Ovarian tissue grafting: Lessons learnt from our experience with 55 grafts

Purpose

Uncertainties remain regarding the clinical efficacy of ovarian tissue cryopreservation and grafting. We report a retrospective analysis of reproductive outcomes and lessons learnt following 55 ovarian tissue transplant procedures at our center from 2006 to 2019.

Methods

We analyzed variables related to graft success such as tissue volume, follicular density, total follicular volume, and age on the duration of graft function.

Results

Follicular density and total follicular volume correlate positively with duration of graft function. All clinical pregnancies in our cohort occurred in women who were aged 35 or less at the time of ovarian tissue cryopreservation.

Conclusion

Graft success, as determined by eventual pregnancy and the longevity of graft function, may be impacted by factors including age at cryopreservation, follicular density, and total follicular volume.

     

Assisted suicide and its implications for occupational therapy

Many people's lives have been extended by the miracles of modern medicine and technology. However, although the use of these new technologies and drugs may keep people alive longer, the question arises about the quality of that extended life. This paper reviews one physician's apparent preoccupation with assisted suicide in order to introduce the controversy regarding the ethical, moral and legal implications of physician-assisted suicide in the USA. We discuss the arguments in favour of and against assisted suicide in the context of quality of life, individual autonomy versus communal responsibility, and professional autonomy. Occupational therapy, in particular, may be ethically challenged since one can argue that its aim is to help people lead a meaningful and purposeful life despite severe performance deficits. Copyright © 1999 Whurr Publishers Ltd.     

Mass lesions of the frontal lobes in acute head injuries. A comparison with temporal lesions

Summary Contusions and lacerations of the frontal lobes are very frequent; 43.4% in the whole series of traumatic brain mass lesions. Clinical, ICP, CT scan data and neuropathological findings in patients with such lesions are analysed and correlated. Moreover, the clinical features and the outcome of frontal masses undergoing surgery are also compared with similar lesions located in the temporal lobes.Frontal lesions cannot be differentiated on purely clinical grounds and the factors governing the outcome in both locations are the same. On the whole, surgical indications nowadays seem to be rather rare; only lesions behaving truly as expanding lesions with obvious intracranial hypertension benefiting from surgery.Brain contusion-laceration syndromes in general can no longer be considered separate entities. Neither should they be included in the miscellaneous group of traumatic intracranial mass lesions, since the pathophysiological significance of purely extracerebral effusions is entirely different.Traumatic contusions and lacerations and/or intracerebral haematomas, whether frontal or located elsewhere, should, instead, be considered in the context of head injuries of a different degree of gravity, as having collateral features which, on occasion, may call for surgical management.     

螺旋CT多平面重建及三维重建在关节损伤中的应用价值

目的：探讨螺旋CT多平面重建(MPR)及三维重建(3D)在关节损伤中的应用价值。方法：选择57例典型关节外伤病人，分析螺旋CT轴位表现及进行MPR和3D后的表现，并将三者进行对照。结果：轴位CT对显示关节骨与软组织由细小病变较好，但对水平面内关节面的改变可能估计不足。MPR和3D有助于弥补轴位CT的不足，较全面评价关节内外的损伤改变，显示多发粉碎性骨折的三维空间关系。结论：螺旋CT轴位图像结合MPR及3D，更加全面、直观地显示关节损伤性改变，对于临床选择治疗方法有重要意义。     

Laparoscopic Assisted Surgery for Crohn''''s Disease an Initial Experience and Results

SurgicaltreatmentisoftenrequiredforpatientswithCrohn'sdiseasewhohaveintestinalstrictureand/orfistula[4.1o.13].Rapidevolutionoflaparoscopicintestinalsurgery,continuousadvancementofinstru-mentation,performanceofmoreextensiveandcom-p1exprocedureshaveledtotheapplicationoflaparo-scopictechniquesinthetreatmentofCrohn'sdis-ease[3'9'12J.Recentreportshavedemonstratedthat,comparedwithtraditional"open"resection,laparo-scopicintestinalsurgeryresultsindecreasedpostoper-ativepain,earlierreturnofintestinalf…     

A simplified technique for embryo biopsy: Use of the same micropipette for zona drilling and blastomere aspiration

Purpose: Using different micropipettes for zona drilling and blastomere aspiration for embryo biopsy is prevalent at centers of preimplantation genetic diagnosis. The purpose of our study was to simplify the technique by using only one micropipette. Methods: In this animal model, ICR mouse embryos at the four-cell stage (n=446) were randomly allocated into two groups: a biopsied group (n=224) for blastomere aspiration and a control group (n=222) without micromanipulation. We used a drilling/biopsy micropipette to drill a hole in the zona by expulsion of acidified Tyrode’s solution and to aspirate the blastomere by gentle suction with the same micropipette and pull it out of the zona. One blastomere was biopsied from each embryo. Results: In all, 222 (99.1%) intact blastomeres were successfully biopsied from 224 embryos. Only two blastomeres were damaged during aspiration. The capacity for blastocyst development (92.4 vs 93.7%) was not different between the two groups, but the percentages of embryos hatching (51.8 vs 18.0%) and hatched (29.9 vs 8.1%) were significantly higher in the biopsied group than in the control group. Conclusions: This simplified technique of embryo biopsy is safe and highly efficient for obtaining blastomeres for preimplantation genetic diagnosis and may also facilitate hatching of the blastocysts.     

西洋参多糖5-2的分离、性质和活性研究

 目的：研究西洋参多糖(PPQ)中均一组分PPQ5 2的分离、糖组成、相对分子量及生物活性。方法：Sephadex DEAE A50和Sephadex G100分离，气相色谱法测定糖组成，基底辅助激光解吸/电离质谱测定相对分子量。用小鼠脾淋巴细胞进行淋巴细胞转化实验和白介素 2促诱生实验。结果：PPQ5-2由D阿拉伯糖和D半乳糖以1∶1.1摩尔比组成，含糖醛酸，相对分子量21 000 D，具有刺激淋巴细胞转化及白介素2促诱生功能。结论：由西洋参中可得到具有免疫刺激活性的含糖醛酸多糖。     

鼻咽癌微血管与远处转移关系的初步研究

目的研究肿瘤血管参数改变在鼻咽癌远处转移中的意义及其评价预后的作用；并由此探讨抗血管生成治疗预防鼻咽癌远处转移的可能性。方法选择５２例初治转移鼻咽癌，与另５２例初治无转移且长期无瘤生存的鼻咽癌在性别、年龄（相差不大于５岁）、Ｔ分期和Ｎ分期方面进行一对一配对，取其肿瘤组织进行微血管的免疫组化染色和计算机图象分析，配对比较４个参数：微血管计数、微血管相对面积、平均血管面积和平均血管周长。并分析这些参数在各型转移鼻咽癌中的差异。结果转移鼻咽癌的微血管计数与微血管相对面积均显著高于非转移组，而转移鼻咽癌的平均血管面积和平均血管周长均显著小于非转移鼻咽癌。上述４个参数在单纯型转移和复合型转移之间，以及单纯骨转移、肝转移、和肺转移之间并无显著性差异。结论肿瘤血管参数的改变与鼻咽癌转移密切相关，可作为预后因素进一步研究，并为预防远处转移的临床综合治疗以及抗血管生成治疗的研究提供依据。     

电视胸腔镜在胸部肿瘤中的应用

电视胸腔镜外科（ＶＡＴＳ）在胸部肿瘤的临床应用尚存争议。自１９９６年１０月～１９９７年８月，我科共行胸腔镜手术１６例：肺癌切除２例，纵隔肿瘤切除３例，恶性胸水行胸膜固定术２例，恶性心包积液行心包开窗术４例，常规开胸术前诊断性探查５例，初期结果较为满意。结论：ＶＡＴＳ创伤较小，安全有效。可选择性地用于胸部良恶性肿瘤的诊断和治疗。     

Influence of visual experience deprivation on the postnatal development of the microvascular bed in layer IV of the rat visual cortex

Cerebral vascular density is correlated with metabolic demands, which increase in highly active brain areas. External inputs are an essential requirement in the modeling of the visual cortex. Experience-mediated development is very active during the first postnatal month, when congruous blood supply is needed. We studied the development of visual cortex vascularization in relation to experience, comparing rats raised in darkness with rats reared in normal conditions. Vascular density, vascular area and their ratio vs. neuronal density were calculated. Conventionally stained semi-thin sections were used to measure the vascular area by computer assisted morphometry. Animals from both groups were sampled at 14, 21, and 60 days postnatal (dpn). We found a significantly lower density of vessels and neurons as well as a smaller vascular area in dark-reared adult rats while no differences were founded at the other ages. Our results also show no differences between the ratio of vessels/neuron, and vascular area/neuron, between both groups. The absence of visual experience causes decrease of cortical activity which correlates with lower vessels density and vascular area, without their ratio/neuron being affected.