Induction of ovulation with D-Trp6-LHRH combined with purified FSH in patients with polycystic ovarian disease

Seventeen patients with polycystic ovarian disease (PCOD) and evidence of mild or severe ovarian hyperstimulation syndrome (OHSS) during therapy with CC/hCG, FSH/hCG or hMG/hCG were treated with D-Trp6-LHRH until medical gonadectomy was attained. Under the suppressive therapy with the GnRH agonist (GnRHa) ovulation was induced with FSH/hCG. In 15 out of 17 patients, ovulatory cycles were obtained with this new modality of treatment. Seven patients conceived (3 viable pregnancies and 4 early abortions) after the 1st treatment cycle. Fourteen of the 17 patients demonstrated symptoms of mild OHSS which did not require hospitalization. Only 1 patient developed severe OHSS after the combined treatment. Our results suggest that therapy with GnRHa, especially in its delayed release formulation, is effective for the prevention of severe ovarian hyperstimulation in PCOD patients undergoing treatment with menotropins for the induction of ovulation.     

Operant and cognitive intervention to restore effective functioning following a death in a family

The present case study describes the successful reduction of aggressive behavior of an adolescent by combining cognitive intervention with operant techniques in order to restore effective family functioning.     

First trimester bleeding in clinical IVF pregnancies

First trimester bleeding has been investigated in 72 pregnantwomen undergoing in-vitro fertilization and embryo transferand was compared to 70 pregnant patients in whom ovula tionwas induced, in addition to 70 spontaneous pregnancies. Abortionrates did not differ significantly between the first two groupsbut were significantly higher in comparison to normal pregnancies.Furthermore, among IVF pregnancies that continued, a high incidenceof first trimester bleeding occurred (P < 0.01). This complicationwas mainly related to luteal insufficiency and multiple pregnancies,whereas hyperstimulation was the major risk factor for bleedingin pregnancies arising from HMG-induced ovulation. Other currentlyunknown, aetiological factors for first trimester bleeding inIVF pregnancies remain to be investigated.     

Mitochondrial abnormalities in oculopharyngeal muscular dystrophy

A family with oculopharyngeal muscular dystrophy (OPMD) is described. Histological and histochemical studies of muscle biopsy showed nonspecific myopathic changes; no "ragged-red" fibers were seen. Electron microscopy demonstrated bizarre large mitochondria with abnormal cristae, but no intranuclear inclusion bodies. Our findings are compatible with the possibility that OPMD is a heterogeneous syndrome, and may be a manifestation of mitochondrial myopathy.     

Evaluation of a CT-Guided Robotic System for Precise Percutaneous Needle Insertion

Purpose

To assess overall targeting accuracy for CT-guided needle insertion using prototype robotic system for common target sites.

Transient osteoporosis of the hip during pregnancy. A case report.

Transient hip osteoporosis is a benign, process mainly affecting men. A 31-year-old woman in the 31st week of pregnancy was diagnosed as having the disorder. Impairment of venous flow associated with pregnancy might have been the cause of the osteoporosis and superficial thrombophlebitis.     

Gradual cervical dilation for termination of early second-trimester pregnancy with a double balloon device

Thirty-two women with pregnancies of 12-15 weeks underwent cervical dilation before abortion using a double balloon device. In all cases, satisfactory dilation was achieved and evacuation accomplished. The slow dilation process, resulting from the continuous indirect dilator effect of the balloons, was not associated with patient inconvenience in most cases. Larger dilation was achieved by adding a continuous instillation of extraovular prostaglandin E2 solution through the device. The double balloon device is a convenient and safe cervical dilator and may be a suitable method for cervical dilation before abortion.     

Idiopathic Subjective Tinnitus Treated by Amitriptyline Hydrochloride/Biofeedback

The efficiency of two treatment modalities for subjective/idiopathic tinnitus (SIT): biofeedback (BF) and amitriptyline hydrochloride (AT) was investigated in 225 randomly selected subjects. Findings show that after 10 weeks of treatment in the BF group, 43.5% of the patients reported an improvement of tinnitus during activity. In the AT group, 27.5% of patients reported subjective improvement of tinnitus at rest although only 15.8% of the AT patients reported improvement during activity. Biofeedback during rest had a significantly better effect on tinnitus disturbance than AT. No objective diminishment of tinnitus loudness was found as a result of any of the treatment modalities. We believe that BF can help tinnitus patients especially during periods of rest and we also suggest trying tricyclic antidepressant drugs such as AT for treatment of tinnitus patients, in small doses, however, to minimize the side effects of this drug. Subjective tinnitus (ST) is one of the most common and yet most unclear of otologic symptoms.(1-4) ST can accompany any type of hearing loss including both sensorineural as well as conductive hearing loss, and may originate from any part of the auditory pathway.(1,5) Treatment of ST must be primarily directed to the basic illness diagnosed after a thorough general ear-nose-throat and neurologic evaluation.(6) Severity of ST is evaluated both objectively, by determining the pitch and intensity of the tinnitus,(7) and subjectively as described by the patient. Because of the relatively high incidence of ST and in some patients, the severe personal reaction to it, many different treatments have been suggested, but generally only small to moderate success has been achieved in reducing tinnitus and its consequences, if any at all.(8) In this study we examined the effect of two treatment modalities: amitriptyline hydro-chloride and biofeedback.