Евалуација на квалитетот на ејакулат кај младите мажи во Република Северна Македонија

Research data show that in the last 50 years (1938-1991) there has been a trend of decreasing sperm concentration in the male population in Europe by 2.3% and in the USA by 0.8%. The reasons for such negative trend are not known, but it is assumed that lifestyle and environmental factors have an influence on genetic factors. Aim of this study was to evaluate sperm quality in young, healthy men in our country, and to compare sperm quality in our population with others in the world. Material and methods: Ejaculates from 203 healthy male subjects, aged 18-32, were stored in a thermostat at 36⁰C and analyzed manually on a native slide and hematoxylin-eosin-stained slides, under a phase contrast microscope. Sperm motility was assessed at two-time intervals, group A, 60 minutes after ejaculation and group B, 120 minutes after ejaculation, while sperm concentration and sperm morphology were assessed at one time interval. Results: Semen analysis showed an average volume of ejaculate 3.45 ± 1.5 ml, sperm concentration in 1 milliliter62.4 ± 39.2 x10(6) /ml, while total sperm concentration was 211.2 ± 173.2 x10(6). In group A, values for progressive spermatozoa were 48.6 ± 18.1 x10(6) /ml and in group B, values for progressive spermatozoa were 47.9 ± 17.3 x10(6) /ml. There was no statistically significant difference between the two time intervals (group A and group B) when interpreting sperm motility, p>0.005. Analysis of morphology of spermatozoa showed a mean value of 6.9% for morphologically normal spermatozoa. Conclusion: The quality of ejaculate in young men in North Macedonia is in the range of reference values according to WHO, and also our results are similar to those from Germany, Turkey, Bulgaria, Faroe Islands.Истражувачките податоци покажуваат дека во последните 50 години (1938-1991) постои тренд на намалување на концентрацијата на сперматозоиди кај машката популација во Европа за 2,3% и во САД за 0,8%. Причините за ваквиот негативен тренд не се познати, но се претпоставува дека начинот на живот и факторите на околината имааt влијаниe врз генетските фактори. Целта на оваа студија беше да се оцени квалитетот на ејакулатот кај млади, здрави мажи во нашата земја, за да можеме да го споредиме квалитетот на ејакулатот кај нашата популација со другите популации во светот. Материјал и методи: Ејакулите од 203 здрави машки испитаници, на возраст од 18-32 години, беа складирани во термостат на 36⁰C и рачно анализирани на нативен препарати препарати обоени со хематоксилин/еозин, под фазно-контрастен микроскоп. Подвижноста на сперматозоидите беше проценета во два временски интервала, група А, 60 минути по ејакулацијата и група Б, 120 минути по ејакулацијата, додека концентрацијата и морфологијата на сперматозоиди беа анализирани во еден временски интервал.  Резултати: Анализата на ејакулатите покажа просечен волумен на ејакулатот 3,45 ± 1,5 ml, концентрација на сперматозоиди во 1 милитар 62,4 ± 39,2 x10 (6) / ml, додека вкупната концентрација на сперматозоиди беше 211,2 ± 173,2 x10 (6). Во групата А, вредностите за прогресивни сперматозоиди беа 48,6 ± 18,1 x10 (6) /ml, во групата Б, вредностите за прогресивни сперматозоиди беа 47,9 ± 17,3 x10 (6) /ml. Немаше статистички значајна разлика помеѓу двата временски интервала (група А и група Б) при интерпретација на подвижноста на сперматозоидите, p>0,005. Анализата на морфологијата на сперматозоидите покажа вредност од 6,9% за присуство на морфолошки нормални сперматозоиди. Заклучок: Квалитетот на ејакулатот кај младите мажи во Северна Македонија е во опсегот на референтните вредности според СЗО. Нашите резултати се слични на оние од Германија, Турција, Бугарија, Фарските Острови

Histological Characteristics of Bruises with Different Age

BACKGROUND: In forensics bruises as injuries take an important part in the interpretation of the causes of death. Since activating the inflammatory response of the body in their formation, histological analysis of the bruised tissue can provide data on the determination the time when the injury occurred.AIM: The aim of this study is to compare the histological features of 1-day and 5-days old bruises.MATERIAL AND METHODS: Bruised human skin samples, 1-day old in group A and 5-day-old in group B, obtained at autopsy from individuals who died from a violent death, were analyzed in this study. The qualitative microscopic analysis was performed on serial paraffin sections of tissues stained with Hematoxylin-eosin and Pearls Prussian Blue method, using a light microscope connected to a digital camera.RESULTS: Qualitative histological analysis of the studied group A  presented with fresh bruises, less than 24 hours old, showed ruptured smaller vessels and extravasated red blood cells in the connective tissue of the skin, with subsequent expansion and infiltration of fibrous septa of the skin. In the area of bleeding an initial infiltration by macrophages was observed. In the studied group B, presented with bruises 3-7 days old, histological analysis showed a marked presence of hemosiderin-laden macrophages and presence of hematoidin granules in the area of bleeding, as well as ruptured small blood vessels and red blood cells extravasation in the dilated fibrous septa.CONCLUSION: A detailed analysis of tissue changes in bruises every day from the initiation until their recovery, a detailed description of the histological finding can be given, which will be supported in the precise determination of the age of the injuries themselves

Endometrioid Adenocarcinoma Arising in Adenomyoma in a Woman with a Genital Prolapse - Case Report

BACKGROUND: Endometrial cancer is the third-ranked genital malignancy in women and includes 3% of cancer deaths. There is a 2.8% chance of a woman developing endometrial cancer during her lifetime. Low-grade endometrioid adenocarcinomas are often seen along with endometrial hyperplasia, but high-grade endometrioid adenocarcinomas have more solid sheets of less-differentiated tumour cells, which are no longer organised into glands, often associated with surrounded atrophic endometrium.CASE REPORT: We present an unusual case of endometrial adenocarcinoma arising in adenomyoma in 74-year old woman presented with genital prolapse, without other clinical symptoms. Ultrasound evaluation revealed endometrium with 4 mm-thickness and atrophic ovaries. The cervical smear was normal. The patient underwent a total vaginal hysterectomy. The histopathology of the anterior uterine wall revealed an intramural adenomyoma of 4 mm in which some endometrial glands with malignant transformation of well-differentiated endometrioid adenocarcinoma without infiltration in surrounding myometrium and lymphovascular invasion were present. The endometrium lining the uterine cavity was predominantly atrophic, and only one focus of simplex and complex hyperplasia was found, with cell-atypia. According to AJCC/FIGO 2010, the tumour was classified: pTNM = pT1B pNX pMX G1 R0 L0 V0 NG1, Stage I. On dismiss, the near-future oncological consultation was recommended.CONCLUSION: We would like to point out the rare occurrence of such type of malignancy and the importance of meticulous histopathology evaluation, even after reconstructive surgery for genital prolapse

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

A galantamine–curcumin hybrid lacks the depressant side effect of acetylcholinesterase inhibitors

AbstractAcetylcholinesterase inhibitors (AChEIs) are drugs that enhance cholinergic neuro-transmission and are used for the treatment of Alzheimer’s disease and myasthenia gravis. Common AChEIs include rivastigmine, donepezil and galantamine (GAL), but they can cause side effects like nausea, vomiting, depression and bradycardia. A potential link exists between AChEIs and increased depression risk. Recently, we have discovered a hybrid compound (4b) combining GAL and curcumin (CCN), which shows improved anticholinesterase activity and neuroprotective effects. It could be developed as a potential multitarget agent for neurodegenerative disorders. Here, we examine the compound’s depressant side effect on mice, comparing it to GAL and CCN. Tests were conducted twice using the tail suspension test (TST) and the forced swim test over an 8-day treatment period. The results showed that 4b lacked the depressant effect of GAL and even displayed a mild antidepressant effect similar to CCN in TST. This suggests that incorporating antidepressant fragments, like CCN, into AChEIs can potentially neutralize their depressive side effects

Nephrotic syndrome after treatment with D-penicillamine in a patient with Wilson’s disease

Wilson’s disease is an inherited autosomal recessive disorder of copper balance leading to accumulation of copper mainly in liver and brain result from absent or reduced function of copper-transporting P-type ATPase. Copper is an essential trace element but in Wilson’s disease it accumulate to the point of toxicity. D-penicillamine is a classic drug for treatment of Wilson’s disease. Its major effect is to promote the urinary copper excretion. The use of D-penicillamine in the therapy of Wilson’s disease is known to be complicated by the development of various glomerular diseases. In this report we describe the development of nephrotic syndrome after 2 years treatment with D-penicillamine in a 31-year-old male undergoing treatment for Wilson’s disease, with a prompt regression at the discontinuation of the drug. We present this case to draw attention to the rare complication as nephrotic syndrome in patients with Wilson’s disease under D-penicillamine treatment and possible underlying causes. It is strongly necessary the therapy and clinical condition of patients with Wilson’s disease to be monitoring regularly - we recommended monthly

Tumor necrosis factor-alpha upregulates 11beta-hydroxysteroid dehydrogenase type 1 expression by CCAAT/enhancer binding protein-beta in HepG2 cells

The enzyme 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) catalyzes the conversion of inactive to active glucocorticoids. 11beta-HSD1 plays a crucial role in the pathogenesis of obesity and controls glucocorticoid actions in inflammation. Several studies have demonstrated that TNF-alpha increases 11beta-HSD1 mRNA and activity in various cell models. Here, we demonstrate that mRNA and activity of 11beta-HSD1 is increased in liver tissue from transgenic mice overexpressing TNF-alpha, indicating that this effect also occurs in vivo. To dissect the molecular mechanism of this increase, we investigated basal and TNF-alpha-induced transcription of the 11beta-HSD1 gene (HSD11B1) in HepG2 cells. We found that TNF-alpha acts via p38 MAPK pathway. Transient transfections with variable lengths of human HSD11B1 promoter revealed highest activity with or without TNF-alpha in the proximal promoter region (-180 to +74). Cotransfection with human CCAAT/enhancer binding protein-alpha (C/EBPalpha) and C/EBPbeta-LAP expression vectors activated the HSD11B1 promoter with the strongest effect within the same region. Gel shift and RNA interference assays revealed the involvement of mainly C/EBPalpha, but also C/EBPbeta, in basal and only of C/EBPbeta in the TNF-alpha-induced HSD11B1 expression. Chromatin immunoprecipitation assay confirmed in vivo the increased abundance of C/EBPbeta on the proximal HSD11B1 promoter upon TNF-alpha treatment. In conclusion, C/EBPalpha and C/EBPbeta control basal transcription, and TNF-alpha upregulates 11beta-HSD1, most likely by p38 MAPK-mediated increased binding of C/EBPbeta to the human HSD11B1 promoter. To our knowledge, this is the first study showing involvement of p38 MAPK in the TNF-alpha-mediated 11beta-HSD1 regulation, and that TNF-alpha stimulates enzyme activity in vivo

Tumor necrosis factor-α upregulates 11β-hydroxysteroid dehydrogenase type 1 expression by CCAAT/enhancer binding protein-β in HepG2 cells

The enzyme 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) catalyzes the conversion of inactive to active glucocorticoids. 11beta-HSD1 plays a crucial role in the pathogenesis of obesity and controls glucocorticoid actions in inflammation. Several studies have demonstrated that TNF-alpha increases 11beta-HSD1 mRNA and activity in various cell models. Here, we demonstrate that mRNA and activity of 11beta-HSD1 is increased in liver tissue from transgenic mice overexpressing TNF-alpha, indicating that this effect also occurs in vivo. To dissect the molecular mechanism of this increase, we investigated basal and TNF-alpha-induced transcription of the 11beta-HSD1 gene (HSD11B1) in HepG2 cells. We found that TNF-alpha acts via p38 MAPK pathway. Transient transfections with variable lengths of human HSD11B1 promoter revealed highest activity with or without TNF-alpha in the proximal promoter region (-180 to +74). Cotransfection with human CCAAT/enhancer binding protein-alpha (C/EBPalpha) and C/EBPbeta-LAP expression vectors activated the HSD11B1 promoter with the strongest effect within the same region. Gel shift and RNA interference assays revealed the involvement of mainly C/EBPalpha, but also C/EBPbeta, in basal and only of C/EBPbeta in the TNF-alpha-induced HSD11B1 expression. Chromatin immunoprecipitation assay confirmed in vivo the increased abundance of C/EBPbeta on the proximal HSD11B1 promoter upon TNF-alpha treatment. In conclusion, C/EBPalpha and C/EBPbeta control basal transcription, and TNF-alpha upregulates 11beta-HSD1, most likely by p38 MAPK-mediated increased binding of C/EBPbeta to the human HSD11B1 promoter. To our knowledge, this is the first study showing involvement of p38 MAPK in the TNF-alpha-mediated 11beta-HSD1 regulation, and that TNF-alpha stimulates enzyme activity in vivo

Extracellular vesicles in blood, milk and body fluids of the female and male urogenital tract and with special regard to reproduction

Extracellular vesicles (EVs) are released from almost all cells and tissues. They are able to transport substances (e.g. proteins, RNA or DNA) at higher concentrations than in their environment and may adhere in a receptor- controlled manner to specific cells or tissues in order to release their content into the respective target structure. Blood contains high concentrations of EVs mainly derived from platelets, and, at a smaller amount, from erythrocytes. The female and male reproductive tracts produce EVs which may be associated with fertility or infertility and are released into body fluids and mucosas of the urogenital organs. In this review, the currently relevant detection methods are presented and critically compared. During pregnancy, placenta-derived EVs are dynamically detectable in peripheral blood with changing profiles depending upon progress of pregnancy and different pregnancy- associated pathologies, such as preeclampsia. EVs offer novel non-invasive diagnostic tools which may reflect the situation of the placenta and the fetus. EVs in urine have the potential of reflecting urogenital diseases including cancers of the neighbouring organs. Several methods for detection, quantification and phenotyping of EVs have been established, which include electron microscopy, flow cytometry, ELISA-like methods, Western blotting, and analyses based on Brownian motion. This review article summarises the current knowledge about EVs in blood and cord blood, in the different compartments of the male and female reproductive tract, in trophoblast cells from normal and pre-eclamptic pregnancies, in placenta ex vivo perfusate, in the amniotic fluid, and in breast milk, as well as their potential effects on natural killer (NK) cells as possible target