The incidence of class "zero" airway and the impact of Mallampati score, age, sex, and body mass index on prediction of laryngoscopy grade

IMPLICATIONS: In an earlier study we proposed the addition of a new airway class, zero (visualization of the epiglottis), to the four classes of the modified Mallampati classification. In this prospective study, 764 surgical patients were assessed with regard to their airway class (including class zero), laryngoscopy grade, and the effect of the airway class and other predictors on the laryngoscopy grade.     

Elevated platelet count in patients with endometrial carcinoma: correlation with selected prognostic factors and with survival

Platelets may play a role in the metastatic process and, among gynecologic malignancies, thrombocytosis has been reported in cervical and ovarian malignancy. The present study was conducted in order to assess the prevalence of thrombocytosis in endometrial carcinoma and to correlate platelet count with prognostic factors and with survival. The prevalence of preoperative thrombocytosis was assessed in 66 endometrial carcinoma patients and their platelet count was correlated with selected prognostic factors and with projected survival. The prevalence of thrombocytosis ( 400 000 µL⁻¹) was low (one of 66 patients) compared with that in cervical and ovarian carcinoma. Nevertheless, a significant ( P = 0.032) correlation was found between an elevated ( 300 000 µL⁻¹) platelet count and unfavorable grade of differentiation. Patients with an elevated count also had a poorer survival rate and a higher prevalence of older age, high stage and deep myometrial invasion, but this trend did not reach statistical significance. The combination of unfavorable grade and an elevated platelet count had a higher specificity and positive predictive value for deep myometrial invasion than unfavorable grade alone. The prevalence of thrombocytosis in endometrial carcinoma is low. An elevated platelet count may have some prognostic significance, but its ultimate role in endometrial carcinoma remains to be elucidated.     

Evaluation of the SQA IIB: a new version of a sperm quality analyzer

OBJECTIVE: To evaluate the SQA IIB (Sperm Quality Analyzer; MES-Medical Electronic Systems, Migdal Haemek, Israel), sperm analyzer that claims to read the three main sperm indices through algorithmic means and without a microscope. DESIGN: Controlled laboratory study comparing two methods of sperm analysis. SETTING: Academic environment. PATIENT(S): Twenty-six healthy volunteers. INTERVENTION(S): Samples from intact or manipulated specimens were analyzed with the standards of the World Health Organization and the SQA IIB. MAIN OUTCOME MEASURE(S): Results by the two methods were compared and evaluated statistically. RESULT(S): Values from the SQA IIB deviated significantly from those obtained by the standard method for all three indices. Disagreement was more than twofold in 53% and more than threefold in 33% of cases. In specimens with <8% motility or total lack of motility, the SQA IIB showed zero concentration, zero motility, and no normal forms. CONCLUSION(S): Analysis of the three main sperm indices by the SQA IIB is of limited accuracy and reliability. The principle of an indirect evaluation through algorithmic means is inadequate. Because it may furnish misleading information, which is sometimes crucial for the treated couple, it is not suitable for screening and cannot be recommended for clinics, sperm banks, or research studies in andrology.     

Anaerobic glycolysis. The metabolism of the preovulatory human oocyte

OBJECTIVES: The aim of the study was to investigate the process of glycolysis in gonadotropic, hyperstimulated, human ovarian follicles. STUDY DESIGN: Follicular fluid (FF) lactate and glucose concentrations were measured in 26 patients with tubal factor infertility undergoing in vitro fertilization treatment. RESULTS: The mean FF lactate and glucose concentrations were 3.17+/-0.90 mM with positive, and 3.39+/-0.91 mM with negative correlations to follicular size. FF lactate concentration correlated negatively to glucose levels. CONCLUSIONS: Our study confirms in vivo the anaerobic glycolysis in gonadotropic, hyperstimulated human ovarian follicles.     

Mutational analysis of <Emphasis Type="BoldItalic">hMsh6</Emphasis> in Israeli HNPCC and HNPCC-like Families

Germline mutations in DNA mismatch repair (DNA-MMR) genes, mainly hMlh1 and hMsh2, underlie Hereditary Non-Polyposis Colorectal Cancer (HNPCC). Germline hMSH6 gene mutations have been reported in a small subset of HNPCC families. In the present study, ethnically diverse individuals with HNPCC and HNPCC-like features were genotyped for hMsh6 germline mutations using exon-specific PCR, DGGE, and DNA sequencing. The study encompassed 92 individuals representing 88 unrelated families who were previously analyzed for Msh2 and Mlh1 mutations: Jewish Ashkenazim (n = 44), non-Ashkenazim (n = 27), Israeli Moslem-Arab (n = 15), Druze (n=3), and Cypriot non-Jews (n = 3). Of the study population, 71 had colon cancer (CRC), mean age at diagnosis was 50.9±13.2 years (range16–73 years), 5 had endometrial cancer (two with concurrent CRC), (mean 43.6±3.26 years, range 38–45 years), and unaffected individuals (n = 18) were first degree relatives within HNPCC families and were genotyped at a mean age of 48.3±11.7 years (range 30–69 years). Of the 92 individuals analyzed, none showed a truncating hMsh6 mutation, and 6 (6.6%) harbored one of three germline missense mutations: a previously reported one (V878A), and two novel mutations (V509A, S227I). The pathogenic significance of these three missense mutations is yet unclear. In addition, 5 polymorphisms were detected, 2 of which were novel. We conclude that the rate of pathogenic hMsh6 mutations in HNPCC families of Jewish and Mediterranean origin is low, and that mutations in other genes probably account for the phenotype in these families.     

Relationship between the energy status of Daphnia magna and its sensitivity to environmental stress

This work tested the hypothesis that animals with a high energy status are more successful in dealing with stress than animals with a low energy status. Daphnids (Daphnia magna) were reared for 2 weeks in four different concentrations of food. Survival was not affected by food supply, and growth and reproduction increased with increasing food ration. This increase correlated well with the energy status, as was measured by scope for growth on day 15. After 2 weeks, the daphnids in the four different food ration groups were exposed for another 2 weeks to a range of increased salinities or cadmium concentrations, while remaining in their respective food concentrations. In the salinity groups, survival, growth, or reproduction were not influenced at low salinities. Exposure to higher salinity significantly decreased survival and reproduction, but this decrease was more pronounced in the highest food concentrations. In the cadmium exposed daphnids, cadmium content increased with increasing exposure concentrations, but accumulation was independent of food rations. Cadmium exposure significantly decreased survival, growth, and reproduction and this decrease again was more pronounced with increasing food concentration. Thus, the high energy status of the daphnids from the high food concentrations at the start of the exposure did not provide an increased capacity to cope with additional stress. Instead, the sensitivity of the daphnids to stress increased with increasing food ration. This increased sensitivity is likely to be the result of a change in life history from emphasizing survival at low food supply to stressing reproduction at high food supply.     

Cancer screening among Native Americans in eastern North Carolina

The purpose of the study is to explore cancer screening predictors and practices among Lumbee Indians in eastern North Carolina. Interviewers from the community conducted phone interviews with 333 men and 456 women aged 40 and older randomly selected from the Lumbee Tribal roll as part of the Lumbee Diabetes and Health Survey. The survey has sections on demographic information and health conditions, family history of chronic conditions, and health behaviors. This paper reports on cancer screening behaviors. Rates of ever being screened for breast, cervical, prostate and colon cancer were relatively high compared with overall national rates. Predictors included younger age, better health, more education, and lifestyle factors such as engaging in regular physical activity and not smoking. Future research should focus on developing culturally appropriate campaigns to increase the frequency of cancer screening to conform to guidelines, and educational programs and interventions to reach Lumbee Indians most at risk for not being screened.