Evidence from a salvaged treatment cycle supports an aetiology for the empty follicle syndrome that is related to terminal follicular developmental events

Oocyte retrieval in a stimulated in-vitro fertilization treatment cycle was unsuccessful when inadvertently carried out 12 h after the administration of human chorionic gonadotrophin (HCG) injection. Repeat follicular aspiration at 36 h post-HCG injection recovered 20 oocytes, out of which 16 metaphase-II eggs were subjected to intracytoplasmic sperm injection and eight became fertilized. Uterine transfer of three cleaving embryos resulted in a singleton pregnancy which went to term and a healthy female infant was delivered. Our experience shows that in addition to issues of HCG bioavailability to the developing follicles, the temporal relationship between HCG administration (or the luteinizing hormone surge) and follicular aspiration is also an important consideration in the determination of the aetiology of the empty follicle syndrome.      

A Tissue Mimicking Polyacrylamide Hydrogel Phantom for Visualizing Thermal Lesions Generated by High Intensity Focused Ultrasound

An optically transparent tissue-mimicking (TM) phantom whose acoustic properties are close to those of tissue was constructed for visualizing therapeutic effects by high intensity focused ultrasound (HIFU). The TM phantom was designed to improve a widely used standard bovine serum albumin (BSA) polyacrylamide hydrogel (PAG), which attenuated ultrasound far less than tissue and, unlike tissue, did not scatter ultrasound. A modified recipe has been proposed in the study by adding scattering glass beads with diameters of 40–80 μm (0.002% w/v) and by raising the concentration of acrylamide (30% v/v). The TM BSA-PAG constructed has an acoustic impedance of 1.67 MRayls, a speed of sound of 1576 m/s, an attenuation coefficient of 0.52 dB/cm at 1 MHz, a backscattering coefficient of 0.242 × 10⁻³ 1/sr/cm at 1 MHz and a nonlinear parameter (B/A) of 5.7. These parameters are close to those of liver. The thermal and optical properties are almost the same as the standard BSA-PAG. The characteristic features of the thermal lesions by HIFU were observed to be more accurately visualized in the TM BSA-PAG than in the standard BSA-PAG. In conclusion, the proposed TM BSA-PAG acoustically mimics tissue better than the standard BSA-PAG and is expected to be preferentially used for assuring if a clinical HIFU device produces the thermal lesion as planned.     

Reconstruction of a Columellar Defect With a Nasolabial Island Flap

Columellar skin defects may be caused by excision of cutaneous malignancy, trauma, or tissue necrosis associated with surgery. Although columellar skin necrosis rarely occurs following rhinoplasty, this condition might be more common when using an external approach than a closed approach. Columellar skin incision performed with exaggerated tip augmentation may cause columellar necrosis. The nasolabial island flap, used unilaterally to cover columellar skin defects, is used for a single-stage reconstruction procedure and is generally not associated with the need for secondary surgeries. This technique is well suited for repairing columellar skin defects. We experienced a patient with columellar skin necrosis occurring after rhinoplasty which was reconstructed using a unilateral single-stage nasolabial island flap.     

Results of percutaneous epididymal sperm aspiration and intracytoplasmic sperm injection in two major groups of patients with obstructive azoospermia

Percutaneous epididymal sperm aspiration (PESA) and intracytoplasmic sperm injection (ICSI) were carried out in patients with congenital bilateral absence of the vas deferens (CBAVD) and men with failed reversal of vasectomy (FRV). PESA was successful in 55 out of 62 patients with CBAVD (89%) and in 57 out of 60 men with FRV (95%). The fertilization rates after ICSI (53 and 55%), cleavage rates (70 and 76%) and pregnancy rates (36 and 32%) did not differ significantly between the two respective groups (CBAVD and FRV). PESA and ICSI are effective both in patients with CBAVD and in those with FRV.      

Changes of urinary nerve growth factor and prostaglandins in male patients with overactive bladder symptom

AIM: Nerve growth factor (NGF) and prostaglandins (PG) in the urinary bladder can be affected by pathology of bladder, and this change can be noted in the urine. This study was performed to investigate the changes in urinary NGF and PG in male patient with overactive bladder (OAB) symptoms. METHODS: The study group included 75 male patients with OAB symptoms and 20 males without bladder symptoms as controls. Evaluation included history-taking, urinalysis, International Prostate Symptom Score (IPSS) and urodynamic study. The NGF, PGE2, PGF(2alpha) and PGI2 levels in voided urine were analyzed by enzyme linked immunosorbent assay and these results were compared in control and OAB patients. Also, the urinary levels of NGF and PG were correlated with IPSS score and urodynamic parameters in OAB patients. RESULTS: The urinary levels of NGF and PGE2 were signi fi cantly increased in patients with OAB compared with control (P < 0.05). The urodynamic study in OAB patients showed that more than half of the patients had detrusor overactivity and bladder outlet obstruction. The incidence of detrusor underactivity was noted in seven patients in the OAB group. The urinary level of PGE2 was decreased in patients with detrusor underactivity compared with patients without detrusor underactivity (P < 0.05), and negatively correlated with maximum bladder capacity in OAB patients (P < 0.05). CONCLUSIONS: NGF and PG may have important role in male patients with OAB, and the urinary level of PGE2 can change according to detrusor function. Therefore, these results may be used as urinary markers to evaluate the OAB symptoms.