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Correlation of Sperm Nuclear Chromatin Condensation Staining Method with Semen Parameters and Sperm Functional Tests in Patients with Spinal Cord Injury, Varicocele, and Idiopathic Infertility
Nasser Salsabili,Abdorasoul Mehrsai,Babak Jalalizadeh,Gholamreza Pourmand
Urology Journal , 2006,
Abstract: Introduction: Our aim was to investigate sperm nuclear chromatin condensation and its correlation with semen parameters and vitality test in infertile patients with spinal cord injury (SCI), varicocele, and idiopathic infertility. Materials and Methods: Sperm chromatin condensation was determined by aniline blue staining in 22 SCI-injured infertile men, 20 with varicocele, and 28 with idiopathic infertility. The results were compared with the semen analysis parameters and the hypo-osmotic swelling test results. Three grades of staining for sperm heads were distinguished: unstained, showing sperm maturity (G0); partially stained (G1); and completely stained, showing sperm immaturity (G2). The total score was calculated as: (G0 × 0) + (G1 × 1) + (G2 × 2). Results: In all groups, the total staining score was higher than 75%, corresponding to a high degree of immaturity of sperm. Patients with SCI had a less sperm nuclear chromatin condensation and chromatin stability than patients with idiopathic infertility and varicocele (total scores, 98% versus 89% and 88%, respectively; P < .01). All of the patients had normal hypo-osmotic swelling test results. Sperm counts for all patients were within the reference range. The mean percentages for normal motility and morphology of the sperm were 15.5% and 15% for patients with SCI, 43% and 15% for patients with varicocele, and 62.5% and 54% for patients with idiopathic infertility. There was no correlation between sperm nuclear chromatin condensation and semen analysis parameters. Conclusion: Aniline blue staining for sperm nuclear chromatin condensation is a method independent of semen analysis and demonstrates the internal structural defects of sperm. This method may have a predictive value in assessing fertility.
Posttransplant Infectious Complications: A Prospective Study on 142 Kidney Allograft Recipients
Gholamreza Pourmand,Mohammadreza Pourmand,Sepehr Salem,Abdorasoul Mehrsai
Urology Journal , 2006,
Abstract: Introduction: We evaluated the posttransplant complications resulting from infections and their association with graft function, immunosuppressive drugs, and mortality. Materials and Methods: A total of 142 kidney allograft recipients were followed for 1 year after transplantation. The patients’ status was assessed during regular visits, and data including clinical characteristics, infections, serum creatinine level, acute rejection episodes, immunosuppressive regimen, graft function, and mortality were recorded and analyzed. Results: Infections occurred in 77 patients (54%). The lower urinary (42%) and respiratory (6.3%) tracts were the most common sites of infection. The most frequent causative organisms were Klebsiella in 34 (24%) and cytomegalovirus in 25 patients (18%). Wound infection occurred in 7 patients (5%). The mortality rate was 7.7% and infection-related death was seen in 5 patients (3.5%) who developed sepsis. Graft loss was seen in 16 patients (11%), of whom 2 developed cytomegalovirus infection, 2 experienced urinary tract infection, and 5 developed sepsis and died. Mycobacterial and hepatitis C infections were noticeably rare (0.7% and 2.8%, respectively). Conclusion: This study showed that infections are important causes of morbidity and mortality during the posttransplant period. We recommend that serologic tests be performed before and after transplantation to recognize and meticulously follow those who are at risk. In our study, high-risk patients were those with elevated serum creatinine levels who received high doses of immunosuppressive drugs. As the urinary tract is the most common site of infection, early removal of urethral catheter is recommended to reduce the risk of infection.
Inadvertent Entrapment of a Central Venous Catheter by a Purse-String Suture during Cardiopulmonary Bypass: A Case Report
Abdorasoul Anvaripour,Forouzan Yazdanian,Mohammad-Zia Totonchi,Houshang Shahryari
Case Reports in Anesthesiology , 2011, DOI: 10.1155/2011/760426
Abstract: A 65-year-old female patient with severe mitral valve stenosis plus coronary artery disease was scheduled for mitral valve replacement and 2-vessel coronary artery bypass graft (CABG) surgeries simultaneously. After a successful procedure, resistance was met on a CVC withdrawal. During postoperative fluoroscopy, fixation of the catheter at the heart was confirmed which necessitated reopening the chest, cutting the suture, and removing the catheter. When a catheter became hard to withdraw after open heart surgery, we should never withdraw it forcefully and blindly. Although rare, one should consider inadvertent entrapment of CVC by a suture as the possible cause.
Evaluation of Urinary Calculi by Infrared Spectroscopy
Abdolrasool Mehrsai,Ali Taghizadeh Afshari,R Zohrevand,Hooman Djaladat
Urology Journal , 2004,
Abstract: Purpose: To analyze urinary calculi composition and its relationship with gender, age, calculus weight, color, and location. Materials and Methods: Two hundred and forty one patients with urinary calculus, who had undergone open lithotomy from June 1999 to April 2001, were enrolled in this prospective study which was performed by Tehran and Oroomieh Medical Sciences Universities. The calculi compositions were analyzed by infrared spectroscopy in Bonn University. Statistical analyses were made by paired t test Results: One hundred and forty five males with a mean age of 40.4 years and 96 females with a mean age of 42.5 years were enrolled in this study. Mean calculus weight was 4.28 gr. Mean calculus number was 4.33. Thirty four (14.1%) calculi were pure (carbonate apatite: 2, brushite: 1, uric acid: 19, cystine: 3, weddellite: 6, mono-NH4-urate: 2, struvite: 1), 207(85.6%) were mixed and none of them contained octa-ca-phosphate, apatite, newberyte, 2,8-dihydroxyadenine, mono-Na-urate, or xanthine. Weddellite was found in 77% of calculi. It comprised more than 50% of them in 26% of cases. Whewellite crystals were found in 78% of calculi. It comprised more than 50% of them in 46% of cases. The most common pure calculus was uric acid and the most common component of calculi was whewellite followed by weddellite. Conclusion: Although there is no comprehensive study on urolithiasis incidence and prevalence in Iran, it can be concluded that whewellite and weddellite may be the most common components of urolithiasis in Iran and uric acid calculi are the most common pure calculi. There was no significant difference in calculi composition in our study.
A Comparison between Clinical and Pathologic Staging in Patients with Bladder Cancer
Abdolrasoul Mehrsai,Daryosh Mansoori,Mohamad Taheri Mahmodi,Alireza Sina
Urology Journal , 2004,
Abstract: Purpose: To determine the accuracy of clinical staging methods of bladder cancer and TURBT results in estimating the pathologic stage of tumor. Materials and Methods: Thirty two patients who had undergone radical cystectomy were studied in this retrospective survey. The results of bimanual examination, cystoscopy, TURBT pathology report and the tumor contour in CT scan, (size, infiltrative deepness, pelvic lymph nodes involvement and hydronephrosis) were recorded. The type of surgery and pathologic report of cystectomy sample were analyzed as well. Then the results of bimanual examination, tumor size, hydronephrosis and CT scan findings including tumor infiltrative deepness, pelvic lymph adenopathy and TURBT findings were compared to pathologic results of cystectomy sample. Results: Seven patients were females and 25 were males. Their mean age was 62 (range 36 to 80) years. Gross hematuria and irritative urinary symptoms were the most common complaints. The duration between symptom manifestation and patient’s referral was 5 days to 72 months (mean 12 months). Bimanual examination in estimating the extravesical involvement of tumor had a specificity of 82%, sensitivity of 46%, positive predictive value of 70% and negative predictive value of 63%. The size of tumor in determining extravesical involvement had a specificity of 41%, sensitivity of 93%, and positive predictive value of 58% and negative predictive value of 87%. Hydronephrosis was present in 15 patients of whom, 14 (93%) had bladder muscle involvement. CT scan specificity was 70%, and sensitivity was 46% regarding pelvic lymph adenopathy and perivesical fat involvement. In TURBT report no muscle sample was observed in 11 cases, so that the interpretations of results were impossible. The reported grade of tumor was lower than pathologic sample of cystectomy in 4 patients. Conclusion: Clinical staging in invasive bladder cancers has not high accuracy regarding the involvement of bladder surrounding fats and pelvic adenopathies. A tumor sized more than 5 cm could be sensitive in estimating extravesical involvement. Positive predictive value of hydronephrosis is considerable regarding bladder muscle involvement. Tumor understaging by TURBT is happened in high percentage of patients with invasive bladder cancer.
Detection of Recurrent Bladder Cancer NMP22 Test or Urine Cytology?
Jalil Hosseini,Ali Reza Golshan,Mohammad Mohsen Mazloomfard,Abdolrasoul Mehrsai
Urology Journal , 2012,
Abstract: Purpose: To assess the accuracy of voided urine cytology versus urinary nuclear matrix protein 22 (NMP22) qualitative assay in the diagnosis of various grades and stages of recurrent bladder transitional cell carcinoma (TCC). Materials and Methods: From July 2007 to February 2009, all patients with history of superficial bladder TCC were included in this multi-center study. Each patient provided three serial voided urine samples for cytologic examination and one sample for the NMP22 qualitative assay prior to urethrocystoscopy. The sensitivity and specificity of urine cytology and the NMP22 test were determined.Results: The sensitivities of the NMP22 test and cytology for detection of recurrence were 78.8% and 44.2%, respectively (P = .001), while the specificities were 69.6% and 83.7%, respectively (P = .019). The NMP22 test showed significantly higher sensitivity than cytology in detecting recurrences in low-risk and intermediate-risk groups.Conclusion: The NMP22 assay could be used for detection of superficial bladder cancer, especially in low- and intermediate-risk groups; however, the value of the test is limited by its low specificity.
Management of Peyronie's Disease by Dermal Grafting
Mohammad Reza Nikoobakht,Abdolrasoul Mehrsai,GH Pourmand,Hooman Jaladat
Urology Journal , 2004,
Abstract: Purpose: To evaluate the results of plaque excision and dermal grafting in Peyronie’s disease. Materials and Methods: Twenty seven patients were scheduled to undergo plaque excision and dermal grafting for Peyronie’s disease. Potency, bending of erected penis, and having painful erection were evaluated in patients before and after operation. To evaluate erectile dysfunction, we used International Index of Erectile Function (IIEF) by interviewing the patients and filling questionnaires by their partners. Doppler ultrasonography was used to determine the vascular competence of penis before and after operation in 15 patients. Results: The disease was more prevalent between the ages of 40 and 60 years. Plaques were located as follows: dorsal in 18, right lateral in 6 and left lateral in 3. Mean plaque size was 11 (range 5 to 18) mm. After plaque excision and dermal grafting, penile deformity, erectile dysfunction, and painful erection had remained yet in 4 (15%) out of 27, 3 (16%) out of 19, and 3 (14%) out of 22, respectively. Doppler ultrasonographic study in 15 patients revealed improvement in peak systolic velocity (P < 0.01). In addition, a decrease in end diastolic velocity was noted also that was not significant statistically (P = 0.26). Resistive index did not improve after operation. Conclusion: This procedure showed significant improvement in penile deformity (85% of cases), erectile dysfunction (84% of cases) and painful erection (86% of cases). We recommend plaque excision and dermal grafting as an effective procedure in treating Peyronie’s disease.
Synchronous Renal Fossa Recurrence with Bladder Metastases Due to Renal Cell Carcinoma
Hooman Djaladat,Abdorrasoul Mehrsai,Hamid Nasseh,Gholamreza Pourmand
Urology Journal , 2005,
Improvement of Erectile Dysfunction after Kidney Transplantation: the Role of the Associated Factors
Abdolrasoul Mehrsai,Shahram Mousavi,Mohammadreza Nikoobakht,Tina Khanlarpoor
Urology Journal , 2006,
A Giant Congenital Posterior Urethral Diverticulum Associated with Renal Dysplasia
Shahram Mousavi,Abdolrasoul Mehrsai,Mohammadreza Nikoobakht,Amir Reza Abedi
Urology Journal , 2006,
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