A simple monthly means chart system for monitoring sperm concentration

A simple, robust monthly means chart system for monitoring sperm concentration was developed and used in our andrology laboratory. The system relied on the central limit theorem to allow estimation of chart limits without resorting to data transformation procedures. Once the chart was drawn up, the arithmetic mean of sperm concentration was determined monthly and plotted. Monthly means which fell outside 2 SE from the baseline mean were investigated. Initial experience with this chart system suggests that it provides a simple and useful quality assurance method which should be applicable to other semen variables such as motility and sperm morphology.      

Radiologic evaluation of mass casualty victims: lessons from the Gander, Newfoundland, accident

This study describes the use of radiologic methods in the identification of 256 bodies after the crash of an airliner in Gander, Newfoundland. Two hundred thirty-one (90%) of the victims were identified positively with dental and/or fingerprint comparisons. Radiologic data confirmed identification in 29 of these victims. Seventeen bodies without dental or fingerprint identification were presumptively identified with a variety of data, which included radiologic characteristics in four cases. Eight bodies were identified with an exclusion matrix. Radiologic input was critical in two of these. The procedures described provide practical information for radiologists in a mass casualty disaster investigation.     

Which AO/OTA 31-A2 pertrochanteric fractures can be treated with a dynamic hip screw without developing a lateral wall fracture? A CT-based study

Purpose

To determine whether radiographic measurements derived from standard computed tomography (CT) evaluation can be used to predict likelihood of a peri-operative lateral femoral wall fracture in AO/OTA 31-A2 pertrochanteric fractures treated with a dynamic hip screw (DHS).

Methods

Fifty-one patients with AO/OTA 31-A2 classified pertrochanteric fractures were evaluated using a pre-operative CT scan of the pelvis with both hips. Dimensions of the lateral wall were calculated for each patient using four parameters: (1) height of the lateral wall above the vastus ridge; (2) circumference of the lateral wall 2 cm below the vastus ridge at an angle of 135°; this circumference was further divided into an anterior, lateral and posterior component; (3) cortical thickness at the centre of the lateral component of the lateral wall; and (4) cortical index. All patients were treated with a 135° DHS. Postoperative radiographs were assessed for lateral femoral wall fracture.

Results

Patients with a lateral wall fracture (17/51) had a smaller circumference (4.47 cm vs 5.44 cm p value?<0.001) as well as a lower height of the lateral femoral wall (1.37 cm vs 2.21 p value?<?0.001). Analysis of the three components of the circumference revealed a significant difference for the anterior component only and not for the lateral and posterior components. There was no statistical difference in the cortical thickness or cortical index in the two groups. The cutoff values for height of the lateral wall and anterior component were calculated using ROC curves and found to be 1.68 cm (AUC 0.918) and 2.10 cm (AUC 0.851) respectively.

Conclusion

AO/OTA 31-A2 pertrochanteric fractures with a lateral wall height of > 1.68 cm and an anterior component of > 2.10 cm in circumference are not likely to sustain a lateral wall fracture when treated with a DHS.

     

Science review: Searching for gene candidates in acute lung injury

Acute lung injury (ALI) is a complex and devastating illness, often occurring within the setting of sepsis, and carries an annual mortality rate of 30–50%. Although the genetic basis of ALI has not been fully established, an increasing body of evidence suggests that genetic predisposition contributes to disease susceptibility and severity. Significant difficulty exists, however, in defining the exact nature of these genetic factors, including large phenotypic variance, incomplete penetrance, complex gene–environment interactions, and strong potential for locus heterogeneity. We utilized the candidate gene approach and an ortholog gene database to provide relevant gene ontologies and insights into the genetic basis of ALI. We employed a Medline search of selected basic and clinical studies in the English literature and studies sponsored by the HopGene National Institutes of Health sponsored Program in Genomic Applications. Extensive gene expression profiling studies in animal models of ALI (rat, murine, canine), as well as in humans, were performed to identify potential candidate genes . We identified a number of candidate genes for ALI, with blood coagulation and inflammation gene ontologies being the most highly represented. The candidate gene approach coupled with extensive gene profiling and novel bioinformatics approaches is a valuable way to identify genes that are involved in ALI.     

Reduction of human immunodeficiency virus-infected cells from donor blood by leukocyte filtration

Several filters for leukocyte removal were evaluated in terms of their ability to reduce the cell-associated human immunodeficiency virus (HIV) load in units of blood either inoculated in vitro with lymphocytes from a chronically infected cell line or collected directly from seropositive donors. Filtration of the experimentally inoculated units of blood resulted in a 5.9 log 10 mean reduction (95% confidence interval:7.4-4.5) of tissue culture infectious units (TCIU) as assayed by end-point titration using the coculture assay. Filtration of the units of blood from anti-HIV positive donors lowered the infectivity by over 2 logs, as detected by the coculture and polymerase chain reaction (PCR) techniques. However, residual cell-associated virus was detected in the majority of experiments. Clinical studies are warranted to determine if leukocyte filtration of blood will reduce the risk of transfusion transmitted viral infections.     

Development and characterization of thermosensitive pluronic-based metronidazole in situ gelling formulations for vaginal application

The purpose of this study was to develop pluronic-based in situ gelling formulations of metronidazole (MTZ) for treatment of bacterial vaginosis, aimed at prolonging the residence time, controlling drug release, enhancing efficacy, decreasing recurrence, and increasing patient compliance. The in situ gel formulations were prepared using different concentrations of pluronic F-127 (PF-127) alone and in combination with pluronic F-68 (PF-68). The prepared formulations were evaluated for their gelation temperature (T(gel)), in vitro drug release, rheological properties, mucoadhesion properties and tolerability by vaginal mucosa in tissue levels. The T(gel) decreased with increasing PF-127 concentration. The T(gel) was modulated by addition of PF-68 to be within the acceptable range of 25-37 °C. With increasing pluronic concentration, the in vitro drug release decreased, viscosity and mucoadhesive force increased. Histopathological examination of rabbit vaginas from the control and treated groups revealed normal histology of the vagina and cervix. Based on the in vitro evaluation of prepared formulations, the in situ gelling liquid formulated with PF-127/PF-68 (20/10 %, m/m) was selected for further clinical evaluation.