Is 24-h sperm motility a useful IVF measure when male infertility is not apparent?

OBJECTIVE: To examine the relationship of 24-h sperm motility between post insemination and fertilization in vitro, in a population with no apparent semen abnormalities. A retrospective study from July 1998 to June 2000. MATERIAL AND METHODS: Four hundred and seventy-one consecutive in-vitro fertilization (IVF) cycles for which the primary diagnosis was not male infertility (total motility count > 40 x 106) were studied. Linear regression was used to examine the general relation between 24-h sperm motility and IVF. The cohort with 0% 24-h motility was compared with all other cycles using the t-test and the chi2-test. Test quality was assessed using the positive likelihood ratio. RESULTS: Overall fertilization was 58 +/- 16%. There were 45/471 cycles (9.5%) with zero fertilization. Linear regression of percent fertilization vs. 24-h motility showed no relationship (r = 0.01). The cohort with 0% 24-h motility had a lower fertilization rate 29 +/- 19% (P = 0.05), and had a higher incidence of no fertilization 7/21 (P = 0.01). The positive likelihood ratio was 4.6. CONCLUSIONS: Zero 24-h motility indicates occult male infertility, and a positive result indicates a fair to good test. Overall there was no relationship between sperm survival at 24 h post insemination and fertilization in vitro. However, 0% 24-h sperm motility was associated with reduced fertilization     

Congenital anomalies and other perinatal outcomes in ICSI vs. naturally conceived pregnancies: a comparative study

Background  

Intracytoplasmic sperm injection (ICSI) procedures have become accepted worldwide and their effect on society is well-known. However, the full extent of the possible complications of these procedures on maternal and neonatal outcome is still unclear.     

Primary Sjögren’s syndrome and B-non-Hodgkin lymphoma: role of CD4+ T lymphocytopenia

Primary Sjögren’s syndrome (PSS) is associated with increased risk of lymphoproliferative malignancy, and B-cell non-Hodgkin lymphoma (B-NHL) is the most frequent type. To evaluate CD4+ T lymphocytes distributions in patients with (PSS) and the association of CD4+ T lymphocytopenia with the development of (B-NHL), this study included 8 (PSS) patients associated with B-NHL (group I), 50 (pSS) patients without B-NHL (group II), and 30 healthy volunteers who served as controls. The frequency of circulating CD4+ and CD8+ T lymphocytes distributions and CD4+/CD8+ T cell ratio was assessed using flow cytometry coulter EPICS-XL and compared between patients groups and controls. There was statistically significant CD4+ T lymphocytopenia in (PSS) patients with B-NHL than those without lymphoma and controls (P = 0.001). Moreover, a significant low CD4+/CD8+ T cell ratio 0.8 in group I than group II and controls (P = 0.001) was found. Significant positive correlations of CD4+ T lymphocytopenia with other risk factors (parotid swelling, vasculitis, rheumatoid factors, low complement, cryoglobulinemia) were detected. CD4+ T lymphocytopenia is associated with B-NHL developed in patients with PSS and can be considered as an important predictor of lymphoma.     

T1 Signal-Intensity Increase in the Dentate Nucleus after Multiple Exposures to Gadodiamide: Intraindividual Comparison between 2 Commonly Used Sequences

BACKGROUND AND PURPOSE:Different T1-weighted sequences have been used for qualitative and quantitative evaluation of T1 signal intensity related to gadolinium deposition in the dentate nucleus in patients who underwent several enhanced MR imaging studies. Our purpose was to perform an intraindividual qualitative and quantitative comparison between T1-weighted spin-echo and 3D magnetization-prepared rapid acquisition of gradient echo sequences in patients who had multiple exposures to gadodiamide.MATERIALS AND METHODS:Our retrospectively selected population included 18 patients who underwent at least 3 administrations of gadodiamide and had a baseline and a final MR imaging performed with both T1-weighted sequences. Qualitative and quantitative analyses were independently performed. Dentate nucleus/middle cerebellar peduncle signal-intensity ratios and signal changes between the baseline and final examinations were compared by using the Wilcoxon signed rank test. Correlation between quantitative and qualitative evaluations was assessed by using a polyserial correlation test.RESULTS:The differences between the 2 sequences for both baseline and last examination dentate nucleus/middle cerebellar peduncle ratios were statistically significant (P = .008 and P = .006, respectively); however, the signal-intensity changes of the ratios with time were not (P = .64). The correlation between the qualitative and quantitative analysis was very strong (near-perfect) (r = 0.9) for MPRAGE and strong (r = 0.63) for spin-echo sequences.CONCLUSIONS:T1-weighted spin-echo and MPRAGE sequences cannot be used interchangeably for qualitative or quantitative analysis of signal intensity in the dentate nucleus in patients who received gadodiamide. Baseline and final examination ratios should be evaluated across time by using the same sequence. Qualitative analysis performed with MPRAGE correlated better with quantitative analysis and may offer advantages over spin-echo sequences for research purposes.

During the past 2 years, several peer-reviewed studies have been published describing an association between progressive high signal intensity on unenhanced T1-weighted images in the globus pallidus and/or dentate nucleus (DN) and the number of administrations of different gadolinium-based contrast agents (GBCAs), suggesting gadolinium deposition in these structures; this has been confirmed in humans and animals.^1–11One major limitation of retrospective human studies of gadolinium deposition is the variability of the MR imaging protocols used, according to the pathology that is being studied and among different institutions.Kanda et al⁵ and Adin et al⁸ used qualitative measurements to evaluate signal-intensity changes in patients who underwent multiple GBCA administrations, by using T1-weighted spin-echo (SE),^5,8 T1 MPRAGE, or T1 FLAIR images.⁸ It is generally assumed that visual analysis correlates well with quantitative analysis, but qualitative assessment of the presence or absence of hyperintensity on T1-weighted MR images is subjective; hence, quantitative signal-intensity measurement is commonly favored.In most of the published literature, the authors have used T1-weighted SE sequences to quantitatively evaluate the signal intensity and signal changes with time. However, in some studies, different T1-weighted sequences have been interchangeably used, including T1-weighted 3D MPRAGE⁶ and FLASH,¹² to quantitatively evaluate signal-intensity changes in the dentate nucleus. Not surprising, the results among different investigators are somewhat contradictory. The use of different sequences may, in part, explain these differences.¹³ It is unclear whether different T1-weighted sequences may be used interchangeably to qualitatively and quantitatively study gadolinium deposition on the basis of their T1-weighting despite their distinct intrinsic properties. Even though quantitative measurements are undoubtedly recommended for scientific publications, they are difficult to apply in clinical practice. On the other hand, qualitative analysis is applied every day to assess normal brain structures and lesions. Considering the increasing concern regarding GBCA administration, we believe qualitative analysis must be evaluated. Therefore, our aim was to determine whether there are differences between the quantitative analysis performed with T1-weighted SE and T1-weighted MPRAGE sequences and to correlate the qualitative appreciation of the T1 signal intensity of the DN with the quantitative analysis of corresponding sequences.     

Magnetic resonance imaging of pancreatitis: An update

Magnetic resonance (MR) imaging plays an important role in the diagnosis and staging of acute and chronic pancreatitis and may represent the best imaging technique in the setting of pancreatitis due to its unmatched soft tissue contrast resolution as well as non-ionizing nature and higher safety profile of intravascular contrast media, making it particularly valuable in radiosensitive populations such as pregnant patients, and patients with recurrent pancreatitis requiring multiple follow-up examinations. Additional advantages include the ability to detect early forms of chronic pancreatitis and to better differentiate adenocarcinoma from focal chronic pancreatitis. This review addresses new trends in clinical pancreatic MR imaging emphasizing its role in imaging all types of acute and chronic pancreatitis, pancreatitis complications and other important differential diagnoses that mimic pancreatitis.     

Comparable Reproductive Outcomes of ICSI for Couples with Unexplained Infertility and Couples with Male Factor Infertility

Objective

The aim of this study was to compare intra-Cytoplasmic Sperm Injection (ICSI) outcomes (fertilization rate, embryo quality, pregnancy rate, and live birth rate) for couples with unexplained infertility and couples with male factor infertility, and if the quality of semen is related to ICSI outcomes.

A study of some factors associated with wound infection

Five hundred and four surgical patients were studied at Princess Basma Hospital, North Jordan, during the period April 1984-January 1985. The overall postoperative wound infection rate was 3.6%. In clean surgery 1.1% of wounds were infected and in potentially contaminated and contaminated surgery the infection rate was 3.3% and 18.5% respectively. Major organisms isolated from infected wounds were Staphylococcus aureus (55.5%), Escherichia coli (16.6%), Proteus vulgaris (11.1%), Pseudomonas aeruginosa, Enterobacter aerogenes and Aeromonas hydrophilia, each with 5.6%. Use of a wound drain, duration of operation and carriage of Staph. aureus by the patient were associated with a higher frequency of wound infection.