There is something about these medical illustrations by Poland-based illustrator and painter, Marcin Oleksak, that is very light and painterly. We don’t often post straightforward medical illustrations, which is a shame, I should do more to promote our wonderful medical illustrators out there!
The incredibly fascinating Royal College of Surgeon’s Hunterian Museum in London has just opened an Olympic-themed exhibit in their Qvist Gallery, Anatomy of an Athlete: Elite sport, surgery and medical art. The Hunterian called upon some of the top artists from the Medical Artists’ Association of Great Britain to create pieces that explore the anatomy and physiology of pro-athlete injuries in this summer’s 2012 London Olympics.
Pictured up top is our good friend Emily Evans of AnatomyUK standing in front of her piece, Hurdles, a triptych depicting a traumatic detachment of the hamstring from the ischial tuberosity. Hurdlers are especially at risk for hamstring injuries, which are extremely painful! Accompanying the triptych is a medical illustration of the surgical technique used to repair the injury.
View more work from the exhibition via the BBC and if you’re in London make sure and stop by!
Don’t forget, we also have prints by the wonderfully talented Emily Evans in the Street Anatomy store. Memento Mori Catrina (top) and Know Thyself (bottom) are available for $50. A3 11.7″ x 16.5″ Giclee prints on Canson Aquarelle rag paper.
Following an accident a few years ago, artist Suzie Chaney became obsessed with anatomy. Specifically bones and the way bone fragments are portrayed in archaeology. She takes the museum-like display of bone and text and molds them into one abstract piece, so as to become more of a study in texture and form.
She explains her process:
I generally make my sculptures by layering plaster and paper, burning away the paper which causes cracking and splits as well as scorch marks. I may often add a soft element: textile, paper, stitches to imply tissue wound, and of course text. This is to anchor it to something alive and human; our thoughts and our minds, and therefore an affirmation of life, if rather a melancholic one!
While many of her pieces are molded by hand, a piece may also be molded on actual bone. Suzie graduated with a BA Hons in Fine Art/Sculpture from the Norwich School of Art, UK. She now lives with her family in France doing everything from sculpture to photography. Sounds wonderful.
View more of Suzie’s work at suziechaney.com.
London-based freelance illustrator Katie Scott, creates pseudo-psychedelic anatomical pieces as well as scientific illustrations. I love her fun interpretations of the inside of the human body, but my god, imagine memorizing the names of all those thinga-mabobs.
View more of Katie’s work via her Tumblr!
[spotted by Megan Revell]
My sincere apologies for the lack of postings and emails, and a special thanks to all of those who have so generously sent in recommendations for places to visit. I am still on the road in Italy with only intermittent internet access and days filled to the brim with museums, churches, anatomical theatres, ossuaries and reliquaries. As a teaser, here are a few of the things Evan Michelson and I have been encountering on our trip thus far. Evan has been posting more details than I; you can find them here. I will post more--with details, I promise!-- very soon upon my return!
Click on images to see larger versions.
Source:
http://morbidanatomy.blogspot.com/feeds/posts/default?alt=rss
Forget basketball brackets—March Madness at EVMS is all about Match Day 2012.
Match Day, March 16, was the day senior medical students learned where they will complete their training after medical school. Students across the country tore into their envelopes at 1 p.m. Eastern Time to find out their matches, but none where as stylish as EVMS.
In true “I love the '90s” fashion, Ninja Turtles took the stage with boy bands, Bay Watch lifegaurds and Vanilla Ice. Wrestling giants Stone Cold Steve Austin and The Rock, threw down their championship belts and were joined in celebration by the Adams Family and Men In Black. See photos of the event.
Residency encompasses the three (or more) years of training that is required before medical school graduates can become practicing physicians.
More coverage of EVMS Match Day:
Virginian-Pilot article
Source:
http://www.evms.edu/eastern-virginia-medical-school/feed/rss.html
Biotechnology, as the term indicates, is the technical use of living organisms and biological processes for obtaining bio products. These products are used in the field of medicine, agriculture and industries. Biotechnology has been used in various day to day processes since time immemorial. From preparation of wine, cheese, curing of tea leaves to natural manures and jute processing, the knowledge of biology has been put to effective use in the various spheres of our lives. With the advent of modern biotechnology in the 1980s, this field has seen a great boom in its totality. The first major footprint of this modern era is believed to have begun when the American Supreme Court granted patent to Ananda Chakraborty for the genetically modified Pseudomona species capable of breaking down crude oil. Ever since it has spread its root wide in every possible field. Hence, now it is being considered as a bright prospect for the future industries.
The statistics
Recently, the reports of a study on the economic viability of biotechnology, conducted by the Centre for the study of Living Standards (a nonprofit Canadian organization aimed at economic research), was published. It was based on the figures provided by the Statistics Canada’s Biotech Use and Development Survey (BUDS). The research was headed by economist Ricardo de Avellez. The study showed great promise in the field with a forecast of $144 billion industry by 2030 at an average growth rate of 9.4%. Canada, being the world’s 10th largest economy, though generates only 1.19% of the total economy GDP from the biotechnology industry, it has seen phenomenal GDP growth at 10.7% between 1999-2007 preceded only by the mining and oil and gas extraction industry at 20.5%. This shows the rich economical implications that this field awaits in the mere future. In 2005 the number of innovative biotech firms increased from 358 in 1999 to 532, almost a 50% growth. Besides the impressive GDP, the employment that the industry has generated around itself is also a boon. Around 13,500 employees were employed in the various firms in 2005, a 74% increase from the figures in 1999. This figure definitely points to the immense potential of this yet to be explored field.
Biotechnology started in three different waves in three different time periods but now they overlap:
1. The Green Wave-Agricultural Biotechnology
This has been there right from the cradle of ancient civilizations. Nowadays with the development of genetically modified crops better yielding, pest resistant, seed less crops are being yielded. Only 20.1% firms and 9.8% of the work force are involved in the agricultural biotechnology and it generates 24.6% of the total revenue. Surely this field has a greater potential and would play an important role in meeting the food demands of the future.
2. The Red Wave-Medical Biotechnology
This field has seen the greatest growth. 58.3% of the biotech companies were involved in the health care system. A majority of 80.9% employees lent their workforce and it generated 70.6% of the revenue. The obvious reasons for its growth are the vaccines, artificial hormones, diagnostic tests, genetically tailored medicine and the list goes on.
3. The White Wave, the most recent Industrial Biotechnology
It is particular to term this a virgin field as its potential has been put to use the least whereas this is the field which shows the greatest promise. From development of biomining to bioremediation, from biofuels to biosensors, this field is teeming with unexplored industrial potentialities. With a small amount of industries into it, the field actually has seen a 10.1% decline in its revenues.
The bottomline
Biotechnology will definitely play a significant role in the country’s economy as more industries based on it will come up. Also the need for sustainable systems and cleaner and greener technology will provide impetus to this versatile field. Combined with the rich abundant natural resources, biotechnology will take the country a long way.
America, the name itself conjures an image of prosperity, high standards of living, a staggering economy, flourishing industries, and everything nice and good. But all these nice and good things were not achieved in a day. It took years of hard work and organization to reach this epoch. Most importantly, this is the fruit of years of continuous research and innovations which have helped this country to surge ahead of the rest in all fields. A few prime gifts of this country to the world includes Internet, and many others as the country gears up to continue its quest to remain not only the most powerful economy but technologically also the country should dig into new found mines of biotechnology. Biotechnology uses micro-organisms and the various biological processes to generate commercially viable bioproducts. At some instances, biotechnology is not used commercially but more importantly just to protect our mother nature and create a greener environment.
Early years
Long before the term biotechnology came into existence, it was indigenously used in various food processing processes like making beer, wine, cheese, etc. Other than that it was used in various aspects of agriculture like selection of high yielding crops, use of legumes to fertilize soil, making natural manures, etc. The advent of modern biotechnology took place in the 1970s. The red wave, in which the potential of biotechnology were appreciated in the field of medicine and put to practical use. The medical industry has found a new direction on the shoulders of biotechnology and surely it’s way ahead is shining bright with the newer discoveries and methodologies. The white wave, the last to strike the field is the industrial application of biotechnology.Yet to build a strong wave and flood the industry and economy with its immense potentialities.
1. Advancement in the field of agriculture
America’s farming is highly mechanized. With that, the use of biotechnology has led to production more than sufficing the needs of the country. High yielding, pest and drought resistant, better nutritional value, altered tasting crops have been produced. This has provided the country food security. And surely in future, with more advancements in biotechnology will take the agriculture up the ladders of prosperity.
2. Advancement in the field of medicine
Currently more than 50% of the biotechnology industry is concentrated in the medical field with the prime work force, staggering growth rate, speedy discoveries and millions of dollars pumped into research. This field has truly bloomed to serve the cause of human health. Genome mapping, monoclonal antibodies, synthesis of antibiotics and artificial hormones, gene therapy, rapid diagnostic methods, anti cancer drugs are the result of the meticulous research in this field. All this helped improve the health of the people and indirectly the nation. The National Alzheimer’s Project Act has been passed to control the disease and at the same time develop new drugs to treat it. Though a lot has been achieved, but this field shouldn’t be allowed to stagnate under any circumstances. As newer resistant viruses and bacteria emerge, the medical force should be prepared with the weapons made from biotechnology.
3. Advancement in the field of industrial application
Industries entirely based on biotech seem just round the corner as the potential of this field are being recognized with rapidity. Biodiesel now, generated at a commercial level can do away with the country’s dependence on the oil supplies from the gulf countries. Also it is a greener technology. Biomining is a method in which a solution of bacteria is used for extraction of metals (copper and gold). Bio-oxidation, a method in which bacteria is used to extract metal from their oxidized form. Both the forms yield high extraction rates upto 85-95%. Bioplastics, enzymes and many other products are awaited to be produced at an industrial level. Jatropha has the potential to replace petroleum as fuel. If the wonders of biotechnology are tapped commercially definitely it would contribute to the flourishing economy of the country. Although its contribution to the country’s GDP is meager, already it is one of the fastest growing sectors employing 130305 in 2005, with a turnover of US $51,655 million the same year. Needless to say that America is leading in all aspects of the biotechnology industry and hopefully it will continue to do so.
Last but not the least
Recently, America is facing steep competition from other developing nations like India and China and so the country needs to be on its toes. The current policies of the Barak Obama government are very favorable for extensive research and large amount of investments in the field. The other brighter side of this industry is the employment it is generating which has become particularly very important after the unemployment during and after recession. The upcoming new industries, the health and as well as the agriculture sector depend hugely on the advancements of biotechnology, so extensive research is being undertaken at all levels. The National Institute of Health is instituted for biotechnology training programs. Lastly the future of NASA, America’s prime space agency, also rests on newer biotech products as it aims to sustain life for a prolonged period outside earth. We hope that biotechnology will bloom to the most beautiful and prosperous future of America.
Background:
In mixed sugar fermentations with recombinant Saccharomyces cerevisiae strains able to ferment D-xylose and L-arabinose the pentose sugars are normally only utilized after depletion of D-glucose. This has been attributed to competitive inhibition of pentose uptake by D-glucose as pentose sugars are taken up into yeast cells by individual members of the yeast hexose transporter family. We wanted to investigate whether D-glucose inhibits pentose utilization only by blocking its uptake or also by interfering with its further metabolism.
Results:
To distinguish between inhibitory effects of D-glucose on pentose uptake and pentose catabolism, maltose was used as an alternative carbon source in maltose-pentose co-consumption experiments. Maltose is taken up by a specific maltose transport system and hydrolyzed only intracellularly into two D-glucose molecules. Pentose consumption decreased by about 20 - 30% during the simultaneous utilization of maltose indicating that hexose catabolism can impede pentose utilization. To test whether intracellular D-glucose might impair pentose utilization, hexo-/glucokinase deletion mutants were constructed. Those mutants are known to accumulate intracellular D-glucose when incubated with maltose. However, pentose utilization was not effected in the presence of maltose. Addition of increasing concentrations of D-glucose to the hexo-/glucokinase mutants finally completely blocked D-xylose as well as L-arabinose consumption, indicating a pronounced inhibitory effect of D-glucose on pentose uptake. Nevertheless, constitutive overexpression of pentose-transporting hexose transporters like Hxt7 and Gal2 could improve pentose consumption in the presence of D-glucose.
Conclusion:
Our results confirm that D-glucose impairs the simultaneous utilization of pentoses mainly due to inhibition of pentose uptake. Whereas intracellular D-glucose does not seem to have an inhibitory effect on pentose utilization, further catabolism of D-glucose can also impede pentose utilization. Nevertheless, the results suggest that co-fermentation of pentoses in the presence of D-glucose can significantly be improved by the overexpression of pentose transporters, especially if they are not inhibited by D-glucose.Source:
http://www.biotechnologyforbiofuels.com/rss/
Background:
The commercialization of second-generation bioethanol has not been realized due to several factors, including poor biomass utilization and high production cost. It is generally accepted that the most important parameters in reducing the production cost are the ethanol yield and the ethanol concentration in the fermentation broth. Agricultural residues contain large amounts of hemicellulose, and the utilization of xylose is thus a plausible way to improve the concentration and yield of ethanol during fermentation. Most naturally occurring ethanol-fermenting microorganisms do not utilize xylose, but a genetically modified yeast strain, TMB3400, has the ability to co-ferment glucose and xylose. However, the xylose uptake rate is only enhanced when the glucose concentration is low.
Results:
Separate hydrolysis and co-fermentation of steam-pretreated wheat straw (SPWS) combined with wheat-starch hydrolysate feed was performed in two separate processes. The average yield of ethanol and the xylose consumption reached 86% and 69%, respectively, when the hydrolysate of the enzymatically hydrolyzed (18.5% WIS) unwashed SPWS solid fraction and wheat-starch hydrolysate were fed to the fermentor after 1 h of fermentation of the SPWS liquid fraction. In the other configuration, fermentation of the SPWS hydrolysate (7.0% WIS), resulted in an average ethanol yield of 93% from fermentation based on glucose and xylose and complete xylose consumption when wheat-starch hydrolysate was included in the feed. Increased initial cell density in the fermentation (from 5 to 20 g/L) did not increase the ethanol yield, but improved and accelerated xylose consumption in both cases.
Conclusions:
Higher ethanol yield has been achieved in co-fermentation of xylose and glucose in SPWS hydrolysate when wheat-starch hydrolysate was used as feed, then in co-fermentation of the liquid fraction of SPWS fed with the mixed hydrolysates. Integration of first-generation and second-generation processes also increases the ethanol concentration, resulting in a reduction in the cost of the distillation step, thus improving the process economics.Source:
http://www.biotechnologyforbiofuels.com/rss/
Discontinuation is a problem in fertility clinics. Many couples discontinue assisted reproductive technologies (ART) without achieving a live birth for reasons other than poor prognosis or the cost of treatment. Discontinuation has been attributed to the burden of treatment. The causes of burden can be broadly classified according to whether they originate in the patient, clinic or treatment. Interventions to alleviate these burdens include provision of comprehensive educational material, screening to identify highly distressed patients, provision of tailored coping tools and improvements in the clinic environment and medical interventions. Practical interventions to reduce the different causes of burden in ART exist, but further development and evaluation of the efficacy of these interventions requires more precise definition of terms and theory. In this paper, we propose a general integrated approach to cover different perspectives in dealing with burden in ART clinics. We firstly describe the integrated approach and present common sources of burden. We then describe interventions that could help reduce the burden in ART. Our paper is aimed at fertility clinic staff because of their day-to-day involvement with patients. However, this discussion should also be relevant to companies that develop treatments and to psychosocial experts. Reducing the burden of treatment should lead to improved outcomes, namely better quality of life during treatment and lower discontinuation rates.
BACKGROUND
Human papillomavirus (HPV) infection has been demonstrated in the sperm of a large percentage of sexually active males and is associated with an impairment of sperm parameters, with a particular negative impact on sperm motility, suggesting a possible role in male infertility. Conventional sperm selection techniques have a low efficiency in removing HPV.
METHODS
Evaluation of sperm parameters, terminal deoxynucleotidyltransferase-mediated dUTP nick-end labeling test to evaluate DNA fragmentation and fluorescence in situ hybridization or immunohistochemistry for HPV were performed on semen samples from infected patients (n= 22), control subjects (n= 13) and on pooled control sperm samples incubated with HPV16-L1 (HPV capsid), before and after direct swim-up and modified swim-up (with added Heparinase-III). Moreover, cytofluorimetry for HPV detection was performed in pooled sperm pre- and post-incubation with HPV 16-L1 before and after direct and modified swim-up. Statistical analysis was performed with a two-tailed Student's t-test.
RESULTS
Direct swim-up reduces the number of HPV-infected sperm by ~24% (P< 0.01), while modified swim-up is able to remove completely HPV DNA both from naturally and artificially infected sperm. Enzymatic treatment with Heparinase-III tended to decrease sperm motility, viability and DNA integrity but the effects were not significant.
CONCLUSIONS
This study shows that Heparinase-III treatment seems not to affect spermatozoa in vitro and suggests that this treatment should be investigated further as a means of preparing sperm from patients who are infected with HPV in order to reduce the risk of HPV infection when using assisted reproduction techniques.
OBJECTIVES
Previous studies concerning ultrasound evaluation of the seminal vesicles (SV) were performed on a limited series of subjects, and considered few parameters, often only before ejaculation and without assessing the patients' sexual abstinence. The aim of this study was to evaluate the volume and the emptying characteristics of the SV and their possible correlations with scrotal and transrectal ultrasound features.
METHODS
The SV of 368 men seeking medical care for couple infertility were evaluated by ultrasound. All patients underwent, during the same ultrasound session, scrotal and transrectal evaluation, before and after ejaculation, and the ejaculate was subjected to semen analysis. A new parameter, SV ejection fraction, calculated as: [(SV volume before ejaculation – SV volume after ejaculation)/SV volume before ejaculation] x 100, was evaluated.
RESULTS
After adjusting for sexual abstinence and age, both pre-ejaculatory SV volume and SV ejection fraction were positively associated with ejaculate volume. As assessed by receiver operating characteristic curve, a cut-off for SV ejection fraction of 21.6% discriminates subjects with normal ejaculate volume (≥1.5 ml) and pH (≥7.2 ml) with both sensitivity and specificity equal to 75%. Subjects with SV ejection fraction of <21.6% more often had a higher post-ejaculatory SV volume and ejaculatory duct abnormalities. Furthermore, a higher post-ejaculatory SV volume was associated with a higher prostate volume and SV abnormalities. Higher epididymal and deferential diameters were also detected in subjects with a higher post-ejaculatory SV volume or reduced SV ejection fraction. No association between SV and testis ultrasound features or sperm parameters was observed. Associations with SV ejection fraction were confirmed in nested 1:1 case–control analysis.
CONCLUSIONS
The SV contribute significantly to the ejaculate volume. A new parameter, SV ejection fraction, could be useful in assessing SV emptying. A SV ejection fraction of <21.6% was associated with prostate–vesicular and epididymal ultrasound abnormalities.
BACKGROUND
Cell-free seminal mRNA (cfs-mRNA) exists in human ejaculate at high concentrations and with high stability, and contains many tissue-specific transcripts secreted from the male reproductive system. Owing to the sensitivity of RNA technology, cfs-mRNAs are ideal candidates for non-invasive biomarkers of physiopathological conditions. This study applied cfs-mRNA in identifying the presence of either germ cells or complete obstruction in men with azoospermia.
METHODS
RT–PCR was performed to amplify the germ cell-specific (DDX4), seminal vesicle-specific (SEMG1) and prostate-specific (TGM4) mRNAs from cfs-mRNAs, which were isolated from the seminal plasma of men with non-obstructive azoospermia (NOA) or obstructive azoospermia (OA). The 39 patients with NOA, diagnosed by testicular biopsy, included 8 men with maturation arrest (MA), 3 men with incomplete sertoli cell only (iSCO) syndrome and 28 men with complete SCO (cSCO). The 29 patients with OA, confirmed by the presence of sperm in the testis or epididymis, included 8 men with congenital bilateral absence of the vas deferens (CBAVD) and 21 men with non-CBAVD. Healthy individuals and vasectomized men were enrolled as controls.
RESULTS
TGM4 was detected in all participants. Consistent with their diagnosis, DDX4 was detected in all patients with MA or iSCO but was absent in most cases of cSCO (n = 21, 75.0%) or non-CBAVD (n = 18, 85.7%), and in all men with vasectomy or CBAVD. The presence of DDX4 in the other seven men with cSCO and three patients with non-CBAVD suggests the presence of germ cells in the testis, and incomplete obstruction, respectively. SEMG1 was undetectable in three patients with CBAVD with bilateral absence of the seminal vesicles, and in two non-CBAVD cases with low ejaculate volume.
CONCLUSIONS
These results suggest that, with high sensitivity and representativity, cfs-mRNA could be non-invasive biomarkers for identifying the presence of germ cells or complete obstruction in azoospermia.
BACKGROUND
The progesterone-regulated glycoprotein glycodelin-A (GdA), secreted by the decidualized endometrium at high concentrations in primates, inhibits the maternal immune response against fetal antigens and thereby contributes to the tolerance of the semi-allogenic fetus during a normal pregnancy. Our earlier studies demonstrated the ability of GdA to induce an intrinsic apoptotic cascade in CD4+ T-lymphocytes and suppress the cytolytic effector function of CD8+ T-lymphocytes. In this report, we investigated further into the mechanism of action of GdA controlling perforin and granzyme B expression in CD8+ T-lymphocytes and the mechanism of action of GdA leading to lymphocyte death.
METHODS
Flow cytometry analysis was performed to check for the surface expression of interleukin-2 receptor α (IL-2Rα) and intracellular eomesodermin (Eomes) in activated T-lymphocytes, whereas quantitative RT–PCR analysis was used to find out their mRNA profile upon GdA treatment. Western analysis was carried out to confirm the protein level of Bax and Bcl-2.
RESULTS
GdA reduces the surface expression of the high-affinity IL-2R complex by down-regulating the synthesis of IL-2Rα (CD25). This disturbs the optimal IL-2 signalling and decreases the Eomes expression, which along with IL-2 directly regulates perforin and granzymes expression. Consequently, the CD8+ T-lymphocytes undergo growth arrest and are unable to mature into competent cytotoxic T-lymphocytes. In the CD4+ T-lymphocytes, growth factor IL-2 deprivation leads to proliferation inhibition, decreased Bcl-2/enhanced Bax expression, culminating in mitochondrial stress and cell death.
CONCLUSIONS
GdA spurs cell cycle arrest, loss of effector functions and apoptosis in different T-cell subsets by making T-lymphocytes unable to respond to IL-2.
BACKGROUND
Sperm chromatin is highly condensed and relatively resistant to chemical and physical treatments. The purpose of this study was to explore the highest temperature that sperm can tolerate and still produce live offspring.
METHODS
Mouse sperm were heated in a water bath at 50, 65, 80 or 95°C for 30 min before they were microinjected into mouse oocytes. Fertilization, embryo development and 1-cell embryo karyotypes were evaluated. Epigenetic reprogramming including DNA methylation and histone H3K4-trimethylation were evaluated by immunofluorescent staining.
RESULTS
The ability of mouse sperm to activate the egg after ICSI was heat sensitive; only 20% of eggs were activated by sperm that had been heated to 50°C and none was activated by sperm heated to 80°C. However, if eggs were activated artificially, mouse sperm subjected to 80°C for 30 min were able to produce live offspring, while 95°C treatment disabled sperm decondensation after ICSI. Once the heat-treated sperm nucleus had developed into a pronucleus, sperm chromatin was able to undergo normal active DNA demethylation and histone methylation. Aberrant chromosome rates increased from 16.3 to 100% when the temperature was raised from 50 to 95°C.
CONCLUSIONS
Heat treatment destroys integrity of sperm chromatin in a temperature-dependent manner. Eighty degree Celsius was the highest temperature that mouse sperm could withstand and still produce live offspring.
BACKGROUND
Increased global industrial activity has exposed humans to a wide variety of chemical substances some of which, called ‘endocrine-disrupting chemicals’ (EDCs) or ‘endocrine disruptors’, can disrupt the endocrine system in the body. The ovarian follicle is a very fragile micro-environment where interactions between hormones, growth factors, the oocyte and its surrounding somatic cells are essential to generate a fully competent oocyte. In vitro experiments suggest that EDCs can disturb this finely tuned balance, but very scarse in vivo data are available to confirm this assumption. Therefore, we have investigated if the presence of EDCs in human follicular fluid is a risk factor for the developmental competence of an in vivo exposed oocyte. Furthermore, because of the limited access to human follicular fluid, we verified if follicular fluid contamination can be predicted based on EDC levels in serum.
METHODS
Follicular fluid (n = 40) and serum (n = 20) samples from women undergoing assisted reproductive technology (ART) were analyzed by means of gas chromatography combined with mass spectrometry to examine the presence of different EDCs, such as polychlorinated biphenyls, polybrominated diphenyl ethers and organochlorine pesticides. Statistical models were used to investigate the relation between the characteristics and ART results of the patients and the contamination status of their follicular fluid and to assess the capacity of serum samples to predict follicular fluid contamination.
RESULTS
Chlorinated biphenyl 153 (72 ± 44 and 201 ± 106 pg/ml) and p,p'-DDE (392 ± 348 and 622 ± 406 pg/ml) were the compounds found in the highest concentrations in follicular fluid and serum samples, respectively. A new variable principal component 1, representing the overall contamination status of the follicular fluid samples, is strongly associated with fertilization rate (P < 0.00001) and the proportion of high-quality embryos relative to the amount of retrieved oocytes (P < 0.05), even when the analysis is adjusted for age, estradiol concentration, BMI, fertilization procedure and male subfertility as explanatory variables. The strong correlations between the EDC concentrations in serum and follicular fluid (r ≥ 0.93) allowed us to build regression models, which accurately predict EDC concentrations in the follicular fluid based on serum samples.
CONCLUSIONS
An overall higher EDC contamination in the follicular micro-environment was associated with a decreased fertilization rate and consequently with a lower chance of an oocyte to develop into a high-quality embryo. In addition, EDC concentrations in serum were reliable predictors of the contamination status of the follicular micro-environment.
BACKGROUND
Polychlorinated biphenyls (PCBs) are common environmental contaminants that represent an important risk factor of reproductive disorders in chronically exposed human populations. However, it is not known whether a short accidental exposure of embryos to PCBs before implantation might influence their further development and whether the effect might be reversible.
METHODS AND RESULTS
To this aim, in vitro-matured sheep blastocysts were incubated with 2 or 4 µg/ml Aroclor 1254 (A1254), a mixture of 60 PCB congeners for 48h after which blastocyst proliferation and ability for outgrowth in vitro were assessed. Blastocysts exposed to A1254 showed: (i) reduced proliferation and cell number (particularly in the inner cell mass compartment); (ii) accumulation of vacuoles and lipid droplets, diffused mitochondrial damage and up-regulation of autophagy markers (ATG6 and LC3), all signs indicative of deregulated autophagy, and (iii) massive cell death. Although exposed embryos resumed growth following A1254 removal, their subsequent development remained severely perturbed.
CONCLUSIONS
These findings indicate that short exposure of blastocysts to PCBs leads to its damage characterized by deregulated autophagy and subsequent cell death.
BACKGROUND
There is currently no consensus about indications for surgery for infertility associated with colorectal endometriosis. The aim of this study was to evaluate cumulative pregnancy rates (CPRs) after ICSI–IVF cycles in patients with colorectal endometriosis and to identify determinant factors of fertility outcome.
METHODS
Prospective longitudinal multicentre study from January 2005 to June 2011. We included 75 patients with colorectal endometriosis and proved infertility without prior surgery for deep infiltrating endometriosis. Univariable analysis was used to identify determinant factors of pregnancy rate. CPR was calculated using cumulative-incidence methods from log-rank test and Kaplan–Meier curves. For multivariable analysis, Cox proportional hazards model was used.
RESULTS
For CPR per patient analysis, the total number of cycles was 113 and the median number of cycles per patient was 1 (range: 1–3). In the whole population the CPR per patient after three ICSI–IVF cycles was 68.6%. The CPR for patients with or without associated adenomyosis was 19 and 82.4%, respectively (P= 0.01). In addition, a patient age over 35 years (P= 0.02) and anti-Mullerian hormone serum level under 2 ng/ml (P= 0.02) were associated with a decreased CPR per patient. At multivariable analysis, adenomyosis [HR = 0.34, 95% CI (0.12–0.99), P= 0.49] was associated with a decreased CPR.
CONCLUSIONS
Our data confirm that ICSI–IVF offers a high CPR per patient. However, determinant factors of CPR should be taken into account when informing couples of their options.
BACKGROUND
Prognostic models for natural conception help to identify subfertile couples with high chances of natural conception, who do not need fertility treatment yet. The use of such models and subsequent tailored expectant management (TEM) is not always practiced. Previous qualitative research has identified barriers and facilitators of TEM among patients and professionals. The aim of this study was to assess the prevalence of those barriers and facilitators and to evaluate which factors predict patients' appreciation of TEM and professionals' adherence to TEM.
METHODS
We performed a nationwide survey. Based on the previously identified barriers and facilitators two questionnaires were developed and sent to 195 couples and 167 professionals. Multivariate analysis was performed to evaluate which factors predicted patients' appreciation of TEM and professional adherence to TEM.
RESULTS
In total, 118 (61%) couples and 117 (70%) professionals responded and 96 couples and 117 professionals were included in the analysis. Patients' mean appreciation of TEM was 5.7, on a 10-point Likert scale. Patients with a lower appreciation of TEM had a higher need for patient information (P = 0.047). The professionals reported a mean adherence to TEM of 63%. Adherence to TEM was higher when professionals were fertility doctors (P = 0.041). Facilitators in the clinical domain were associated with a higher adherence to TEM (P = 0.091). Barriers in the professional domain had a negative impact on adherence to TEM (P = 0.008).
CONCLUSIONS
The limited implementation of TEM is caused by both patient and professional-related factors. This study provides practical tools to improve the implementation of TEM.
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