Percutaneous needle aspiration has been widely used in the diagnosis of pulmonary lesions, because it is a fairly simple procedure with good diagnostic accuracy and low complication rate. Among its complications, the spread of malignant cells along the needle tract is rare but serious one. We report a case of chest wall implantation of lung cancer after the percutaneous fine needle aspiration biopsy. A 57-year-old man had undergone a right upper lobectomy for squamous cell carcinoma [T2N0M0] of the lung, 3 months after the operation, a growing mass, located far from the previous thoracotomy incision, developed on the right anterior chest wall where the diagnostic thin needle biopsy had been performed before the lobectomy. A wide excision of the chest wall mass was performed, and permanent histology showed squamous cell carcinoma as noted before.
Objective: This study was performed to compare the clinical outcomes of GnRH antagonist (Cetrorelix) single dose and multiple dose protocols for controlled ovarian hyperstimulation with GnRH agonist long protocol. Materials and Method: From September 2001 to March 2002, 48 patients (55 cycles) were performed controlled ovarian hyperstimulation for ART using by either GnRH antagonist and GnRH agonist. Single dose of 3 mg GnRH antagonist was administered in 15 patients (17 cycles, single dose group) at MCD #8 and multiple dose of 0.25 mg of GnRH antagonist was administered in 15 patients (18 cycles, multiple dose group) from MCD #7 to hCG injection day. GnRH agonist was administered in 18 patients (20 cycles, control group) by conventional GnRH agonist long protocol. We compared the implantation rate, number of embryos, and clinical pregnancy rate among three groups. Student-t test and Chi-square were used to determine statistical significance. Statistical significance was defined as p<0.05. Results: There were no significant differences in ampules of used gonadotropins, number of mature oocytes, obtained embryos between single and multiple dose group, but compared with control group, ampules of used gonadotropins, number of mature oocytes, obtained embryos were decreased significantly in both groups. Clinical pregnancy rate and implantation rate were not different in three groups. There were no premature LH surge and ovarian hyperstimulation syndrome in three groups. Multiple pregnancy were occurred 1 case in multiple dose group and 2 case in control group. Conclusions: GnRH antagonist is a safe, effective, and alternative method in the controlled ovarian hyperstimulation compared with GnRH agonist. Clinical outcomes and efficacy of both single and multiple dose protocol are similar between two groups.
Objectives: The purpose of this systematic review is to assess the effects of herbal medicine with in vitro fertilization-embryo transfer (IVF-ET) based on the current evidence. Methods: Eligible randomized controlled trials (RCT) searched from Pubmed which compared a combination of herbal medicine and IVF with IVF alone were included. Results: Sixteen trials, in which 2025 women involved, were included in this review. The review results showed that the effect of traditional herbal medicine can improve the clinical pregnancy rate (herbal medicine intervention: 30.36~63.64%, Control: 9.38~47.5%) and rate of high quality oocytes and embryos. The mechanism may be through regulating follicular fluid to improve microenvironment for oocytes which would lead to a successful embryo implantation. Conclusions: This analysis showed that combination of IVF and traditional herbal medicine used in the included trials improve clinical pregnancy rate and IVF success. During in vitro fertilization, TCM can regulate the microenvironment in the follicular fluid to mature the oocyte, improve the quality of the embryo, and help the development and implantation of the embryo. Further large randomized placebo controlled trials are needed to confirm the effectiveness of traditional herbal medicine with concurrent IVF.
The use of osseointegrated implant has been reported that is an acceptable procedure for the restoration of totally or partially edentulous patient and that offers good predictability of long term success. It is difficult to get high success rate in edentulous maxillae with inadequate bony quality and quantity, and anatomic limitations such as pneumatic maxillary sinus and nasal floor. The various trials such as sinus lifting, bone grafting, guided bone regeneration, trabecular condensation with osteotome, and the use of wide-diameter implant have been introduced to solve these problems. This study was undertaken to assess the evaluation of clinical prognosis of the implant restorations with these various implantation techniques in the maxillary edentulous area. One hundred eight patients were treated with a total of 386 endosseous implants from March 1994 to January 1998 at Dept. of Dentistry, Korea Veterans Hospital in Seoul Korea. The various techniques for implantation in the edentulous maxillae were supplied to overcome the limitations of implant fixation. These techniques consist of sinus lifting, guided bone regeneration, onlay bone grafting, and osteotome trabecular condensation technique. The total success rate of implant restoration of this study was 93% in the maxillae. The success rate of implant restorations with conventional technique was 94.6%, with osteotome trabecular condensation technique was 94.1%, with guided bone regeneration technique was 93.3%, with bone grafting technique was 92.9%, with sinus lifting technique was 83.8%. The success rate on the maxillary anterior area was 95.2% and that on the posterior area was 91.9%. The failures were associated not only with surgical installation techniques but also bony quality and quantity, characteristics of implant, and stress distribution when in function.
Background: There are no guidelines for the optimal incubation time or temperature to improve pregnancy outcomes in testicular sperm extraction-intracytoplasmic sperm injection (TESE-ICSI) cycles. We aimed to evaluate whether a 24-hour in vitro culture of testicular spermatozoa affects pregnancy outcomes in TESE-ICSI cycles. Methods: This was a retrospective study of 83 TESE-ICSI cycles using testicular spermatozoa in 46 couples with male partners suffering from nonobstructive or obstructive azoospermia. Sperm retrieval was performed either on the oocyte retrieval (OR) day (65 cycles in 33 couples; group A) or on the day before OR (18 cycles in 13 couples; group B) followed by in vitro culture for 24 hours. The clinical characteristics and pregnancy outcomes, including the number of retrieved oocytes, fertilization rates, embryo transfer rates, implantation and clinical pregnancy rates, were compared between the two groups. Results: There were no differences in terms of clinical characteristics except for the levels of luteinizing hormone (LH) in males. Group B had higher LH levels than group A (4.56±1.24 IU/L vs. 3.67±1.07 IU/L, p= 0.017). Group B showed higher fertilization rate (72.4%±32.1% vs. 59.2%±21.7%, p=0.045), implantation rate (35.0%±34.1% vs. 14.0%±21.5%, p=0.010), pregnancy rate per cycle (80% vs. 39%, p=0.033), and clinical pregnancy rate per cycle (80% vs. 37.5%, p=0.024) than those of group A. Conclusion: Testicular sperm retrieval performed on the day before OR followed by in vitro culture can potentially improve pregnancy outcomes.
Kim, Min Ji;Lee, Hyun Jung;Yu, Young;Seo, Back Kyung;Cha, Sun Hwa;Kim, Hae Suk;Song, In Ok;Byun, Hye Kyung;Koong, Mi Kyoung;Kang, Inn Soo;Yang, Kwang Moon
Clinical and Experimental Reproductive Medicine
/
v.32
no.3
/
pp.243-251
/
2005
Objective: Low-dose aspirin have been proposed to improving endometrial receptivity and pregnancy rate in COH-IVF by increasing endometrial perfusion. However, the effect of low-dose aspirin in COH-IVF could be negligible because there have been large quantity of other important factors responsible for changing endometrial perfusion accompanied by COH procedure. In contrast, in frozen-thawed embryo transfer cycles which were not accompanied by COH procedure, the effects of low-dose aspirin in endometrial blood flow seems to be more certain than in COH-IVF cycles. In this study, we analyzed the effect of low-dose aspirin treatment on implantation and pregnancy rates in patients undergoing frozen-thawed embryo transfer Methods: From January 2003 to December 2003, total 264 cycles from 264 patients who attended infertility clinic at Samsung Cheil Hospital were enrolled in this study. All cases included in this study, embryos were frozen and thawed at the pronuclear stage and three days after incubation, at least 2 or more good quality embryos were transferred into uterus. In study group, low dose aspirin (100 mg/day) was administrated from the first or second date of menstrual day to 9 days after embryo transfer. On the other hand, control group did not take any medicine except estradiol valerate for endometrial priming. Several variables including implantation and pregnancy rates were compared in both groups. After then, each groups were stratified by endometrial thickness checked at embryo transfer (ET) day such as (28 mm versus <8 mm) and same variables above described were compared between study and control groups. Results: The mean age, infertility duration, endometrial thickness at embryo transfer day and mean number of transferred embryo were not significantly different in both groups. Also, implantation rates (study group: 15.8%, control group: 20.5%) and pregnancy rate (study group: 45.1%, control group: 43.5%) were not significantly different between two groups. (p>0.05) After we analyzed same variables stratified by endometrial thickness checked at embryo transfer day, we could not found any significant difference between study and control groups. Conclusions: Low-dose aspirin treatment seems to have no advantage of improving implantation and pregnancy rates in patients undergoing frozen-thawed embryo transfer.
Background: The detection of circulating microemboli by transcranial Doppler ultrasonography (TCD) has the potential to select the patients with high risk for future symptomatic brain embolism. We prospectively evaluated the positive rate and the frequency of microembolic signals (MES) before and after the heart valve surgery (HVS). Material and Method: Fifty in-patients with heart valve disease were enrolled in this study. Patients with history of previous stroke or heart valve surgery were excluded. Two unilateral TCD monitoring sessions were peformed from middle cerebral artery for 1-hour, before and after HVS. Result: Mechanical Heart valves were implanted in 28 patients, tissue valves were implanted in 10 patients, and remaining 12 patients received mitral valve repair. Positive rate of MES was significantly increased after HVS (50%), compared to that of before HVS (8%, p=0.00). There was no relation between MES after HVS and intensity of anticoagulation, cardiac rhythm, patients' age, and history of hypertension. The positive rate of MES after implantation of mechanical heart valve (71.4%) was significantly higher than those after implantation of tissue valve or mitral valve plasty (p=0.002). Conclusion: Positive rate of MES was increased significantly after the implantation of HVS. The changes of MES in those with mechanical prosthesis may be related to the increased risk or embolism after Hvs.
Hwang, Ji Young;Park, Jae Kyun;Kim, Tae Hyung;Eum, Jin Hee;Song, Haengseok;Kim, Jin Young;Park, Han Moie;Park, Chan Woo;Lee, Woo Sik;Lyu, Sang Woo
Clinical and Experimental Reproductive Medicine
/
v.47
no.4
/
pp.312-318
/
2020
Objective: The objective of the study was to compare the effects of long-term and short-term embryo culture to assess whether there is a correlation between culture duration and clinical outcomes. Methods: Embryos were divided into two study groups depending on whether their post-warming culture period was long-term (20-24 hours) or short-term (2-4 hours). Embryo morphology was analyzed with a time-lapse monitoring device to estimate the appropriate timing and parameters for evaluating embryos with high implantation potency in both groups. Propensity score matching was performed to adjust the confounding factors across groups. The grades of embryos and blastocoels, morphokinetic parameters, implantation rate, and ongoing pregnancy rate were compared. Results: No significant differences were observed in the implantation rate or ongoing pregnancy rate between the two groups (long-term culture group vs. short-term culture group: 56.3% vs. 67.9%, p=0.182; 47.3% vs. 53.6%, p=0.513). After warming, there were more expanded and hatching/hatched blastocysts in the long-term culture group than in the short-term culture group, but there was no significant between-group difference in embryo grade. Regarding pregnancy outcomes, the time to complete blastocyst re-expansion after warming is shorter in women who became pregnant than in those who did not in both culture groups (long-term: 2.19±0.63 vs. 4.11±0.81 hours, p=0.003; short-term: 1.17±0.29 vs. 1.94±0.76 hours, p=0.018, respectively). Conclusion: The outcomes of short-term culture and long-term culture were not significantly different in vitrified-warmed blastocyst transfer. Regardless of the post-warming culture time, the degree of blastocyst re-expansion 3-4 hours after warming is an important marker for embryo selection.
Object: The present study was accomplished to obtain a gene expression profile of the luminal epithelium during embryo apposition in comparison of implantation (1M) and interimplantation (INTER) sites. Material and Method: The mouse uterine luminal epithelium from IM and INTER sites were sampled on day 4.5 (Day of vaginal plug = day 0.5) by Laser Captured Microdissection (LCM). RNA was extracted from LCM captured epithelium, amplified, labeled and hybridized to microarrays. Results from microarray hybridization were analyzed by Significance Analysis of Microarrays (SAM) method. Differential expression of some genes was confirmed by LCM followed by RT-PCR. Results: Comparison of IM and INTER sites by SAM identified 73 genes most highly ranked at IM, while 13 genes at the INTER sites, within the estimated false discovery rate (FDR) of 0.163. Among 73 genes at IM, 20 were EST/unknown function, and the remain 53 were categorized to the structural, cell cycle, gene/protein expression, immune reaction, invasion, metabolism, oxidative stress, and signal transduction. Of the 24 structural genes, 14 were related especially to extracellular matrix and tissue remodeling. Meanwhile, among 13 genes up-regulated at INTER, 8 genes were EST/unknown function, and the rest 5 were related to metabolism, signal transduction, and gene/protein expression. Among these 58 (53+5) genes with known functions, 13 genes (22.4%) were related with $Ca^{2+}$ for their function. Conclusions: Results of the present study suggest that 1) active tissue remodeling is occurring at the IM sites during embryo apposition, 2) the INTER sites are relatively quiescent than IM sites, and 3) the $Ca^{2+}$ may be a crucial for apposition. Search for human homologue of those genes expressed in the mouse luminal epithelium during apposition will help to understand the implantation process and/or implantation failure in humans.
In the past, conservative bypass surgery was usually performed for palliation of malignant obstruction of the gastrointestinal tract. However, endoscopic stenting was developed recently, and technical advances and clinical experience have made it possible to establish stent implantation as one of the main treatment options. There are several advantages in stent implantation over bypass surgery, such as high feasibility and technical success rate, non-invasiveness, rapid symptomatic response, short hospitalization, and cost-effect benefits. Complications, such as stent ingrowth, stent injury by bile or acid, and migration, may occur and early re-insertion is frequently needed. Recently, diverse novel stents which are powered to predict stent migration or ingrowth have been developed and are being used in the clinical setting. In general, stent implantation is known to be beneficial in patients who are expected to survive <6 months, and surgical bypass may be more effective in patients who can survive >6 months. In this review, we have compared the technical feasibility, clinical outcomes, complications, and cost-benefit between stent implantation and bypass surgery, and determined the optimal treatment strategy in malignant upper gastrointestinal obstruction.
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