Individual ovarian volumes obtained from 2-dimensional and 3-dimensional ultrasound lack precision.

Measuring ovarian volume has been suggested as a possible screening test to assess a woman's ovarian reserve. For such a screening tool to be clinically useful, knowledge of its precision and reproducibility is essential. Recent advances in ultrasound scanning techniques allow the measurement of volumes in three dimensions rather than the traditional estimation from two dimensions. Transvaginal 2-dimensional (2D) and 3-dimensional (3D) ultrasound examinations were performed on 49 women attending a tertiary centre for investigation or treatment for subfertility between January and May 2006. Two observers calculated ovarian volume using both 2D (prolate ellipsoid formula) and 3D techniques [virtual organ computer-aided analysis (VOCAL)] with rotation steps of 30 degrees (3D-30). For the four comparisons (inter- and intra-observer; 2D and 3D-30) intraclass coefficients of 0.97 to 0.98, and standard errors ranging from 17% to 14% (for inter-observer 2D and intra-observer 3D, respectively) were obtained. The corresponding coefficients of repeatability ranged from 33% to 28%. These results suggest that measurement of transvaginal ovarian volumes using both 2D and 3D ultrasound is imprecise for individuals. The imprecision is greater for lower ovarian volumes, which may be important in clinical practice. The average of two or more measurements is likely to be more accurate than a single measurement.

Ischemic stroke in young adults: Results from the university of Wisconsin stroke registry.

We prospectively evaluated 128 consecutive young adults aged 18-50 years who suffered from at least one ischemic stroke. Men (92 of 128, 72%) predominated and had a mean age of 41 ± 8 years. Women (36 of 128, 28%) had a mean age of 40 ± 8 years (ns). Risk factors that separated male and female groups included previous stroke, which as seen overall in 34% (43 of 128; M/F = 38/5, p = 0.002), andstroke in thefamily, which was seen overall in21% (27 of 128;M/F = 22/5, p = 0.005). Thirty-day mortality was seen in 3% (4 of 128), all of whom were men. Stroke causes included atherosclerotic in 22% (28 of 128; M/F = 19/9, ns), cardioembolic in 17% (22 of 128, M/F = 17/5, ns), arteriopathic in 17% (22 of 128, M/F = 11/11, p < 0.002 for female preponderance), and coagulopathic in 15% (19 of 128, M/F = 18/1, p = 0.002 for male preponderance). Stroke causes remained "undetermined, " including small deep stroke and mixed causes, in 16%( 21 of 128; M/F = 17/4, ns), "uncertain, " including migraine-related and mitral valve prolapse, in 9% (11 of 128; M/F = 3/8, p = 0.002 for female preponderance), and "unknown" in 4% (5 of 128; M/F = 5/0, ns). These data, as part of the University of Wisconsin Stroke Registry, compare favorably to similar, previously published series from other institutions. Composite data from several of these series are also included.

Parkinson's disease, ischemic stroke, dementia, and cranial computed tomography: Preliminary study.

We sought to determine whether clinical features, stroke profiles, and cranial computed tomography (CCT) findings differed in nondemented and demented Parkinson's disease (PD) patients. Data were collected from our previously published case-control review of 119 idiopathic PD patients discharged from our Veterans Affairs Medical Center Neurology Service from 1982 through 1990. Historical, physical, age, age at onset of PD, duration of PD, motor severity, frequency of ischemic stroke and stroke risk factors, modified Hachinski Ischemic Score (MHIS), and CCT findings were recorded. We previously estimated that the number ofpatients with PD and dementia was 31 of 119 (26%) from our case-control review of idiopathic PD patients. Eighty-two male PD patients, 31 demented and 51 nondemented, had CCT data available for review. Demented PD patients were older (p < 0.01), had fewer normal CT scans (p = 0.0004), and more cerebral atrophy and leuko-araiosis (p = 0.0003) than nondemented PD patients. Clinical atherosclerosis did not significantly distinguish the groups, but 9 of 31 (29%) demented PD patients had a modified HIS ≥ 5 and thus suggestive of, at least, multi-infarct dementia. Demented PD patients were older overall at PD onset, but did not appear to have significantly longer PD duration or more motor severity. Demented PD patients were also apt to have had a much more current CCT (p < 0.01) than nondemented patients. Although clinical atherosclerosis did not clearly separate groups, more than one-quarter of demented PD patients seem to have components of vascular dementia.

Stroke and Parkinson's disease.

BACKGROUND AND PURPOSE: We sought to determine whether the recently reported decreased incidence of stroke and atherosclerotic disease in a university hospital-based Parkinson's disease patient population would be demonstrated in our patient population. METHODS: We performed a retrospective case-control review of the last 119 Parkinson's disease patients discharged from the Middleton Veterans Affairs Hospital Neurology Service to study the incidence of ischemic stroke, myocardial ischemia, tobacco use, and other stroke risk factors. Controls were age and sex matched and were randomly taken from 238 non-Parkinson's disease discharges in which stroke or myocardial infarction was not the reason for hospitalization. RESULTS: The cumulative incidences of ischemic stroke, hypertension, and diabetes mellitus were not significantly different between groups. Myocardial infarction, coronary artery disease, tobacco use, atrial fibrillation, cancer, and ethanol abuse were significantly more prevalent in the controls, whereas dementia and congestive heart failure were the only variables studied that were more prevalent in the Parkinson's disease patients. CONCLUSIONS: Our study failed to demonstrate that Parkinson's disease patients from a Veteran population were protected from ischemic stroke.

Lymphokine signal transduction.

Lymphokines are a group of signalling molecules involved in communication between cells, mainly those of the immune system. The lymphokines are multi-functional and most of them have mitogenic or co-mitogenic activity. An understanding of lymphokine biology is essential to understand how the immune system develops and functions and to provide a rationale for their use in immunotherapy. The potential to understand the cell biology of the lymphokines has recently become more apparent as molecular biological techniques have first of all produced recombinant factors and secondly have provided clues to the signal transduction pathways by cloning receptors, applying site-directed mutational analysis and also probing for specific promoters and enhancers that are activated along the signal pathway. This review discusses the information that has come from the recent analyses which blends with the biochemical analysis of the second messenger systems in an effort to understand the signalling pathways of the lymphokines.