Fecundity of infertile women with minimal or mild endometriosis. A clinical study.

Despite significant developments in medical and surgical approaches for treating endometriosis, the optimal therapy has yet to be established. The relationship between prevalence of fecundity and stage of endometriosis according to their management was studied. Of 151 consecutive women with laparoscopy-proved endometriosis stage-1 and 2, operative laparoscopy was performed in 49, medical treatment in 59 and expectant management in 43 cases. During a 24-month period the cumulative pregnancy rates were found to be 36.7%, 30.5% and 20.9% respectively. Survival analysis showed that the probability of carrying the pregnancy beyond 20 weeks were 30.6%, 25.4% and 16.2% respectively. Diagnosis and treatment of early endometriosis is beneficial for the infertile women. Laparoscopic surgery seems to be the milestone of treatment in these cases, increasing the fecundity and involving minimal risk.

Laparoscopic treatment of hydrosalpinx: factors affecting pregnancy rate.

STUDY OBJECTIVE: To evaluate the efficacy of laparoscopic surgery in a series of women with hydrosalpinx. DESIGN: Prospective, observational study (Canadian Task Force classification II-2). Setting. University-affiliated hospital. PATIENTS: Sixty-one women undergoing bilateral neosalpingostomy and restoration of tubal ovarian anatomy laparoscopically, and followed for 24 months. INTERVENTION: Video-controlled operative laparoscopy using standard four-puncture technique. MEASUREMENTS AND MAIN RESULTS: During 24-month follow-up, cumulative intrauterine pregnancy rates at 6-month intervals were 6.8%, 13.6%, 20.5%, and 20.5% for patients with only distal tubal obstruction and 12%, 23%, 29%, and 29% for those with mild degree of tubal disease and periadnexal adhesions. Miscarriage rate for intrauterine pregnancies was zero in both groups. CONCLUSION: Operative laparoscopy seems to be an effective treatment for hydrosalpinx in terms of pregnancy outcome.

Non-Hodgkin's lymphoma during pregnancy--case report.

Occurrence of Non Hodgkin's lymphoma (NHL) in pregnancy is very rare. A 24-year-old woman with NHL stage IVB complicating pregnancy is presented. The diagnosis was made by biopsy at 27 weeks. The patient received combination chemotherapy which led to remission of the disease. The baby was delivered by an emergency caesarean section, due to fetal distress at 31 weeks. Unfortunately after a short period of remission a relapse occurred and magnetic resonance imaging (MRI) showed cerebral involvement, indicating a poor prognosis. She died seven months later from disseminated disease.

The crystal structure of the complexes of concanavalin A with 4'-nitrophenyl-alpha-D-mannopyranoside and 4'-nitrophenyl-alpha-D-glucopyranoside.

Concanavalin A (Con A) is the best-known plant lectin and has important in vitro biological activities arising from its specific saccharide-binding ability. Its exact biological role still remains unknown. The complexes of Con A with 4'-nitrophenyl-alpha-D-mannopyranoside (alpha-PNM) and 4'-nitrophenyl-alpha-D-glucopyranoside (alpha-PNG) have been crystallized in space group P2(1)2(1)2 with cell dimensions a = 135.19 A, b = 155.38 A, c = 71.25 A and a = 134.66 A, b = 155.67 A, and c = 71.42 A, respectively. X-ray diffraction intensities to 2.75 A for the alpha-PNM and to 3.0 A resolution for the alpha-PNG complex have been collected. The structures of the complexes were solved by molecular replacement and refined by simulated annealing methods to crystallographic R-factor values of 0.185/0.186 and free-R-factor values of 0.260/0.274, respectively. In both structures, the asymmetric unit contains four molecules arranged as a tetramer, with approximate 222 symmetry. A saccharide molecule is bound in the sugar-binding site near the surface of each monomer. The nonsugar (aglycon) portion of the compounds used helps to identify the exact orientation of the saccharide in the sugar-binding pocket and is involved in major interactions between tetramers. The hydrogen bonding network in the region of the binding site has been analyzed, and only minor differences with the previously reported Con A-methyl-alpha-D-mannopyranoside complex structure have been observed. Structural differences that may contribute to the slight preference of the lectin for mannosides over glucosides are discussed. Calculations indicate a negative electrostatic surface potential for the saccharide binding site of Con A, which may be important for its biological activity. It is also shown in detail how a particular class of hydrophobic ligands interact with one of the three so-called characteristic hydrophobic sites of the lectins.