No abstract

Summary The scope of this study was to evaluate the accuracy, precision and specificity of the sperm concentration measurements by the Strömberg‐Mika Cell Motion Analyser (SM‐CMA). Our data show that the instrument generally underscores the sperm concentration and therefore the uncorrected measurements must be corrected by the operator using the ‘mouse’‐driven option. In terms of precision, the system appears to have an excellent internal precision whereas its repeatability is influenced by the sperm concentration, the sample's homogeneity and the correction of the raw data. In order to increase the system's repeatability, we suggest that sperm counts should be carried out in various fields of the counting chamber, and the mean of the corrected values be taken as representative of the sperm concentration in the ejaculate if the various measurements show a homogenous (poissonian) distribution. The correction of the raw data with the ‘mouse’‐driven correction option was also shown to improve the system's reproducibility. Concerning specificity, our data evidenced that, without technical correction, the instrument failed to correctly classify certain spermatozoa as such, thereby grossly underscoring sperm counts. This finding was more evident at low sperm counts. Overall, the SM‐CMA requires additional laboratory time but the corrected sperm counts are comparable to manual counts and semi‐automated counts with the added option that it provides the andrologists with various motility characteristics not possible with the latter methodologies.

Since progesterone has been claimed to induce acrosomal reaction and hyperactivated motility of human spermatozoa, the present study was undertaken to determine if its presence at concentrations similar to those of peri-ovulatory follicular fluid could influence the effect of peritoneal fluid on sperm motility in vitro. To this end, 11 sperm samples were incubated at 37 degrees C with five peritoneal fluids with/without exogenous progesterone, and sperm motility was assessed using a computer-assisted analyser at time (t) = 0, 2.5, 5 and 24 h. Overall there was no observable constant trend for enhancement or inhibition of sperm motility. Progesterone generally induced a negative effect on those sperm samples with high velocities in the native peritoneal fluids and a positive effect on those sperm samples demonstrating low motility in the native peritoneal fluids. The incorporation of progesterone into the incubation medium seemed to result in a 'tuning' of sperm velocity to around 30-50 micron/s. However, a given sperm sample reacted differently when incubated with various peritoneal fluids and, reciprocally, different semen samples incubated with the same peritoneal fluid showed very variable motility patterns. The greater variability of the effects exerted by progesterone on sperm motility could arise from the fact that each sperm sample may contain subpopulations of gametes with different sensitivity to progesterone.

Both occlusion and pseudoaneurysm are complications of femoropopliteal bypass surgery. Open revision is the gold standard, but it is associated with high morbidity and mortality compared with endovascular treatment. Percutaneous stent-graft repair is a valid option either for recovering the patency of occluded prosthetic femoropopliteal bypass or for excluding anastomotic pseudoaneurysm. In this report, it is presented a case of occlusion concomitant to a pseudoaneurysm of the distal anastomosis in a previous prosthetic femoropopliteal bypass; a simultaneous endovascular treatment of both complications has been performed through self-expanding stent-graft (Viabahn) placement.

An 81-year-old man was referred for removal of a malpositioned left transjugular tunneled dialysis catheter (TDC; Fig 1). No blood was aspiratable from the catheter. Computerized tomography (CT) confirmed its extravascular course: Its leading segment lay interposed between the descending aorta and left main pulmonary artery (LtMPA). Because the patient was stable and mediastinal bleeding was excluded on contrast-enhanced CT (Fig 2), preemptive embolization of the extravascular route during removal was undertaken. Unexpectedly, the catheter contrast study opacified the LtMPA in communication with left brachiocephalic vein (LtBCV), where the catheter was bent over the artery (Fig 3; Video 1 [available online on the article'sFigure 1. Chest radiographic (a) posteroanterior and (b) lateral views show the anomalous course of TDC directed toward the posterior left side of the mediastinum (arrowheads); a malfunctioning temporary right central venous catheter is present (arrow).