Three years' experience with levonorgestrel-releasing intrauterine device and Norplant-2 implants: a randomized comparative study

A randomized comparative study of levonorgestrel-releasing intrauterine device (LNG-IUD) and Norplant^R-2 implants was carried out in 200 women for 36 months. Three thousand one hundred woman-months of use were observed with each device. Only one pregnancy occurred in users of LNG-IUD at the 12th month of use. The change in bleeding pattern was the most frequent reason for discontinuation. The discontinuation rate for irregular bleeding with Norplant-2 was 17.3 and 26.8 at 24 and 36 months, respectively, as compared to 3.3 with LNG-IUD at both 24 and 36 months. The differences were statistically significant. Removal for amenorrhea and pain only occurred in acceptors of LNG-IUD. About 20–40% of women using Norplant-2 had prolonged bleeding through 36 months. The percentage of amenorrhea in LNG-IUD was the highest (29.3%) at the end of two years of use. More than 97% of subjects reported satisfaction with the methods used by themselves.

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Resumen Un estudio aleatorizado en el que se comparan los dispositivos intrauterinos que descargan levonorgestrel (LNG-IUD) con los implantes Norplant-2 se realizó en 200 mujeres durante 36 meses. Se observó un período de utilización correspondiente a tres mil cien meses-mujer con cada uno de los dispositivos. Hubo un solo embarazo, en el decimosegundo mes, entre las usuarias de LNG-IUD. La alteración del flujo menstrual fue la razón invocada con mayor frecuencia para el abandono del método. Los porcentajes de abandono por la irregularidad de la menstruación en el caso de los Norplant-2 fue de 17,3 y 26,8 a los 24 y 36 meses, respectivamente, en comparación con 3,3 con los LNG-IUD a los 24 y 36 meses. Estas diferencias son estadísticamente significativas. El retiro por amenorrea y dolores sólo ocurrió entre las mujeres que tenían los LNG-IUD. Los Norplant-2 ocasionaron sangrado prolongado durante los 36 meses estudiados en alrededor del 20 al 40% de las mujeres. El porcentaje de amenorrea con los LNG-IUD llegó al nivel máximo (29,3%) al cabo de dos años de uso. Más del 97% de las mujeres se mostraron satisfechas con los métodos que utilizaban.

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Resumé Une étude randomisée comparant les dispositifs intra-utûrins libérant du lévonorgestrel (LNG-IUD) aux implants Norplant-2 a été effectuée sur 200 femmes pendant 36 mois. On a ainsi observé une période d'utilisation correspondant à trois mille cent mois/femme avec chacun des dispositifs. Une seule grossesse s'est produite, au douzième mois, parmi les utilisatrices de LNG-IUD. L'altération du flux menstruel a été la raison le plus souvent invoquée pour l'abandon de la méthode. Les pourcentages d'abandon du fait de l'irrégularité de la menstruation dans le cas des implants se sont élevés à 17,3 et 26,8 après respectivement 24 et 36 mois, alors qu'ils n'atteignaient que 3,3 pour les LNG-IUD, tant à 24 qu'à 36 mois. Ces différences sont statistiquement significatives. Le retrait à la suite d'aménorrhée et de douleurs n'a été constaté que chez des femmes portant les LNG-IUD. Le Norplant-2 a occasionné des saignements prolongés pendant les 36 mois étudiés chez environ 20 à 40% des femmes. Dans le cas des LNG-IUD, le taux d'aménorrhée était le plus élevé (29,3%) au terme de deux années d'utilisation. Plus de 97% des patientes se sont dites satisfaites de la méthode qu'elles appliquaient.

     

Magnetic resonance imaging and single-photon emission computed tomography changes in hypoglycemia-induced chorea.

We present two case studies, one of generalized chorea and one of hemichorea, both after severe hypoglycemia episodes. Both cases showed hyperperfusion in their SPECT scans. The MRI and SPECT findings serve as clues regarding the role of basal ganglion dysfunction associated with chorea.     

移植肾破裂的处理

目的　提高移植肾破裂的防治水平。方法　 6例移植肾破裂 ,手术前 2例 ,手术后 4例。 2例术前供肾破裂 ,采用切开移植肾破裂处包膜 +裂口内明胶海绵填塞 +肠线修补 +肠线编织肾袋收缩保护移植肾。 1例术后移植肾破裂早期 ,出血少 ,针对顽固性高血压采用“硝普钠”降压 ,配合常规抗排斥药物。 3例术后移植肾破裂出血量估计超过 10 0 0ml者 ,采用手术延长移植肾破裂处包膜 +裂口内明胶海绵填塞 +肠线修补 +肠线编织肾袋收缩保护移植肾。结果　 ( 1)手术前 2例手术后 4例 ,采用切开或者延长移植肾破裂处包膜 +裂口内明胶海绵填塞 +肠线修补 +肠线编织肾袋收缩保护移植肾并配合“硝普钠”降压的方法处理 ,均未再破裂出血 ,移植肾功能恢复良好。 ( 2 ) 1例术后移植肾破裂早期的患者 ,针对顽固性高血压采用“硝普钠”降压 ,配合常规抗排斥药物 ,非手术治疗成功。结论　 ( 1)采用手术切开或延长移植肾破裂处包膜 +裂口内明胶海绵填塞 +肠线修补 +肠线编织肾袋收缩保护移植肾可以有效治疗移植肾破裂。 ( 2 )移植肾破裂出血少的情况下 ,可以在密切观察下非手术治疗     

Potential contribution of nuclear factor-kappaB to cerebral vasospasm after experimental subarachnoid hemorrhage in rabbits.

Nuclear factor-kappaB (NF-kappaB) plays a key role in inflammation, which is involved in the development of cerebral vasospasm after subarachnoid hemorrhage (SAH). In the present study, we assessed the potential role of NF-kappaB in regulation of cerebral vasospasm. Nuclear factor-kappaB DNA-binding activity was measured in cultured vascular smooth muscle cells (VSMCs) treated with hemolysate and pyrrolidine dithiocarbamate (PDTC, 80 micromol/L), an inhibitor of NF-kappaB. Forty-two rabbits were divided into three groups: control, SAH, and PDTC groups (n=14 for each group). The caliber of the basilar artery was evaluated. Nuclear factor-kappaB DNA-binding activity and the gene expression levels of cytokines and adhesion molecules in the basilar artery were measured. Immunohistochemical study was performed to assess the expression and localization of tumor necrosis factor (TNF)-alpha, intercellular adhesion molecule (ICAM)-1, and myeloperoxidase (MPO). It was observed that NF-kappaB DNA-binding activity was significantly increased by treatment with hemolysate in cultured VSCMs, but this increase was suppressed by pretreatment with PDTC. Severe vasospasm was observed in the SAH group, which was attenuated in the PDTC group. Subarachnoid hemorrhage could induce increases of NF-kappaB DNA-binding activity and the gene expression levels of TNF-alpha, interleukin (IL)-1 beta, ICAM-1, and vascular cell adhesion molecule (VCAM)-1, which were reduced in the PDTC group. Immunohistochemical study demonstrated that the expression levels of TNF-alpha, ICAM-1, and MPO were all increased in the SAH group, but these increases were attenuated in the PDTC group. Our results suggest that NF-kappaB is activated in the arterial wall after SAH, which potentially leads to vasospasm development through induction of inflammatory response.     

Status and trend of HIV-1 infection and AIDS in Taiwan, December, 1991.

From May 1, 1985 to December 31, 1991, a total of 4,962,707 serum samples from 8 population groups in Taiwan were tested for anti-human immunodeficiency virus type 1 (anti-HIV-1). In total, 256 samples were seropositive; of these individuals, 43 developed acquired immunodeficiency syndrome (AIDS): 29 were homosexuals; 5 were hemophiliacs; 8 were heterosexuals and 1 was of unknown risk. Although the prevalence of HIV-1 infection and AIDS remains low compared with other countries, since 1988 the increase has been rapid. Before 1977 the majority were homosexuals and hemophiliacs; thereafter the risk groups diversified, with a trend away from homosexuals and hemophiliacs towards heterosexuals and intravenous drug abusers (IVDAs). A few patients have caused serious social problems for the public, health care workers and families. Active community efforts are needed to achieve future success in the control of HIV-1 infection and AIDS in Taiwan.     

Effect of Ureaplasma urealyticum infection on IL-laand IL-6 secretion by rat Sertoli cells

Objective: To observe the effect of Ureaplasma urealyticum (UU) infection on the IL-1α and IL-6 secretion by rat Sertoli cells. Methods: Eight 20-day-old UU-free male SD rats (average weight 40 g) were used. Under sterile condition, the testes were removed and separately digested with collagenase typeⅡand hyaluronidase. High purity Sertoli cells were then isolated and adjusted to a concentration of 8×105/mL with DMEM/Ham's F-12. In the infected group, 1 mL Sertoli cell suspension and 100 mL UU (serotype 8, T960) were introduced into one well of a 24 well culture plate. In the control group, 1 mL Sertoli cell suspension and 100 mL medium were introduced. IL-1αand IL-6 were determined in the culture supernatant with ELISA. Results: The production of IL-1αwas significantly lower and of IL-6 significantly higher in the infected than those in the control groups (P<0.01). Conclusion: UU infection reduces the IL-1αand increases the IL-6 secretion by rat Sertoli cells. UU infection is probably involved in     

Computerized tomography based on DEI refraction information.

Conventional computerized tomography (CT) technique is based on the absorption contrast. In recent years, X-ray phase-contrast CT (PCCT) has been developing rapidly. It uses the phase information to reconstruct the object and provide high contrast and spatial resolution. Diffraction enhanced imaging (DEI) method is one of the three phase-sensitive X-ray imaging techniques. DEI method employs an analyzer crystal to extract the object's refraction information which can be used for CT. However, when DEI refraction CT is combined with the conventional CT algorithm, it should be satisfied that the refraction information of an arbitrary point in the object is invariable at every projection view. In this paper, the invariance condition of refraction information is analyzed and two feasible methods are provided for reconstruction. Using these two methods, two samples of weak absorption are reconstructed with the experimental data obtained at Beijing Synchrotron Radiation Facility (BSRF).     

Prevalence of depressive and anxiety disorders in an assisted reproductive technique clinic

Hum. Reprod., 19, 2313–2318, 2004 The following mistake