Sentinel-lymph-node mapping with indocyanine green in robotic-assisted laparoscopic surgery for early endometrial cancer: a retrospective analysis.

BACKGROUND: The therapeutic value of lymphadenectomy in early stage endometrial cancer (EC) is still debated. Sentinel-lymph-node identified with indocyanine green (ICG) can replace lymphadenectomy in the staging of endometrial cancer minimizing the potential morbidity of a complete lymphadenectomy. The aim of this study was to analyze our initial experience using indocyanine green for sentinel-lymph-node mapping in a minimally robotic-assisted laparoscopic approach with Da Vinci XI near-infrared (NIR) fluorescence imaging system. METHODS: A total of 23 patients who underwent robot-assisted laparoscopic surgery with the Da Vinci Xi Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) with NIR imaging and ICG fluorescence detection for early stage EC were retrospectively analyzed. RESULTS: Sentinel-lymph-node mapping was achieved in 18 patients for a detection rate of 78.26%, bilateral pelvic detection was possible in 14 patients (60.9%) and no sentinel-lymph-node mapping was noted in 4 patients (17.4%). We compared 11 patients (Group 1) at intermediate and high- risk of recurrence who underwent sentinel-lymph- node mapping and pelvic lymphadenectomy and 12 patients (Group 2) at low risk of recurrence who underwent only sentinel-lymph-node mapping. A statistically significant difference was found for the average operation time and for the hospital stays. CONCLUSIONS: The high detection rate, absence of intraoperative or postoperative complications, the short time required for mapping and removal of the sentinel-lymph-nodes and the short duration of the hospital stay, support performing sentinel-lymph-node in all women with early endometrial cancer.

Corrigendum to "Inositol and In Vitro Fertilization with Embryo Transfer".

[This corrects the article DOI: 10.1155/2017/5469409.].

Inositol and In Vitro Fertilization with Embryo Transfer.

Recently, studies on inositol supplementation during in vitro fertilization program (IVF) have gained particular importance due to the effect of this molecule on reducing insulin resistance improving ovarian function, oocyte quality, and embryo and pregnancy rates and reducing gonadotropin amount during stimulation. Inositol and its isoforms, especially myoinositol (MYO), are often used as prestimulation therapy in infertile patients undergoing IVF cycle. Inositol supplementation started three months before ovarian stimulation, resulting in significant improvements in hormonal responses, reducing the amount of FSH necessary for optimal follicle development and serum levels of 17beta-estradiol measured the day of hCG injection. As shown by growing number of trials, MYO supplementation improves oocyte quality by reducing the number of degenerated and immature oocytes, in this way increasing the quality of embryos produced. Inositol can also improve the quality of sperm parameters in those patients affected by oligoasthenoteratozoospermia.

Endocrine and clinical effects of myo-inositol administration in polycystic ovary syndrome. A randomized study.

OBJECTIVE: To evaluate the effects the administration of myo-inositol (MYO) on hormonal parameters in a group of polycystic ovary syndrome (PCOS) patients. DESIGN: Controlled clinical study. SETTING: PCOS patients in a clinical research environment. PATIENTS: 50 overweight PCOS patients were enrolled after informed consent. INTERVENTIONS: All patients underwent hormonal evaluations and an oral glucose tolerance test (OGTT) before and after 12 weeks of therapy (Group A (n»10): MYO 2 g plus folic acid 200 mg every day; Group B (n»10): folic acid 200 mg every day). Ultrasound examinations and Ferriman-Gallwey score were also performed. MAIN OUTCOME MEASURES: Plasma LH, FSH, PRL, E2, 17OHP, A, T, glucose, insulin, C peptide concentrations, BMI, HOMA index and glucose-to-insulin ratio. RESULTS: After 12 weeks of MYO administration plasma LH, PRL, T, insulin levels and LH/FSH resulted significantly reduced. Insulin sensitivity, expressed as glucose-to-insulin ratio and HOMA index resulted significantly improved after 12 weeks of treatment. Menstrual cyclicity was restored in all amenorrheic and oligomenorrheic subjects. No changes occurred in the patients treated with folic acid. CONCLUSIONS: MYO administration improves reproductive axis functioning in PCOS patients reducing the hyperinsulinemic state that affects LH secretion.

Best methods for identification and treatment of PCOS.

The polycystic ovarian syndrome (PCOS) includes a wide spectrum of clinical symptoms and signs. Three different diagnostic classifications have been proposed to define this disease. The first one, published in 1990, known as the "NIH criteria" requires the simultaneous presence of hyperandrogenism and menstrual dysfunction in order to diagnose PCOS. Later on, in 2003, an expert panel met in Rotterdam and added to the previous criteria the presence of polycystic ovarian morphology detected by transvaginal ultrasonography. The later classification broadened the spectrum of PCOS and also included women with oligomenorrhea and PCO without hyperandrogenism or hyperandrogenism and PCO without menstrual dysfunction. Finally, the Androgen Excess Society, published in 2006 new diagnostic criteria which required the presence of clinical or biochemical hyperandrogenism, with either PCO or menstrual dysfunction to diagnose PCOS. This review focuses on the diagnostic techniques and methods of treatment for PCOS patients. Special attention is given to the role of insulin resistance and the potential utility of insulin sensitizers in management of the syndrome. The benefit and utmost importance of lifestyle modification for the long-term health of these women is stressed as well. It is hoped that some clarity in this regard will allow more women to not only be diagnosed and managed properly for their presenting symptoms (hirsutism, irregular menses, etc.), but also to be educated and managed for the continuing health risk of insulin resistance throughout their lives.

The radicular dentine temperature during laser irradiation: an experimental study.

The detoxification and sterilization radicular surfaces that have been produced by periodontal diseases could be accomplished after polishing (root planing) using the thermal elevation resulting from CO2 laser on continuous emission. In vitro experiments reveal that thermal elevations reached on the surfaces or in the depth are proportional to the dispersed energy. The thermal elevation in the depth (0.5-1 mm from the impact point) remained moderate because of the water absorption potentials of the radiations. Energies from 2 to 4.5 J can help obtain the combination of surface temperature elevation, which allows detoxification, and of a thermal elevation in the depth, compatible with vital tissues. This energy has to be delivered at an application time under 0.6 sec in continuous mode.

Horned gena, an atavistic sex-linked dominant mutation in Tribolium confusum.

Horned gena (Hg), a sex-linked dominant mutation with semilethal effects in the imago stage, was found in Tribolium confusion. The Hg mutant is characterized by a pair of horns of variable size and shape that arises from the genoclypeal suture in mildly expressed beetles or a more pronounced horn-like structure resulting from a folding of the genal shelf near the compound eyes. In these beetles there is considerable stress on the exoskeleton of the head so that the cranium is fragmented between the eyes, leaving large, irregularly shaped areas of the head unprotected by cranial exoskeleton. These beetles die presumably because of bacterial infection or because they cannot retain moisture within their bodies. This mutation differs from the mutation V-Grube found in another tenebrionid, Tenebrio molitor. Taxonomic, genetic, and cytological evidence is presented suggesting that Hg is a gene of ancient origin, having existed at least since the genera of Tenebrionidae were being evolved.