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11.
Is the outcome of in-vitro fertilization and embryo transfer treatment improved by spontaneous or surgical drainage of a hydrosalpinx? 总被引:4,自引:7,他引:4
Sowter MC; Akande VA; Williams JA; Hull MG 《Human reproduction (Oxford, England)》1997,12(10):2147-2150
A pilot study was designed to examine whether the outcome of embryo
transfer in women with a hydrosalpinx might be improved by surgical
drainage of the hydrosalpinx at the time of oocyte collection for in- vitro
fertilization treatment. A comparative, controlled but retrospective
analysis of the results was performed of all women with infective tubal
damage aged <40 years old, who had ovulatory cycles, a normal uterus and
a partner with normal spermatozoa. A standardized treatment regimen was
used. A maximum of three embryos were transferred. Hydrosalpinx was defined
by prior hysterosalpingography and/or laparoscopy with transcervical dye
injection. A total of 237 embryo transfer cycles in women with
hydrosalpinges (tubal distension not visible in 151, visible but not
drained in 30 and drained in 56) were compared with 705 embryo transfer
cycles in women with tubal disease but no hydrosalpinx. Results were
analysed in the first three cycles but also separately in the first cycle
to check for bias. Success rates were higher in the first cycle, but did
not significantly influence overall differences. Implantation rates were
significantly reduced overall in the hydrosalpinx group (8.0 versus 13.2%
for controls; P < 0.001), being 8.3% (P < 0.01) in the subgroup
without evident tubal distension and 7.5% (not significant) in the drained
hydrosalpinx group. This study shows that tubal damage with distal
occlusion is associated with a marked reduction in embryo implantation,
even in the absence of obvious fluid distension. Surgical drainage of
distended hydrosalpinges appears to offer no benefit.
相似文献
12.
Chrysopoulo MT Jeschke MG Ramirez RJ Barrow RE Herndon DN 《Archives of surgery (Chicago, Ill. : 1960)》1999,134(3):283-286
BACKGROUND: Recombinant human growth hormone (rhGH) has been shown to favorably modulate the acute-phase response and may improve the clinical outcome. OBJECTIVE: To examine whether rhGH attenuates the elevated tumor necrosis factor alpha (TNF-alpha) levels that correlate with increased multiorgan failure and mortality in burned adults and children. DESIGN: Twenty children with burns of greater than 40% of the total body surface area were randomly divided into 2 groups to receive placebo (n = 10) or rhGH, 0.2 mg/kg per day intramuscularly (n = 10). SETTING: Pediatric burn hospital. MAIN OUTCOME MEASURE: Serum TNF-alpha levels by enzyme-linked immunoassay at baseline (day 0) and at 21 and 42 days after injury. For statistical analysis, we used the Kruskal-Wallis and Friedman tests. RESULTS: No significant differences in age (mean +/- SD, 6.2+/-1.6 vs 5.0+/-1.2 years) or percentage of total body surface area burn (mean +/- SD, 65.1%+/-8.2% vs 57.1%+/-5.2%) could be shown between the groups given rhGH and placebo. Baseline TNF-alpha levels were elevated from reference values in both groups. Twenty-one and 42 days after rhGH administration, serum TNF-alpha levels were significantly decreased from those at baseline (P<.05). No significant decrease in TNF-alpha levels was observed in the placebo group (P = .5). CONCLUSIONS: Recombinant human growth hormone significantly lowers serum TNF-alpha levels after burn injury. This is consistent with the beneficial effect that rhGH has on the acute-phase response. 相似文献
13.
Laparoscopic partial nephrectomy. The European experience 总被引:15,自引:0,他引:15
Rassweiler JJ Abbou C Janetschek G Jeschke K 《The Urologic clinics of North America》2000,27(4):721-736
Laparoscopic partial nephrectomy is technically difficult but oncologically effective. The operation should be performed in centers with expertise. Hemostasis can be achieved using bipolar coagulation and fibrin glue-coated cellulose. Further studies will determine whether less invasive alternatives (focused ultrasound, cryotherapy) will meet the high standard of open (or laparoscopic) nephron-sparing surgery for small renal cell carcinoma. 相似文献
14.
Screening for complement deficiency in bacterial meningitis 总被引:1,自引:0,他引:1
T Ernst PJ Späth C Aebi UB Schaad MG Bianchetti 《Acta paediatrica (Oslo, Norway : 1992)》1997,86(9):1009-1010
Seventy-seven children with bacterial meningitis were screened for complement deficiency. Both the classical and the alternate pathways were normal in 75 patients. Transiently reduced total haemolytic activity of the classical pathway was documented in a boy with meningococcal meningitis. Total haemolytic activity of both the classical and the alternate pathways were reduced in another patient with pneumococcal meningitis: individual complement components determination indicated predominant activation of the alternate pathway. 相似文献
15.
Identification of differentially expressed genes in aflatoxin B1- treated cultured primary rat hepatocytes and Fischer 344 rats 总被引:4,自引:1,他引:4
Harris AJ; Shaddock JG; Manjanatha MG; Lisenbey JA; Casciano DA 《Carcinogenesis》1998,19(8):1451-1458
Aflatoxin B1 (AFB1), a mutagen and hepatocarcinogen in rats and humans, is
a contaminant of the human food supply, particularly in parts of Africa and
Asia. AFB1-induced changes in gene expression may play a part in the
development of the toxic, immunosuppressive and carcinogenic properties of
this fungal metabolite. An understanding of the-role of AFB1 in modulating
gene regulation should provide insight regarding mechanisms of AFB1-induced
carcinogenesis. We used three PCR- based subtractive techniques to identify
AFB1-responsive genes in cultured primary rat hepatocyte RNA: differential
display PCR (DD-PCR), representational difference analysis (RDA) and
suppression subtractive hybridization (SSH). Each of the three techniques
identified AFB1- responsive genes, although no individual cDNA was isolated
by more than one technique. Nine cDNAs isolated using DD-PCR, RDA or SSH
were found to represent eight genes that are differentially expressed as a
result of AFB1 exposure. Genes whose mRNA levels were increased in cultured
primary rat hepatocytes after AFB1 treatment were corticosteroid binding
globulin (CBG), cytochrome P450 4F1 (CYP4F1), alpha-2 microglobulin,
C4b-binding protein (C4BP), serum amyloid A-2 and glutathione S-transferase
Yb2 (GST). Transferrin and a small CYP3A-like cDNA had reduced mRNA levels
after AFB1 exposure. Full-length CYP3A mRNA levels were increased. When
liver RNA from AFB1-treated male F344 rats was evaluated for transferrin,
CBG, GST, CYP3A and CYP4F1 expression, a decrease in transferrin mRNA and
an increase in CBG, GST, CYP3A and CYP4F1 mRNA levels was also seen.
Analysis of the potential function of these genes in maintaining cellular
homeostasis suggests that their differential expression could contribute to
the toxicity associated with AFB1 exposure.
相似文献
16.
17.
J.C.?BrokmannEmail author R.?Rossaint S.?Bergrath B.?Valentin S.K.?Beckers F.?Hirsch S.?Jeschke M.?Czaplik 《Der Anaesthesist》2015,64(6):438-445
Background
The demographic change and an increasing multimorbidity of patients represent increasing challenges for the adequate prehospital treatment of emergency patients. The incorporation of supplementary telemedical concepts and systems can lead to an improved guideline-conform treatment. Beneficial evidence of telemedical procedures is only known for isolated disease patterns; however, no mobile telemedical concept exists which is suitable for use in the wide variety of different clinical situations.Aim
This article presents a newly developed and evaluated total telemedical concept (TemRas) that encompasses organizational, medical and technical components. The use of intelligent and robust communication technology and the implementation of this add-on system allows the telemedical support of the rescue service for all emergencies.Methods
After development of the telemedical rescue assistance system, which includes organizational, medical and technical components, a telemedical centre and six ambulances in five different districts in North-Rhine Westphalia were equipped with this new tool. During the evaluation phase of 1 year in the routine emergency medical service the rate of complications as well as differences between urban and rural areas were analyzed with respect to different target parameters.Results
Between August 2012 and July 2013 a total of 401 teleconsultations were performed during emergency missions and 24 during secondary interhospital transfers. No complications due to teleconsultation were observed. The mean duration (±SD) of teleconsultations was longer in rural areas than in urban areas with 28.6±12.0?min vs. 25.5±11.1?min (p?<?0.0001). In 63.2?% of these missions administration of medications was delegated to the ambulance personnel (52.0?% urban vs. 73.6?% rural, p?<?0.0001). The severity of ailments corresponded to scores of III and VI in the National Advisory Committee for Aeronautics (NACA) classification.Conclusion
Emergency medical care of patients with support by a telemedical system is technically feasible, safe for the patient and allows medical treatment independent of spatial availability of a physician in different emergency situations.18.
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