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Background: White matter hyperintensities (WMH) predict incident strokes and new lacunes; moreover, WMH may also affect infarct locations. Our aim in this study was to examine the spatial relationship between WMH and acute lacunar infarction. Methods: Five hundred and ninety patients with acute lacunar infarction in supratentorial region were included. Four situations between infarction and WMH were assessed by axial and coronal MRI: no contact (Grade 0), contact without overlap (Grade Ia), partial overlap (Grade Ib), and complete overlap (Grade II) with preexisting WMH. Furthermore, we defined infarctions in Grades Ia and Ib as edge-localized infarctions and investigated their predictors and short-term outcome. Results: 47.9% (283) of the infarctions were edge-localized infarctions (Grade Ia = 27.6% and Grade Ib = 20.3%), 51.5% (304) were Grade 0, only 0.5% (3) were Grade II. Patients with edge-localized infarction had larger infarct size, more severe WMH, higher National Institutes of Health Stroke Scale (NIHSS) and lower Barthel index (BI) score at admission than those with non-edge-localized infarction. They also had lower BI score at discharge. Infarction in subcortical white matter, diffusion-weighted imaging infarct size, periventricular WMH and deep WMH were predictors for edge-localized infarction. Conclusions: Half of lacunar infarctions were located at the edge of WMH. Both periventricular WMH and deep WMH were predictors for edge-localized infarction. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Aims: To study the effect of adenomyosis on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes in infertile patients. Methods: We performed a retrospective, database-searched cohort study based on 10,268 patients undergoing controlled ovarian hyperstimulation and IVF/ICSI between 2009 and 2011 in our unit. Adenomyosis was diagnosed by transvaginal ultrasound. A high-quality matched cohort study with strict inclusion criteria was conducted. We compared the basic characteristics and main IVF/ICSI outcomes between the two groups. Results: We identified 83 patients with adenomyosis, of whom we included 77, and strictly matched them to 77 patients without adenomyosis. Higher day 3 estrogen levels and a longer duration of gonadotropin stimulation days were found in women with adenomyosis compared to control subjects. Patients with adenomyosis had a nonsignificant trend toward a lower clinical pregnancy rate and a higher miscarriage rate (p = 0.103 and 0.09, respectively). The delivery rate was significantly lower in the adenomyosis group in comparison to the matched controls (p = 0.022). Conclusions: Within the limitations of a retrospective study (albeit with a remarkably large number of observations), our results suggest that transvaginal ultrasound-diagnosed adenomyosis could have a negative impact on the main IVF/ICSI outcomes. Improving the diagnostic validity and scoring of disease severity in patients with adenomyosis is suggested. © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]