ABSTRACT
In vitro fertilisation (IVF) and related technologies are arguably the most challenging of all cell culture applications. The starting material is a single cell from which one aims to produce an embryo capable of establishing a pregnancy eventually leading to a live birth. Laboratory processing during IVF treatment requires open manipulations of gametes and embryos, which typically involves exposure to ambient conditions. To reduce the risk of cellular stress, we have developed a totally enclosed system of interlinked isolator-based workstations designed to maintain oocytes and embryos in a physiological environment throughout the IVF process. Comparison of clinical and laboratory data before and after the introduction of the new system revealed that significantly more embryos developed to the blastocyst stage in the enclosed isolator-based system compared with conventional open-fronted laminar flow hoods. Moreover, blastocysts produced in the isolator-based system contained significantly more cells and their development was accelerated. Consistent with this, the introduction of the enclosed system was accompanied by a significant increase in the clinical pregnancy rate and in the proportion of embryos implanting following transfer to the uterus. The data indicate that protection from ambient conditions promotes improved development of human embryos. Importantly, we found that it was entirely feasible to conduct all IVF-related procedures in the isolator-based workstations.
Subject(s)
Blastocyst/cytology , Cell Count/methods , Embryo Transfer/standards , Fertilization in Vitro , Reproductive Techniques, Assisted/instrumentation , Animals , Embryo Transfer/methods , Equipment Design , Female , Fetal Viability/physiology , Humans , Hydrogen-Ion Concentration , Laboratories , Mice , Observer Variation , Oocytes/cytology , Ovulation Induction , Regression Analysis , Sperm Injections, Intracytoplasmic/methods , TemperatureABSTRACT
Rosai-Dorfman disease (RDD), otherwise known as sinus histiocytosis with massive lymphadenopathy, is a rare histiocytic syndrome of unknown etiology, dominated by histiocytic and lymphocytic infiltration of enlarged lymph nodes. Thyroid involvement is rare and its impact unknown. We report a case of RDD involving the thyroid, initially diagnosed and managed as anaplastic carcinoma, and review the literature for previously reported cases of thyroid involvement. A 71-year-old woman sought further evaluation after treatment elsewhere for a 4-month history of a rapidly enlarging goiter causing local compression. Pathology was reported to show anaplastic thyroid carcinoma with prominent histiocytic infiltration. On review, we found characteristic features of RDD within the thyroid and cervical lymph nodes. The patient showed serologic evidence of autoimmune thyroid disease. Two years after thyroidectomy, there was no evidence of recurrent disease. We have identified only three previously reported cases of RDD involving the thyroid, all of them in women. In all cases, the patient has survived without evidence of disease progression, suggesting that thyroid involvement may not change the generally good prognosis of RDD. The description of autoimmune thyroid disease in our case and in two of the three previously reported cases, suggests a link with autoimmune thyroid disease.
