PIP: Kartagener's syndrome (occurrence of bronchitis and sinusitis in patients with transposed viscera or situs inversas) increases susceptibility to purulent infections of the upper and lower respiratory tract, leading to long-term damage to the respiratory tract. Arge reported that male sterility is a component of Kartagener's syndrome. Application of electron microscopy (EM) techniques to the study of the sperm of infertile men showed the presence of immotile spermatozoa with abnormal anoxemal structures. Afzelius, in examining respiratory tracts, reported tracheobronchial clearance with no mucociliary transport; absence of ciliary motion in biopsy material; and, similarity in EM appearance of ciliary anoxemes and sperm. Most of the subjects studied had Kartagener's syndrome; others had immotile sperm and chronic respiratory infection but not situs inversus. Other studies had similar observations; Eliasson et al. introduced the term "immotile ciliasyndrome." Sturgess et al. reported the presence of a completely differenct ciliary anoxemal defect in both respiratory tract and spermatozoa of 3 siblings with chronic respiratory tract disease but not Kartagener's syndrome. The defect in Kartagener's syndrome is the absence of dynein arms (believed to be responsible for the generation of ciliary movements and radial spokes which allow the cilia to bend) while the defect in Sturgess cases is lack of radial spokes. Whatever the mechanism, the movement of the cilia is restricted. In respiratory tracts, this defect leads to loss of ciliary cleansing action with chronic infective sequelae as in Kartagener's syndrome. It is not known whether the ciliated cells of the fallopian tubes can result in female sterility, nor if ciliary immotility in the brain ventricles and central canal of the spinal end (these areas are lined with ciliated cells) has been associated with any disorder. The sensory hairs of olfactory and vestibular cells also have dynein arms capable of some motility. Further research along these lines should be encouraged.