Ultrastructure of Spermatozoa from Infertility Patients

Standard examination of human semen currently remains a main test for examination of male fertility disorders. Although parameters of sperm quality in fertile men are generally higher than in sterile ones, there is a substantial overlap between the two populations, indicating that other important factors affect fertility, but are not assessed in conventional assay. Currently, tests determining the functional properties of sperm have been intensively developed. This review considers an electron microscopic examination of sperm, which assesses the structure and function of the sperm nuclear, penetration and motor apparatus. The detection of sperm chromatin structure can help to understand the causes of early embryonic malformation. Genetically caused and functional disorders of the structure and function of spermatozoa are discussed. Indications for electron microscopic examination of spermatozoa in fertility disorders are given

Traumatic partial hindfoot amputation with injury to the posterior tibial artery

Introduction Talus and calcaneus fractures account for about 2 % of skeletal injury and 70 % of the foot fractures. Open fractures of the hindfoot are diagnosed in 30 %. More than half of the injuries are graded as type III according to classification of R.B. Gustilo, J.T. Anderson (1976). Injury to the posterior tibial artery is observed in 6.4 % of patients. Amputations resulting from an osseous-vascular injury and gangrene and crushed soft tissues are observed in 3-60 %. The objective was to demonstrate a rare clinical case of traumatic partial hindfoot amputation on the right side associated with open calcaneus and talus fracture and injury to the posterior tibial artery and resulted in a good outcome. Material and methods A clinical case of a 36-year-old patient who suffered a traumatic partial hindfoot amputation and injury to the posterior tibial artery. Results Restoration of the anatomy and the function of the right foot was achieved in the patient. Discussion There are no clinical guidelines and a unified classification for bone and vascular injuries and no universal method for the treatment of a combined injury including an open fracture of bones and injury to blood vessels. The choice of treatment modality, diagnosis of osteovascular injuries are produced on an individual basis depending on the external and internal factors affecting the injuries. An angiotraumatological approach used to treat the patient with the hind foot injury on the right included early primary surgical treatment of the osteovascular injury, accurate reduction and stable fixation using a sparing technique for the calcaneus, repair of the posterior tibial artery, complex drug therapy to improve blood rheology, reduce coagulability, address tissue ischemia and provide adequate regional anesthesia. Conclusion The combination of factors and use of an angiotraumatological approach employing organ sparing strategy and a multidisciplinary team of orthopaedic and trauma surgeons, angiosurgeons, anesthesiologists-resuscitators facilitated foot salvage, improved function and supportability

The Centriolar Adjunct–Appearance and Disassembly in Spermiogenesis and the Potential Impact on Fertility

During spermiogenesis, the proximal centriole forms a special microtubular structure: the centriolar adjunct. This structure appears at the spermatid stage, which is characterized by a condensed chromatin nucleus. We showed that the centriolar adjunct disappears completely in mature porcine spermatozoa. In humans, the centriolar adjunct remnants are present in a fraction of mature spermatids. For the first time, the structure of the centriolar adjunct in the cell, and its consequent impact on fertility, were examined. Ultrastructural analysis using transmission electron microscopy was performed on near 2000 spermatozoa per person, in two patients with idiopathic male sterility (IMS) and five healthy fertile donors. We measured the average length of the “proximal centriole + centriolar adjunct„ complex in sections, where it had parallel orientation in the section plane, and found that it was significantly longer in the spermatozoa of IMS patients than in the spermatozoa of healthy donors. This difference was independent of chromatin condensation deficiency, which was also observed in the spermatozoa of IMS patients. We suggest that zygote arrest may be related to an incompletely disassembled centriolar adjunct in a mature spermatozoon. Therefore, centriolar adjunct length can be potentially used as a complementary criterion for the immaturity of spermatozoa in the diagnostics of IMS patients