Estradiol benzoate treatment before ovum pick-up increases the number of good quality oocytes retrieved and improves the production of transferable embryos in Japanese Black cattle.

The aim of this study was to evaluate the efficacy of treatment with estradiol benzoate (EB) at luteal phase prior to the ovum pick-up (OPU) during in vitro production of transferable embryos in Japanese Black cattle. A total of 15 cows were used as oocyte donors for OPU. Of those, four donors were randomly allocated (three times) into each of two treatment groups as a crossover study, and OPU session was carried out six times per one donor. Another eleven donors were used in a paired difference test by one crossover trial. Donors in the control group received no hormonal treatment; whereas, donors in the EB group received 1 mg of EB as a single injection. First, we observed dynamics of ovarian follicles and emergence of follicular wave after EB injection using transrectal ultrasonography. The number and proportion of medium-sized follicles with 4 to 6 mm in diameter increased gradually and achieved a peak at 72 and 96 hours after EB injection. The OPU was performed 88 hours after EB injection. The EB-treated donors had a higher proportion of follicles with 4 to 6 mm in diameters at the time of OPU. The stimulation with EB significantly increased the numbers of follicles aspirated, and the good quality cumulus-oocyte complexes per OPU. Furthermore, in the EB group, the percentage of transferable blastocysts was significantly greater than that in the control group (P<0.05). In conclusion, a single EB injection before OPU increases the number of medium-sized follicles and can produce more transferable embryos.

Cilostazol administration with combination enteral and parenteral nutrition therapy remarkably improves outcome after subarachnoid hemorrhage.

OBJECTIVE: In order to prevent cerebral vasospasm (VS) following aneurysmal subarachnoid hemorrhage (SAH), we introduced combined enteral nutrition (EN) and parenteral nutrition (PN) with oral cilostazol administration to the postoperative patient after SAH and investigated the effect on VS. METHODS: After aneurysmal SAH, 130 postoperative patients were enrolled in this study between April 2008 and March 2012. The patients enrolled before April 2010 were treated by conventional therapy (control group). The patients enrolled after April 2010 were administrated cilostazol 200 mg/day and received EN and PN simultaneously (combined group). RESULTS: The combined group consisted of 62 patients and the control group of 68 patients. Angiographic VS occurred in 33.9 % (n = 21) of the combined group and in 51.5 % (n = 35) of the control group (p = 0.051, Fisher exact test). The incidence of symptomatic VS was significantly lower in the combined group (p = 0.001). The incidence of new cerebral infarctions was also significantly lower in the combined group (p = 0.0006). Clinical outcome at discharge was also significantly better in the combined group than in control group (p = 0.031). CONCLUSIONS: Cilostazol administration with combination EN and PN is remarkably effective in preventing cerebral VS after aneurysmal SAH.

Radical surgery for a ventricular septal defect associated with trisomy 18.

PURPOSE: Congestive heart failure is one of the major causes of early death of patients with trisomy 18. Ventricular septal defect (VSD) is the most common heart defect in patients with trisomy 18, and closure of the VSD may elongate the lifespan of the patient. Morphological characteristics of these patients, such as thoracic deformity, prominent right ventricular hypertrophy, and dysplastic tricuspid valve may complicate closure of the VSD. We report our initial experience of VSD closure in patients with trisomy 18 and estimate the feasibility of the surgical procedure. METHODS: Between June 2005 and September 2007, five female patients with trisomy 18 and VSD underwent radical operations. Four of them had undergone previous palliative surgery entailing pulmonary artery banding. RESULTS: All patients survived surgery. The average cardiac arrest time during surgery was 74 +/- 22 min. No early death occurred within 30 days of surgery. One patient with hydrocephalus treated by a previous ventriculoperitoneal shunt died in hospital owing to postoperative intracranial hypertension. Four of five patients were discharged from the hospital. Of the four discharged patients, a girl who underwent primary radical operation died of pneumonia. Another patient died of sudden cardiopulmonary arrest. The average survival of the patients in this study was 815 +/- 389 days at data acquisition, with two patients still alive. CONCLUSION: Closure of VSDs in patients with trisomy 18 was found feasible and was associated with extended survival.