Outcome of frozen embryo replacement cycles following elective cryopreservation of all embryos in women at risk of developing ovarian hyperstimulation syndrome

Aim: Our aim was to compare the outcome in subsequent frozen embryo replacement cycles in four groups of patients who had elective cryopreservation of all their embryos because they were considered to be at increased risk of developing severe ovarian hyperstimulation syndrome. Design: Sixty-two (91%) of 68 IVF cycles (68 patients) in which elective cryopreservation of all embryos was performed were analyzed. All patients continued on the GnRH agonist, buserelin, after oocyte recovery until the onset of vaginal bleeding. Frozen embryo replacement occurred in a hormone replacement cycle that started either on day 3 of the withdrawal bleed (group I;N=15) or after serum estradiol levels had fallen to <100 pmol/L (group II;N=16). The other patients commenced a frozen embryo replacement cycle several months later in either a hormone replacement (group III;N=15) or a natural (group IV;N=16) cycle. Results: Two patients developed severe ovarian hyperstimulation syndrome. There were no significant differences among the four groups regarding demographic variables, the dose of hMG used, and the clinical outcome. There was a higher but not significantly different clinical pregnancy rate in group I (26.7%), compared to group II (12.5%), group III (13.3%), and group IV (18.8%). Conclusions: Several options exist for the timing and protocol used for frozen embryo replacement in patients who had elective cryopreservation for the prevention of ovarian hyperstimulation syndrome, none of which was found to be clearly superior in this observational report.Presented at the 1994 Annual Conference of the American Fertility Society.     

Clinical analysis of congenital bile duct dilatation: Experience with 160 patients over a 7-year period

From July 1989, to June 1996, 160 patients with congenital bile duct dilatation (CBD) were treated at our institution. The incidence of CBD at our institution has increased annually. In approximately 90% of patients with CBD there was associated anomalous arrangement of the pancreaticobiliary ductal system, and we concluded that this was one of the main causes of CBD. Pediatric endoscopic retrograde cholangiopancreatography was first introduced to China in 1989, and has been successfully performed in 90.2% of 92 patients at our institution. We found that age at diagnosis was closely related to the subtype, complications, and mortality of CBD. The subtype also correlated with the presenting symptoms. One hundred and forty-seven of the 160 patients underwent surgery. Of these 147 patients, 136 (92.5%) were cured with normal liver function and 9 (6.1%) improved with liver impairment. Two patients died, one of postoperative pneumonia and one of liver failure. We conclude that early radical surgery and careful postoperative follow-up are essential in the prevention of CBD complications such as cholangitis, pancreatitis, biliary stones, and development of carcinoma. This article is based on a special lecture delivered before the 19th meeting of the Japanese Society of Pancreatico-biliary Maljunction, on September 14, 1996, in Tokyo     

Orbital Hydatid Cyst: CT and MRI

Orbital hydatid cyst is rare. We present a case with CT and MRI, emphasizing the superiority of the latter. Received: 19 August 1996 Accepted: 9 September 1996     

子宫内膜异位症患者子宫内膜人白细胞抗原的免疫组化研究

目的 研究子宫内膜异位症(内异症)患者在位和异位子宫内膜人白细胞抗原HLA—DR的表达。方法 采用酶标链霉亲合素—生物素(LSAB)技术对19例内异症不孕患者在位和异位子宫内膜腺细胞HLA—DR抗原的表达进行免疫组化研究，以19例非子宫内膜异位症的不孕患者作为对照。结果 内异症患者在位和异位子宫内膜腺细胞HLA—DR抗原的表达较对照组明显增强(P＜0．01)。结论 子宫内膜HLA—DR抗原的异常表达可能参与了内异症免疫学异常的发生。     

氧化作用与子宫内膜异位症

子宫内膜异位症是育龄妇女的常见疾病 ,近年来其发病率有上升趋势 ,研究认为EM发生发展与腹腔氧化作用有关。氧化作用是一种炎症反应 ,EM中巨噬细胞释放的氧化活性物 ,腹腔液中氧化低密度脂蛋白及其产物的增加 ,子宫内膜细胞氧化酶与抗氧化酶的异常表达 ,腹腔液中VitE的消耗 ,均说明EM与腹腔氧化作用有关。本文综述有关研究结果为用抗氧化剂和抗炎症制剂预防EM发生提供新的研究途径     

Molluscum contagiosum occurring in an epidermal cyst--report of 3 cases.

We present three unusual cases of molluscum contagiosum occurring in epidermal cysts. All of them are asymptomatic, elevated, oval nodules diagnosed clinically as epidermal inclusion cyst or prurigo nodularis. Histology showed true epidermal cysts containing molluscum bodies throughout the cyst wall and some type of laminated material within the cyst itself. The lesion, in all three cases developed in the pubic area of young adult men.     

医源性子宫内膜异位症的治疗进展

医源性子宫内膜异位症是指由于医学检查或治疗的影响而使子宫内膜异位种植，存活或已有的内膜异位灶进一步发展，近年发病率逐渐上升，原因主要与各种妇产科操作的增多有关，现就医源性子宫内膜异位症的治疗进展作一综述。     

In-vitro fertilization and the ovarian hyperstimulation syndrome.

Eight patients who developed severe ovarian hyperstimulation syndrome (OHSS) were identified among 1302 patients undergoing in-vitro fertilization (IVF) over a 1 year period (prevalence of 0.6%); 63% had ultrasonically diagnosed polycystic ovaries (PCO) and 75% were undergoing their first attempt at IVF. Pretreatment with a superactive luteinizing hormone-releasing hormone (LHRH) analogue significantly increased the prevalence of severe OHSS (1.1% versus 0.2%, P less than 0.05) compared with ovarian stimulation with clomiphene citrate and human menopausal gonadotrophin (HMG). The mean serum oestradiol concentration on the day of human chorionic gonadotrophin (HCG) administration was 8200 +/- 2300 pmol/l. A mean of 19.6 +/- 6.8 follicles had been aspirated and 13.1 +/- 7.7 oocytes recovered at transvaginal ultrasound-directed oocyte recovery. All patients had an embryo transfer and luteal support in the form of HCG. The clinical pregnancy rate was 88%, multiple pregnancy rate 71% and implantation rate 63.5 +/- 41.3%. In a group of seven patients who were hospitalized for moderate OHSS during the same period, peak oestradiol levels were significantly lower than in those with severe OHSS (P less than 0.05). Of the group with moderate OHSS, 57% had PCO, the clinical pregnancy rate was 100% and multiple pregnancy rate 43%. Patients with ultrasound-diagnosed PCO have an increased risk of developing OHSS and the dose of HMG administered to them should be minimized. In patients at risk of developing OHSS, progesterone instead of HCG should be used for luteal support. Transfer of a maximum of two embryos or freezing all embryos for transfer in a subsequent cycle may reduce the likelihood of multiple pregnancy.     

Analysis on Mental Features and Nursing Countermeasures for Malignant Ovarian Tumor Patients

Objective To inquire into the mental features of malignant ovarian tumor patients and advance the way to appease the mental state. Methods The mental health status of 168 malignant ovarian tumor patients was evaluated using Symptom Checklist 90 （SCL-90）, and compared with that of normal crowd and other gynecologic malignant tumor patients. Results The scores of suppression, anxiety, fear, somatization, constrain, hostility, interpersonal relationship of the ovary malignant tumor patients were higher than those of the normal model, and the scores of suppression, anxiety, interpersonal relationship higher than those of other gynecologic malignant tumor patients. Conclusions To strengthen the nursing teaching, understand the mental state on time, use moral support therapy, and help the patients to change their inadequate attitude and behavior, can strengthen the therapy confidence and promote the health rehabilitation.