Relationship between even early cleavage and day 2 embryo score and assessment of their predictive value for pregnancy

The aim of this study was, firstly, to define the different patterns of early cleavage (EC) observed at 26 h after either IVF or intracytoplasmic sperm injection (ICSI) and, secondly, to assess the predictive value of one of these patterns, even EC (EEC), on pregnancy rate in combination with day 2 embryo score. In the first part of the study, the relationship between three different EC patterns (EEC, uneven EC and EC with fragmentation of the day 2 embryo) and embryo morphology was determined. EEC was shown to be strongly associated with good embryo morphology. In the second part of the study, it was shown that EEC used in combination with embryo score improved selection of embryos for transfer. The presence of EEC significantly (P < 0.001) enhanced mean implantation rate in all transfer categories involving identically scored embryos, in both compulsory single embryo transfers and elective single embryo transfers. Multivariate analysis demonstrated that EEC and embryo score had strong complementary predictive value for pregnancy. Based on these findings, it was concluded that even though they are associated, EEC and embryo score could be combined to increase pregnancy rate, especially in elective single embryo transfer programmes.     

The clinical picture and surgery of pheochromocytomas. Our experience over 25 years]

The pheochromocytoma syndrome, caused by an abnormal secretion of catecholamines, is a rare pathology responsible for 0.1-2% cases of hypertension in the overall population considered. Although in the past we deemed the pheochromocytoma could cause prevalently the typical syndrome characterized by paroxysmal hypertensive crises, now we think that the usual clinical presentation is a continue or subcontinue hypertensive state (65%). In this paper the authors refer the clinical experience acquired in 25 years in the General and Cardiovascular Institute of the University of Milan (head: Prof. Ugo Ruberti), analyzing epidemiological aspects and pathogenesis of pheochromocytoma, with particular care to diagnostic methodologies and referring the therapeutic choices. From 1965 until today 40 patients have been surgically treated for pheochromocytoma mono or bilateral. 43 operations have been done, carrying out 46 adrenalectomy. Two complication must be referred: an ictus cerebri consequent upon an hypertensive crisis and one death caused by intraoperative ventricular fibrillation. Normalization of arterial pressure has been obtained in all patients.     

Quantified ultrastructural study of spermatozoa in unexplained failure of in vitro fertilization

Failure of in vitro fertilization or very low cleavage rates may occur even though oocyte and semen parameters seem satisfactory. Quantified ultrastructural study of spermatozoa was performed in such cases of failure (n =6) or low cleavage rate (<20%; n =4). Through 1 to 11 retrievals, the number of inseminated oocytes ranged from 14 to 145. The results were compared to those of six fertile men. Quantification was achieved by cataloguing cell defects of the spermatozoon heads and mid-/principal pieces of the flagella. Using the data from each specimen, the percentages of total cellular abnormalities in the head/mid-/principal pieces were established. At the level of the head overall percentages for six groups of defects were determined. The overall percentage of combined head abnormalities, defined as the presence of at least three of these six defects on the same spermatozoon head, was established. Statistical differences among control and patient groups were analyzed by nonparametric Mann—Whitney Utest. The percentages of anomalies of the midpiece and of the principal piece were not significantly different between patients and controls. Motility assessed by spermogram was considered functionally uncompromised. In eight patients the percentage of cell alterations of the head (93–100 vs 77.3 ± 6.4%) and the percentage of combined anomalies of the head (78.1–100 vs 60.8 ± 8.5%) were significantly different between patients and controls. In two cases, the percentages established for all head parameters considered were not globally different from those observed in controls. Thus in 8 cases of 10, electron microscopy with quantified analysis supplied valuable evidence about the poor quality of these sperm samples judged as normal under light microscopy and may provide an explanation for their impaired fertilizability. In the two other cases the fact that the sperm appeared to be ultrastructurally normal does not rule out functional sperm pathology. Alternatively, defects in the oocyte may also account for unexplained failures of in vitro fertilization.     

Alcohol, drugs, pharmacologic agents, and street safety

Deaths due to road accidents during weekends have become a worrying phenomenon in Italy. With the aim of highlighting the role of psychotropic substances (alcohol, drugs of abuse) in causing road accidents, a survey based on clinical and chemico-toxicological analyses has been carried out on car drivers in the Veneto region during night weekends since 1994. Rapid clinical screening was carried out on 7952 drivers. 1399 of these, suspected to be under the influence of psychotropic substances, were subjected to complete clinical and toxicological ascertainment involving the following procedures: a) anamnesis, aiming at evidence of possible current or past use of psychotropic substances; b) objective clinical examination, aiming at finding evidence of recent (signs of acute or chronic intoxication) or past use (signs of withdrawal or associated organic pathologies) of psychotropic substances; c) double sampling of blood and urine and chemico-toxicological analysis using immunochemical, GC-HS and GC/MS-SIM techniques. As well as many data of social and behavioural interest, processing of results demonstrated that: a) 56.7% of the drivers examined had consumed alcoholic beverages; b) 30.4% had BACs higher than the threshold permitted in Italy (80 mg/100 ml); c) 15.7% of drivers were found to be under the influence of drugs of abuse or psychoactive drugs; d) the most frequently found substances were (in order): cannabinoids, stimulants (cocaine, amphetamines), opiates.     

Chronic cocaine treatment induces dysregulation in the circadian pattern of rats' feeding behavior

The effects of protracted cocaine administration (15 mg/kg i.p., twice a day for 9 days) on the circadian pattern of feeding behavior was studied in individually housed male Sprague-Dawley rats, maintained under a 12:12 light:dark cycle. Water and food were available ad libitum and food intake was measured twice a day before, during and after withdrawal of cocaine (or saline) treatment. Neither total 24-h food intake, nor body mass at the end of the experiment, was significantly different between cocaine-treated and control animals. However, cocaine administration affected the temporal distribution of food consumption. During the dark (activity) phase, rats receiving cocaine injections consumed significantly less food than control animals, and this effect persisted for up to 3 days of cocaine withdrawal. During the light (rest) phase, cocaine administration promoted food consumption and a significantly higher food intake was also observed during the first five cocaine withdrawal days. Continuous monitoring of locomotor activity did not reveal significant changes in the circadian pattern of activity between the two experimental groups during different treatment periods, except for an acute increase in locomotion within an hour after daytime cocaine injection. The results of this study demonstrate that sub-chronic cocaine administration alters the circadian pattern of rats' feeding behavior.     

Platelet-rich plasma:the role in neural repair

<正>The efficacy of platelet-rich plasma(PRP)to promote tissue regeneration has been largely confirmed in several clinical settings,such as in human maxillo-facial(Froum et al.,2002),heart(Vu et al.,2015)and orthopaedic surgery(Zhang and Wang,2010).Up to date,few studies are available regarding the topical use of platelet-rich plasma in models of