Blood type predicts live birth in the infertile population

Purpose

To determine if blood type in infertile women relates to the likelihood for live birth (LB) following IVF, and to the etiology for infertility.

Methods

Retrospective study of patients undergoing IVF at two academic centers in the northeast US. Relationships between blood type (A, B, AB, O) and patient characteristics, IVF cycle parameters and LB were assessed utilizing multivariable logistic regression analyses.

Results

In the studied population (n = 626), women with type O were significantly more likely to have baseline FSH > 10 IU/L after adjusting for age, BMI and race (OR 5.09, 95 % CI 1.4–18.7, p = 0.01). Conversely, women with blood type A were significantly more likely to have ovulatory infertility compared to those with blood type O after adjusting for age and BMI (OR 3.2, 95 % CI 1.7–6.2). Blood type B was associated with increased likelihood of live birth (OR 1.9, 95 % CI 1.10–3.41, p = 0.03) after adjusting for factors recognized to impact IVF outcome.

Conclusion

Ovulatory infertility and baseline FSH > 10 IU/L were more prevalent in women with blood type A and O respectively. However, those of blood type B had significantly higher odds for LB compared to other blood types after adjusting for factors recognized to impact on IVF cycle outcome. While underlying mechanisms are unclear, for infertile women, patient’s blood type is seemingly relevant for IVF cycle outcome.     

Ultra-small diameter coils for treatment of intracranial aneurysms

This study reports our initial clinical experience treating very small intracranial aneurysms using only Target® Nano™ coils.Retrospective angiographic and clinical analysis was performed on a non-randomized single arm registry of all intracranial aneurysms treated with only Target® Nano™ coils (1 mm and 1.5 mm diameter only) during a 12 month period at two academic hospitals.Fourteen patients with 14 intracranial aneurysms were treated. The maximum diameter of saccular aneurysms treated ranged from 1.5 to 3.5 mm; minimum aneurysm diameter was 1.1 to 2 mm. The immediate complete aneurysm occlusion rate was 86% (12/14), and a small residual within the aneurysm was seen in 14% (2/14) of cases.Packing density from coils ranged between 24% and 83% (mean 51%). The immediate complication rate was 0% (0/14). The angiographic/MR angiography follow-up period was 22 to 70 weeks (mean 37 weeks) with an overall complete occlusion rate of 9/11 (81%), recurrence in 18% (2/11), and lack of follow-up in three cases, two due to death during hospitalization and one procedure not yet due for imaging follow-up. Both patients who died presented with brain aneurysm ruptures prior to treatment. Both recurrences were retreated with repeat coiling procedures.Our initial results using only Target® Nano™ coils for the endovascular treatment of very small intracranial aneurysms have demonstrated initial good safety and efficacy profiles.     

APASL consensus statements and recommendations for hepatitis C prevention,epidemiology, and laboratory testing

The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on “APASL consensus statements and recommendations for management of hepatitis C” in March 2015 to revise the “APASL consensus statements and management algorithms for hepatitis C virus infection” (Hepatol Int 6:409–435, 2012). The working party consisted of expert hepatologists from the Asian–Pacific region gathered at the Istanbul Congress Center, Istanbul, Turkey on 13 March 2015. New data were presented, discussed, and debated during the course of drafting a revision. Participants of the consensus meeting assessed the quality of the cited studies. The finalized recommendations for hepatitis C prevention, epidemiology, and laboratory testing are presented in this review.     

Transesophageal three-dimensional echocardiographic assessment of anomalous coronary arteries

We describe the usefulness of transesophageal three-dimensional echocardiography in the evaluation of anomalously arising coronary arteries in four adult patients recently studied by us.     

Ultrasound guided aspiration biopsy of peripheral pulmonary lesions

Forty-six patients with peripheral lung lesions underwent ultrasound-guided percutaneous needle aspiration biopsy. Aspirates were sent for cytological and/or microbiological examination. Confirmative diagnosis was obtained in 40 patients (86.9%). Twenty-eight patients had positive cytology for malignancy and 12 patients with benign lesions had diagnosis made by cytologic and microbiologic examination. None of the lesions could be diagnosed by sputum cytology and fibreoptic bronchoscopy with biopsy or brushings. No complication was observed in any patient. We conclude that ultrasound guided aspiration biopsy is a useful and safe method for the diagnosis of peripheral pulmonary masses. The diagnostic yield far exceeds that which can be obtained by sputum cytology and fibreoptic bronchoscopy with biopsy.     

Molecular characterization of weak D phenotypes by site-directed mutagenesis and expression of mutant Rh-green fluorescence protein fusions in K562 cells

BACKGROUND AND OBJECTIVES: Mutations detected in 161 weak D samples from Caucasians have been classified into 16 types. Because flow cytometry using monoclonal anti-D antibodies (mAbs) has shown that weak D red cells display type-specific antigen density, these mutations in transmembranous regions have been assigned weak D phenotypes. The present study attempts to confirm or refute this assignment. MATERIALS AND METHODS: We amplified DNA from four Japanese weak D samples using the polymerase chain reaction (PCR), and directly sequenced the amplified DNA. Using site-directed mutagenesis, we constructed three vectors expressing mutant RHDs-- G212C, V270G (weak D type 1) and G358A (type 2)--in K562 cells. The expression of RhD antigens was examined by flow cytometry using mAbs. RESULTS: A new mutation resulting in a conversion at amino acid residue 212 (Gly to Cys) was detected in a Japanese weak D sample. K562 cells transduced with mutant RhD cDNA reacted weakly in a type-specific manner with mAbs. CONCLUSIONS: The mutations--G212C (new weak D type), V270G (weak D type 1) and G358A (type 2)-- in transmembranous regions had obvious effects on the D epitopes recognized by mAbs. The results of this study provide direct evidence that these mutations can account for weak D phenotypes.     

Squamous cell carcinoma of stomach.

Squamous cell carcinomas in the gastrointestinal tract are known to occur in oro-pharynx, esophagus and anal canal. Gastric squamous cell carcinoma is a rare epithelial tumour. Surgical treatment is the same as that for an adenocarcinoma, though prognosis is probably worse.     

Effects of insulin on the acetylcholine-induced hyperpolarization in the guinea pig mesenteric arterioles

Background: Insulin induces endothelium-dependent vasodilatation, which may be casually related to the insulin resistance and hypertension. Endothelium-derived nitric oxide (NO) is the most important mechanism of insulin-induced vasodilatation, and a possible contribution of endothelium-derived hyperpolarizing factor (EDHF) is also considered. Attempts were made to observe the effects of insulin on acetylcholine (ACh)-induced hyperpolarization in the submucosal arteriole of the guinea pig ileum, the objective being to investigate possible involvement of EDHF in the actions of insulin. Methods: Conventional microelectrode techniques were applied to measure the membrane potential of smooth muscle cells in the submucosal arteriole. EDHF-induced hyperpolarization was elicited by ACh in the presence of both N^ω-nitro- -arginine ( -NNA) (100 μM) and diclofenac (1 μM). Results: The resting membrane potential was −70.9 mV, and Ba²⁺ (0.5 mM) depolarized the membrane to −33.0 mV. Insulin (10 μU/ml to 100 mU/ml) did not change the membrane potential in the absence or presence of Ba²⁺. In the presence of Ba²⁺, ACh (3 μM) hyperpolarized the membrane with two components, an initial large hyperpolarization followed by a slow and small one. Low concentration of insulin (100 μU/ml) did not alter the ACh-induced hyperpolarization. High concentration of insulin (100 mU/ml) shortened the time required to reach the peak amplitude and tended to increase the peak amplitude of the ACh-induced hyperpolarization. Conclusions: The data show that insulin enhances the ACh-induced hyperpolarization in the submucosal arterioles of the guinea pig ileum. The results suggested that EDHF also accounts for one of the endothelial factors involved in the insulin-induced vasodilatation.     

Statins inhibit high glucose-mediated neutrophil-endothelial cell adhesion through decreasing surface expression of endothelial adhesion molecules by stimulating production of endothelial nitric oxide

Neutrophil-endothelial adhesion is a crucial step in vascular inflammation, which is recognized as the direct cause of atherosclerosis-mediated serious diseases. We demonstrated previously that high glucose increased adhesion in a protein kinase C (PKC)-dependent manner within 48 h through increasing surface expression of endothelial adhesion molecules. On the other hand, statins, used for patients with hypercholesterolemia, have been shown to decrease the incidence of atherosclerosis-mediated diseases, but direct effects of statins on endothelial cells remain unclear. In this study, we examined the effects of these compounds on high glucose-mediated neutrophil-endothelial adhesion with respect to the participation of PKC and nitric oxide (NO). After human endothelial cells were cultured for 48 h in high glucose medium, neutrophils from healthy volunteers were added and allowed to adhere for 30 min. Adhered neutrophils were quantified by measuring their myeloperoxidase activities, and surface expression of endothelial adhesion molecules was determined with an enzyme immunoassay. Both pravastatin (0.05 microM) and fluvastatin (0.5 microM) significantly attenuated the adhesion mediated by 27.8 mM glucose for 48 h through decreasing surface expression of endothelial adhesion molecules (intercellular adhesion molecule-1, P-selectin, and E-selectin). NO synthase inhibitors reduced the inhibitory effects of statins, whereas statins did not affect the adhesion mediated by a PKC activator. These data suggest that statins act directly on endothelial cells to inhibit expression of adhesion molecules and neutrophil adhesion mediated by high glucose through increasing endothelial NO production, but not by inhibiting PKC.     

Multiple anomalous systemic-pulmonary connections and coronary-pulmonary artery fistula associated with large aneurysms in an elderly woman

Abstract We report the repair of a coronary artery fistula arising from the right coronary artery draining into the right pulmonary artery associated with multiple systemic-pulmonary connections. (J Card Surg 2012;27:565-567).