The effects of female age on the outcome of testicular sperm extraction and intracytoplasmic sperm injection in infertile patient with azoospermia

Introduction: Testicular sperm extraction (TESE) is well-defined procedure for surgical sperm retrieval in obstructive and non-obstructive azoospermia. This study was focused on the effectiveness of testicular sperm extraction and intracytoplasmic sperm injection (ICSI) for azoospermic men with different female age subgroups.Materials and methods: A total of 107 men with azoospermia underwent TESE and ICSI treatment. The women were examined in three groups 20–29, 30–34 and 35 years or older. The main outcome in this study was fertilization and pregnancy rates with TESE and ICSI.Results: Spermatozoa were successfully retrieved during 97 of 107 (90.7%) TESE attempts, resulting in the fertilization of 286 of 563 (50.4%) injected metaphase II oocytes. Two hundred and fifty-five of them were transferred (89.8%). The clinical pregnancy rate and ongoing pregnancy rate per embryo transfer were 22.5% and 20.6% respectively. When comparing the fertilization and pregnancy rates, it was observed that women between the ages of 20–29 years had significantly higher pregnancy rates than women over 34 years of age (p < 0.05).Conclusion: The female age is a major factor in determining successful implantation in ICSI.     

Thromboembolic disease: variability of interobserver agreement in the interpretation of CT venography with CT pulmonary angiography

OBJECTIVE: The objective of this study was to determine interobserver agreement in the diagnosis of acute deep venous thrombosis on CT venography performed in addition to CT pulmonary angiography. SUBJECTS AND METHODS: One hundred forty-six CT venograms of 144 patients (mean age, 61.74 years) clinically suspected of having pulmonary embolism were analyzed prospectively and independently by two experienced thoracic and body imaging radiologists and later by consensus of the two radiologists. The CT venography protocol consisted of 5-mm-thick axial images at 20-mm intervals from the popliteal fossa to the renal veins. Images were acquired 3-4 min after the start of 100-150 mL of undiluted contrast medium administration at 4 mL/sec. Thirteen venous segments were analyzed in each patient. There were 1586 analyzable venous segments. RESULTS: Interobserver agreement, with the patient as the unit of analysis, was moderately good (kappa, 0.59; 95% confidence interval [CI], 0.39-0.78). Kappa values were similar for CT venography studies performed with 150 mL of contrast medium and 4-min delay (kappa, 0.62; 95% CI, 0.30-0.88) and with 3-min delay and 100 mL of contrast medium (kappa, 0.56; 95% CI, 0.32-0.80). Interobserver disagreement occurred in 17 (12%) of 146 CT venography studies. Findings of 11 CT venography studies were interpreted as negative, and six were interpreted as positive after consensus interpretation. CONCLUSION: Interobserver agreement for deep venous thrombosis with CT venography is moderately good.     

Spectral Clustering for Unsupervised Segmentation of Lower Extremity Wound Beds Using Optical Images

Chronic lower extremity wound is a complicated disease condition of localized injury to skin and its tissues which have plagued many elders worldwide. The ulcer assessment and management is expensive and is burden on health establishment. Currently accurate wound evaluation remains a tedious task as it rely on visual inspection. This paper propose a new method for wound-area detection, using images digitally captured by a hand-held, optical camera. The strategy proposed involves spectral approach for clustering, based on the affinity matrix. The spectral clustering (SC) involves construction of similarity matrix of Laplacian based on Ng-Jorden-Weiss algorithm. Starting with a quadratic method, wound photographs were pre-processed for color homogenization. The first-order statistics filter was then applied to extract spurious regions. The filter was selected based on the performance, evaluated on four quality metrics. Then, the spectral method was used on the filtered images for effective segmentation. The segmented regions were post-processed using morphological operators. The performance of spectral segmentation was confirmed by ground-truth pictures labeled by dermatologists. The SC results were additionally compared with the results of k-means and Fuzzy C-Means (FCM) clustering algorithms. The SC approach on a set of 105 images, effectively delineated targeted wound beds yielding a segmentation accuracy of 86.73 %, positive predictive values of 91.80 %, and a sensitivity of 89.54 %. This approach shows the robustness of tool for ulcer perimeter measurement and healing progression. The article elucidates its potential to be incorporated in patient facing medical systems targeting a rapid clinical assistance.     

Femoral nerve and rectus femoris muscle of the rat: a study in anatomy, histology, and histoenzymes

A study in the anatomy of the femoral-inguinal area of the femoral nerve and its branches, as well as the rectus femoris muscle, was undertaken on 27 male Wistar rats. Histological stains were used on both the nerve (Champy-Maillet stain) and the muscle (hematoxylin and eosin, Engel-Cunninghan's trichrome, and Masson's trichrome). Histochemical characteristics of the muscle tissue were determined by NADH-tetrazolium reductase and ATPase techniques; at the same time, the different cell group types, along with their distributions, were identified. This study is presented as a working model for experiments on nerve degeneration and regeneration as well as for research on the repercussions of nerve function on the dependent muscle.     

Does auditory tube angle really affect childhood otitis media and size of the mastoid?

Objective

To assess the cross-sectional area of mastoid air cells and auditory tube angles (ATA), which were defined as the angles between the longitudinal line bisecting the transverse length of the external auditory canal and the longitudinal axis of the auditory tube (AT), both in healthy ears and diseased ears in patients with unilateral chronic otitis media (COM).

Methods

25 patients who had unilateral COM were included in the study. Assessment was performed using a quantitative digital image processing computer tomography (CT) program.

Study design

Prospective study with institutional review board approval including adult patients who had otological symptoms since their childhood period.

Results

Mastoid areas were greater on the healthy side than on the diseased side (p < 0.05). ATA were not significantly different among groups (p > 0.05). When we compared ATA with mastoid area in each group; there were no significant correlations in both healthy group and COM group (p > 0.05). Mastoid size in COM group was smaller than in the healthy group.

Conclusion

We suggest that middle ear inflammations in childhood may affect mastoid size but, the anatomic relationships of the auditory tube, mastoid and middle ear that form a functional unit may not be significantly important in chronic ear disease.     

Evaluation of the Glasgow coma scale score in critically Ill infectious disease patients

Summary In this prospective study the Glasgow Coma Scale (GCS) score was evaluated in 107 critically ill infectious disease (ID) patients admitted to the Intensive Care Unit (ICU) during a 1-year period. Patients were separated into two groups: those affected by central nervous system (CNS) infections and those affected by infections other than of the CNS. There were no apparent differences in the first ICU day GCS score values between the two groups (11±4 vs. 11±4, p=0.5318). Univariate logistic regression analysis confirmed a significant relationship between the first ICU day GCS score and the subsequent ICU mortality in the group of patients with CNS infections (r=0.3152, p=0.0015) but not in the group with infections not affecting the CNS (r=0.0919, p=0.1106). Our preliminary results suggest that the prognostic value of the GCS score is valid only in patients with CNS infections but not in other ID patients.

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Evaluierung der Glasgow Coma Skala bei schwerkranken Patienten mit Infektionen

Zusammenfassung Die Glasgow Coma Scale (GCS) wurde bei 107 schwerkranken Patienten mit Infektionen im Rahmen einer prospektiven Studie evaluiert. Es handelte sich um Patienten, die während eines Jahres in der Intensivpflegestation behandelt wurde. Sie wurden nach dem Vorliegen oder nicht Vorliegen einer Infektion des Zentralnervensystems in zwei Gruppen eingeteilt. In den GCS-Scores am ersten Tag der Intensivpflegebehandlung wiesen die beiden Gruppen keine Unterschiede auf (11±4 und 11±4; p=0,5318). Die logistische Regressionsanalyse für eine Variable deckte eine signifikante Beziehung zwischen dem GCS Punktewert am ersten Tag und der folgenden Sterberate bei Patienten mit ZNS-Infektionen auf (r=0,3152; p=0,0015). Bei Patienten, deren Infektion das ZNS nicht betraf, war eine derartige Beziehung nicht zu erkennen (r=0,0919; p=0,1106). Diese vorläufigen Ergebnisse lassen darauf schließen, daß der Glasgow Coma Score nur bei Patienten mit ZNS-Infektionen eine valide Funktion hat, nicht aber bei Patienten mit anderen Infektionen.

     

Changes in the Number of CD8+ T Lymphocytes in the Peripheral Blood of Patients with Various Autoimmune Diseases after Autologous Hematopoietic Stem Cell Transplantations and their Relations to the Survival Times

The changes in the number of CD8⁺ T lymphocytes were studied before (0 day) and then 30 days after the autologous hematopoietic stem cell transplantations (AHSCT) in 14 therapy refractory patients with autoimmune diseases. The years of survival and the clinical states were also evaluated. The number of CD8⁺ T cells was determined by an hematologic automat and by flow cytometry. Longer than 5-year survival times were found in 6 cases, whereas there was no progression (improvement) in 2 cases, and 4 patients were lost. The increase in the number of CD8⁺ cytotoxic T cells was gradual in the first 2 months and reached the significantly highest values among all subtypes of lymphocytes. It was of a special interest that in all the 4 patients who died, the numbers of CD8⁺ T cells were less than 150/μl on the 30th day after AHSCT, whereas all the 10 patients with a higher cell number survived. These results suggest that the early monitoring of the number (not only the ratio) of regenerating CD8⁺ T cells in the peripheral blood can be a useful and quantitative laboratory measurement after AHSCT, and it has a significant relation also to the survival times of transplanted patients.