The semen parameters and sperm ultrastructural morphology have been described in semen samples from two groups of Yemeni subjects. The first 'exposed' group comprised 65 khat addicts, while the second control group included 50 non-khat addict subjects. The mean age was 39.94 +/- 13.85 and 35.72 +/- 11.35 years in the exposed and control groups respectively, without a significant difference. The mean duration of khat addiction among the addicts was 25.34 +/- 12.96 years (range 6.00-48.00). Statistically significant differences were detected between the semen parameters of the two groups. Such parameters, including semen volume, sperm count, sperm motility, motility index and percentage of normal spermatozoa, were lower among addicts. Significant negative correlation was also found between the duration of khat consumption and all semen parameters (r ranged from -0.30 to -0.74). At the transmission electron microscopy level, a counting system was incorporated to compare the numbers of normal spermatozoa with deformed and dead spermatozoa in ultrathin plastic sections. The total mean percentage of deformed spermatozoa was approximately 65%. Different patterns of sperm deformation were demonstrated, and included both the head and flagella in complete spermatozoa, aflagellate heads, headless flagella and multiple heads and flagella. Deformed heads showed aberrated nuclei with immature nuclear chromatin and polymorphic intranuclear inclusions; these were associated with acrosomal defects. The deformed flagella demonstrated numeric aberrations of the axonemal 9 + 2 configuration and structural defects of their associated elements. Persistent cytoplasmic droplets were observed frequently. This study has shown for the first time the deleterious effects of khat addiction on semen parameters in general and sperm morphology in particular of all addicts, especially those who have consumed khat for longer periods of time.

New ultrastructural observations on the sequences of adherence, attachment, and penetration of Helicobacter pylori (HP) into the gastric epithelium were described in 32 endoscopic biopsies selected randomly from 168 samples of patients with active chronic gastritis. The adherence of HP to the target cell was initiated by direct contact with the microvillar coat, or glycocalyx, leading to the loss of that coat. The next step was demolishing of the surface microvilli, which separate the organisms from the cell cytoplasmic apices containing the main target of the HP, the mucoid granules. Thus the organisms come into close contact with the uncoated cell membrane and are ready for firm attachment. The attachment process was enhanced by the appearance of HP fibrillarlike strands (FLS). Up to three sites of attachment were recognized for individual organisms. Penetration into the apical cytoplasmic regions occurred by one of the organism's poles without damaging the host cell membrane. While a cell is being penetrated by one pole, FLS may extend from the other free pole to be in direct contact with the limiting membranes of the neighboring cell mucoid granules. Penetration into the gastric cells by a great number of organisms leads to serious cell damage and ultimately to cell disintegration. As a response, many neutrophils were found penetrating into the base of the gastric glands from the surrounding lamina propria; these cells were found damaged and disintegrated in the gland lumena. The neutrophils were absolutely HP-nonphagocytic. This study suggests that the dynamic activity of HP in the gastric epithelium and the possible release of the neutrophil granular contents in the gastric lumena play important roles in the gastric lesions during active chronic gastritis.

New ultrastructural observations are described in skin lesions of two brothers with Richner-Hanhart's syndrome (RHS). Physical examination of the two patients showed painful skin lesions of palms and soles combined with denderitic corneal ulceration and mental retardation. The diagnosis of RHS was confirmed biochemically with high tyrosine levels in both blood and urine. Examination by transmission electron microscopy revealed several abnormal ultrastructural changes in the epidermal cells. The horny cells contained heterogeneously, electron-dense cytoplasm with many lipid droplets. The granular cell cytoplasm contained abundant tonofibrils and keratohyaline granules. The spinous cell cytoplasm was vacuolated due to the presence of minute tyrosine crystals, which are known to have a lytic effect. The surrounding keratinocytes contained multilobed nuclei. The basal epidermal cells appeared normal except for Merkel cells, which were severely damaged by vacuolatio, also due to the presence of tyrosine crystals. This study showed that high tyrosine levels can induce several ultrastructural pathological changes in the epidermal cells, including the skin chemoreceptor Merkel cells.

Ultrastructure of white blood cells (WBC) were studied in peri pheral venous blood from Saudi patients with acute falciparum malaria (AFM) and compared with their counterparts in same patients 2 weeks after chloroquine treatment and full recovery. A counting system was incorporated to determine the rate of abnormal to normal cell type in plastic thick sections during the course of the disease. Neutrophilia, monocytosis, eosinopenia and lymphocytosis were associated with various ultrastructural abnor malities including: (1) Knobby phagocytic polymorphnuclear neu trophils (PMN) and promyelocytes, and PMN with highly vacuo lated cytoplasm. (2) Irregularly outlined electron-dense nuclei in non-functional monocytes. (3) Unusual distribution of nuclear chro matin in resting B-lymphocytes, while others possess highly vacuo lated cytoplasm and knobby surfaces. (4) Absence of granules in granular lymphocytes containing the known diagnostic paratubular crystalline arrays. (5) Plasmablasts containing electron-dense gra nules and swollen mitochondria. These abnormalities were sug gested to be due to the high level o f parasitaemia producing some toxic soluble products. They may also be attributed to alteration of bone marrow macrophages as a sequence of their interaction with soluble parasite products or their phagocytic parasitized red cells and debris released during the rupture of schizonts. This study showed that the number of abnormal WBC increases in patients with high level of parasitaemia; plasmablasts have the lowest rate o f abnormalities, while monocytes have the highest; old patients present with lower degree of parasitaemia than young patients due to a less mature immune system; and the AFM may have independent effects on the structure of human WBC. Résumé : Paludisme à P. falciparum. IV-Altérations ultrastructurales des globules blancs périphériques.L 'ultrastructure des globules blancs est étudiée dans le sang vei neux périphérique chez des malades d 'Arabie Saoudite atteints de paludisme aigu à falciparum. Elle est comparée à celle des glo bules blancs chez les mêmes malades deux semaines après traite ment à la chloroquine et guérison totale.Des comptages ont été réalisés sur coupes semi-fines pour déter miner le pourcentage d'anomalies cellulaires pendant le cours de la maladie. Neutrophilie, monocytose, éosinopénie et lymphocy tose étaient associées à diverses anomalies ultrastructurales : 1) protubérances de l'enveloppe évoquant des knobs chez les promyélocytes, parfois associées à un cytoplasme très vacuolisé chez les polynucléaires neutrophiles ; 2) contour nucléaire irrégu lièrement dense chez les monocytes non fonctionnels ; 3) distribution anormale de la chromatine nucléaire dans certains lymphocytes B au repos, tandis que d 'autres ont un cytoplasme vacuolisé et une surface rugueuse ; 4) absence de granules chez les lymphocytes gra nuleux contenant les structures cristallines paratubulaires ; 5) granules denses et mitochondries gonflées dans les plasmoblastes.Cette étude montre que, le nombre de glo...

Ultrastructural alterations of human erythrocytes infected with asexual forms of Plasmodium falciparum were studied in naturally infected Saudi patients. These included surface knobs and nodules as well as invaginations associated with cytoplasmic vesicles observed in erythrocytes infected with asexual forms of the parasites. Such nodules and surface invaginations have been previously described only in erythrocytes infected with P. ovale and P. vivax, respectively. Within the cytoplasm of infected erythrocytes were membrane-bound clefts, similar to those that appear to be a common characteristic in all red cells infected with malaria parasites. Vacuolations were often seen in the peripheral cytoplasm and may represent hemolyzed areas. Collapsed cells with an internal-lucent interior and surrounded by an irregularly folded membrane may represent completely hemolyzed erythrocytes.