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31.
Awoniyi O. Awonuga Nicola Dean Jamal Zaidi Rudiger U. Pittrof Jinan S. Bekir Seang-Lin Tan 《Journal of assisted reproduction and genetics》1996,13(4):293-297
Aim: Our aim was to compare the outcome in subsequent frozen embryo replacement cycles in four groups of patients who had elective cryopreservation of all their embryos because they were considered to be at increased risk of developing severe ovarian hyperstimulation syndrome.
Design: Sixty-two (91%) of 68 IVF cycles (68 patients) in which elective cryopreservation of all embryos was performed were analyzed. All patients continued on the GnRH agonist, buserelin, after oocyte recovery until the onset of vaginal bleeding. Frozen embryo replacement occurred in a hormone replacement cycle that started either on day 3 of the withdrawal bleed (group I;N=15) or after serum estradiol levels had fallen to <100 pmol/L (group II;N=16). The other patients commenced a frozen embryo replacement cycle several months later in either a hormone replacement (group III;N=15) or a natural (group IV;N=16) cycle.
Results: Two patients developed severe ovarian hyperstimulation syndrome. There were no significant differences among the four groups regarding demographic variables, the dose of hMG used, and the clinical outcome. There was a higher but not significantly different clinical pregnancy rate in group I (26.7%), compared to group II (12.5%), group III (13.3%), and group IV (18.8%).
Conclusions: Several options exist for the timing and protocol used for frozen embryo replacement in patients who had elective cryopreservation for the prevention of ovarian hyperstimulation syndrome, none of which was found to be clearly superior in this observational report.Presented at the 1994 Annual Conference of the American Fertility Society. 相似文献
32.
Ischemic necrosis of the entire femoral head and rapidly destructive hip disease: potential causative relationship 总被引:6,自引:0,他引:6
Kyung Nam Ryu Eui Jong Kim Myung Chul Yoo Yong Koo Park David J. Sartoris Donald Resnick 《Skeletal radiology》1997,26(3):143-149
Objective. Rapidly destructive hip disease (RDHD) is an uncommon disorder of the hip that has been considered a disease of unknown cause
and distinct from ischemic necrosis of the femoral head. The objective of this study was to investigate ischemic necrosis
of the femoral head as one potential cause of RDHD. Design and patients. In 600 patients who underwent MR imaging of the hip, 20 cases of ischemic necrosis involving the entire femoral head in 18
patients (3%) were retrospectively studied with routine radiography and MR imaging. All patients had surgically confirmed
ischemic necrosis of the femoral head. Results and conclusions. All patients showed rapid destruction of the femoral head on routine radiography and MR imaging as compared with the gradual
onset of clinical symptoms. Plain radiographs showed several bone fragments at the inferomedial aspect of the femoral head
(75%), acetabular erosions (55%), eccentric depression at the lateral articular surface of the femoral head conforming to
the adjacent acetabulum (35%), and mild osteoarthritis (15%). Bone sclerosis was often present at sites of impaction between
the femoral head and the acetabulum. MR imaging showed marked distention of the joint capsule in all cases. In 14 of 20 cases,
the contents of the joint space showed predominantly low or intermediate signal intensity on T1- and T2-weighted images. Ischemic
necrosis involving the entire femoral head may represent one of the causes of RDHD. 相似文献
33.
We studied 100 patients who underwent an isolated aortic valve replacement (AVR) between 1974 and 1991. The patients were divided into the following two groups and compared: group A, which consisted of 40 patients operated on before 1978 who underwent continuous left coronary perfusion with blood; and group B, which consisted of 60 patients operated on after 1979 in whom St. Thomas solution was used in combination with topical cardiac cooling. Moreover, we divided the group B patients into two subgroups: group Bl, who underwent AVR before 1986 during which we administered St. Thomas solution with ice slush every 30 min; and group B2, who had AVR after 1986 in which we used St. Thomas solution with a cold saline (4°C) solution and treated with a small amount of slushed ice every 15 min. The incidence of supraventricular tachycardias was 15% in group A, 50% in group BI, and 15% in group B2. The severity of preoperative New York Heart Association (NYHA) functional class, the type of valve lesions, cardiothoracic ratio, left ventricular function, aortic clamp time, bypass time, and use of drugs did not correlate with the incidence of supraventricular tachycardias in either group A or B. In group B2 patients, we paid a lot of attention to cooling the right atrium as well as the left ventricle by immersing the whole heart using a 4°C saline solution, which led to a remarkable reduction of the incidence of supraventricular tachycardia. This fact indicates that right atrial preservation is one of the most important factors for reducing the incidence of supraventricular tachycardia. 相似文献
34.
Background: For patients with incurable malignant gastric outlet obstruction and cholestasis, laparoscopic gastrojejunostomy combined
with endoscopic biliary stent placement seems to offer a minimally invasive palliation.
Methods: We retrospectively analyzed the data of 16 patients submitted to laparoscopic gastrojejunostomy. Laparoscopic gastroenterostomy
was performed as an antecolic, side-to-side gastrojejunostomy with enteroenterostomy. In 12 patients cholestasis was relieved
preoperatively by stent placement via endoscopy (n= 6, 37.5%), percutaneous access (n= 5, 31%) or bilioenteric anastomosis (n= 1, 6.25%). One patient needed a percutaneous Yamakawa prosthesis postoperatively.
Results: Mean operative time was 126 min. There were no intraoperative complications. In one patient conversion to open surgery became
necessary because of extensive adhesions. The only postoperative complication was bleeding from a trocar site requiring reintervention;
there was no mortality. Median postoperative hospital stay was 7 days. Delayed gastric emptying was observed in 3 (18.7%)
patients. Median survival was 87 days after the operation. All patients died from their primary disease but could maintain
oral intake during the remaining survival time.
Conclusions: We conclude that laparoscopic gastrojejunostomy and endoscopic or percutaneous biliary stenting provide a good functional
result while impairing the quality of life only to a minimal extent.
Received: 7 May 1996/Accepted: 12 December 1996 相似文献
35.
羟基磷灰石涂层人工股骨柄的临床应用 总被引:5,自引:0,他引:5
自1989年12月~1993年11月,共收治各类髋关节病14例(15髋),均行FURLONG羟基磷灰石(HA)涂层人工髋关节置换术。术后平均随访32个月,髋关节功能按Haris评分结果为平均95分。无患肢疼痛和其它不适症状,亦无术后并发症发生。X线结果显示,股骨侧假体无松动、下沉表现,周围未见明显透亮线。术后3个月假体表面出现增生性骨反应,并在术后3~4年内逐渐增加。无明显骨萎缩表现。结合实验及临床研究结果,证明此种髋假体应用的短期疗效令人满意,其长期疗效尚有待进一步观察。 相似文献
36.
T. Vander M. Medvedovsky I. Shelef L. Duchano A. Tomer Y. Herishanu 《European journal of neurology》2004,11(8):569-571
While a dural sinus thrombosis (DST), is a well-known consequence of the use of oral contraceptives, the role of hormone replacement therapy (HRT) in DST was not previously evaluated. We report two postmenopausal women, presenting with DST under HRT. Antiphospholipid antibodies in one case and borderline protein S deficiency in another were diagnosed. Only five cases of DST under HRT were previously reported and in two of them additional prothrombotic risk factors were found. According to these and previous cases, HRT is not an independent risk factor for DST. 相似文献
37.
全髋置换术对下肢短缩的治疗 总被引:1,自引:0,他引:1
目的:探讨全髋关节置换术对肢体短缩的纠正。方法:2000年2月~2002年12月,将30例接受单侧全髋关节置换术的患进行了研究:男19例,女12例。术前通过临床及对骨盆前后位X线片的测量评估双下肢不等长的程度,然后利用模板预测髋臼及股骨假体的置入位置,估计股骨颈的截骨水平以维持双下肢等长。术中先标记并测量股骨近端至髋臼上方两标记之间的距离,而后在术前估计的位置进行股骨颈截骨。置入假体试模之后再次测量两标记之间的距离和检查髋周软组织的张力、关节活动和drop-kick试验。最后通过调整股骨头假体颈部或头部长度进一步进行纠正。结果:22例肢体短缩2cm以上的病人中。术后双下肢等长(双下肢相差在1cm内)20例,2例仍有短缩,1例短3cm,另1例短1.5cm。8例肢体短缩在1~2cm的病人术后肢体完全等长。全部病人没有髋关节的僵硬和疼痛,活动范围恢复75%以上26例,恢复50%~75%4例。结论:通过术前测量评估,术中定位测量。术中软组织充分松解,置入假体试模后再次测量和检查髋周软组织的张力、关节活动和drop-kick试验,可以有效地治疗下肢的短缩。 相似文献
38.
Makoto Kamada Kenji Ohsaka Susumu Nagamine Hidemitsu Kakihata 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2003,51(10):552-556
Acute aortic dissection complicated with acute myocardial infarction (AMI) is the most fatal situation. We experienced the
successful treatment for acute type A aortic dissection complicated with inferior AMI following aortic valve replacement (AVR).
A 60-year-old man had had AVR for aortic regurgitation. Sixteen months after the AVR, he had a sudden onset of severe chest
pain with complete atrioventricular block. Immediately, temporary pacing and cardiac catheterization were conducted, showing
the occlusion of the right coronary artery due to acute type A aortic dissection. On his way to our hospital, direct current
shock was conducted 3 times for ventricular fibrillation. We replaced the ascending aorta combined with coronary artery bypass
grafting and the postoperative course was uneventful. The key to treat acute aortic dissection complicated with AMI is early
accurate diagnosis, prompt temporary pacing for bradycardia, defibrillation for lethal arrhythmia and insertion of a perfusion
catheter if possible. These preoperative hemodynamic stabilization gives us the chance to save these patients. 相似文献
39.
Gassel H. -J. Engemann R. Hutchinson I. V. Morris P. J. 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1987,372(1):941-942
Summary After orthotopic rat liver transplantation in the fully allogeneic BN (RT-1n) to LEW (RT-11) combination, the phenomenon of spontaneous tolerance of donor antigen occurs. We demonstrate two different immune mechanisms that may account for this process. Using adoptive transfer assays we show the presence of donor-specific T-suppressor lymphocytes in the spleens of long-term surviving liver graft, recipients. These cells prolong - adoptively transferred into irradiated syngeneic hosts — the survival of donor-specific (BN) but not third-party (DA) renal allografts (I00 days vs 1I days in control groups). Secondly, we demonstrate the replacement of Kupffer cells in the graft by recipient macrophages using polymorphic monoclonal antibodies in an immunoperoxidase technique. This may contribute to graft adaptation and thus to long-term graft acceptance. 相似文献
40.
Tun Li Myung G. Lee Win L. Chiou 《Journal of pharmacokinetics and pharmacodynamics》1986,14(5):495-509
Effects of differences in the rate and composition of intravenous fluid replacement for urine loss on the pharmacokinetics and pharmacodynamics of furosemide were evaluated using the dog as a model animal. Each of six dogs received 8-hr constant intravenous infusion of 20 mg (15 mg used in one dog) of furosemide with 0% replacement (treatment I), 50% replacement (treatment II), and 100% replacement (treatment III) with lactated Ringer's solution, as well as with 100% replacement with 5% dextrose in water (treatment IV). Most pharmacokinetic parameters, such as plasma clearance, steady-state volume of distribution, mean residence time, and terminal half-life, were essentially the same in all four treatments. Renal clearances and urinary excretion rates of the drug in treatments II–IVwere essentially the same, but about 20% higher than those in treatment I.In spite of the similarities in kinetic properties, diuretic and/or natriuretic effects from furosemide were markedly different among the four treatments. For example, mean 10-hr urine outputs were 646, 1046, 3156, and 1976 ml and mean 10-hr sodium excretions were 87.0, 142, 383, and 97.2 mmole for treatments I–IV,respectively. Except for treatment III,diuresis and/or natriuresis were found to be time-dependent, generally decreasing with time until reaching a low plateau during later hours of infusion. The present findings also showed that (1)no fluid replacement and 100% replacement with 5% dextrose solution both produced the same degree of severe acute tolerance in natriuresis, indicating the insignificance of water compensation in tolerance development; (2)in treatment II,where neutral sodium balance was achieved, the development of acute tolerance in diuresis and natriuresis can mainly be attributed to negative water balance under this special condition; (3)at steady state the hourly diuresis and natriuresis could differ up to about ten times between treatments. Some implications for the kinetic/dynamic relationship or modeling, in the clinical use, and in the bioequivalence evaluation of dosage forms are discussed. 相似文献