The effects of follicular fluid from patients with different indications for IVF treatment on the binding of human spermatozoa to the zona pellucida

This study compared the effects of human follicular fluid (hFF) from women with endometriosis, tubal factor and male factor on the zona binding capacity of human spermatozoa. Samples of hFF were collected from 30 patients, 10 patients for each of the indications of infertility, at the time of oocyte retrieval in an in-vitro fertilization/embryo transfer programme. The hemizona binding assay (HZA) was used to assess the effect of these hFF on the zona binding potential of human spermatozoa. The mean numbers of spermatozoa bound to the zona pellucida after treating the spermatozoa with hFF from endometriosis, tubal factor and male factor were 90.5 +/- 20.9, 108.9 +/- 22.3 and 101.2 +/- 13.4 respectively. These were significantly lower than their corresponding controls, the spermatozoa of which were incubated with Earle's balanced salt solution (endometriosis 238.7 +/- 34.7; tubal factor 210.8 +/- 41.6; male factor 205.4 +/- 26.3; P <0.002). The hemizona binding index (HZI) was similar between male factor samples (52.0 +/- 6.7) and tubal factor samples (53.8 +/- 4.2). Spermatozoa incubated with hFF from endometriosis patients (36.0 +/- 4.1) had an HZI that was significantly lower than those treated with hFF from tubal factor patients (P <0.01). Probably due to small sample size, the differences in HZI between endometriosis samples and male factor samples did not reach statistical significance (P = 0.076). These data suggest that there was a stronger sperm-zona binding inhibitory effect of hFF from patients with endometriosis than from those without the disease.      

Central diabetes insipidus in a newborn with deletion of chromosome 7q

Abstract: We report an infant with midline craniofacial defects and holoprosencephaly due to chromosome 46, XY, del (7) (pter →q34) who presented at 1 week of age with central diabetes insipidus. The importance of hypothalamic-pituitary endocrine investigation in patients with this syndrome, and more generally, in patients with midline craniofacial malformation or holoprosencephaly is emphasized. As infants with chromosome 7q deletion bear close phenotypic resemblance to infants of Trisomy 13, chromosomal confirmation and karyotype banding is mandatory to establish an accurate diagnosis and for genetic counselling of their parents.     

Atlantoaxial fixationwith transarticular screws—Magerl technique

Fixation of the atlantoaxial joint using transarticular screws is a safe and effective means of stabilizing the C1–C2 joint.It is particularly useful when the posterior arch of C1 is cartilaginous or hypoplastic. Improvement in imaging techniques has contributed to its increasing safety.     

Prevalence of tuberculin skin test positivity and conversions among healthcare workers in New York City during 1994 to 2001.

OBJECTIVE: To determine the prevalence of and risk factors for tuberculin skin test positivity and conversion among New York City Department of Health and Mental Hygiene employees. DESIGN: Point-prevalence survey and prospective cohort analysis. Sentinel surveillance was conducted from March 1, 1994, to December 31, 2001. PARTICIPANTS: HCWs in high-risk and low-risk settings for occupational TB exposure. RESULTS: Baseline tuberculin positivity was 36.2% (600 of 1,658), 15.5% (143 of 922) among HCWs born in the United States, and 48.5% (182 of 375) among HCWs not born in the United States. There were 36 tuberculin conversions during 2,754 observation-years (rate, 1.3 per 100 person-years). For HCWs born in the United States, the risk for tuberculin conversion was greater in high-risk occupational settings compared with low-risk settings (OR, 5.7; CI95, 1.7-19.2; P < .01). HCWs not born in the United States and those employed at the Office of the Chief Medical Examiner (OCME) were at high risk for baseline tuberculin positivity (OR, 3.2; CI95, 1.7-5.8; P < .001); OCME HCWs (OR, 4.7; CI95, 2.3-9.4; P < .001), those of Asian ethnicity (OR, 4.3; CI95, 1.4-13.5; P < .01), and older HCWs (OR, 1.0; CI95, 1.0-1.1; P < .05) were at a higher risk for conversion. CONCLUSIONS: Although the prevalence of tuberculin positivity decreased after the peak of the recent TB epidemic in New York City, the conversion rate among HCWs in high-risk occupational settings for TB exposure was still greater than that among HCWs in low-risk settings. Continued surveillance of occupational TB infection is needed, especially among high-risk HCWs.