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PubMedDate not supplied

Right prefrontal activation during encoding, but not during retrieval, in a non-verbal paired-associates task.

Brain imaging studies have shown that episodic encoding into long-term memory preferentially activates the left prefrontal cortex and retrieval activates the right prefrontal cortex. However, it is unclear to what degree verbal analysis contributes to the left prefrontal activation during encoding. The present study was designed to avoid verbal analysis during encoding by using abstract pictures and computer-generated sounds which were difficult to code verbally. Sounds and pictures were grouped into six stimulus-stimulus pairs. When the sound from a pair was presented, the subjects were instructed to recall and visualize the associated picture. After 2.0 s the associated picture and another picture appeared on the screen and the subjects were required to identify the associated picture. Feedback about the choice was then given. Regional cerebral blood flow (rCBF) was measured with [15O]butanol and positron emission tomography (PET) in 10 subjects during initial training on the paired-associates task (encoding scan) and after 35 min of training (retrieval scan). Performance during the encoding scan was 59% correct and during the retrieval scan 98% correct, with a mean reaction time of 709 ms during retrieval. The rCBF was also measured during a control condition without any instruction to encode or retrieve. Compared with retrieval, encoding showed significant activation of the posterior part of the right middle frontal gyrus, the right inferior parietal cortex, the cingulate cortex, the left inferior parietal cortex and the left inferior and middle temporal gyri. The rCBF increase during encoding was strongly correlated with the rate of encoding. Retrieval was compared with both encoding and control. In none of these comparisons was there any prefrontal activation. The lack of prefrontal activation during near-perfect performance of the retrieval task suggests that the prefrontal cortex is not necessarily active when retrieval is fast and accurate, or what might be called automatic. Encoding was not associated with more activation of the left than the right prefrontal cortex. This result presents a limitation to the generality of left prefrontal activation during episodic encoding, which has been found in several previous brain imaging studies. Differences between studies in the relative activation of left and right prefrontal cortex during encoding and retrieval might be due to differences in paradigms, the type of stimulus used, and the demand for working memory and verbal analysis.

Adult↗

PubMed2004

Evaluation of the retrievability of the OptEase IVC filter in an animal model.

PURPOSE: A new inferior vena cava filter was evaluated in vivo to determine the percutaneous retrievability after an implantation period of up to 18 days. MATERIALS AND METHODS: The inferior venae cavae of six goats were percutaneously implanted with three filters, and one animal received two filters. To assess filter stability, a plain radiograph was obtained after 7-9 days and on the day of retrieval. After cavography, filter retrieval with an endovascular snare and retrieval catheter was performed in three animals after 12 days and in three others after 14 days. In one animal, retrieval of one filter was performed after 18 days, and one filter was intended to be permanent. Twenty-eight days after filter retrieval, cavography was performed before inferior vena cava removal for gross and histologic examination. RESULTS: All filters (N = 20) were implanted without complications. There was no migration during the implantation period. Preretrieval cavography demonstrated all filters to be patent and centered. Filters intended for retrieval (n = 19) were all successfully extracted at 12 (nine filters), 14 (nine filters), and 18 days (one filter). For the animal with the filter extracted at 18 days, one filter remained in situ intentionally. Postretrieval cavography showed no visible signs of vessel wall anomalies. There were no complications during the 28 days of follow-up after retrieval. Presacrifice cavography showed no evidence of caval wall abnormalities. In all animals, gross examination of the inner wall of the explanted vena cava showed only minimal macroscopic changes. The struts of the filter in situ for 46 days (18 days with 28 days of follow-up) were overgrown with neointima. Histological study of the 19 filter retrieval sites revealed no to moderate intima proliferation, minimal residual signs of hemorrhages, and no or only occasional slight inflammatory reaction. CONCLUSIONS: In this animal model, the new vena cava filter demonstrated event-free retrieval, without postretrieval complications, up to 18 days postimplantation. After implantation of 46 days, the filter showed neointima overgrowth of the struts.

Animals↗

PubMed2004

Extended interval for retrieval of Günther Tulip filters.

PURPOSE: To evaluate the Gunther Tulip vena cava filter with regard to ease of placement, complications, and retrieval over long time periods. MATERIALS AND METHODS: In 53 patients (ratio of men to women, 24:29; mean age, 52.8 years) retrievable Gunther Tulip filters (Vena Cava M Reye Filter Set; William Cook Europe, Denmark) were inserted. Indications included planned major surgery with recent pulmonary embolus or high pulmonary embolus risk (n = 16), extensive ilio-femoral thrombus (n = 11), deep vein thrombosis with anticoagulant complications (n = 9), breakthrough pulmonary embolus despite anticoagulant therapy (n = 4), and contraindication to anticoagulant therapy (n = 13). All patients were followed-up for immediate and long-term complications. RESULTS: Fifty-three filters were successfully placed in 52 of 53 patients, yielding a success rate of 98.1%. Nineteen patients underwent attempted retrieval of their filter. Sixteen of 19 retrieval procedures were successful (84%). In three patients, the filter could not be removed on attempted retrieval (extensive filter thrombus in two patients and attachment to the wall in one patient). One patient received two filters, which were both successfully retrieved at a later date. Median implantation time for retrievable filters was 34 days (range, 7-126 days). Mean follow-up for patients with permanent filters was 13 months. Two major complications (pneumothorax and break through pulmonary embolus) and three minor complications (right internal jugular vein thrombosis in two patients and transient Horner's Syndrome in one patient) were recorded. CONCLUSION: Insertion and retrieval of filters is safe and feasible. Preliminary data suggest that Gunther Tulip filter retrieval is feasible over and above the manufacturer's recommended retrieval interval of 14 days.

Adult↗

PubMed1989

Oocyte retrieval in an in vitro fertilization-embryo transfer program: comparison of four methods.

The records of 191 patients involved in 316 treatment cycles over 3 years in an in vitro fertilization-embryo transfer program were reviewed. Follicular aspiration, oocyte retrieval, pregnancy rates, technical difficulty, and complications were compared in four oocyte retrieval methods: 117 laparoscopic retrievals, 116 ultrasound (US)-guided percutaneous transvesical retrievals, 43 US-guided transvaginal retrievals, and 40 combined US and laparoscopic retrievals. The mean number of aspirated follicles (9.14) was greatest in the transvaginal retrieval group, but the ratio of oocytes to punctured follicles was not statistically greater in any of the groups. The overall clinical pregnancy rate per cycle was highest in the transvaginal retrieval group: 12 of 43 cycles resulted in pregnancy, or 27.9%. The number of delivered babies (16.3%) was also highest in the transvaginal retrieval group. US-guided transvaginal oocyte retrieval is recommended as the method of choice.

Embryo Transfer↗

PubMed2005

Overlap in the functional neural systems involved in semantic and episodic memory retrieval.

Neuroimaging and neuropsychological data suggest that episodic and semantic memory may be mediated by distinct neural systems. However, an alternative perspective is that episodic and semantic memory represent different modes of processing within a single declarative memory system. To examine whether the multiple or the unitary system view better represents the data we conducted a network analysis using multivariate partial least squares (PLS ) activation analysis followed by covariance structural equation modeling (SEM) of positron emission tomography data obtained while healthy adults performed episodic and semantic verbal retrieval tasks. It is argued that if performance of episodic and semantic retrieval tasks are mediated by different memory systems, then there should differences in both regional activations and interregional correlations related to each type of retrieval task, respectively. The PLS results identified brain regions that were differentially active during episodic retrieval versus semantic retrieval. Regions that showed maximal differences in regional activity between episodic retrieval tasks were used to construct separate functional models for episodic and semantic retrieval. Omnibus tests of these functional models failed to find a significant difference across tasks for both functional models. The pattern of path coefficients for the episodic retrieval model were not different across tasks, nor were the path coefficients for the semantic retrieval model. The SEM results suggest that the same memory network/system was engaged across tasks, given the similarities in path coefficients. Therefore, activation differences between episodic and semantic retrieval may ref lect variation along a continuum of processing during task performance within the context of a single memory system.

Adult↗

PubMedDate not supplied

OptEase retrievable inferior vena cava filter: initial multicenter experience.

The purpose of this article is to describe our experience with the retrievable OptEase inferior vena cava filter (IVCF) (Cordis Corporation, Miami Lakes, FL) in the prevention of pulmonary embolus (PE). Forty patients (24 men, age range 15-85 years, mean age 38 years) who were at temporary risk of PE underwent insertion and retrieval of the OptEase IVCF at two institutions. Eleven patients were treated with filter implantation and subsequent repositioning in the inferior vena cava (IVC) to extend implantation time. All patients were followed up for 24 hours after retrieval, with additional follow-up at the physician's discretion. Forty patients had successful filter insertion. Two patients who underwent intravascular ultrasound guidance for filter deployment required filter repositioning within 24 hours owing to inadvertent placement in the right common iliac vein. All 40 patients underwent successful filter retrieval with no adverse events. In those patients who did not undergo IVCF repositioning, the time to retrieval ranged from 3 to 48 days (mean +/- SD 16.38 +/- 7.20 days). One patient had a successful retrieval at 48 days, but all other retrieval experiences were performed within 23 days. The second strategy involved implantation, with repositioning at least once before final retrieval. This latter strategy occurred in 11 patients, and the time to first capture ranged from 4 to 30 days (mean +/- SD 13.82 +/- 6.13 days). No symptomatic PE, IVC injury or stenosis, significant bleeding, filter fracture, or filter migration was observed. In this feasibility study, the OptEase IVCF prevented symptomatic PE, was safely retrieved or repositioned up to 48 days after implantation, and served as an effective bridge to anticoagulation. In patients who require extended IVCF placement, the OptEase IVCF can be successfully repositioned within the IVC, thereby extending the overall implantation time of this retrievable IVCF.

Adolescent↗

PubMed2002

Comparison of tibial plateau angle between clinically normal Greyhounds and Labrador Retrievers with and without rupture of the cranial cruciate ligament.

OBJECTIVE: To compare tibial plateau angle (TPA) between Greyhounds without damage to the cranial cruciate ligaments and Labrador Retrievers with and without damage to the cranial cruciate ligaments. DESIGN: Clinical study. ANIMALS: 87 client-owned dogs and 15 research colony Greyhounds. PROCEDURE: Standing position, horizontal-beam radiography was performed on Greyhounds and unaffected Labrador Retrievers to determine standing TPA. Lateral radiography of the stifle joint was performed on all dogs to determine traditional TPA. Age and body weight were recorded for unaffected and affected Labrador Retrievers. RESULTS: Greyhounds had mean standing TPA of 1.56 degrees and mean traditional TPA of 22.50 degrees. Unaffected Labrador Retrievers had mean standing TPA of 3.52 degrees and traditional TPA of 27.97 degrees. Affected Labrador Retrievers had mean traditional TPA of 25.55 degrees. No significant difference was found in mean standing TPA between Greyhounds and unaffected Labrador Retrievers. Standing TPAs in Greyhounds and unaffected Labrador Retrievers were not significantly different from a plane drawn parallel to the ground. Significant differences in traditional TPAs were detected among all 3 groups. CONCLUSIONS AND CLINICAL RELEVANCE: Greyhounds had mean traditional TPA of 22.50 degrees; similar angles should be considered normal for dogs. Although affected Labrador Retrievers had mean traditional TPA that was significantly greater than that of Greyhounds, the steepest TPA was found in unaffected Labrador Retrievers. Because Greyhounds and unaffected Labrador Retrievers had similar standing TPAs, we conclude that although TPA may be associated with damage to the cruciate ligaments, many dogs with a steep TPA do not develop cruciate ligament disease.

Animals↗

PubMed1989

The properties of retrieval cues constrain the picture superiority effect.

In three experiments, we examined why pictures are remembered better than words on explicit memory tests like recall and recognition, whereas words produce more priming than pictures on some implicit tests, such as word-fragment and word-stem completion (e.g., completing -l-ph-nt or ele----- as elephant). One possibility is that pictures are always more accessible than words if subjects are given explicit retrieval instructions. An alternative possibility is that the properties of the retrieval cues themselves constrain the retrieval processes engaged; word fragments might induce data-driven (perceptually based) retrieval, which favors words regardless of the retrieval instructions. Experiment 1 demonstrated that words were remembered better than pictures on both the word-fragment and word-stem completion tasks under both implicit and explicit retrieval conditions. In Experiment 2, pictures were recalled better than words with semantically related extralist cues. In Experiment 3, when semantic cues were combined with word fragments, pictures and words were recalled equally well under explicit retrieval conditions, but words were superior to pictures under implicit instructions. Thus, the inherently data-limited properties of fragmented words limit their use in accessing conceptual codes. Overall, the results indicate that retrieval operations are largely determined by properties of the retrieval cues under both implicit and explicit retrieval conditions.

Adult↗

PubMed1998

[Percutaneous retrieval of intravascular foreign bodies].

INTRODUCTION: The spreading of interventional procedures and the frequent use and replacement of central venous catheters have contributed to a relative increase in the occurrence of intravascular foreign bodies (FBs). Their retrieval is justified by potential complications related to their characteristics, location and permanence. The high morbidity related to surgical retrieval, especially in case of intravenous FBs (often located in the right cardiac chambers or the pulmonary artery) has contributed to the spreading of interventional retrieval procedures. The purpose of percutaneous retrieval is: 1) to hook the FB to stop its migration to more critical districts; 2) to extract it through the percutaneous access route or, if the latter is unfeasible, 3) to simplify surgical retrieval. MATERIAL AND METHODS: We report our experience with 15 patients presenting an FB [intravenous (i.v.) in 11 cases and intra-arterial (i.a.), in 4]. Retrieval was performed mainly with snare-loop catheters (13 cases, together with a pig-tail catheter in 3 patients) and also with Dormia baskets (3 cases, together with a snare loop in 1 case). To ensure the percutaneous retrieval, we used introductors with a greater caliber than that of the FB, the latter generally being a 6-7 F intravenous catheter. The percutaneous approach was mostly transfemoral (right femoral in 9 cases and bilateral femoral, left femoral, axillary and left jugular in 1 case each). RESULTS: Percutaneous retrieval was successful in all the i.v. cases and in 1 ia case. The other 3 ia cases required surgical removal under local anesthesia after percutaneous hooking and displacement of the FB to a more accessible site. No major complications were observed during retrievals. CONCLUSIONS: Based on our personal results and in agreement with the major international reports, we believe that percutaneous retrieval should be considered the treatment of choice for FBs. The procedure success depends on an accurate diagnostic approach, good knowledge of materials and techniques and the operator's experience, as well as the possibility of an interdisciplinary collaboration of the interventional radiologist with the surgeon and anesthesist.

Adult↗

PubMed2001

Cellular imaging of zif268 expression in the hippocampus and amygdala during contextual and cued fear memory retrieval: selective activation of hippocampal CA1 neurons during the recall of contextual memories.

The neuroanatomical and molecular basis of fear memory retrieval was studied by analyzing the expression of the plasticity-associated immediate early gene zif268. Cellular quantitative in situ hybridization revealed that zif268 is expressed within specific regions of the hippocampus and amygdala during fear memory retrieval. Within the hippocampus, increased expression of zif268 was observed within CA1 neurons, but not dentate gyrus neurons, during the retrieval of contextual, but not cued, fear associations. In contrast, zif268 expression was increased within neurons of the amygdala (lateral, basal, and central nuclei) during the retrieval of both contextual and cued fear memories. These results demonstrate activation of hippocampal CA1 neurons in contextual fear memory retrieval that was not merely a correlate of the behavioral expression of fear itself, because it was limited to the retrieval of contextual, and not cued, fear memories. Further studies revealed that the selective increase in hippocampal CA1 zif268 expression seen after contextual fear memory retrieval was limited to the retrieval of recent (24 hr) but not older (28 d) memories. These experiments represent the first demonstration that zif268 expression in specific neuronal populations is associated with memory retrieval and suggest that this gene may contribute to plasticity and reconsolidation accompanying the retrieval process.

Acoustic Stimulation↗

PubMed2005

[Antigen retrieval immunohistochemistry under the influence of pH value and time].

OBJECTIVE: To find the best antigen retrieval buffer and retrieval time for the immunohistochemical staining of P504S, P63, CD10, and Ki-67. METHODS: The following tissues were fixed in 10% formalin: the tissues of prostate carcinoma, benign prostate hyperplasia, proliferative breast disease and cunnus epithelial tissue infected by human papilloma virus. Immunohistochemical stainings for these tissues were processed by EnVision's methods. The first antibodies were P504S for prostate carcinoma, P63 for benign prostate hyperplasia, CD10 for proliferative breast disease, and Ki-67 for cunnus epithelial tissue infected by human papilloma virus. The same second antibody EnVision was used for all the tissues. For each tissue, we used three different antigen retrieval buffers, CA (pH 6.0), EDTA (pH 8.0) and EDTA-Tris (pH 9.0). For each buffer, there were 4 durations for antigen retrieving, namely 12, 20, 25 and 30 min. The positive signals in different conditions were observed and compared under light microscope. RESULTS: The best signal for P504S was observed after retrieval in the EDTA-Tris buffer (pH 9.0) for 20 min, P63 for 30 min, and Ki-67 for 25 min. The best positive signal for CD10 was observed after retrieval in all the buffers with different pH value for 20 or 25 min. CONCLUSION: Different antigens have their own optimal retrieval buffers and the optimal retrieval time. Relatively, for the antigen retrieval of Ki-67, P504S and P63, EDTA-Tris buffers with pH 9.0 is better than other low pH retrieval buffers.

Antigen-Antibody Complex↗

PubMed2004

Consequences of impaired data quality on information retrieval in electronic patient records.

OBJECTIVES: To assess the quality of specific information in electronic patient records and the consequences of sub-optimal data quality on automated information retrieval. METHODS: Patient records were evaluated with respect to accuracy of data relevant for retrieval according to a source-oriented, time-oriented and concept-oriented view of the record. Retrieval effectiveness was estimated using various methods based on record structure, text based retrieval and combinations of these. RESULTS: 98.1% of record documents were consistent regarding author, 99.8% regarding department of origin and 90.9% regarding document date. Document type was definitely not consistent in 8% of the documents. Estimated recall was 97% with 50% precision for document retrieval on the basis of date, and varying from 31 to 100% for retrieval based on document type. Retrieval based on manually supplied semantic tags performed better than simple string-based methods and improved when combined with string-matching mechanisms. CONCLUSIONS: Data attributes central for automated document retrieval in electronic patient records showed variable accuracy, with potentially negative consequences for basic record navigation. Text-based retrieval was inferior to methods based on data representing record structure. Quality of specific information elements suffered from lack of precise definitions and adequate mechanisms for quality assurance.

Information Storage and Retrieval↗

PubMedDate not supplied

Evaluation of the quality of information retrieval of clinical findings from a computerized patient database using a semantic terminological model.

OBJECTIVES: To measure the strength of agreement between the concepts and records retrieved from a computerized patient database, in response to physician-derived questions, using a semantic terminological model for clinical findings with those concepts and records excerpted clinically by manual identification. The performance of the semantic terminological model is also compared with the more established retrieval methods of free-text search, ICD-10, and hierarchic retrieval. DESIGN: A clinical database (Diabeta) of 106,000 patient problem record entries containing 2,625 unique concepts in an clinical academic department was used to compare semantic, free-text, ICD-10, and hierarchic data retrieval against a gold standard in response to a battery of 47 clinical questions. MEASUREMENTS: The performance of concept and record retrieval expressed as mean detection rate, positive predictive value, Yates corrected and Mantel-Haenszel chi-squared values, and Cohen kappa value, with significance estimated using the Mann-Whitney test. RESULTS: The semantic terminological model used to retrieve clinically useful concepts from a patient database performed well and better than other methods, with a mean detection rate of 0.86, a positive predictive value of 0.96, a Yates corrected chi-squared value of 1,537, a Mantel-Haenszel chi-squared value of 19,302, and a Cohen kappa of 0.88. Results for record retrieval were even better, with a mean record detection rate of 0.94, a positive predictive value of 0.99, a Yates corrected chi-squared value of 94, 774, a Mantel-Haenszel chi-squared value of 1,550,356, and a Cohen kappa value of 0.94. The mean detection rate, Yates corrected chi-squared value, and Cohen kappa value for semantic retrieval were significantly better than for the other methods. CONCLUSION: The use of a semantic terminological model in this test scenario provides an effective framework for representing clinical finding concepts and their relationships. Although currently incomplete, the model supports improved information retrieval from a patient database in response to clinically relevant questions, when compared with alternative methods of analysis.

Data Interpretation, Statistical↗

PubMed1997

Role of calcium chelation in high-temperature antigen retrieval at different pH values.

Recent work by Shi et al. on the mechanism of high-temperature antigen retrieval has claimed that the antigen retrieval process is pH-dependent, with different antigens benefitting at high or low pH values of antigen retrieval solutions. It has previously been claimed that chelation of Ca2+ at high temperature is an essential feature of the antigen retrieval process. In order to resolve this apparent dichotomy, the relative antigen retrieval effects were analysed using the buffers employed by Shi et al. in both a facilitating and an inhibitory mode. The results show that calcium-related effects are optimal at high pH values and do not operate at very low pH. The relative antigen retrieval effectiveness of hydrochloric acid and its metal halide solutions were also investigated in relation to pH. The results of these experiments showed that whilst HCl alone produced antigen retrieval (AR), it also produced severe tissue damage, which was reduced by the inclusion of inorganic salts. These results suggest that antigen retrieval at low pH may be achieved through the dissociation of Ca2+ complexes by high concentrations of H+ ions and/or the breaking up of cross-links from formalin fixation. Results are also presented to show that chaotropic denaturants such as urea and guanidine hydrochloride also function principally through calcium chelation, whilst detergents have no role to play in high-temperature retrieval.

Calcium↗

PubMed2005

Incidence, retrieval methods, and outcomes of stent loss during percutaneous coronary intervention: a large single-center experience.

Our goal was to examine the incidence and consequences of stent loss during percutaneous coronary intervention (PCI) and the retrieval techniques used. We retrospectively reviewed 11,773 consecutive PCI cases involving stents performed at our institution between January 1994 and March 2004 to identify cases of stent loss. Stent loss occurred in 38 of 11,773 PCI procedures involving stents (0.32%; 95% CI = 0.23-0.44%). Mean age of the patients was 67 +/- 11 years and 82% were men. Stent loss occurred more frequently in lesions with calcification and/or significant proximal angulation. In three patients, the stent was crushed and covered with another stent without attempting retrieval. Stent retrieval was attempted in 35 of 38 cases and was successful in 30 (86%). The following retrieval methods were used (more than one method was used in some cases): advancing a balloon through the stent, inflating the balloon, and withdrawing the stent (45%); twirling two wires around the stent (5%); loop snare (26%); biliary forceps (12%); Cook retained fragment retriever (10%); and basket retrieval device (2%). Patients in whom stent loss occurred had a higher incidence of bleeding requiring transfusion (24% vs. 7%; P < 0.001) and more often required emergency coronary artery bypass surgery (5% vs. 0.4%; P < 0.001). No patients in whom the stent was crushed or deployed in the coronary artery had any major cardiac complication. Stent loss during PCI occurs infrequently. Lost stents can be successfully retrieved in the majority of cases using a variety of retrieval techniques, yet stent loss is associated with an increased risk of complications. Stent deployment or crushing may be a good alternative to retrieval.

Aged↗

PubMed2005

One month of human memory consolidation enhances retrieval-related hippocampal activity.

We studied the role of the hippocampus in memory retrieval at 1 day and 1 month following associative learning of word pairs. Retrieval-related brain activity was recorded using functional magnetic resonance imaging in 20 healthy students, of which 12 were good learners and eight were poor learners. At the day lag, the poor learners exhibited enhanced neural recruitment in the hippocampus and neocortex to reach a retrieval performance comparable to that of the good learners. Over the 20 subjects, there was a positive correlation between retrieval-related hippocampal activity at the day lag and forgetting over the month retention interval (the greater the activity, the more forgetting). Although the poor learners' retrieval performance declined dramatically from the day to the month lag, the good learners maintained a high retrieval performance, which distinguishes them as good memory consolidators. Their retrieval-related hippocampal and neocortical activity increased from the day to the month lag. This increase was observed both when retrieval performance was matched between the day and the month lag and when the learning procedure for information retrieved at the day and the month lag was matched. This activity increase in the task-specialized neural network from the day lag to the month lag may reflect an increase in task demands or the proliferation of hippocampal-neocortical memory traces during memory consolidation as suggested by the multiple trace theory.

Adult↗

PubMed1995

Cytokine and coagulation characteristics of retrieved blood after arthroplasty.

OBJECTIVES: To investigate cytokine and coagulation/fibrinolysis characteristics in blood retrieved from wounds using an autotransfusion system, and to compare the cytokine pattern in the retrieved blood with those in the systemic circulation and in the initial portion of drainage blood from the wound. DESIGN: Prospective controlled clinical study. SETTING: The postoperative ward of a University hospital. PATIENTS AND PARTICIPANTS: Blood retrieval was performed over a period of 4-6 h on patients who had just undergone arthroplasty (nine hips, one knee). In five other cases involving hip arthroplasties, the initial portion of drainage blood was studied. MEASUREMENTS AND RESULTS: Coagulation/fibrinolysis parameters were analyzed in blood retrieved using the Stryker Consta Vac system. Concentrations of tumor necrosis factor alpha (TNF), interleukin-1 beta (IL-1) and interleukin-6 (IL-6) were analyzed in the retrieved blood, in the systemic circulation of the patients at the beginning and at the end of blood retrieval and in the initial portion of drainage blood from the surgical area. In the retrieved blood, the activities of thrombin, kallikrein and plasmin were increased, antithrombin and free protein S were decreased, and in all samples IL-6 was >1000 pg/ml. Postoperative plasma concentrations of IL-6 rose from a median value of 0 to 116 pg/ml (p <0.01). Four patients had circulating TNF concentrations (range: <15-50 pg/ml). Plasma IL-1 was not detected. TNF and IL-1 were detected in all samples of initial blood from the surgical area and IL-6 in one sample. CONCLUSION: Hypercoagulability and high concentrations of IL-6 were present in the retrieved blood. The cytokine pattern in the initial portion of blood from the surgical area differed from those in the retrieved blood and in the systemic circulation.

Aged↗

PubMed1997

In vitro fertilization programmed for weekday-only oocyte harvest: analysis of outcome based on actual retrieval day.

OBJECTIVE: Our aim was to assess the effect of the day of ovum retrieval on outcome in an IVF program scheduled for weekday-only ovum retrievals. DESIGN: This was a retrospective study of patients who underwent transvaginal ultrasound-guided ovum retrieval (TVUS-OR) in an IVF program from August 10, 1992, to April 30, 1993. SETTING: A university-based tertiary referral hospital center was the setting. PARTICIPANTS AND METHODS: All patients (n = 501) who underwent TVUS-OR were divided into three groups: (1) patients who underwent TVUS-OR on Monday; (2) patients who underwent retrieval on Tuesday, Wednesday, or Thursday; and (3) patients who underwent retrieval on Friday. All patients were induced by the same controlled ovarian hyperstimulation protocol, which consisted of a GnRH analogue "flare-up" followed by parenteral menotropins, after a scheduled oral contraceptive-induced menses. Patients and cycle characteristics in the three groups were compared and clinical outcome was evaluated. RESULTS: The similarity of patients and cycle characteristics confirmed the uniformity of the three groups. No difference was found in any of the clinical outcomes. However, in the first half of the program, we revealed a trend in which patients at high risk for ovarian hyperstimulation syndrome, requiring freezing all embryos and not allowing transfer during the treatment cycle, occurred more commonly in women whose retrieval occurred on Monday. This trend disappeared in the second half of the analysis. CONCLUSIONS: In an in vitro fertilization program in which ovum retrievals occurred only on weekdays, no significant difference in outcome was found in patients undergoing ovum retrieval on Monday or Friday versus midweek. In addition to significant savings by eliminating weekend retrievals, IVF outcome is not compromised.

Adult↗