Impact of highly purified versus recombinant follicle stimulating hormone on oocyte quality and embryo development in intracytoplasmic sperm injection cycles.

The quality of oocytes and developing embryos are the most relevant factors determining the success of an in vitro fertilization (IVF) treatment. However, there are very few studies analyzing the effects of different gonadotrophin preparations on oocyte and embryo quality. A retrospective secondary analysis of data collected from a prospective randomized study was performed to compare highly purified versus recombinant follicle stimulating hormone (HP-FSH vs. rFSH). The main outcome measures were quantity and quality of oocytes and embryos, dynamics of embryo development, cryopreservation, clinical pregnancy and live birth rate. The number of retrieved and of mature (MII) oocytes showed no significant differences. Fertilization rate was significantly higher in the HP-FSH group (68.9% vs. 59.9%, p = 0.01). We also found significantly higher rate of cryopreserved embryos per all retrieved oocytes (23.4% vs. 14.5%, p = 0.002) in the HP-FSH group. There were no significant differences in clinical pregnancy and in live birth rates. Oocytes obtained with HP-FSH stimulation showed higher fertilisability, whereas pregnancy and live birth rates did not differ between the groups. However, patients treated with HP-FSH may benefit from the higher rate of embryos capable for cryopreservation, suggesting that cumulative pregnancy rates might be higher in this group.

[Diagnostic benefit of the use of implanted loop recorder (Reveal Plus) for patients with syncope with unclear aetiology]. / Diagnostický prínos pouzitia implantovaného sluckového rekordéra (Reveal Plus) u pacientov so synkopou nejasnej etiológie.

UNLABELLED: The objective of the study was to evaluate the diagnostic yield of a loop recorder (Reveal Plus, Medtronic) in the diagnosis of syncope conditions whose aetiology remains unclear despite the performance of a full diagnostic procedure. PATIENTS AND METHOD: Loop recorders were implanted in 25 patients with recurrent syncope (9 men, 16 women, average age 59 +/- 14 years), who reported 4 +/- 2.7 episodes of syncope (2-10 episodes). A complete diagnostic algorithm was performed for all patients before implantation including the head-up tilt test, an invasive electrophysiological examination and a neurological examination. The aetiology of the syncope was not established by these examinations. RESULTS: During an average monitoring period of 13 +/- 8 months (1-24 months) 10 patients experiences recidivating syncope, 7 patients experienced pre-syncope and 1 patient experienced palpitations. 7 were asymptomatic during monitoring. Symptomatic arrhythmia was detected in 10 patients (40%). The most frequent finding was bradyarrhythmia (6 patients--sinus arrest in 3 patients, serious bradycardia in 2 patients, AV block in 1 patient). Tachyarrhythmia was the cause of symptoms in 4 patients (supraventricular tachycardia in 3 patients, ventricular bigeminy in 1 patient). In the case of 5 patients (20%) syncope (pre-syncope) took place in the absence of a serious arrhythmia and was classified as vasovagal syncope. CONCLUSION: The implantable loop recorder established a diagnosis in 15 of 25 patients (60%) with syncope that was not diagnosed by conventional tests and it is a highly beneficial method for diagnosing syncope.

Cardiovascular risk factors as predictors of mortality in type II diabetic patients.

BACKGROUND: Mortality among diabetic patients is high and attempts have been made to find clinical markers which would help to identify patients at risk. MAIN PURPOSE: The purpose of this study was to assess whether cardiovascular risk factors like previous myocardial infarction, left ventricular dysfunction, hypertension, renal insufficiency, and 24-hour mean or minimum heart rate, significantly contribute to the mortality in this group of patients. METHODS: 45 male patients with type II diabetes mellitus were studied by ambulatory electrocardiography to obtain the information about the 24-hour mean and minimum heart rates; records from baseline hospitalization were reviewed for clinical variables. After 55 months mortality data were retrieved. Cox's proportional hazards regression model was used to study the effect of clinical variables on mortality in multivariate analysis. RESULTS: All-cause mortality was 38%. The groups of survivors and nonsurvivors differed significantly in terms of age, the presence of left ventricular dysfunction and renal insufficiency. No significant difference in 24-hour mean or minimum heart rate was registered. In the Cox's model, the presence of left ventricular dysfunction, renal insufficiency and age significantly and independently predicted mortality. CONCLUSION: The present study, showed that left ventricular dysfunction and renal insufficiency were related to the all-cause mortality of type II diabetic patients independently of age, after 55 months of follow-up. Prognostic significance of 24-hour mean or minimum heart rate has not been proven.

[Malignant ventricular arrhythmia in a heart transplant patient]. / Malígne komorové arytmie u chorého s transplantovaným srdcom.

The authors describe a case of a 48-year old man living more than 9 years with a transplanted heart. Beside chronic complications (repeated rejection, gradual progression of renal and hepatic insufficiency, osteoporosis, marrow suppression), deterioration of cardiac insufficiency and angiographically documented coronary disease of the graft, there appeared haemodynamically severe persisting ventricular tachycardias degenerating into ventricular fibrillation. Frequent exacerbation of tachyarrhythmias despite the applied antiarrhythmic drugs (mexiletine, amiodarone) which were only partially effective, required repeated electrical cardioversions/defibrillations (totally 16 times). The patient in the clinical state of multi-organ failure which contraindicated retransplantation, died after almost 3 weeks after the appearance of malign arrhythmias. Electrophysiological characteristics of the transplanted heart modify the management of these patients.

[Pharmacotherapy of silent myocardial ischemia in patients on hemodialysis]. / Farmakoterapia tichej ischémie myokardu u hemodialyzovaných chorých.

Cardiovascular complications are the main causes of morbidity and mortality of patients on regular dialysis treatment. Myocardial ischaemia in those patients may be promoted apart from accelerated atherosclerosis also by many extracoronary and extracardial factors. In a group of 60 haemodialyzed patients followed up on a long-term basis silent myocardial ischaemia is encountered during 24-hour Holter monitoring in 30-40% of the examined patients. Its occurrence at the end of haemodialysis and during the early posthemodialytic period and its long persistence are typical. The authors examined 20 regularly dialyzed patients with transient depressions of the ST segment in whom they tested retarded nitroglycerin, metoprolol and verapamil. All three drugs had a significant effect on the myocardial ischaemia (intensity and duration of depressions of the ST segment). In addition to correction of the modifying factors of silent myocardial ischaemia the authors prefer verapamil in order to influence the negative sequelae of secondary hyperparathyroidism. If pharmacotherapy of myocardial ischaemia is ineffective, in patients on regular dialysis treatment stress radionuclide scintigraphy or echocardiography and selective coronarography are indicated, which decide on a possible revascularization operation in these risk patients already during the pretransplantation period.

[Noninvasive electrocardiographic monitoring and ventricular arrhythmias in patients after myocardial infarct]. / Neinvazívne elektrokardiografické sledovania a komorové arytmie u chorých po infarkte myokardu.

It is generally accepted that ventricular arrhythmias represent a predictor of prognosis after myocardial infarction, and that their impact on the increase of risk is especially unfavourable when associated with myocardial ischaemia or reduced left ventricular function. The aim of the study was to assess the significance and contribution of noninvasive ECG methods in detection of risk due to sudden cardiac death in Q postmyocardial infarction patients. Two-hundred and seventy patients were examined by exercise testing which in 5.2% of cases revealed couplet ventricular extrasystoles and 0.8% yielded non-sustained ventricular tachycardia. 24-hour-Holter ECG recording was performed in 168 patients (19.0% of couplet ventricular extrasystoles, 9.0% of non-sustained and 0.6% of sustained ventricular tachycardia respectively), and 300 patients were examined by late ventricular potentials analysis with a result of 25% positive cases. During 3 years of follow-up, 20 out of 300 patients (6.7%) died suddenly; in this group late ventricular potentials occurred significantly more frequently than in survivors. Exercise testing plays a major role in the detection of myocardial ischaemia, while Holter recording and signal averaging for detection of late ventricular potentials are important in noninvasive diagnosis of ventricular arrhythmias. Their combination with other ECG techniques (heart rate variability, QT dispersion) and determination of global function of the left ventricle may help to identify the group of patients in whom subsequent electrophysiological study is indicated in order to determine the optimal therapy for mortality reduction after myocardial infarction. (Fig. 5, Tab. 3, Ref. 20.)

Gas chromatography of tryptophan together with other amino acids in hydrochloric acid hydrolysates.

The classical hydrolysis of proteins with hydrochloric acid using tryptamine [3-(2-aminoethyl)indole] as additive revealed that tryptophan can be measured without destruction together with other amino acids by gas chromatography. An extensive study was made to establish the optimum conditions for protein hydrolysis (time and temperature of hydrolysis, amount of tryptamine) and for the derivatization of amino acids. The amino acid contents (including tryptophan) of standard proteins such as lysozyme, bovine and human albumin, human gamma-globulin, casein and alpha-chymotrypsin and protein matrices (meat and fish meals, sunflower) were determined, after hydrochloric acid hydrolysis (4 h, 145 degree C) in the presence of tryptamine. as N, O, (S)-trifluoroacetyl isobutyl esters with SE-30 as the stationary phase. The reproducibility of the measurements was 4.6% (relative standard deviation) or less.

Spectrophotometric determination of tryptophan in intact proteins by the acid ninhydrin method.

The interaction of tryptophan, lysozyme and tyrosine with ninhydrin in strong acid media has been investigated at 20, 25, 30, and 35 degrees C by spectrophotometry. Second-order rate constants and molar absorptivity values have been evaluated from an analytical point of view. Optimum conditions for the selective estimation of tryptophan, tryptophan residues in intact proteins, and indoles--without the disturbing effect of tyrosine--have been given. Under optimum conditions, in the concentration range from 2.5 X 10(-8) to 3.0 X 10(-7)M, molar absorptivity values and reproducibility data for various reactants have been reported. Molar absorptivity values (Am X 10(-3)/M X cm) of tryptophan (21.35), lysozyme (19.33), bovine serum albumin (21.05), human serum albumin (21.00), casein (17.85), alpha-chymotrypsin (18.28), trypsin (14.43), indole (5.03), and indole-3-acetic acid (13.75) have been measured with a standard error of 2.3% or less for any particular reactant.

Monitoring of Maillard reactions in soy products.

Chemical mechanism and the analytical methods suggested in the literature for the analysis of early Maillard reactions are summarised and critically evaluated. The applicability of our method for the measurement of the Maillard reactions - the soluble raffinose oligosaccharides and the basic amino groups of proteins - are illustrated by following early Maillard reactions in differently denaturated soya bean samples. The quantitative relations of Maillard reactions taking place in natural matrices could be clarified by monitoring both of the reactants by means of methods not requiring correction factors.

Search for C-type particles in human neoplasia.

The salient biologic and morphologic characteristics of RNA tumor (oncornavirus) virus are reviewed. The ultrastructure of replicating oncornaviruses is illustrated in detail. C-type particles wide spread in at least three orders of animals were sighted in human sarcomas and leukemias. One case, an infantile fibrosarcoma, is presented from our cases surveyed for the presence of C-type particles. Tissue cultures derived from this tumor contained viral particles and had an elevated reverse transcriptase activity associated with the presence of 70 S RNA. The particles were larger (125 to 150nm) than those of the murine or avian Type C particles.

Ewing's sarcoma, extraskeletal and of bone. Case report with ultrastructural analysis.

Ewing's sarcoma is considered a primary malignant tumor of bone. Histologically, it is characterized by small round cells with poorly delineated borders. Ultrastructural studies reveal large amounts of glycogen aggregated in the undifferentiated cytoplasm of the tumor cells which show variable amount of organelles. The cell membrane shows desmosomes in some cases but not in others. Intercellular argentophylic fibers are by and large absent. In a survey of human sarcomas for the possible presence of viral agents, a sarcoma has been encountered in a 15 year old male originating in the area of the posterior bladder wall and prostate that satisfies morphologic criteria for the diagnosis of Ewing's sarcoma but is extraskeletal in origin. Histology and ultrastructure as well as tissue cultural characteristics of this tumor were studied in comparison with a second patient (age 14) with Ewing's sarcoma originating in the right clavicle. None of the two tumors yielded virus particles in culture.