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PubMed2004

A comparative study of induction of estrus and ovulation by three different intravaginal devices in ewes during the non-breeding season.

The aim of the present study was to compare three methods of estrus synchronization in ewes during the non-breeding season. Forty-two ewes were randomly grouped for three treatments with different intravaginal devices for 12 days: Group A) CIDR, Group B) Self-made P sponge, Group C) MAP (medroxyprogesterone acetate) cream sponge. Furthermore, all groups were divided into two treatments with (R) or without ram presence to examine the "ram effect". Blood was collected from all treated ewes, and progesterone (P(4)), estradiol 17-beta (E(2)) and luteinizing hormone (LH) concentrations were measured by enzyme-immunoassay. All ewes showed estrus behavior between Day 0 to 3 after device removal, and the mean onset times of their estrus were 23.0, 33.0 and 21.0 h for Groups AR, BR and CR, respectively. On Day 5 as examined by laparoscopy, the ovulation rates (and number of ovulated ewes) were 1.45 (11/11), 1.25 (12/14) and 1.21 (14/14) for Groups A, B and C, respectively. In Group C, the time to LH surge was significantly (P<0.05) later (32.4 h) than those in Groups A (27.0 h) and B (25.5 h). Ram presence did not affect the number of ovulated ewes, ovulation rate or time to LH surge. The ram introduction group had significantly (P<0.05) lower E(2) concentrations during the period from 0 h to 36 h than the groups without ram presence. These results suggest that the self-made P sponge or MAP cream sponge was effective as well as CIDR, and ram introduction was not necessary, for induction of estrus and ovulation during the non-breeding season.

Animals↗
PubMed1988

Return to fertility after discontinuation of copper IUD use: a study of 55 pregnancies involving Multiload Cu-250 users among private patients in Indonesia.

Return to fertility after discontinuation of use of the Multiload Cu-250 intrauterine device was found to be excellent. This was the conclusion of a seven-year study of 55 pregnancies involving 53 MLCu250 users who had their devices removed because they wanted another child. Average age was 25.02 years and average parity 1.25. Length of IUD use ranged between 1.00 and 66.42 months, averaging 27.28 months. Interval between time of removal and first day of the last menstrual period (REM-LMP) prior to conception ranged from -0.51 to 49.03 months, with an average of 5.90 months. In four cases removal was not followed by any further periods. Thirty-five (63.64%) pregnancies occurred within six months and seven (12.72%) between six and twelve months after removal. Of the 55 conceptions, 46 (83.63%) took place within one year and a total of 52 (94.54%) within two years after IUD discontinuation. The length of IUD use appeared not to affect negatively either the return to fertility or the outcome of pregnancy and offspring. In the 14 cases involving extended use of the MLCu250 beyond three years, the average REM-LMP interval was 4.15 months. Outcome of pregnancy and offspring was generally good. Except for two spontaneous abortions, one premature and two post-mature births, one case of atonic postpartum hemorrhage and one neonatal death due to respiratory distress involving a child with Down's syndrome, all other pregnancies progressed to term, with the birth weights of the newborns in 43 cases averaging 3387 grams. Of the 42 newborns with known gender, 26 (61.90%) were male and 16 (38.10%) were female. Whether this decidedly above-normal male to female ratio at birth of 162.50 (against a norm of 105-106) was a consequence of previous copper IUD use merits further study.

Adult↗
PubMed1983

[Analysis of surface deposits on intrauterine contraceptive devices].

The surface deposits on stainless steel contraceptive devices removed from the uterus after various periods of insertion were examined and analyzed by means of scanning electron microscopy, X-ray energy dispersive analysis, Augar electron spectroscopy, X-ray photoelectron spectroscopy, transmission electron microscopy and atomic absorption spectrophotometer for microquantitative analysis. The data obtained were compared with those of copper-bearing IUDs (TCu 200) obtained by the same methods. The wire coils of stainless steel IUDs which had been in situ for 5 years showed on evident changes but the copper wire coils of the same duration showed varying degrees of erosion. The analysis clearly showed that the wire coils of both types of IUDs were encrusted with deposit. Deposition began on copper-bearing IUDs earlier than on stainless steel IUDs (27 days and 3 months after insertion, respectively). This process began earlier than was reported in other literature. The amount of deposits increased with the time of insertion, but there were great individual variations. Through the above mentioned microanalysis, it was found that the principal composition of the deposition both types of IUDs was calcium and existed in the crystal form of calcium carbonate. The substance attaching to the crystals were very likely nitrogenous organic compounds. Regarding the mechanism of the deposit formation, the authors suggest that it may be similar to that of calculus. The influence of the deposits on the complications of IUD insertion, such as uterine bleeding and unwanted pregnancy, is discussed briefly in this article should be studied for further details.

Calcium↗
PubMed1986

Analysis of surface deposits on intrauterine contraceptive devices.

Surface deposits on stainless steel contraceptive devices removed from the uterus after varying periods of insertion were examined and analyzed by means of scanning electron microscopy (SEM), X-ray energy dispersive analysis (XEDA), Augar electron spectroscopy (AES), X-ray photoelectron spectroscopy (XPS), transmission electron microscopy (TEM) and atomic absorption spectrophotometry for microquantitative analysis. The data obtained were compared with the data for copper-bearing IUDs (TCu200) obtained by the same method. The wire coils of stainless steel IUDs which had been in situ for 5 years showed no obvious changes, but copper wire coils showed varying degrees of erosion after the same period of time. Analysis clearly showed that the wire coils of both types of IUD were encrusted with deposits. Deposition began earlier on copper-bearing IUDs than on stainless steel IUDs (27 days and 3 months after insertion, respectively). This process began earlier than has previously been reported in the literature. The amount of deposit increased with duration of insertion, but there were large individual variations. The microanalysis showed that the principal component of the deposit on both types of IUD was calcium, which was present in the crystal form of calcium carbonate. The substances attaching to the crystals were similar to the nitrogenous organic compounds. We suggest that the mechanism regulating the deposited formation may be similar to that of calculus. The influence of these deposits on complications relating to IUD insertion, such as uterine bleeding and accidental pregnancy, is briefly discussed in this article. The subject should be studied in greater detail.

Calcium Carbonate↗
PubMed1996

Development of selective low-density lipoprotein (LDL) apheresis system: immobilized polyanion as LDL-specific adsorption for LDL apheresis system.

Low-density lipoprotein (LDL) is widely recognized as one of the major risk factors for developing coronary heart diseases. Despite intensive development of LDL-lowering drugs, there still exist those patients with refractory hyperlipidemia whose plasma LDL levels are not sufficiently lowered by drugs. LDL apheresis, direct removal of plasma LDL from circulating blood, is thought to be the most promising treatment for such refractory patients. Various techniques, such as the use of an immunoadsorbent utilizing an anti-LDL antibody, have been used in an attempt to achieve the selective removal of LDL. However, none were widely used because of complications, poor selectivity, and so forth. To establish a safe and effective LDL apheresis system, we chose a synthetic affinity adsorbent as the LDL-removing device. Synthetic polyanion compounds were used as the affinity ligands for LDL adsorbent to simulate the anion-rich sequence of LDL binding sites in the human LDL receptor. Among various polyanion compounds, those polyanions with sulfate or sulfonate groups and hydrophilic backbone were found to have strong affinity for LDL. In contrast, polyanions with carboxyl groups showed poor affinity. Dextran sulfate (DS) was selected as the affinity ligand of LDL adsorbent for its high affinity and low toxicity. The influence of its charge density and molecular weight on its affinity for LDL was suitable. The affinity rapidly increased as the charge density increased, then, reached a constant value. Little affinity was found for either the DS monomer (glucose sulfate) or DS with a molecular weight higher than 10(4) daltons whereas DS with molecular weights in the midrange showed strong affinity. DS with a midrange molecular weight was immobilized on cellulose hard gel to give LDL adsorbent clinical application. The adsorbent demonstrated an excellent selectivity for LDL and very low density lipoprotein (VLDL) in vitro. Adsorption of high-density lipoprotein and major plasma proteins was almost negligible. Additional study of the LDL-binding mechanism revealed that DS directly interacts with positively charged sites on LDL, which demonstrates that the nature of the interaction is the same as that of LDL receptor. An LDL adsorption column (Liposorber) packed with an LDL adsorbent and polysulfone hollow-fiber plasma separator (Sulflux) was developed as an efficient LDL apheresis system. Clinical investigation proved that this system is capable of intensively lowering the plasma LDL level without affecting major plasma components.

Adsorption↗
PubMed2004

Trilucent breast implants: voluntary removal following the Medical Device Agency recommendation. Report on 115 consecutive patients.

In June of 2000, the U.K. Medical Device Agency recommended the removal of Trilucent implants as a precautionary maneuver in response to reports of local inflammatory reactions. This decision allowed the authors to operate on 115 consecutive patients between June of 2000 and January of 2001. On the preoperative examination, the authors found a very high incidence of rippling (66 percent), whereas capsular contracture was seen in only three patients (2.6 percent). Rippling was significantly more common in patients with subglandular implants. Five implants were found ruptured during the operation. This figure, together with the relative ease of implant breakage at removal, shows a premature deterioration of the implant shell. The authors also comment on implant bleeding, which seems common in this type of breast implant. The authors think that this is a possible cause for the rippling phenomenon, resulting from a reduction of the implant content. On the basis of these findings, the authors conclude that Trilucent implants are associated with a poor cosmetic outcome and a high rate of complications.

Adult↗
PubMed1984

Modified tissue culture medium for corneal storage I. Investigation of the effect of antibiotics on bacterial contamination.

A series of experiments were performed to determine the effect of modified tissue culture medium (MTCM), temperature, time, and antibiotics on the replication of Staphylococcus epidermidis and Pseudomonas aeruginosa. A known inoculum of the organisms (usually 10(6)/mL) was introduced, and the recovery of viable organisms was compared by different methods of culturing, including techniques of diluting, inactivating, or removing the antibiotic from the system. The invalidity of techniques that failed to remove the antibiotic from the system was substantiated. The newly developed antibiotic removal device was superior to all other culturing techniques. Penicillin G potassium was ineffective in the MTCM system, and gentamicin reagent solution was not uniformly effective against a gentamicin-sensitive strain of P aeruginosa. Placement of the MTCM at room temperature for two hours enhanced the antibacterial activity of gentamicin, although organisms may still be recovered in small numbers.

Anti-Bacterial Agents↗
PubMed1984

Modified tissue culture medium for corneal storage. II. Investigation of the effect of the corneoscleral rim on bacterial contamination.

Our previous experiments showed the effect of time, temperature, and antibiotics on replication of Staphylococcus epidermidis and Pseudomonas aeruginosa introduced into the modified tissue culture medium (MTCM). Penicillin G potassium was ineffective in the MTCM, and gentamicin sulfate was not uniformly effective against a gentamicin-sensitive organism. Placement of the MTCM at room temperature for two hours enhanced the antibacterial activity of gentamicin. Culturing techniques that fail to remove the antibiotic from the system are invalid. Experiments reported herein showed that the addition of the corneoscleral rim (or extraneous protein) prolongs the survival of these same organisms. Organisms can survive in the MTCM despite high concentrations of gentamicin. Maintaining the MTCM at room temperature for two hours after storage at 4 degrees C effectively reduces but may not completely eliminate the recovery of organisms. The antibiotic removal device may be superior to other methods for recovering viable organisms.

Animals↗
PubMed1983

Vascular complications associated with percutaneous intra-aortic balloon pumping.

A percutaneous intra-aortic balloon pump (PIABP) was inserted in 112 patients. Successful placement was achieved in 102 patients, 67 of whom survived long enough to have the device removed. Vascular complications related to the PIABP were noted in 15 patients. Reversal of ischemic signs followed PIABP removal in six patients, but nine required femoral artery exploration for thrombectomy, repair of femoral laceration, or repair of false aneurysm. No patient died as a result of PIABP or correction of associated vascular complications, though five of the patients with vascular problems died of cardiac complications. Nine of ten survivors in this group were asymptomatic, and one had persistent paresthesias six months postoperatively. Most clinically significant vascular complications were due to the technique of balloon removal, and several modifications that were effected recently are expected to decrease the incidence of complications requiring surgical intervention.

Angina Pectoris↗
PubMedDate not supplied

Pharmacokinetics of valproic acid and metabolites in mouse plasma and brain following constant-rate application of the drug and its unsaturated metabolite with an osmotic delivery system.

Human therapeutic valproic acid (VPA) levels could be maintained in the mouse for a period of 1 week by constant rate application via subcutaneously implanted osmotic minipumps. Also, the concentrations of VPA metabolites observed in mouse plasma were similar to those seen in human plasma. The drug application could be prolonged by replacing exhausted pumps with freshly-filled devices. Removal of the implanted pumps and measurement of the decay of the drug levels revealed that the half-life of the main plasma metabolite 2-en(2-propyl-2-pentenoic acid) exceeded that of VPA. This result was confirmed by constant-rate application of this metabolite; the plasma clearance of 2-en (as calculated from the steady-state levels observed) was found to be lower than that of VPA. Brain levels of VPA and 2-en during steady-state were 3-10 per cent of corresponding plasma levels. The blood-brain kinetics of 2-en following administration of VPA were similar to those observed following application of 2-en itself. VPA was cleared faster from the brain than from the plasma, while 2-en was more persistent in the brain than in the plasma. Our results indicate that controlled, constant-rate application of drugs such as VPA, via implantable osmotic minipumps, may be a valuable procedure for a number of pharmacological and toxicological studies, particularly where persistent drug levels must be maintained for extended time periods.

Animals↗
PubMed2005

FilterWire distal embolic protection device for vein graft stenting: initial single-center experience.

BACKGROUND: Saphenous vein graft (SVG) intervention is associated with a significant incidence of major adverse cardiac events (MACE) related to distal vessel embolization. The FilterWire distal embolic protection device has recently been approved as an adjunct to SVG intervention. We report here our initial experience in a single center in 30 consecutive patients using this device in SVG stenting. HYPOTHESIS: This study examined the outcomes and complications associated with these devices, as well as whether proficiency with the devices increased with greater experience and whether there were measurable outcome differences between devices. METHODS: We retrospectively identified all patients in whom a FilterWire device was placed at our hospital between June 2001 and June 2004. RESULTS: The device was successfully deployed in 29 of 30 patients, and all patients were stented successfully. Overall MACE rate was 6.6%, consistent with reports in larger multicenter clinical trials. Transient decreases in flow were noted while the device was in place in six patients, but improved in five patients with device removal. CONCLUSIONS: This early experience in a single center using FilterWire embolic protection indicates that excellent clinical results can be obtained by the adoption of filter protection for SVG intervention, without evidence for a detrimental learning curve.

Aged↗
PubMed1987

Laser smoke effect on the bronchial system.

The photoresection of endobronchial tumors produces smoke which is partly inhaled by the patient as well as the surgical staff. In an animal study we investigated whether a single exposure or repetitive exposures to smoke might have harmful side effects on the airways. Eleven sheep were exposed to smoke produced by laser-vaporizing (6,500 J) sections of bronchial tissue (1 cm3) in a Plexiglas chamber. The smoke analysis revealed 0.92 mg/liter particles with a mean particle size of 0.54 micron. Carbon monoxide content was estimated as 0.04%. We measured the effects of one or three separate ten-minute exposures on airway resistance, gas exchange, and mucociliary clearance rate in the trachea. We found that the smoke inhalation resulted in a decrease of arterial PO2 with relatively little change in airway mechanics. Tracheal mucus velocity, a marker of lung mucociliary clearance, was significantly depressed in a dose-dependent manner with increasing smoke exposures. Results of bronchoalveolar lavages performed before and one day after the exposure showed that the smoke inhalation induced a severe inflammation with dramatic increases of inflammatory cells. The total number of cells per milliliter lavage return increased from 3.2 million to 25 million; percent neutrophils increased from 2.3 to 45.6% and percent macrophages decreased from 86 to 41%. These findings indicate that the side effects of smoke inhalation during intrabronchial laser surgery should not be neglected. The impairment of the defense mechanism of the lung combined with the inflammation as well as hypoxia might be fatal in compromised patients. Effective smoke removal devices should be developed to protect the patient as well as the surgeon.

Animals↗
PubMedDate not supplied

Venous access in pediatric oncology patients.

Long-term central venous access is an integral part of the management of many, but not all children with cancer. The proper selection of those children who require this access and which access device (external vs. totally implanted) is best suited to that child is important to minimize complications and obtain optimal results. Although most of these devices can be expected to last the duration of the treatment protocol or the patient's life, complications (infection, occlusion, dislodgment) occur with higher than desired frequency, infection being the most common. No measures are clearly beneficial in preventing infection, but most infections can be treated successfully without device removal. Premature removal or dislodgement occurs more frequently with external catheters and may be minimized by techniques used at insertion. Occlusion, detected early, can be successfully managed by clot lysis in most children.

Catheterization, Central Venous↗
PubMed1988

Hysteroscopic removal of copper-containing intrauterine devices with missing tails during pregnancy.

During a 15-month period, CO2 hysteroscopy was carried out on 21 pregnant women wearing IUDs with retracted tails. Ultrasonography was done prior to hysteroscopy to determine the size of the gestational sac and the site of the device. Successful removal of the device occurred in 17 cases. The paper describes the technique, the findings of the study, and the limitations of the procedure.

Adult↗
PubMed1990

Blood culture techniques for the diagnosis of melioidosis.

The effects of variations in laboratory technique on the speed and sensitivity of isolation of Pseudomonas pseudomallei from blood were evaluated prospectively. Pseudomonas pseudomallei was isolated from 154 of 546 cultures from 325 patients with suspected or confirmed melioidosis. Subcultures after 12 to 24 and 36 to 48 hours of incubation were positive in 52.3% and 80.8% respectively. The yields from 20 ml (blood to broth ratio 1:4) and 50 ml (blood to broth ratio 1:10) brain heart infusion broth bottles were equivalent in patients not receiving treatment for melioidosis. During therapy, the 50 ml bottles grew Pseudomonas pseudomallei significantly faster than the 20 ml bottles (p less than 0.01), and gave a higher overall yield for cultures processed in antimicrobial removal devices (p less than 0.05). These devices themselves increased the speed of isolation of the organism from treated patients (p less than 0.01). In most cases, all bottles collected from a patient before treatment were positive, and a single 20 ml bottle had an estimated relative sensitivity of 85.7% (95% confidence interval 77.1-94.3%). Early subculture should be employed routinely for the laboratory diagnosis of septicaemic melioidosis. However, blood culture techniques do not need to be sophisticated. Culture of 5 ml blood in 20 ml broth is a simple and sensitive procedure suitable for regions where melioidosis is currently under-diagnosed.

Bacteriological Techniques↗
PubMed2006

Bilateral canaliculitis following SmartPLUG insertion for dry eye syndrome post LASIK surgery.

BACKGROUND: Dry eyes are a common symptom following LASIK corneal refractive surgery. Treatments include topical lubricants to supplement the tear film, and punctal occlusion to reduce tear outflow. Canaliculitis is a recognised complication of punctal plugs, but has not previously been described following insertion of newer generation semi-permanent intra-canalicular plugs, such as the SmartPLUG. METHODS: Case report. RESULTS: We describe a 60-year-old female who underwent bilateral LASIK surgery leading to aggravation of her dry eye syndrome. She was managed with the insertion of semi-permanent intra-canalicular moldable silicone SmartPLUGs. She subsequently developed bilateral canaliculitis requiring bilateral canaliculotomy. CONCLUSIONS: To the best of our knowledge, this is the first report of bilateral canaliculitis following intra-canalicular SmartPLUG insertion. This case illustrates that punctal occlusion with the newer generation intra-canalicular plugs carries a risk of canaliculitis and that irrigation is not always effective in removing these devices.

Dacryocystitis↗
PubMed1977

Psychological timing of orthodontic treatment.

A questionnaire type of study was undertaken to test the hypothesis that prepubescent patients are more cooperative than adolescents. Older children were held to be psychologically resistant to the demands of orthodontic treatment because of their involvement in Oedipal conflicts, a normal but distracting aspect of "growing up". Our observers found that patients under 12 were more cooperative than other age groups in the wearing of headgear and other removable devices. They were less cooperative in keeping appointments or in protecting appliances from breakage. The differences were significant at the 5 per cent level of confidence. If responders' observations are an accurate index of true performance, the study suggests that, from a psychological standpoint, activator and headgear treatment should be begun sometime after age 6 and soon enough to be completed before the onset of puberty.

Adolescent↗