Ultrastructural markers of quality are impaired in human metaphase II aged oocytes: a comparison between reproductive and in vitro aging.

PURPOSE: Childbearing delay contributes to the increase of subfertile couples that require assisted reproductive technology (ART). Subfertility relates with reproductive aging (RA). In vitro aging (IvA) (due to extended culture) may also impair oocyte competence. Aims of this study were to evaluate and compare the oocyte ultrastructure after RA and IvA. METHODS: Cumulus-oocyte complexes (COCs) (n = 68), with metaphase II oocyte and expanded cumulus, from consenting patients (<35 years old and ≥35 years old, n = 36), were selected by phase contrast microscopy and fixed at pick up, or after 24 h culture. COCs (n = 44) were studied by light and qualitative/morphometric transmission electron microscopy. Two-way ANOVA, with age and culture as grouping factors, was applied for statistical analysis (p < 0.05). Metaphase II cumulus-free oocytes (n = 24) were selected for confocal microscopy observations. RESULTS: Significant decrease of mitochondria-smooth endoplasmic reticulum aggregates, increase of mitochondria-vesicle complexes size and amount, decrease of cortical granules and microvilli, and alterations of the spindle structure characterized both RA and IvA oocytes. These changes were significantly more evident in the RA oocytes submitted to IvA. RA oocytes also showed changes of the zona pellucida and occurrence of vacuoles after culture. Cumuli appeared re-compacted after culture, irrespective of the age of the patients. CONCLUSIONS: These data demonstrated that aging is related to decay of oocyte ultrastructural quality, and that oocytes from elder women are more sensitive to prolonged culture (IvA) than the oocytes from younger women. These morphological results should be considered when applying ART in aged patients, rescue ICSI, or artificial oocyte activation.

Carcinoma of the prostate and motor neuron disease.

Non metastatic neurological concomitants of tumors are well known. They include an amyotrophic lateral sclerosis (ALS)-like syndrome in association with various tumors. The association with prostatic carcinoma is very rare. The case reported here seems to confirm the outcome of epidemiological research: the association is fortuitous.

[Treatment of abnormal movements of extrapyramidal origin with tiapride]. / Trattamento dei movimenti anormali di origine extrapiramidale con tiapride.

The authors report results attained by means of a replaced benzamide, thiapride, in the treatment of 21 subjects showing involuntary movements of extra-pyramidal origin and more exactly: extra-pyramidal syndromes due to drugs (3), idiopathic dyscinesias (8), choreas (6), dystonias (3), essential tremor (1). The drug was administered per os as well as per IM and EV. Results were good or fair in 71% of cases. The clearest improvements were obtained in iatrogenic dyscinesias (torticollis, diaphragm clonisms). The drug was well tolerated in all cases, both from the clinical and hematochemical standpoint, even at the highest dosages, and, in particular, no case of amenorrhea or galactorrhea was pointed out. Finally, the authors explain how the best results with thiapride may probably be obtained in those forms in which an hyperfunction of the dopaminergic system is proved, thanks to the competitive action of the molecule on presynaptic dopaminergic receptors.

Foix-Chavany syndrome: CT study and clinical report of three cases.

The Foix-Chavany syndrome is a neurological entity characterized by linguo-bucco-facial apraxia almost always caused by disturbed cerebral circulation. Three typical cases of this syndrome are described and the role of the CT scan to obtain a definite diagnosis is emphasized.