Edna Schechtman

Local injury to the endometrium doubles the incidence of successful pregnancies in patients undergoing in vitro fertilization

OBJECTIVE Exploration of the possibility that local injury of the endometrium increases the incidence of implantation. DESIGN Prospective study. SETTING Clinical IVF unit. PATIENT(S) A group of 134 patients, defined as good responders to hormonal stimulation, who failed to conceive during one or more cycles of IVF and embryo transfer (ET). INTERVENTION(S) The IVF treatment and ET were preceded by repeated endometrial biopsies, in a randomly selected 45 of a total of 134 patients. MAIN OUTCOME MEASURES Outcome of IVF-ET treatments. RESULT(S) Transfer of a similar number of embryos (3.4 +/- 1.0 and 3.1 +/- 0.9 in the experimental and control patients, respectively) resulted in rates of implantation (27.7% vs. 14.2%, P =.00011), clinical pregnancy (66.7% vs. 30.3%, P =.00009), and live births per ET (48.9% vs. 22.5%, P =.016) that were more than twofold higher in the experimental group as compared to controls. CONCLUSION(S) These results suggest that IVF treatment that is preceded by endometrial biopsy doubles the chance for a take-home baby.

Local injury of the endometrium induces an inflammatory response that promotes successful implantation

OBJECTIVE To study whether an injury-induced inflammation might be the mechanism underlying the favorable effect of endometrial biopsy on the implantation rate in in vitro fertilization (IVF) patients. DESIGN Controlled clinical study. SETTING A medical center IVF unit and a research institute. PATIENT(S) Women undergoing IVF who had previous failed treatment cycles. INTERVENTION(S) Endometrial samples were collected from two groups of patients on day 21 of their spontaneous menstrual cycle. The experimental, but not the control group underwent prior biopsy treatment on days 8 or/and 11 to 13 of that same cycle. MAIN OUTCOME MEASURE(S) Abundance of immune cells, cytokines/chemokines level, correlation between these parameters and pregnancy outcome. RESULT(S) A statistically significantly higher amount of macrophages/dendritic cells (HLA-DR+ CD11c+ cells) and elevated proinflammatory cytokines, tumor necrosis factor-α (TNF-α), growth-regulated oncogene-α (GRO-α), interleukin-15 (IL-15), and macrophage inflammatory protein 1B (MIP-1B), were detected in day-21 endometrial samples of the experimental group. A direct stimulatory effect of TNF-α on MIP-1B, GRO-α, and IL-15 messenger RNA (mRNA) expression was demonstrated. A positive correlation was found between the levels of macrophages/dendritic cells, MIP-1B expression, and TNF-α expression and the pregnancy outcome. CONCLUSION(S) A biopsy-induced inflammatory response may facilitate the preparation of the endometrium for implantation. Increased MIP-1B expression could possibly serve for prediction of implantation competence.

Self-reports of safe driving behaviors in relationship to sex, age, education and income in the US adult driving population.

This study analyzed the data of a health and safety survey conducted on a representative sample of the adult driving population. The analysis focused on the relationships between self-reported safe driving behaviors (including belt use, observing speed limits, and abstaining from drinking and driving), and demographic characteristics (including sex, age, education and income). The results showed that the three behaviors are quite independent of each other, and, contrary to some stereotypes, there is no single high-risk group that is most likely to violate all three safe driving behaviors. The only consistent effect was that of sex: women reported higher observance rates of all three behaviors. Reported use of safety belts increases with age and education for both men and women. However while for women the reported use increases with income, for males the reported use does not change with income. Complete avoidance of drinking and driving was reported by most drivers in all groups, and the high rates hardly varied across the different age, education, and income groups. The number of people who reported that they observe the speed limit all the time increased with age, but decreased with increasing education and income. The results have implications for identifying violation-specific high-risk groups, and stressing different factors for each.

A Measure of Association Based on Gini's Mean Difference

A measure of association between two random variables is proposed, which represents a compromise between the classical correlation coefficient and the rank correlation coefficient. The new measure is based on the covariance between two variables where one variable is taken in its variate values while the other is ranked. The large sample distribution of this measure is studied and some possible applications are mentioned.

Using Analysis of Gini (ANOGI) for Detecting Whether Two Subsamples Represent the Same Universe

A wildly discussed shortcoming of panel surveys is a potential bias arising from selective attrition. Based on data of the German Socio-Economic Panel Study (SOEP), the authors analyze potential artifacts (level, structure, income inequality) by comparing results for two independently drawn panel subsamples started in 1984 and 2000. They apply ANOGI (analysis of Gini) techniques, the equivalent of ANOVA performed with the Gini coefficient. They rearrange, reinterpret, and use the decomposition in the comparison of subpopulations from which the different samples were drawn. Taking into account indicators for income, significant differences between these two samples with respect to income inequality are found in the first year, which start to fade away in Wave 2 and disappear in Wave 3. The authors find credible indication for these differences to be driven by changes in response behavior of short-term panel members rather than by attrition among members of the longer running sample.

Magnetic resonance imaging reveals functional diversity of the vasculature in benign and malignant breast lesions

Tumor perfusion through the microvascular network can be imaged noninvasively by dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI). The objective of the current study was to quantify the microvascular perfusion parameters in various human breast lesions and to determine whether they varied between benign lesions and malignancy and whether they were altered with increased invasiveness.

Antivascular Treatment of Solid Melanoma Tumors with Bacteriochlorophyll–serine-based Photodynamic Therapy¶

We describe here a strategy for photodynamic eradication of solid melanoma tumors that is based on photoinduced vascular destruction. The suggested protocol relies on synchronizing illumination with maximal circulating drug concentration in the tumor vasculature attained within the first minute after administrating the sensitizer. This differs from conventional photodynamic therapy (PDT) of tumors where illumination coincides with a maximal concentration differential of sensitizer in favor of the tumor, relative to the normal surrounding tissue. This time window is often achieved after a delay (3–48 h) following sensitizer administration. We used a novel photosensitizer, bacteriochlorophyll–serine (Bchl–Ser), which is water soluble, highly toxic upon illumination in the near‐infrared (λmax 765–780 nm) and clears from the circulation in less than 24 h. Nude CD1 mice bearing malignant M2R melanotic melanoma xenografts (76–212 mm3) received a single complete treatment session. Massive vascular damage was already apparent 1 h after treatment. Changes in vascular permeability were observed in vivo using contrast‐enhanced magnetic resonance imaging (MRI), with the contrast reagent Gd‐DTPA, by shortening spin–spin relaxation time because of hemorrhage formation and by determination of vascular macromolecular leakage. Twenty‐four hours after treatment a complete arrest of vascular perfusion was observed by Gd‐DTPA–enhanced MRI. Histopathology performed at the same time confirmed primary vascular damage with occlusive thrombi, hemorrhage and tumor necrosis. The success rate of cure of over 80% with Bchl–Ser indicates the benefits of the short and effective treatment protocol. Combining the sensitizer administration and illumination steps into one treatment session (30 min) suggests a clear advantage for future PDT of solid tumors.

Reduced Repair of the Oxidative 8-Oxoguanine DNA Damage and Risk of Head and Neck Cancer

An increasing number of studies indicate that reduced DNA-repair capacity is associated with increased cancer risk. Using a functional assay for the removal of the oxidative DNA lesion 8-oxoguanine by the DNA-repair enzyme 8-oxoguanine DNA glycosylase 1 (OGG1), we have previously shown that reduced OGG activity is a risk factor in lung cancer. Here, we report that OGG activity in peripheral blood mononuclear cells from 37 cases with squamous cell carcinoma of the head and neck (SCCHN) was significantly lower than in 93 control subjects, frequency matched for age and gender. Retesting of OGG activity 3 to 4 years after diagnosis and successful treatment of 18 individuals who recovered from the disease showed that OGG activity values were similar to those determined at diagnosis, suggesting that reduced OGG activity in case patients was not caused by the disease. Logistic regression analysis indicated that the adjusted odds ratio (OR) associated with a unit decrease in OGG activity was statistically significantly increased [OR, 2.3; 95% confidence interval (95% CI), 1.5-3.4]. Individuals in the lowest tertile of OGG activity exhibited an increased risk of SCCHN with an OR of 7.0 (95% CI, 2.0-24.5). The combination of smoking and low OGG was associated with a highly increased estimated relative risk for SCCHN. These results suggest that low OGG is associated with the risk of SCCHN, and if confirmed by additional epidemiologic studies, screening of smokers for low OGG activity might be used as a strategy for the prevention of lung cancer and SCCHN.

Practice parameter: Initiation of treatment for Parkinson’s disease: An evidence-based review

To the Editor: We have read with interest the practice parameter by Miyasaki et al.1 concerning the use of dopamine agonists (DA) in the treatment of patients with early Parkinson’s disease (PD). The authors stressed in this evidence-based review that cabergoline, pramipexole, and ropinirole were shown to be superior to levodopa in delaying the motor fluctuations and dyskinesias. However, they did not recommend any of the three DA as the first choice of treatment, arguably because there have been no adequate trials comparing these drugs with each other as monotherapy in early PD. To address this issue we compared the three …

On the proper bounds of the Gini correlation

Abstract Gini correlation measures the dependence between two random variables, whose properties are a mixture of Pearson’s and Spearman’s correlations. For any given marginal distributions, the range of Gini correlation is [−1, 1]. (This property does not hold for Pearson’s correlation). Some possible applications are given.