Endometrial fluid collection in women with hydrosalpinx after human chorionic gonadotrophin administration: a report of two cases and implications for management

The impact of hydrosalpinx (HSPX) on in-vitro fertilization (IVF) outcome has recently been the subject of intense debate. Most, but not all, studies have reported decreased implantation and pregnancy rates and increased early pregnancy loss in HSPX patients. This has led to prophylactic salpingectomies prior to IVF in HSPX patients despite the lack of any prospective studies to suggest that any improvement will occur. Women with HSPX constitute a heterogeneous population because some conceive easily with IVF while others do not until after surgical correction. HSPX also increases in size with ovarian stimulation, and can cause implantation failure by fluid reflux into the uterine cavity. Careful assessment of the endometrial lining is mandatory in HSPX to rule out fluid reflux from the HSPX. We present two case reports of patients whose HSPX enlarged with ovarian stimulation, causing fluid reflux into the uterine cavity which was only noted after human chorionic gonadotrophin (HCG) administration.      

Maternal hypothermia: an unusual complication of magnesium sulfate therapy

Reported is a case of maternal hypothermia associated with magnesium sulfate therapy for treatment of preterm labor. Hypothermia was accompanied by fetal and maternal bradycardia. After discontinuation of magnesium sulfate infusion, maternal temperature, pulse, and fetal heart rate gradually returned to normal. No adverse effects were noted on either maternal or fetal outcome.     

Housing satisfaction for persons with psychiatric disabilities

Provision of residential services to people with mental illness has assumed increasing importance since deinstitutionalization and as community‐ based services have increased. This large‐scale multisite study of housing programs specifically for persons with mental illness examines one of the factors that lead to successful residential tenure for persons with serious mental illness. To date, the Lehman Quality of Life Scale has been used primarily to assess satisfaction with housing in studies of residential services. This article reports on a new measure of housing satisfaction. This new 25‐item instrument was developed, field tested in a variety of housing settings across the country, and analyzed for reliability and validity by a group of housing researchers and clinicians. The implications of using this instrument for future evaluation and research on housing for persons with mental illness are examined. © 2003 Wiley Periodicals, Inc. J Comm Psychol 31: 581–590, 2003.     

The relationship between body balance function and occlusal function during the mixed dentition period

The aim of this study was to investigate the relation between body balance and occlusal balance during the mixed dentition stage. Fifty-six healthy children with Hellman's Dental Age IIIA: (31 boys and 25 girls) with an average age of 8.1 years, were selected from an elementary school. The body balance, distance and area of gravity center movement (GCM) were measured with automatic posture analytical devices. Occlusal abilities were measured with pressure-sensitive sheets (Dental Prescale^®), including occlusal contacts area, average occlusal pressure, maximum occlusal pressure, occlusal force and occlusal balance. Analysis of occlusal balance was determined by separating the middle group (| x | ≤ 5 mm) from the deflection group (| x | > 5 mm) based on the position of occlusal balance center. Similarly, the children were instructed to perform the GCM area of eyes-closed exercise. The first 25% of the participants with the best balance were grouped as the good balance group; and the last 25% with the worse balance were grouped as the bad balance group. Results showed that occlusal contact area and occlusal force of the middle group were more than the deflection group, GCM distance and area of the middle group were less than the deflection group. occlusal contacts area and occlusal force of the good balance group were more than the bad group. Body balance function and occlusal balance function were observed to have mutual influence during Hellman's Dental Age IIIA stage in this study.     

Fat-to-glucose interconversion by hydrodynamic transfer of two glyoxylate cycle enzyme genes

The glyoxylate cycle, which is well characterized in higher plants and some microorganisms but not in vertebrates, is able to bypass the citric acid cycle to achieve fat-to-carbohydrate interconversion. In this context, the hydrodynamic transfer of two glyoxylate cycle enzymes, such as isocytrate lyase (ICL) and malate synthase (MS), could accomplish the shift of using fat for the synthesis of glucose. Therefore, 20 mice weighing 23.37 ± 0.96 g were hydrodinamically gene transferred by administering into the tail vein a bolus with ICL and MS. After 36 hours, body weight, plasma glucose, respiratory quotient and energy expenditure were measured. The respiratory quotient was increased by gene transfer, which suggests that a higher carbohydrate/lipid ratio is oxidized in such animals. This application could help, if adequate protocols are designed, to induce fat utilization for glucose synthesis, which might be eventually useful to reduce body fat depots in situations of obesity and diabetes.     

Chirurgische Behandlung infizierter Knochendefekte

Zusammenfassung Die unhappy triad der Knochenchirurgie, Infekt, Defekt und Instabilität stellt uns auch heute noch vor schwer zu lösende Probleme. Das Vorgehen der Wahl scheint uns die Stabilisierung der Fragmente mittels einer internen (Osteosynthese) oder externen (äußere Spanner) Fixation, die radikale Ausräumung des Herdes, die vorübergehende Spüldrainage nach Willenegger [26, 27, 28] und schließlich das Auffüllen des Defektes mit autologer Spongiosa zu sein. Bei allen unseren in dieser Studie erfaßten 25 Patienten kam es zum knöcherner Einbau des Transplantates und Abheilung des Haut- und Weichteildefektes, bei vier Patienten be schleunigte eine Spalthautverpflanzung die Heilung. 23 Fälle sind 1 bis 6 Jahre nach der Behandlung vom Infekt her rezidivfrei geblieben, bei sämtlichen Patienten konnte die Belastungsstabilität erreicht werden.Durch das beschriebene Vorgehen konnte in allen Fällen die Gelenkfunktion erhalten oder verbessert werden. Das aktive Eingreifen gestattet zudem Achsen- und Längenkorrekturen.Klinische, szintigraphische und histologische Untersuchungen zeigen, daß der Einbau des spongiösen Transplantates unmittelbar nach der Verpflanzung einsetzt und nach 3 Monaten soweit fortgeschritten ist, daß die Belastungsstabilität erreicht wird.

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Autogenous cancellous bone in osteomyelitis with defects of bone, soft tissue and skin

Summary Surgeons are still confronted with the grave problem of the unhappy triad of bone surgery, i.e. infection, osseous defect and instability. To us the stabilisation of fragments by means of internal or external fixation, the radical saucerization and packing of the cavity with autogenous cancellous bone with preceding irrigation drainage seems to be the procedure best suitable. 25 patients with infected defects of bone, soft tissue and skin were treated accordingly and followed up 1 to 6 years later: In all cases the graft had been integrated and the skin- and soft tissue defects had healed. In 23 cases osteomyelitis had not re-occured, weight bearing stability had been achieved in all 25 cases.The described procedure had either maintained or even improved articular function. Additionally the active intervention allowes correction of axis and length.It is demonstrated by radiological, scintigraphical and histological examinations, that the integration of the cancellous bone transplant begins immediately after transplantation and is advanced within three months to such a point that weight bearing becomes possible.

     

Second trimester maternal serum analytes in triploid pregnancies: correlation with phenotype and sex chromosome complement

Second trimester maternal serum alpha-fetoprotein (MS-AFP), human chorionic gonadotrophin (hCG), unconjugated estiol (uE3), and inhibin-A (INH-A) levels were evaluated in pregnancies complicated by triploidy. In addition to seven new triploid pregnancies, the results for 67 published cases were reviewed. All cases appear to fall into two major groups. First, those identifiable as screen-positive for both Down syndrome and an open neural tube defect (ONTD) with elevated MS-AFP, grossly elevated hCG, low/normal uE3, and probably elevated INH-A. Pregnancies in the second group are identifiable as screen-positive for trisomy 18 with low/normal MS-AFP, and very low hCG, uE3 and INH-A. Triploid pregnancies with high maternal serum hCG nearly always show a placenta with partial mole (25/27 or 93%), a high frequency of ONTDs or ventral wall defects (VWDs) (8/28 or 29%) and have either an XXX or XXY karyotype (observed ratio 6:10, respectively). Low hCG is infrequently associated with a molar placenta (1/11 or 9%), does not appear to be associated with ONTDs or VWDs (0/29 or 0%), and shows an excess of XXX over XXY karyotypes (observed ratio 17:2). There were 16 cases with either a molar placenta, an ONTD or a VWD that received the MS-AFP and hCG tests. All 16 were screen-positive for an ONTD (MS-AFP> or =2 multiples of the median). In addition, all 31 cases that received MS-AFP, hCG, uE3 (and where available INH-A) were screen-positive for either Down syndrome or trisomy 18. The findings are discussed in the context of expected differences between digynic and diandric triploidy. It is suggested that the sex chromosome complement in triploidy is an important factor in determining risk for partial mole development and in utero survival.