1994 William J. Stickel Silver Award. Closing base wedge versus Austin bunionectomies for metatarsus primus adductus.

Hallux abducto valgus with concomitant metatarsus primus adductus was treated by either an isolated Austin bunionectomy or by a combination of a modified McBride bunionectomy, along with a closing base wedge osteotomy, on a total of 73 patients (88 feet) from 1983 to 1993. Both subjective and objective similarities and differences were compared between these two groups of patients. Long-term elevation or depression of the first ray was analyzed by using a technique termed sagittal plane displacement. The prevalent preoperative symptoms were significantly reduced postoperatively in both groups of patients. Initial postoperative elevation of the first ray occurred in approximately one third of the cases in both groups. Long-term elevation of the first ray was greater with the base wedge osteotomy and did not change appreciably with the Austin procedure. The sagittal plane displacement method is a helpful tool in analyzing changes in the position of the first ray perioperatively.

Changes in morphology, sperm penetration and fertilization of ovulated hamster eggs induced by oviductal exposure.

In the human, mature eggs at the pre-ovulatory follicular stage placed into the oviduct via gamete intra-Fallopian transfer (GIFT) establish more implantations and pregnancies than do those for standard in-vitro fertilization and embryo transfer (IVF). Previous studies in the hamster have shown that mature follicular eggs are less readily penetrated by spermatozoa than oviductal eggs. This study examines whether ovulation or pre-fertilization exposure to the oviduct per se affects sperm penetration and fertilization of mature ova. Three types of eggs were used: pre-ovulatory, follicular [12 h post-human chorionic gonadotrophin (HCG), 1-1.5 h pre-ovulation], and ovulated (bursal and oviductal, both 15 +/- 0.5 h post-HCG). Bursal eggs were obtained by ligating the infundibulum on one or both sides of the tract. The morphological changes in eggs due to oviductal exposure were quantified using computerized image analysis. Cumulus-free follicular and bursal eggs were significantly less penetrated than oviductal eggs 1 h post-insemination (36, 39 and 62%, respectively). Cumulus-intact oviductal compared to bursal eggs, paired within females, were fertilized at a significantly higher rate (4 h post-insemination; 89 and 58%, respectively). Fresh oviductal and bursal eggs had equivalent cell diameters (79 microns) and zona thickness (15-15.8 microns), but oviductal compared with bursal eggs had larger zonae (119 and 116 microns, respectively) and perivitelline volumes (107 and 47 pl). Oviductal, but not bursal, zonae had the oviductal glycoprotein, oviductin, bound to them. We conclude that prefertilization oviductal exposure and not ovulation or time post-HCG alters the morphology and fertilizability of eggs.