Search

Purpose: We have previously published a retrospective matched-case control study comparing the effect of recombinant LH (r-hLH) versus highly purified human menopausal gonadotropin (hMG) supplementation on the follicle-stimulating hormone (FSH) during controlled ovarian hyperstimulation (COH) in the GnRH-antagonist protocol. The result from that study showed that the cumulative live birth rate (CLBR) was significantly higher in the r-hLH group (53% vs. 64%, p = 0.02). In this study, we aim to do a cost analysis between these two groups based on our previous study. Methods: The analysis consisted of 425 IVF and ICSI cycles in our previous study. There were 259 cycles in the r-hFSH + hMG group and 166 cycles in the r-hFSH + r-hLH group. The total cost related to the treatment of each patient was recorded. Probabilistic sensitivity analysis (PSA) and a cost-effectiveness acceptability curve (CEAC) were performed and created. Results: The total treatment cost per patient was significantly higher in the r-hFSH + r-hLH group than in the r-hFSH + hMG group ($4550 ± 798.86 vs. $4290 ± 734.6, p = 0.003). However, the mean cost per live birth in the r-hFSH + hMG group was higher at $8052, vs. $7059 in the r-hFSH + r-hLH group. The CEAC showed that treatment with hFSH + r-hLH proved to be more cost-effective than treatment with r-hFSH + hMG. Willingness-to-pay was evident when considering a hypothetical threshold of $18,513, with the r-hFSH + r-hLH group exhibiting a 99% probability of being considered cost-effective. Conclusion: The cost analysis showed that recombinant LH is more cost-effective than hMG supplementation on r-hFSH during COH in the GnRH-antagonist protocol. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to assess the impact of endometrioma on patients who undergo ART treatment due to endometriosis. Methods: A retrospective study was conducted on women ≤ 40 years of age who underwent ART treatment at an academic medical center between January 2014 and December 2020. Two-hundred-and-eight women had received IVF/ICSI treatment due to endometriosis and there were 89 patients presence of endometrioma. Patients were further divided into primary endometrioma, recurrent endometrioma and those having received cystectomy for endometrioma prior to IVF/ICSI. The control group included 624 infertile women without endometriosis. Results: In the endometrioma subgroup (B) the blastocyst formation rate was significantly lower when compared with the endometriosis (A) and control groups (C). The cumulative live birth rates (CLBRs) (60.5% versus 49.4% versus 56.9%, p = 0.194 in A versus B, p = 0.406 in A versus C, p = 0.878 in B versus C) were comparable. Multiple logistic regression analysis revealed that female age, total FSH dose and blastocyst formation rate were the significant variables in predicting CLBR (OR 0.89, CI 0.80–0.99, p < 0.025, OR 0.68 CI 0.53–0.88, p = 0.003 and OR 30.04, CI 9.93–90.9, p < 0.001, respectively). The CLBRs were comparable at 47.1%, 60% and 57.9% in the primary endometrioma, s/p cystectomy and recurrent endometrioma group. Conclusion: Although the blastocyst formation rate was lower in the endometrioma group, CLBR was not worse than those who were in the endometriosis or control group. Cystectomy for endometrioma did not alter IVF/ICSI outcomes if the ovarian reserve was comparable. Recurrent endometrioma did not worsen IVF/ICSI outcomes than primary endometrioma. [ABSTRACT FROM AUTHOR]

Although numerous studies have attempted to establish the relationship between adenomyosis and infertility, no consensus has emerged. Our aim was to investigate whether adenomyosis and endometriosis affected IVF outcomes in our patients. This was a retrospective study of 1720 patients from January 2016 to December 2019. In total, 1389 cycles were included: 229 cycles in the endometriosis group (group E), 89 cycles in the adenomyosis group (group A), 69 cycles in the endometriosis and adenomyosis group (group EA), and 1002 cycles in the control group (group C). Most patients in groups A and EA received GnRH agonist treatment before FET. The 1st FET live birth rates (LBR) were 39.3%, 32.1%, 25% and 48.1% in groups E, A, EA, and C. The miscarriage rates were 19.9%, 34.7%, 39%, and 17.6%. The per retrieval cycle cumulative live birth rates (cLBRs) in patients < 38 y/o were 56.4%, 58.1%, 44.8%, and 63%. The per retrieval cycle cLBRs in patients ≥ 38 y/o were 25%, 9.8%, 17.2%, and 29.5%. Among groups A and EA, LBRs were 25.58% and 18.89% in patients with a ≥ sevenfold decrease and a < sevenfold decrease in CA-125 level, respectively, after GnRH agonist treatment. Endometriosis was not associated with a poorer pregnancy outcome. Patients with adenomyosis with/without endometriosis had higher miscarriage rates, lower LBRs, and lower cLBRs, especially in patients aged ≥ 38 years, even after GnRH agonist treatment before FET cycles. Patients who have a greater than sevenfold decrease in CA-125 level after GnRH agonist treatment might have better clinical pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Desmoid tumor originating from the small intestine is extremely rare. We report a 50-year-old man who presented with the sudden onset of severe abdominal pain. Computerized tomography (CT) demonstrated a huge homogeneous tumor in the lower abdomen that appeared to be in continuity with the distal ileum. The mass adherent to the ileum was resected and proved to be a desmoid tumor. The patient has remained recurrence free on follow-up. [ABSTRACT FROM AUTHOR]

Ex situ conservation is a common strategy for the restoration of endangered species. Botanical gardens play an important role in the restoration of plants; however, hybridization could happen if transplantation is not considered carefully. Two naturally allopatric taxa Acer albopurpurascens and A. buergerianum var. formosanum, grown in the Taipei Botanical Garden, hybridized spontaneously. Hybridization was shown by the presence of intermediate phenotypes and genetic data. To confirm the direction of pollen flow, indirect evidence of maternally inherited chloroplast DNA indicated that A. buergerianum var. formosanum was the pollen receiver. The hybrids shared parts of ancestral genetic variations with their parents. Furthermore, several novel haplotypes that were slightly different from their parents were cloned, which revealed higher genetic diversity of the hybrid population than the parental populations. Such a phenomenon is called the rare allele phenomenon. In comparison with haplotypes of parents and hybrids, and according to the estimation of minimum recombination events and the likelihood ratio tests, the genetic variations were brought about by recombination events, such that the rare allele phenomenon might be related to the recombination. The hybridization that occurred in the botanical garden underscores the importance of spatial isolation when carrying out ex situ plantations. [ABSTRACT FROM AUTHOR]

Polycystic liver disease (PCLD) without polycystic kidney is infrequent in clinical setting. Family clustering is found in patients with PCLD, and it is inherited in an autosomal dominant fashion. Through positional cloning in North America and Europe (mostly in Dutch and Finnish descents), mutations in PRKCSH gene on chromosome 19 were found to be responsible for the disease. We investigated the prevalence of liver cysts and PCLD in Taiwan and investigated whether the PRKCSH mutations exist in Taiwanese. The prevalence of liver cysts is only 0.17% in people under 30 years old and increased gradually to 14.29% in people between 55 and 60 years old and 14.19% in people over 65 years old. PCLD was not found in people under 40 years old. The prevalence is 0.15% between 40 and 45 years old, and increased to 1.37% between 55 and 60 years old, 1.21% between 60 and 65 years old, and 0.99% over 65 years old. There is only one polymorphism (deletion of one GAG repeat in exon 11) found, and the genotype and allele frequency were the same in Taiwanese patients and controls. No mutation, even polymorphism reported in the literature, was found in the 20 cases of PCLD. Our results suggest that PRKCSH gene is not a major genetic cause of PCLD and there may be at least another locus responsible for the disease in Taiwan. [ABSTRACT FROM AUTHOR]

Piper polysyphonum is an endemic species in southeast Asia, in the narrow habitat located in the Chinese provinces of Guizhou and Yunnan, and the country of Laos. Recently, loss of forests due to agricultural activity has dramatically reduced the habitat and population size of P. polysyphonum. In this study, eleven primer sets of polymorphic microsatellite DNA loci were developed for P. polysyphonum. Allele numbers ranged from two to ten, with observed heterozygosities ranging from 0.222 to 0.889. Four loci exhibited a departure from Hardy-Weinberg equilibrium, possibly due to population admixture. No loci pairs revealed significant linkage disequilibrium. Among the eleven loci, two with extremely high numbers of TCG repeats were obtained. The polymorphic microsatellite DNA markers reported here should provide a helpful means to address questions concerning population structure and demographic history of P. polysyphonum for conservation efforts. [ABSTRACT FROM AUTHOR]

Abstract  The endoscopic finding of nodular gastritis (NG) is highly associated with presence of Helicobacter pylori infection. How the endoscopic patterns and histopathology of NG change after eradication of H. pylori is unclear. Twenty-one adults (3 men and 18 women) with H. pylori-associated NG found on endoscopy were enrolled for this study. The histological findings included gastritis activity, bacterial colonization, and lymphoid follicles. Repeat endoscopy for the endoscopic as well as histopathological features of gastric biopsy specimens was performed 2 months later after eradication treatment. H. pylori was successfully eradicated in 19 patients. Endoscopic NG disappeared in 12, improved in 5, and was unchanged in 4. After treatment, there was significant improvement in scores for gastritis activity [P P P = 0.047, 95% CI 0.04–0.52), primarily among patients whose endoscopic pattern resolved completely. The disappearance of nodularity on endoscopy was accompanied by a decrease in follicular gastritis score. [ABSTRACT FROM AUTHOR]

The aim of this study is to assess the prevalence and associated risk factors of lens opacities among type 2 diabetics in Kinmen, Taiwan. A community-based mass screening ascertained 971 type 2 diabetics from 1991 to 1993. From that population, a total of 578 (59.5%) patients with type 2 diabetes underwent eye screening in 1999 with a 45° thin slit-lamp biomicroscopy and ophthalmoscopy to examine the lens after dilation of the pupils. The prevalence of nuclear, cortical, and posterior subcapsular (PSC) opacity without surgery among type 2 diabetics was 22.5, 20.2, and 19.9%, respectively. The number of females affected was statistically higher than males in each type of lens opacity. The prevalence of each type of lens opacity also showed a statistically significant increase with (χ2 test). Based on multiple logistic regressions, age was the most significant factor related with each type of lens opacity. Triglyceride at baseline was associated with nuclear opacity (≥200 vs. <200 mg/dl, OR = 2.35, 95% CI: 1.15–4.79) and PSC opacity (≥200 vs. <200 mg/dl, OR = 2.11, 95% CI: 1.00–4.43). In conclusion, our results show that in addition to age, higher triglyceride level may increase the risk of prevalent nuclear or PSC opacity in type 2 diabetics. [ABSTRACT FROM AUTHOR]

Summary Cryptophycins-1 and 52 (epoxides) were discovered to have in-vitro and in-vivo antitumor activity in the early 1990s. The chlorohydrins of these, Cryptophycins-8 and 55 (also discovered in the early 1990s) were markedly more active, but could not be formulated as stable solutions. With no method to adequately stabilize the chlorohydrins at the time, Cryptophycin-52 (LY 355073) entered clinical trials, producing only marginal antitumor activity. Since that time, glycinate esters of the hydroxyl group of the chlorohydrins have been synthesized and found to provide stability. Three of the most active were compared herein. Cryptophycin-309 (C-309) is a glycinate ester of the chlorohydrin Cryptophycin-296. The glycinate derivative provided both chemical stability and improved aqueous solubility. After the examination of 81 different Cryptophycin analogs in tumor bearing animals, C-309 has emerged as superior to all others. The following %T/C and Log Kill (LK) values were obtained from a single course of IV treatment (Q2d 5) against early staged SC transplantable tumors of mouse and human origin: Mam 17/Adr [a pgp (+) MDR tumor]: 0%T/C, 3.2 LK; Mam 16/C/Adr [a pgp (-) MDR tumor]: 0%T/C, 3.3 LK; Mam 16/C: 0%T/C, 3.8 LK; Colon 26: 0%T/C, 2.2 LK; Colon 51: 0%T/C, 2.4 LK; Pancreatic Ductal Adenocarcinoma 02 (Panc 02): 0%T/C, 2.4 LK; Human Colon HCT15 [a pgp (+) MDR tumor]: 0%T/C, 3.3 LK; Human Colon HCT116: 0%T/C, 4.1 LK. One additional analog, Cryptophycin-249 (C-249, the glycinate of Cryptophycin-8), also emerged with efficacy rivaling or superior to C-309. However, there was sufficient material for only a single C-249 trial in which a 4.0 LK was obtained against the multidrug resistant breast adenocarcinoma Mam-16/C/Adr. C-309 and C-249 are being considered as second-generation clinical candidates. [ABSTRACT FROM AUTHOR]

The article presents a case study on a 54-year-old man with dyspepsia. The patient was treated with omeprazole, 20 mg. daily, but was not given Helicobacter pyroli eradication therapy. After 6 weeks, the man felt better and regained the weight that he had lost. It is found out that ultrastructural evaluation may have a role in investigating poor healing of gastric ulcers or persistent infection.