The Practice Committee of the American Society for Reproductive Medicine

• This study examined the specificity of deviations in patterns of normal brain asymmetry on the magnetic resonance imaging scans of 10 dyslexic, 10 attention deficit disorder/hyperactivity (ADD/H), and 10 normal age- and sex-matched control children. Reliabilities of region of interest measurements for left and right anterior and posterior width and area, length of the bilateral insular region, and length of the bilateral planum temporale were excellent. Both the dyslexic and ADD/H children had significantly smaller right anterior-width measurements than did normal subjects. The dyslexics also had a bilaterally smaller insular region and significantly smaller left planum temporale than did the normal subjects. Seventy percent of the normal and ADD/H children had the expected left greater than right pattern of plana asymmetry, while only 10% of the dyslexic children did. The very significant increase in the incidence of plana symmetry or reversed asymmetry seems unique to dyslexia and may be related to deviations in normal patterns of corticogenesis. Although significantly more dyslexic children were left-handed than were the normal and ADD/H children, no significant relationship emerged between left-handedness, incidence of allergies or familial autoimmune disease, and variability in indexes of brain morphologic findings.

Brain morphology in developmental dyslexia and attention deficit disorder/hyperactivity.

Objective. —To investigate the effects of prophylactic therapy with antiarrhythmic agents on mortality in patients with myocardial infarction. Data Sources and Study Selection. —Data were obtained from all completed, published or unpublished, randomized, parallel controlled trials of antiarrhythmic agents, regardless of sample size. Investigators were contacted for data on patients excluded after randomization. Data Extraction. —Data on mortality were extracted by one author and confirmed where necessary by the others. Data Synthesis. —Mortality data from 138 trials on 98 000 patients were combined by the Yusuf-Peto adaptation of the Mantel-Haenszel method. There were 660 deaths among 11 712 patients allocated to receive class I agents and 571 deaths among 11 517 corresponding control patients (51 trials: odds ratio [OR], 1.14;95% confidence interval [Cl], 1.01 to 1.28;P=03). Of 26 973 patients allocated to receive β-blockers (class II agents), 1464 died compared with 1727 deaths among 26 295 control patients (55 trials: OR, 0.81; 95% CI, 0.75 to 0.87;P=.00001). Of 778 patients allocated to receive amiodarone (a class III agent), 77 died compared with 101 deaths in 779 control patients (eight trials: OR, 0.71; 95% Cl, 0.51 to 0.97;P=.03). There were 982 deaths in 10 154 patients allocated to receive a class IV agent (calcium channel blockers) and 949 deaths in 10 188 control patients (24 trials: OR, 1.04; 95% CI, 0.95 to 1.14;P=.41). Conclusions. —The routine use of class I antiarrhythmic agents after myocardial infarction is associated with increased mortality. β-Blockers have been conclusively demonstrated to reduce mortality. The limited data on amiodarone appear promising. Data on calcium channel blockers remain unpromising. (JAMA. 1993;270:1589-1595)

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=jama&articleId=408693&pdfFileName=jama_270_13_038.pdf

Effects of Prophylactic Antiarrhythmic Drug Therapy in Acute Myocardial Infarction: An Overview of Results From Randomized Controlled Trials

Chromosomally derived sterility has long been recognized. A review of the literature of somatic chromosome investigations in infertile males has shown that 13.7% of azoospermic males and 4.6% of oligozoospermic males have an abnormal karyotype. In the first group, sex chromosome abnormalities predominate (mainly 47,XXY), whereas in the latter, autosome anomalies (i.e. Robertsonian and reciprocal translocations) are the most frequent. A similar review on meiotic studies revealed that meiotic chromosome anomalies can explain male infertility in 4.3-40.4% of patients. Recently, fluorescent in-situ hybridization studies on spermatozoa from infertile men were published; it was suggested that both X-Y pairing and pairing of the autosomes were impaired, resulting in spermatogenic disruption. We investigated cytogenetically 694 infertile men with abnormal sperm parameters. More patients are needed for this research to investigate the relationship, if any, between the type of chromosome abnormality and its influence on the number, morphology and motility of spermatozoa. To be able to provide proper counselling for those couples whose male infertility can now be treated by intracytoplasmic sperm injection, it is suggested that clinical investigations should include mitotic and meiotic studies, an analysis of the chromosome content of individual spermatozoa and a DNA analysis of blood and spermatozoa to detect partially deleted Y chromosome material.

Cytogenetics of infertile men

http://www.srossell.com/Publications/5%20shapleske%20pt_brain%20research%20reviews.pdf

The planum temporale: a systematic, quantitative review of its structural, functional and clinical significance.

Chromosomal analysis of 1000 spermatozoa from 33 normal men was performed using in vitro fertilization of zona-free golden hamster eggs. The frequency of abnormal sperm complements was 8.5%: 5.2% were aneuploid and 3.3% had a structural chromosome abnormality. The frequencies of hyperhaploid (2.4%) and hypohaploid (2.7%) sperm complements were not significantly different and all chromosome groups were represented among the aneuploid complements. The majority (22/33) of structurally abnormal complements had a chromosome break. The percentages of X and Y-bearing sperm were 53.9% and 46.1%, which is significantly different from the expected one to one ratio.

The chromosome constitution of 1000 human spermatozoa

The chromosomal constitution of 1582 human sperm from 30 normal men of proven fertility was investigated after sperm penetration of hamster eggs. A minimum of 30 sperm chromosome complements were analysed per donor so that the distribution and variation in the frequency and type of sperm chromosomal abnormalities could be assessed. The mean frequency of sperm chromosomal abnormalities in individual men was 10.4% (+/- 6.0%) with a range of 0-24.7%. For numerical abnormalities the mean was 4.7% (+/- 2.9%) with a range of 0-10% and for structural abnormalities the mean was 6.2% (+/- 6.0%) with a range of 0-23.1%. The 95% confidence intervals for the mean of an individual male were 0-10.5% for numerical abnormalities, 0-18.2% for structural abnormalities, and 0-22.4% for total abnormalities. There was a significant excess of hypohaploid complements compared with hyperhaploid complements. Since hypohaploid complements could be caused by technical artefact, a conservative estimate of aneuploidy was obtained by doubling the frequency of hyperhaploid sperm, yielding an estimate of 2.4% aneuploidy. The proportion of X-bearing (53%) and Y-bearing (47%) sperm did not differ significantly. These results were compared to the other two large studies of sperm chromosome complements from normal men.

Variation in the frequency and type of sperm chromosomal abnormalities among normal men.

13 cancer patients were studied before radiotherapy (RT) and at regular intervals after RT to determine the effect of RT on chromosomal abnormalities in sperm. The men were 19–47 years old and received testicular radiation doses of 0.4–5.0 Gray. Human pronuclear sperm chromosomes were analysed after penetration of zona-pellucida-free hamster eggs. Unfortunately the hamster egg penetration rates were exceedingly low, both before and after RT and this limited the number of sperm chromosome complements which could be analysed. Before RT, the frequency of abnormal sperm chromosome complements was 0% ( 0 9 ). After RT, the majority of men were azoospermic for 24 months but complements could be analysed from 4 men. In the first 12 months the frequency of abnormalities was 13% ( 1 8 ) and at 24 months it was 13% ( 7 55 ). By 36 months after RT, most men had recovered sperm production and the frequency of abnormalities in 8 men was 21% ( 18 86 ), which is significantly higher than the rate in control donors (8.5%). For individual men the range was 6–67%, and there was a significant correlation between testicular radiation dose and the frequency of sperm chromosomal abnormalities. The frequencies of both numerical and structural abnormalities were significantly increased after RT. This is the first evidence that radiation may increase the frequency of chromosomal abnormalities in human gametes.

An increased frequency of human sperm chromosomal abnormalities after radiotherapy

The relationship between sperm chromosomal abnormalities and sperm morphology in humans

• The computed cranial tomograms (CCTs) of 26 dextral boys with developmental dyslexia were examined for asymmetry of width and length in the frontal and occipital regions. Contrary to several previous reports, reading disability was not associated with an increase in the frequency of reversed occipital widths. There were, however, proportionately more symmetric occipital widths than expected in comparison with a control sample and previously established norms. Differences in verbal or performance IQs were not related to relative cerebral size. Language delay was also not associated with brain measurements. The CCT may be increasing in use as a tool in the investigation of children with developmental dyslexia. We conclude that CCT is not warranted unless an underlying disorder associated with significant neurologic signs is discovered by examination.

Alfred W. Rademaker

Papers

The chromosome constitution of 1000 human spermatozoa

Variation in the frequency and type of sperm chromosomal abnormalities among normal men.

An increased frequency of human sperm chromosomal abnormalities after radiotherapy

The relationship between sperm chromosomal abnormalities and sperm morphology in humans

Cerebral Asymmetry in Developmental Dyslexia