Sperm velocity in seminal plasma and the association with gender of offspring

The gender of the offspring is determined by the fertilizing sperm. Previous gender studies were based on washed sperm, but not on sperm in seminal plasma. The objective was to correlate motility parameters assessed during semen analyses with the offspring gender. For comparison, fixed sperm head DNA quantitated by Hoechst 33342 fluorescence microscopy was also analyzed. Forty-six patients undergoing assisted reproduction procedures resulted in livebirth deliveries with either male or female-predominant offsprings. Sperm head fluorescence was weakly correlated to the gender in 61% of the cases. Sperm of patients with male offsprings had slower curvilinear (44.2 +/- 1.8 mean +/- SEM, versus, 49.9 +/- 2.7 micro /sec) and slower average path velocities (32.4 +/- 1.2 versus 36.3 +/- 1.7 micro /sec). Using cut-off values for the curvilinear (< 49 micro /sec) and average path (< 36 micro /sec) velocities of sperm swimming in seminal plasma, the two parameters predicted 75 and 68% of the male offspring births, respectively. The data suggest that sperm movement in seminal plasma is a marker for factors that skew the ratio of the X- to Y-sperm populations.     

External jugular vein vascular malformation: sonographic and MR imaging appearances

Vascular malformations arising from the wall of the external jugular vein are rare. This case series discusses the sonographic and MR imaging appearances of four such cases and reviews the literature. The diagnosis should be suggested preoperatively particularly because of the close relationship such malformations to the external jugular vein, as this helps surgeons to plan the operative procedure. The imaging appearances are similar to those of other vascular malformations elsewhere in the head and neck.     

Non-Hodgkin lymphoma of the larynx: CT and MR imaging findings

BACKGROUND AND PURPOSE: Non-Hodgkin lymphoma (NHL) of the larynx is a rare tumor. The aim of this study was to report the CT and MR features of laryngeal NHL in four patients to determine if there are any features that might be helpful to distinguish NHL from other laryngeal tumors. METHODS: The CT and MR images of four patients with laryngeal NHL were retrospectively reviewed for tumor volume and distribution, appearance, local invasion, and lymphadenopathy. RESULTS: Tumor volume ranged from 4 to 45 mL(3). Tumor was based in the submucosal (2/4 [50%]), mucosal (1/4 [25%]), or both regions (1/4 [25%]) and was centered in the supraglottis (4/4 [100%]) but also involved the glottis (4/4 [100%]) and subglottis (2/4 [50%]). Laryngeal tumor involved the aryepiglottic folds (4/4 [100%)]), ventricles and false cords (4/4 [100%]), epiglottis (3/4 [75%]), paraglottis (3/4 [75%]), true cords (4/4 [100%]), anterior commissure (4/4 [100%]), and laryngeal cartilage (1/4 [25%]). The tumor extended into the hypopharynx (4/4 [100%]), strap muscles (1/4 [25%]), prevertebral muscles (1/4 [25%]), tongue base (1/4 [25%]), and walls of the oropharynx (1/4 [25%]) and nasopharynx (1/4 [25%]). Bilateral cervical lymphadenopathy with extracapsular tumor spread was present in one patient. CONCLUSION: Laryngeal NHL is a tumor that usually has a large submucosal component centered in the surpaglottis. The tumor extends into the glottis, with less frequent spread to the subglottis, laryngeal cartilage, and strap muscles. Laryngeal NHL also involves the hypopharynx, with large tumors extending superiorly into the tongue base, oropharynx, and nasopharynx. A laryngeal tumor with a large supraglottic submucosal component should alert the ragiologist to the possibility of NHL.     

The medial collateral ligament of the elbow is not isometric: an in vitro biomechanical study

BACKGROUND: The anterior bundle of the medial collateral ligament (AMCL) of the elbow has been shown to be the most important valgus stabilizer of the elbow. However, the isometry of this band has not been quantified. HYPOTHESIS: Isometric fibers exist within the AMCL, and these fibers are located within its central region. STUDY DESIGN: Controlled laboratory study. METHODS: Twelve cadaveric elbow specimens were mounted in a testing apparatus in a valgus gravity-loaded orientation. Passive supinated flexion was performed and the motion recorded using an electromagnetic tracking device. Hundreds of attachment points for the AMCL of the elbow were recorded on the medial epicondyle and ulna. The overall change in length between each point on the ulna to every humeral point, throughout the arc of motion, was quantified (DeltaL = Lmax - Lmin). The locations of the smallest DeltaL values were determined relative to the attachment site of the AMCL on the medial epicondyle. RESULTS: True isometry was not found throughout the arc of flexion. The smallest DeltaL values averaged 2.8 +/- 1.2 mm (range: 0.7 mm to 5.2 mm). Isometric fibers do not exist within the AMCL; however, "nearly" isometric areas are located on the lateral aspect of the attachment site of the AMCL on the medial epicondyle, near the anatomic axis of rotation. CONCLUSIONS: We postulate that these nearly isometric areas would be the most ideal location for graft attachment during reconstruction of the AMCL.     

Evaluation of renal parenchymal disease in a rat model with magnetic resonance elastography.

Alterations in the mechanical properties or "hardness" of tissues allow physicians to detect disease by palpation. Recently, attempts have been made to quantitate and image these tissue properties with the use of magnetic resonance elastography (MRE). This technique has been validated in ex vivo specimens, including kidney, breast, and prostate. In this study, in vivo MRE imaging of rat renal cortex is demonstrated and validated with a disease model that will facilitate further studies. Normal rats and rats with nephrocalcinosis induced with either 2 or 4 weeks of ethylene glycol exposure were studied with MRE. Histology in the diseased rats documented the presence of nephrocalcinosis. MRE measurements and images of shear stiffness were highly reproducible in individual rats. The shear stiffness of the renal cortex in normal rats was 3.87 kPa (95% CI 2.84-4.90 kPa). The shear stiffness increased to 5.02 kPa (95% CI 3.34-6.70 kPa) after 2 weeks of exposure, and to 6.49 kPa (95% CI 4.84-8.14 kPa) after 4 weeks of exposure (P = 0.0302, alpha < 0.05). MRE is capable of detecting alterations in the tissue mechanical properties of kidneys in vivo. It is a promising noninvasive technique that might have pathologic and prognostic significance.     

Tensionless Spigelian herniorrhaphy using a bilayered prosthetic patch: historical, anatomical, diagnostic, and operative perspectives

Spigelian hernias, which represent <2% of all hernias of the vellum abdominis (abdominal wall) anterior, can be a diagnostic challenge for clinicians. Noninvasive imaging techniques, including ultrasonography (US) and computerized axial tomography (CAT), substantially complement clinical inferences based on interrogation and physical examination. Successful definitive care mandates comprehension of the regional, topographical, and visceral anatomy in axial, coronal, and transverse planes. Reported herein is the successful use of a bilayered prosthetic patch, advantageous because of its unimodular and biplanar configuration, to perform a tensionless herniorrhaphy.     

Class III Obesity Continues to Rise in African-American Women

Background: The Behavior Risk Factor Surveillance System (BRFSS) survey, a random telephone survey of the United States, found a rising prevalence of Class III obesity, body mass index (BMI) >40 kg/m². African-American women were largely responsible for this increase. The prevalence of Class III obesity in African-American women in the BRFSS during the year 2000 was 6%, identical to the Pennington Biomedical Research Center (PBRC) database during the same year. The PBRC Database might predict the trend in class III obesity in the years 2000-2002. Methods:The PBRC is an academic research center in Baton Rouge, that maintains a database with information collected by telephone regarding BMI and race, for subjects responding to solicitations to participate in clinical trials. This database contains 7,787 subjects entered from 1995 through 2002, of which 1,820 were African-American women and 3,006 were Caucasian women. The prevalence of Class III obesity was plotted for women of these 2 racial groups and compared with the year 2000 prevalence in the BRFSS. Results: The prevalence of Class III obesity in African-American women increased from 0.5% in 1995 to 6% in 2000 (identical to the BRFSS) and to 7.5% in 2002. The prevalence of Class III obesity in Caucasian women remained about 3%. Conclusion:The prevalence of Class III obesity continues to rise in African-American women, a group with greater need and less access to obesity surgery, the only effective treatment, than Caucasian women, an inequality deserving of public policy attention.     

Nonhabitual seizures in patients with implanted subdural electrodes

The implantation of subdural electrodes has been widely employed in the invasive monitoring of patients with medically refractory epilepsy. The use of subdural electrodes, though, has been associated with rare but occasionally troublesome complications. We report the occurrence of nonhabitual seizures after implanting subdural grid electrodes. Among 57 patients diagnosed with medically refractory epilepsy who were evaluated in our department over a 12-month period, 21 patients underwent craniotomy for subdural grid/strip electrode implantation. Subdural grids and strips (AdTech, Racine, Wisc., USA) were used for continuous video EEG monitoring. In 3 patients, during subdural monitoring, consistent nonhabitual seizure activity was recorded. This was both clinically and electrographically different than the patients' habitual seizures. The patients' nonhabitual seizures disappeared postoperatively after removing the implanted electrodes. The occurrence of nonhabitual seizures, though quite rare, could lead to mislocalization of an epileptogenic focus. This complication might be the result of direct mechanical cortical irritation or chemical irritation caused by blood breakdown products. The occurrence of nonhabitual seizures comes to add itself to the existing list of complications associated with employment of subdural electrodes for invasive monitoring.