Longitudinal development of obesity in the post-Fontan population.

BACKGROUND/OBJECTIVES: An elevated body mass index (BMI) in childhood is a significant risk factor for cardiovascular disease, and it may pose an additional risk to children and adults with palliated univentricular congenital heart disease. However, little is known about longitudinal development of obesity in this population. The objective of this study is to determine the prevalence of overweight (OW) and obese (OB) habitus at the time of Fontan palliative surgery, to track changes in BMI after surgery, and ultimately to determine whether factors such as gender, ethnicity, preoperative heart defect and ventricular dominance are associated with later development of OW or OB. SUBJECTS/METHODS: A retrospective chart review of 84 patients undergoing Fontan palliation was performed. Demographic data including gender, ethnicity, preoperative heart defect and ventricular dominance were recorded. Height, weight and BMI were obtained at the time of Fontan and on a yearly basis post surgery. RESULTS: At the time of Fontan palliation, 10.7% of patients were OB or OW. During the five years following palliation, the percentage of OB or OW patients trended upward, from 20.3% the year following surgery to 30% at 5 years post Fontan. Repeated measures generalized estimating equation showed a significant association between Hispanic ethnicity and increased BMI Z-scores for the 5 years after Fontan palliation (P<0.001); there was no association between BMI Z-scores and patient sex, lesion or ventricular dominance. CONCLUSIONS: During the first 5 years after Fontan palliation, there is a trend toward increasing percentages of OB and OW patients. In addition, there is a significant association between Hispanic ethnicity and being OW or OB before and after surgery. Further study is needed to determine whether OW/OB status is associated with worse health outcomes in this patient population.

Effect of monoclonal antisperm antibodies on the penetration rates of human spermatozoa in zona-pellucida-free hamster oocytes.

The penetration rate of human spermatozoa in zona pellucida-free hamster oocytes was reduced by four monoclonal antisperm antibodies (A-24, B-20, III3 and VII-5) of six tested. The other two (VI-1 and VI-16) left the penetration rates virtually unchanged. The extent of the penetration rate reduction depended on the concentrations of antibodies A-24, B-20, III-3 and VII-5; if undiluted, they produced a significant reduction in the penetration rates; the largest average reduction was almost 50% with undiluted antibody A-24. Decreasing concentrations of the monoclonal antisperm antibodies resulted in significantly smaller reductions in the sperm penetration rates. The reason for the reduced penetration rates observed might have been a blockage of receptors on the sperm surface by the antibodies. That can inhibit enzyme reactions of the spermatozoa or interfere with the interaction between oocyte and spermatozoon membranes. Only antibody III-3 caused agglutination of human spermatozoa in the micro sperm agglutination and immobilization tests. Therefore, the agglutination or immobilization of spermatozoa might not be responsible for the reduced penetration rates after the addition of monoclonal antibodies, in contrast to findings with polyclonal antibodies.

[Modification of the penetration rate of human spermatozoa in the zona pellucida free hamster oocyte system by the use of polyclonal and monoclonal antibodies to human sperm]. / Die Beeinflussung der Penetrationsrate humaner Spermatozoen im Zona-pellucida-freien Hamsteroozytensystem durch Einsatz polyklonaler und monoklonaler Antikörper gegen humane Spermatozoen.

Incubation of human spermatozoa with polyclonal anti-sperm antibodies from sterile females reduced the penetration rates in the zona-pellucida-free hamsteroocyte assay significantly. Twelve sera having titers from 1:4,096 to 1:64 were used. Fifty-three ejaculates from men with normozoospermia were tested. A few of the ejaculates used were classified as slightly pathological showing asthenospermia. At an average titer 1:860 the reduction of penetration rate was about 49% (range 9-90%). The degree of reduction was dependent on the agglutination titer of the test serum, the presence of immobilizing antibodies, the amount of antiserum added, and on the quality of the ejaculates to a minor extent. The penetration rate of human spermatozoa in zona-pellucida-free hamster-oocytes was reduced by 4 monoclonal anti-sperm-antibodies (A-24, B-20, III,3, and VII-5) out of 6 tested. The other 2 (VI-1 and VI-16) left the penetration rates virtually unchanged. The extent of penetration rate reduction depended on the concentrations of antibodies A-24, B-20, III-3, and VII-5; if undiluted, they produced a significant reduction of penetration rates, the largest average reduction being almost 50% with undiluted antibody A-24. Decreasing concentrations of the monoclonal anti-sperm-antibodies resulted in significantly smaller reductions of sperm penetration rates. The reason for the reduced penetration rates observed may be a blockage of receptors on the sperm surface by the named monoclonal anti-sperm-antibodies. This can inhibit enzyme reactions of the spermatozoa, or interfere with the interaction between oocyte and spermatozoa membranes. It is noted that only the antibody III-3 caused agglutination of human spermatozoa in the micro-sperm-agglutination and immobilization test. Therefore, the agglutination or immobilization of spermatozoa may not be held responsible for the reduced penetration rates after addition of monoclonal antibodies, as opposed to the findings with polyclonal antibodies.

[The effect on penetration rate of human spermatozoa into the zona pellucida free hamster oocyte system of monoclonal antibodies against human spermatozoa]. / Die Beeinflussung der Penetrationsrate humaner Spermatozoen im zona pellucida-freien Hamster-Oozyten-System durch monoklonale Antikörpern gegen humane Spermatozoen.

The penetration rate of human spermatozoa in zona pellucida-free hamster oocytes was reduced by 4 monoclonal anti-sperm-antibodies (A-24, B-20, III-3, and VII-5) out of 6 tested. The other 2 (VI-1 and VI-16) left the penetration rates virtually unchanged. The extent of penetration rate reduction depended on the concentrations of antibodies A-24, B-20, III-3, and VII-5; if undiluted, they produced a significant reduction of penetration rates, the largest average reduction being almost 50% with undiluted antibody A-24. Decreasing concentrations of the monoclonal anti-sperm-antibodies resulted in significantly smaller reductions of sperm penetration rates. The reason for the reduced penetration rates observed may be a blockage of receptors on the sperm surface by the named monoclonal anti-sperm-antibodies. This can inhibit enzyme reactions of the spermatozoa, or interfere with the interaction between oocyte and spermatozoa membranes. It is noted that only the antibody III-3 caused agglutination of human spermatozoa in the micro-sperm-agglutination and immobilization tests. Therefore, the agglutination or immobilization of spermatozoa may not be held responsible for the reduced penetration rates after addition of monoclonar antibodies, as opposed to the findings with polyclonal antibodies (Steinberg - 1985&).