Faculty Bibliography

OBJECTIVE: Our objective was to evaluate retrospectively the influence of different types of anesthesia on the outcome of ovum retrieval. METHODS: Sedation combined with local anesthesia was used on 120 occasions (Group I), epidural block in 139 ovum retrievals (Group II), and general anesthesia in 173 cycles (Group III). RESULTS: No differences were found in embryo yield or number or the quality of the embryo transferred. Of 99 pregnancies achieved, 66 live deliveries were recorded. Significantly lower clinical pregnancy rates were found in Group III (14.5%) compared with Group II (23.7%; P = 0.018) or Group I (25.8%; P = 0.0074). Highly significant differences were found in the delivery rates between Group III (8.7%), Group II (20.11%; P = 0.0017), and Group I (19.2%; P = 0.0043). CONCLUSION: The use of general anesthesia, especially nitrous oxide, for oocyte retrieval has an adverse effect on IVF outcome. This deleterious effect manifests itself only after embryo transfer and leads to lower pregnancy and delivery rates

PURPOSE: This study was designed to investigate the effect of intestinal subepithelial collagenous thickening on diabetic diarrhea because one of the seven patients diagnosed with collagenous colitis was diabetic. METHODS: Rectosigmoidoscopic rectal biopsies were taken from 50 diabetic patients (8 with and 42 without diarrhea), 20 nondiabetic patients with diarrhea, and 10 healthy patients. Histopathologic examinations and measurements of subepithelial collagen layers were performed on these biopsies. RESULTS: In diabetic patients who had diarrhea, the subepithelial collagen layer (SCL) was thicker than it was in diabetics without diarrhea (P < 0.05). In diabetic groups, the SCL was thicker than it was in both nondiabetics with diarrhea and those without diarrhea (P < 0.05). There was no statistical difference between nondiabetics with diarrhea and those without (P > 0.05). There was no correlation between collagen thickness, age, and diabetes duration (P > 0.05). CONCLUSIONS: It was concluded that there was a thickening of the colonic SCL in diabetic patients

A hybrid of two localized spectroscopy techniques, chemical shift imaging (CSI) and Hadamard spectroscopic imaging (HSI), is used to obtain an array of 16 x 16 x 4 (3 x 3 x 3 cm3 voxels) proton-decoupled phosphorus (31P) spectra of human brain. For equal spatial resolution, this organ's oblate shape requires fewer axial than coronal or sagittal slices. These different spatial requirements are well suited to 1D, 4th order, transverse HSI in the axial direction, combined with 2D 16 x 16 CSI in the other two orientations. The reduced localization matrix (16 x 16 x 4 over just the brain versus a cubic-16 x 16 x 16 matrix of equal resolution, over the entire head) may proportionally shorten data acquisition if the voxel size is not signal-to-noise limited. In addition, the use of Hadamard encoding can improve the intervoxel spectral isolation

A technique is demonstrated to obtain interleaved proton (1H) and 1H-decoupled phosphorus (31P) spectra of human brain using 2D CSI. A modified commercial full-body imager and a dual-tuned birdcage head-coil were employed. Because proton relaxation times are shorter than those of phosphorus, TR(1H) can be chosen to be shorter than TR(31P), thus permitting a 1H acquisition to be inserted in each 31P cycle. The scheme results in significant time savings as both CSI data sets are obtained concurrently with patient loading, coil tuning, shimming, and imaging needed to be done only once

A method is proposed for carrying out chemical-shift imaging simultaneously on several nuclei (1H and 31P in this example), using a commercial clinical NMR imager fitted with a second RF channel and a dual-tuned birdcage coil to fit the human head. Nuclei of different gamma are examined at the same field of view by exciting each nucleus successively at times proportional to gamma during the same phase-encoding gradient waveform. Thus, each higher-gamma nucleus is exposed to a smaller area of the gradient. Additionally, since in vivo protons typically have a shorter T1 and roughly an order of magnitude higher sensitivity than phosphorus, it is possible to interleave 1H-only acquisitions between the simultaneous 1H, 31P observations while the lower-gamma nucleus relaxes. Consequently, additional information is obtained with either higher spatial resolution or greater sensitivity (more signal averaging) without lengthening the duration of the examination

In up to 60% of women with chronic renal disease an elevation of blood pressure is seen during pregnancy. The pathogenesis of this complication may be related to a diminished synthesis of vasodilatory substances by endothelial cells and to an increased sensitivity to vasopressor hormones such as angiotensin II. Previous experimental studies in rats with early chronic renal disease (adriamycin nephropathy, AN) have shown that this pregnancy-induced hypertension is associated with a lowered synthesis of glomerular PGE2. In the present study the vascular response to vasoactive substances was evaluated. In AN rats the sensitivity to an acute infusion of angiotensin II was augmented, whilst it was blunted in normal pregnant rats. Chronic treatment with the thromboxane-(Tx)-receptor antagonist, daltroban (60 mg/kg/day, p.o.) administered from mid-pregnancy induced a similar reduction in blood pressure in both AN virgin and pregnant rats. This suggests that adriamycin per se may induce vascular damage which may interfere with the normal vascular adaptation to pregnancy. Stimulation of NO synthesis with L-arginine decreased MAP values significantly in PAN rats but did not modify them during normal pregnancy. In additional experimental inhibition of the endothelial-derived relaxing factor (EDRF), nitric oxide (NO) synthesis with NAME from mid-pregnancy significantly increased SBP and MAP in normal rats. By contrast, in PAN rats chronic NAME treatment had no effect. In summary, the development of hypertension in pregnant rats with AN may be associated to endothelial cell dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS)