IVF-ET in women with refractory polycystic ovarian disease

Polycystic ovarian disease may be a cause of hormonal infertility. This condition is often refractory to therapy. Three groups of randomly chosen women with refractory polycystic ovarian disease (PCOD) were treated by induction of ovulation with pFSH/hCG, pFSH/hMG/hCG or after down-regulation of the ovaries with a GnRH analogue (Decapeptyl). Out of 18 patients six conceived in the first in vitro fertilization-embryo transfer (IVF-ET) cycle, and two further women conceived in a later cycle. It is suggested that patients with refractory PCOD should be referred for IVF-ET therapy, possibly after treatment with a GnRH analogue.     

Computer applications to radioactive-seed: brain-tumor implants

Malignant brain tumors, in general, and anaplastic astrocytoma and glioblastoma multiforme in particular, have been highly refractory to conventional treatments including surgery, chemotherapy and external-beam irradiation. Although better local control can be achieved with high-dose, external beam irradiation, necrosis of normal brain tissue reduces the quality of life and survival. In order to localize the radiation dose given to brain tumors, the temporary implantation of 125I and 192Ir seeds is undergoing clinical trials at several medical centers. Computers play a key role in this treatment modality: in addition to being essential for image reconstruction of CT scans, a computer is used to reconstruct a tumor volume from outlined regions on individual cuts; a programable calculator is used in conjunction with a stereotaxic head holder to obtain the coordinates of the radioactive seeds; a radiation-therapy, treatment-planning computer is used to optimize the radioactive-seed positions and strengths, and to generate the corresponding dose distribution.     

Pregnancy Outcome in Maturity Onset Diabetes at Young Age (MODY)

Diabetes mellitus is not a single disease, but rather a syndrome comprised of a variety of diseases characterized by hyperglycaemia. Indeed it has a heterogeneous nature. Maturity Onset Diabetes of the Young or MODY is an unusual, mild type of hyperglycaemia, which develops in young women, (below the age of 25), who do not require insulin. This study describes 10 pregnancies in MODY women, who are compared to a group of patients with insulin-dependent diabetes mellitus (IDDM), a group with gestational diabetes, and a control group of normal, healthy pregnant women. Our group of pregnant MODY patients proved to have an intermediate form of diabetes, more severe than gestational diabetes and yet not as severe as insulin-dependent diabetes mellitus. Mean duration of diabetes was shorter and mean daily insulin requirement (during pregnancy) was lower among MODY patients in comparison to IDDM gestants. Moreover the frequency of maternal complications and Caesarean deliveries in MODY patients were lower than in the IDDM group, but higher when compared to the gestational diabetes group.     

The impact of spermatic vein ligation on the male factor in in vitro fertilization-embryo transfer and its relation to testosterone levels before and after operation

Criteria for improved semen quality after varicocele operations are not clear, as they do not express sperm fertilization capacity, its most important qualification. Twenty-two couples, 12 with mechanical female infertility (group I) and 10 with normal female fertility (group II), in whom the husband had subfertile semen in the presence of varicocele, and who had failed preoperative in vitro fertilization-embryo transfer (IVF-ET) attempts, were readmitted for the IVF-ET procedure following the repair of varicocele. In group I, a 20% pregnancy rate was achieved after the operation, while no pregnancies occurred before surgery. In group II, four pregnancies (40%) were achieved after operation. Plasma testosterone (T) levels demonstrated a significant increase in 50% of the patients in both groups after surgery, resulting in a concurrent improved fertilization, cleavage, and pregnancy rates.     

Mechanical Wear of Pacemaker Lead Insulation. A Cause of Loss of Pacing

A pacemaker-treated patient is described in whom lead insulation defect caused sudden loss of capture. The defect was caused by mechanical wear of the posterior leaflet of the tricuspid valve and resulted in shunting of the pulse generator with a current drain exceeding the capacity of the pacemaker. In three further cases a similar explanation to sudden loss of pacing was highly suspected.     

Pelvic kidney presenting as tumor praevia: report of a case diagnosed by ultrasound

A case is described in whom pelvic kidney presented as tumor praevia in early labor. Ultrasound examination revealed that the mass was a ptotic, functioning pelvic kidney, indicating that abdominal delivery should be resorted to in order to avoid its damage.     

Compensatory renal growth after unilateral nephrectomy in the new-born rat

1. The right kidney in a series of control rats aged between 5 days and 115 days was weighed. The kidney weight/body weight ratio was greater in young than in older rats, but decreased linearly with increasing age.2. After unilateral nephrectomy of rats 5 days old, the remaining kidney underwent compensatory growth. The rate and extent of this growth were greater than in adult rats.3. The concentrations of RNA and DNA in the renal cortex and medulla of rats 5 days old were higher than in adult animals. The concentrations of the two nucleic acids fell with age, and reached adult levels after approximately 6 weeks.4. After unilateral nephrectomy of rats 5 days old, the concentrations of RNA and DNA in the medulla were not significantly different from those in control animals. In the cortex, however, there was a delayed increase in the RNA/DNA ratio, which reached a level some 12% higher than that in control rats. This increase was smaller than that observed in unilaterally nephrectomized adult rats.5. The cortical Q(O2) of the remaining kidney of unilaterally nephrectomized new-born rats was elevated by some 20% within 1 day of unilateral nephrectomy. Cortical Q(O2)'s remained higher than those of control animals for 3-4 weeks.6. Since after unilateral nephrectomy, the increase in renal mass in new-borns was greater than that in adults, whereas the degree of cortical cellular hypertrophy (as estimated by the RNA/DNA ratio) was smaller than in adults, it is likely that in new-born animals a significant contribution to compensatory growth comes from cellular hyperplasia.