Somatic hypermutation defects in two adult hyper immunoglobulin M patients

Immunologic Research - Hyper immunoglobulin M (HIGM) syndrome is a rare disorder of the immune system with impaired antibody functions. The clinical picture of the patients varies according to the...     

Subthalamic deep brain stimulation affects heading perception in Parkinson’s disease

Journal of Neurology - Parkinson’s disease (PD) presents with visuospatial impairment and falls. It is critical to understand how subthalamic deep brain stimulation (STN DBS) modulates...     

Long-term effect of varicocele repair on intratesticular arterial resistance index

PURPOSE: To investigate the long-term effect of varicocele repair on ipsilateral intratesticular arterial resistance index (RI) using color Doppler sonography (CDS). METHODS: A total of 26 infertile patients with left varicocele who underwent a testicular artery and lymphatic-sparing subinguinal varicocelectomy were examined with CDS for intratesticular flow parameters before and at least 6 months after surgery. We also evaluated preoperative and postoperative semen parameters. RESULTS: The mean values of RI, end-diastolic velocity and pulsatility index decreased significantly after surgery, whereas no significant change was observed in peak systolic velocity. Repair of the varicocele resulted in a statistically significant increase in the total sperm count, motility, morphology, and total motile sperm count. However, no significant correlation was found between sperm parameters and RI values (p > 0.05). CONCLUSIONS: Our data show that a significant improvement occurs in testicular blood supply and sperm parameters after surgical varicocele repair, without significant correlation between these 2 changes.     

The Effects of Serum Potassium and Magnesium Levels in a Patient with Gitelman's Syndrome on the Timing of Ventricular Wall Motion and the Pattern of Ventricular Strain and Torsion

Gitelman's syndrome is a primary renal tubular hypokalemic metabolic alkalosis. Hypokalemia and hypomagnesemia can cause cardiac tissue excitability and conduction. Global ventricular mechanical function is directly related to the contractile properties of cardiac myocytes, which are largely dependent on the flow of ions such as potassium and magnesium. Here, we show that increased levels of potassium, in addition to magnesium, in a patient with Gitelman's syndrome significantly impacts the timing of ventricular wall motion and the pattern of ventricular strain and torsion. Two‐dimensional speckle tracking echocardiography was used for evaluation of the hypokalemic–hypomagnesemic period (first day) and third day after potassium chloride and magnesium replacement therapy. The transthoracic echocardiography showed that the percent ejection fraction was similar in hypokalemic–hypomagnesemic (63%) and normokalemic–normomagnesemic (after potassium and magnesium therapy, 67%) hearts. However, decreased left ventricular apical 4‐chamber peak systolic longitudinal strain, left ventricle global peak systolic strain, and global torsion values increased after potassium chloride and magnesium replacement therapy.     

Improved cycle outcomes after laparoscopic ovarian diathermy in hyper-responder patients with previous ART failure

Excessive response to ovarian stimulation is common among hyper-responder patients undergoing assisted reproductive technology (ART). Cycle cancellations and severe ovarian hyperstimulation syndrome (OHSS) are all detrimental consequences observed within this cohort and several approaches have been proposed to enhance outcomes. The current study is designed to evaluate whether laparoscopic ovarian diathermy (LOD) improves ART outcomes and pregnancy rates by reducing Anti-mullerian hormone (AMH) levels in a group of patients who had a history of recurrent ART failure and high response. A total of 40 hyper-responder patients with history of previous ART failure were included. Group I consisted of 22 patients that underwent LOD prior to ART. Group II consisted of 18 patients that underwent only ART. Cycle outcomes of groups were compared. Following LOD, significant reduction in AMH levels were detected in group I (4.75?ng/mL to 2.25?ng/mL). Clinical pregnancies were similar among groups (40% versus 27.8% p?=?0.65). There was no cycle cancellation in Group I, whereas there were three cycle cancellations observed due to OHSS in Group II. Our results indicate that LOD might offer enhanced fertility outcomes and may reduce the likelihood of cycle cancellations in hyper-responders with previous ART failures.