Effect of parental age on fertilization and pregnancy characteristics in couples treated by intracytoplasmic sperm injection

The purpose of this study was to investigate any influence of maternal and/or paternal age on gamete characteristics and pregnancy outcomes in intracytoplasmic sperm injection (ICSI) cycles. In all, 821 consecutive ICSI cases were analysed retrospectively. While a significant linear decline in semen volume was detected, no significant differences in the concentration, motility or morphology of the spermatozoa were found with paternal ageing. A significant decline in the number of oocytes retrieved and the number of mature oocytes obtained was found with advancing maternal age. An increase in the occurrence of digyny was noted with parental ageing, while no difference in single or bipronuclear fertilization was found. Older women had a decreased incidence of single pronucleus formation and an increase in digyny, but no significant difference in the percentage of oocytes that underwent two-pronuclear fertilization was detected with regard to maternal ageing. Pregnancy outcomes were not influenced by the age of the male partner, while a strong negative correlation was found with maternal ageing. To better analyse male partner ageing as a factor affecting pregnancy outcome, we analysed a subgroup of patients with a female partner aged <35 years who underwent ICSI. No paternal influence on ICSI pregnancy outcome was found in this subgroup of patients. We conclude that the influence on pregnancy outcome after ICSI is related mostly to maternal and not paternal age.      

Atropine resistance in asthma: definition and provisional hypothesis

Out of a group of 55 asthmatics, 16 fitted the strict definition of atropine resistance (less than 20% FEV1 response to inhaled anticholinergic drugs, with a 20% or more FEV1 response to subsequent inhalation of beta 2-adrenergic stimulants). 26 were defined as atropine responsive in that they had a 20% or more FEV1 response to anticholinergic drugs. Significantly more atopic than non-atopic asthmatics were in the atropine-resistant group (chi 2 = 6.12; p less than 0.025). Atropine resistance is not related to age. It is probably due to excessive vagal activity resulting from sensitization of vagal irritant receptors by antigen. Atropine resistance appears to be ameliorated by treatment with corticosteroid drugs or disodium cromoglycate. These features suggest a link between allergic and vagal components in asthma.     

Quantitative coronary arteriography: design and validation

The authors assessed the performance of an automatic and rapid coronary quantification method by evaluating its accuracy in a stenosis phantom. Measurements were obtained with a lucite phantom with 2-, 3-, and 4-mm vessel diameters and concentric stenoses of 33%, 50%, 67%, and 75%. Direct digital angiographic images as well as 10 X 10 spot films and 35-mm cine angiography films were acquired with and without structural noise and mask subtraction. The films were digitized with magnification factors of one and two. An interactive analysis program was used to automatically determine the vessel edges with a Gaussian fit to the cross-sectional density profiles perpendicular to the center line of the vessel. Relative changes of the densitometric cross-sectional area along the vessel were used to assess the percentage of stenosis. Densitometric measurements were comparable in both digital and cine angiograms (r = .99 and r = .98, respectively); however, diameter measurements showed a higher variability and were dependent on the amount of magnification applied to the images.     

Ectopic ACTH syndrome: redefinition and case report.

A case is reported which supports the principle that ACTH precursors best characterise so-called ectopic ACTH-syndrome, which should therefore more accurately be referred to as ectopic ACTH-precursor syndrome.