anti-inflammatory treatment and facilitates the diagnosis of inflammatory processes in andrology.

下顎骨骨折を契機に発見された急性骨髄性白血病の1例

We report the rare case of a mandibular fracture in a patient with acute myeloid leukemia（AML）. A 69-year-old man was referred to us because of a mandibular fracture. On admission, the white cell count was 14100/μl with 69.5 ％ blastoid cells, the hemoglobin level was 6.9 g/dl, and the platelet count was 23000/μl. Bone marrow aspiration revealed hypercellular marrow containing many peroxidase-positive blastoid cells（85.4 ％）. A mandibular fracture with AML was diagnosed, and we initially planned an operation for the mandibular fracture. However, because infection is known to be the most common cause of death in patients with leukemia, antibiotics were administered in accordance with the guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Subsequently, fixation of the mandible and drainage of the intermandibular space were performed, with no evidence of severe infection in the perioperative period. On postoperative day 13, the patient received induction therapy with cytarabine and idarubicin. Although the leukemia responded well to chemotherapy, the patient died of an intracerebral hemorrhage after consolidation therapy.

Dietary supplementation with laminarin, a fermentable marine β (1–3) glucan, protects against hepatotoxicity induced by LPS in rat by modulating immune response in the hepatic tissue

We tested the hypothesis that laminarin (LAM), a β (1–3) polysaccharide extracted from brown algae, can modulate the response to a systemic inflammation. Male Wistar rats ( n = 7 per group) were fed a standard diet (control) or a diet supplemented with LAM for 25 days (5% during 4 days followed by 10% during 21 days). Thereafter, Escherichia coli lipopolysaccharides (LPS; 10 mg/kg i.p.) were injected and the animals were sacrificed 24 h after LPS challenge. The hypothermia, hyperglycemia and hypertriglyceridemia occurring early after LPS administration were less pronounced in LAM-treated rats than in controls. The increase in serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) activities – reflecting hepatic alterations – was lessened after LPS injection in LAM-treated rats compared to control rats. LAM treatment decreased serum monocytes number, nitrite (NO 2) and tumor necrosis factor-alpha (TNF-α). LAM also modulated intra-hepatic immune cells: it lowered the occurrence of peroxidase-positive cells (corresponding to monocytes/neutrophils) and, in contrast, it increased the number of ED2-positive cells, corresponding to resident hepatic macrophages, i.e. Kupffer cells. In conclusion, the hepatoprotective effect of marine β (1–3) glucan during endotoxic shock may be linked to its immunomodulatory properties. We propose that both lower recruitment of inflammatory cells inside the liver tissue and lower secretion of inflammatory mediators play a role in the tissue protective effect of LAM. These effects could be due to a direct effect of β-glucan on immune cells, or to an indirect effect through their dietary fibre properties (fermentation in the gut).

Age-related changes in seminal polymorphonuclear elastase in men with asymptomatic inflammation of the genital tract

To investigate age-related inflammatory events in the male genital tract. In a total of 4265 randomly collected patients attending the andrological outpatient clinic of the Center for Dermatology and Andrology, University of Giessen, Germany, ejaculate volume, pH-value, sperm concentration, total and progressive sperm motility, concentration of polymorphonuclear (PMN) elastase, number of peroxidase-positive cells and fructose were measured and correlated with patient's age. While ejaculate volume, motility and fructose all correlated negatively with age, sperm concentration, PMN elastase and the pH-value showed a positive correlation. The prevalence of male genital tract inflammation (as defined by PMN elastase > 250 ng/mL) and its severity increased significantly. PMN elastase did not correlate with sperm motility. Fructose as a marker of seminal vesicle function showed a significant negative relationship with the PMN elastase levels, the number of peroxidase-positive cells and sperm motility. The significant increases of PMN-elastase levels as marker of male genital tract inflammation in older men appear to be indicative of age-related changes in local immunoregulatory mechanisms. Because there is no association of PMN elastase with sperm motility, a direct inhibitory effect of this enzyme can be excluded.