ABSTRACT
We present an unusual case of an unstable pelvic fracture during pregnancy period, who suffered fetal death and splenic rupture simultaneously which developed massive delayed hemorrhage in abdomen. When considering potential causes of fetal death, direct trauma to the uterus, placenta, or fetus was not associated with a higher fetal mortality rate, compared with maternal hemorrhage. A cesarean section and splenectomy could rescue the maternal life from the hemorrhage situation. Successful treatment of these rare cases is possible with careful pre-, peri-, and post-operative evaluation of the mother and fetus by a multidisciplinary team.
Subject(s)
Female , Humans , Pregnancy , Cesarean Section , Fetal Death , Fractures, Bone , Hemorrhage , Pelvic Bones , Wounds and InjuriesABSTRACT
High-velocity penetrating pelvic injury is one of the most difficult challenges to trauma surgeons. The injury sites frequently include soft tissue, pelvis, genitourinary tract, vascular structures and intraabdominal viscera. We present an unusual case of a male patient suffering a collision at night with a deformed steel bar penetrating into his right groin. Careful planning of the surgical approach is important before extracting the foreign body. The possibility of multiorgan damage to intrapelvic structures such as colon, urinary bladder, vessels and nerves, frequently necessitates a multidisciplinary involvement and systematic approach. Besides, limited incision as well as modification should be considered, and debridement and perioperative antibiotics can be used to reduce the risk of serious wound infection.
Subject(s)
Adult , Humans , Male , Abdominal Injuries , General Surgery , Foreign Bodies , General Surgery , Multiple Trauma , General Surgery , Wounds, Penetrating , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To explore the use of L-carnitine before percutaneous epididymal sperm aspiration-intracytoplasmic sperm injection (PESA-ICSI) in the treatment of obstructive azoospermia.</p><p><b>METHODS</b>Seventy-nine cases of obstructive azoospermia treated in our center from Sep 2008 to Aug 2009 were divided into an L-carnitine (n = 43) and a control group (n = 36), the former given oral L-carnitine at 1 g bid for 3 months before PESA-ICSI, while the latter left untreated. Comparisons were made between the two groups in the number of retrieved oocytes and fertilized oocytes as well as the number and rate of good embryos.</p><p><b>RESULTS</b>There were no significant differences between the two groups in the number of retrieved oocytes and fertilized oocytes. But the number and rate of good embryos were significantly higher in the L-carnitine than in the control group (P < 0.05).</p><p><b>CONCLUSION</b>Three-month oral medication of L-carnitine before PESA-ICSI can raise the number and rate of good embryos in obstructive azoospermia patients and therefore benefit the therapeutic outcome.</p>
Subject(s)
Adult , Humans , Male , Azoospermia , Therapeutics , Carnitine , Therapeutic Uses , Epididymis , Sperm Injections, Intracytoplasmic , Methods , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the effects of different proportions of cryoprotectant to seminal plasma on the motility of post-thaw human sperm.</p><p><b>METHODS</b>Different proportions of cryoprotectant to seminal plasma (1:1 and 1:3) were used for freezing sperm, and the forward movement and total motility rates of the frozen-thawed sperm were compared.</p><p><b>RESULTS</b>The forward movement and total motility rates were (58.60 +/- 5.57)% and (66.17 +/- 5.24)% before cryopreservation. The 1:1 proportion achieved post-thaw forward movement and total motility rates of (40.53 +/- 8.97)% and (51.23 +/- 9. 30)%, while the 1:3 (44.7 +/- 8.67)% and (51.50 +/- 7.40)%, respectively. Significantly decreased sperm motility was observed after cryopreservation (P < 0.05). Statistically significant differences were found in the forward movement but not in the total motility of the frozen-thawed sperm between the two proportions.</p><p><b>CONCLUSION</b>Cryopreservation causes obvious damage to human sperm. Higher proportion of cryoprotectant to seminal plasma (1:3) can improve the forward movement of post-thaw sperm as compared with the lower one (1:1).</p>
Subject(s)
Adult , Humans , Male , Cryoprotective Agents , Pharmacology , Freezing , Semen , Sperm MotilityABSTRACT
<p><b>OBJECTIVE</b>To compare the effects of the cryoprotectant containing glucose and that containing sucrose on the motility of post-thaw human sperm.</p><p><b>METHODS</b>The cryoprotectant containing glucose and that containing sucrose were applied to 50 semen samples and the motility of the post-thaw human sperm was compared before and after cryopreservation and between the study groups.</p><p><b>RESULTS</b>The forward motility and total motility of the sperm were (58.4 +/- 5.7)% and (63.4 +/- 6.1)% before cryopreservation, (43.8 +/- 7.6)% and (48.4 +/- 7.6)% after thawing with the cryoprotectant containing glucose, and(42.6 +/- 8.9)% and (48.0 +/- 8.5)% after thawing with the cryoprotectant containing sucrose. Decreased sperm motility was observed after cryopreservation, with statistic significance (P < 0.01). There was no significant difference in the forward and total motility of the post-thaw sperm between the two cryoprotectants.</p><p><b>CONCLUSION</b>Cryopreservation inflicts obvious damage on sperm. Sucrose is a feasible sperm cryoprotectant.</p>
Subject(s)
Adult , Humans , Male , Cryopreservation , Methods , Cryoprotective Agents , Pharmacology , Glucose , Pharmacology , Semen Preservation , Methods , Sperm Motility , Spermatozoa , Physiology , Sucrose , PharmacologyABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficiency of density gradient and improved swim-up methods for motile sperm isolation from fresh semen samples in intracytoplasmic sperm injection and embryo transfer (ICSI-ET) program, thus guiding the clinical application.</p><p><b>METHODS</b>The fertilization rate, cleavage rate, high-quality embryo rate, clinical pregnancy rate, sperm abnormal rate and recovery rate of 42 cycles were studied prospectively. The cycles were divided into two groups with respect to the motile sperm isolation methods.</p><p><b>RESULTS</b>No obvious difference was found in the fertilization rate, cleavage rate, high-quality embryo rate and clinical pregnancy rate between the two methods. The abnormal sperm rate induced by the improved swim-up method was significantly higher than that of the density gradient method (P < 0.01). For severe oligozoospermia, the recovery rate of motile sperm with density gradient was higher than that of improved swim-up (P < 0.01).</p><p><b>CONCLUSION</b>In the ICSI-ET, there is no obvious difference in clinical pregnancy outcome between the two methods. The method of improved swim-up can be used for all patients but those with severe oligozoospermia.</p>
Subject(s)
Adult , Female , Humans , Male , Pregnancy , Cell Separation , Methods , Centrifugation, Density Gradient , Embryo Transfer , Pregnancy Outcome , Pregnancy Rate , Prospective Studies , Sperm Injections, Intracytoplasmic , Spermatozoa , Cell BiologyABSTRACT
Objective To evaluate the development of immature oocytes after freezing-thawing by conventional cryopreservation method for mature oocytes.Methods Immature oocytes were collected from stimulated ovaries of intracytoplasmic sperm injection(ICSI)cycles.Immature oocytes were in vitro matured directly or after slow freezing-fast thawing and immunostained for tubulin and chromatin and at last visualized by confocal microscopy.Results No statistical difference was found in maturity rate between freezing groups and the controls.There was a statistically significant increase in abnormalities of chromosome(23.7% vs. 50%)and spindle(28.9% vs.53.9%)in the GV freezing group compared with the GV control(P