Well leg compartment syndrome (WLCS) is a rare but potentially devastating complication that is seen after gynecological, urological, and colorectal operations. We report a case of a 31-year-old woman presenting with right lower limb WLCS after laparoscopic myomectomy. The operation was performed in the lithotomy position combined with the Levitator and Trendelenburg positions and the duration of the procedure was approximately 6 hours. Both legs were attached with elastic stockings and intermittent pneumatic compression applied for prevention of deep vein thrombosis.
Objective: To determine the efficacy of laparoscopic surgery for managing infertile patients with endometriosis.Design: Retrospective study.Setting: Assisted Reproductive technology (ART) Center, Fukuda Hospital, Kumamoto, Japan.Patient(s): Consecutive total of 209 infertile patients who had undergone laparoscopic surgery for endometriosis as a first-line therapy were enrolled.Intervention(s): Eighty-three women were also involved in ART programs.Main Outcome Measure(s): Age, infertile period, revised American Fertility Society (re-AFS) score, peritubal and periovarian adhesions were compared between pregnant and nonpregnant patients. We also evaluated the pregnancy rate and infertile period, adhesion score and re-AFS score. We compared cumulative pregnancy rates in patients with no (Group CF, n = 142), unilateral (Group U, n = 41) and bilateral endometriomas (Group B, n = 26).Result(s): An infertile period > 3 years and a mean adhesion score > 21 points were negatively correlated with pregnancy rates. There were no significant differences in pregnancy rates after surgery and after ART across the four disease stages. The cumulative pregnancy rate of Group B (53.8%) was significantly lower than Groups CF (76.1%) (p<0.01) and U (80.5%) (p<0.05).Conclusion(s): Women with no or unilateral endometriomas and a duration of infertility > 2 years should be encouraged to undergo laparoscopic surgery. However, encouraging such women with bilateral endometriomas to move directly to ART might improve their ability to achieve a pregnancy. Further prospective studies are necessary to test this hypothesis.
Toll-like receptor 7 (TLR7) acts as a crucial component of the innate immune system. Upon TLR7 binding to its ligand, myeloid cells, including dendritic cells (DCs) and macrophages, are activated and play vital roles in initiating adaptive immunity. Consequently, TLR7 agonists have been employed in cancer immunotherapy. We have synthesized DSP-0509, a systemic injectable TLR7 agonist, and in this investigation, we examined the effects of DSP-0509 on tumor-infiltrating lymphocytes (TILs) utilizing single-cell RNA sequencing (scRNA-seq) in a mouse model bearing tumors. Our results demonstrated that DSP-0509 induced an expansion of immune cell populations, such as Natural Killer (NK) cells, CD4
Aim: To assess the appropriateness of assisted hatching using long zona dissection of human frozen–thawed blastocysts at the time of warming, especially in women over 35 years of age or with repeated implantation failures. Methods: Of 177 frozen–thawed blastocyst transfer cycles, 89 control cycles had an intact zona and 88 cycles had assisted hatching using long zona dissection of human thawed blastocyst at the time of warming. These two groups were further subdivided by age to a total of four subgroups: ≤34 years (assisted hatching, n = 39; controls, n = 39) and ≥35 years (assisted hatching, n = 49; controls, n = 50). Twenty‐seven cycles in the control group and 28 cycles in the assisted‐hatching group had repeated implantation failures. The clinical and ongoing pregnancy rates and the implantation rate between the two groups were analyzed retrospectively. Results: The clinical pregnancy and implantation rates in women ≤34 years were significantly higher after the application of assisted hatching compared with the control group (87.2% and 71.2% vs 56.4% and 46.6%, P < 0.001). The clinical pregnancy and implantation rates of women with repeated implantation failures were higher after the application of assisted hatching compared with the control group (64.3% and 46.3% vs 48.1% and 34.1%), but this difference was not statistically significant. Conclusions: Routine assisted hatching using long zona dissection at the time of warming on frozen–thawed blastocysts is a safe and easy method to perform and is extremely beneficial for increasing the pregnancy rate in young women ≤34 years of age, but not in women ≥35 years of age. Despite increased pregnancy and implantation rates in patients with repeated implantation failures, statistical significance was not achieved. (Reprod Med Biol 2007; 6 : 211–218)
To determine the first line of infertility treatment for managing patients with unilateral or bilateral ovarian endometriomas.We evaluated pregnancy outcome in patients who had received ovarian surgery for unilateral (Group U, n = 47) or bilateral endometriomas (Group B, n = 38) and aspiration with or without alcohol fixation for unilateral (Group u, n = 37) or bilateral endometriomas (Group b, n = 22). Subsequently, 64 of these women, excluding 29 dropouts, underwent assisted reproductive technology. We compared the clinical pregnancy rates of the four groups.The cumulative pregnancy rate after operation of Group B (18%) was significantly lower than that of a cyst-free control group (n = 143; 44%) and Group U (43%). Group B had fewer oocytes fertilized during ART than did Group b (P < 0.005) and fewer blastocysts available for transfer (P < 0.005). The cumulative pregnancy rate of Group B was also lower than in Group b (P = 0.052).Pregnancy outcomes of Group B were not better than for Group b. Therefore, encouraging such women to move directly to ART might help avoid ovarian damage and improve their ability to achieve a pregnancy.
Meeting abstracts TLR7 agonists are being progressed as potential immunotherapeutics for the treatment of cancer. TLR7 agonism is believed to trigger a plasmacytoid dendritic cell driven immune response which drives anti-tumor efficacy. In addition to modulation of the immune system, TLR7 may be
Determination of anti-mycobacteria antibody titers by ELISA for the early diagnosis of tuberculosis was critically reviewed from methodological point of view. Especially, the method of data-handling to calculate the antibody titers from optical density values obtained by ELISA and also the method to evaluate the clinical usefulness of this test were reassessed. Determination of anti-mycobacteria antibody titer by ELISA is highly sensitive and satisfactorily specific, and far more useful than, or at least as useful as, various on-going methods for the early diagnosis of pulmonary as well as extra-pulmonary tuberculosis. This test should be included in a routine examination system for the diagnosis of tuberculosis in the clinical laboratories.
Aim: To evaluate the efficacy of cryopreservation of all blastocysts for future transfers in stimulated cycles. Methods: We carried out fresh blastocyst transfer cycles on day 5 ( n = 290) or day 6 ( n = 119) and thawed blastocyst transfer cycles that were frozen on day 5 ( n = 136), day 6 ( n = 71) or day 6 electively ( n = 21). We retrospectively compared the clinical outcome of fresh blastocyst transfers with thawed blastocyst transfers according to the day of blastocyst transfer or freezing. Results: The clinical implantation rates in women with stimulated cycles were significantly higher after the transfer of thawed blastocysts compared with the transfer of fresh blastocysts (day 5, P < 0.0005; day 6, P < 0.00005). Although the implantation rate of fresh day 6 transfer cycles was lower than that of elective day 6 frozen–thawed cycles, this difference was not statistically significant ( P = 0.17). Conclusions: Thawed blastocysts demonstrated a better potential for implantation when compared with fresh blastocysts in stimulated cycles. We concluded that elective cryopreservation of all blastocysts on day 5 is an effective option to improve the clinical outcome in stimulated cycles. Additionally, with cryopreservation of all day 6 blastocysts, the implantation rates of first embryo transfers may increase by allowing the best‐quality blastocysts to be transferred in thawed cycles. (Reprod Med Biol 2008; 7 : 75–83)
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