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Pan TM, Chiou CS, Hsu SY, Huang HC, Wang TK, Chiu SI, Yea HL, Lee CL. Food-borne disease outbreaks in Taiwan, 1994. J Formos Med Assoc 1996; 95:417-20. [PMID: 8688712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
In 1994, 102 outbreaks of food-borne disease involving 4,726 cases were reported to the Taiwan Department of Health. This is the highest number of outbreaks and cases in recent years in Taiwan. Of these outbreaks, 72.5% (74/102) were caused by bacterial pathogens, with Vibrio parahaemolyticus responsible for 56.7% (42/74), Staphylococcus aureus 20.3% (15/74), Bacillus cereus 14.9% (11/74) and Salmonella spp other than S. typhi and S. paratyphi 8.1% (6/74). V. parahaemolyticus has been a leading cause of problems in Taiwan for many years. Contamination of seafood with this organism has been reported frequently, particularly in the warmer months. In 1994, small outbreaks (fewer than 5 cases) and large outbreaks (more than 50 cases) represented 31.4% (32/102) and 12.7% (13/102), respectively, of the total. The median outbreak size was 10 cases. A high proportion (54%, 7/13) of the large outbreaks was associated with commercial lunch-boxes supplied to elementary and junior high schools. Health education to improve food sanitation and supervision of food sanitation practices need to be strengthened.
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Wang CW, Lee CL, Soong YK. Hysteroscopic extraction of a vaginal foreign body in a child. THE JOURNAL OF THE AMERICAN ASSOCIATION OF GYNECOLOGIC LAPAROSCOPISTS 1996; 3:443-4. [PMID: 9050672 DOI: 10.1016/s1074-3804(96)80080-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A 3.5-year-old girl had a persistent, foul-smelling, blood-tinged vaginal discharge. She was initially treated for recurrent and persistent vulvovaginitis, which resulted in no improvement. Vaginoscopy revealed an intravaginal foreign body, which was removed successfully by hysteroscopy. We believe hysteroscopy is safe, convenient, effective, and easy to perform, even in a child.
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Lai YM, Chang FH, Lee CL, Lee JD, Huang HY, Wang ML, Chan PJ, Chang MY, Soong YK. Coculture of human spermatozoa with reproductive tract cell monolayers can enhance sperm functions better than coculture with Vero cell monolayers. J Assist Reprod Genet 1996; 13:417-22. [PMID: 8739059 DOI: 10.1007/bf02066175] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
PURPOSE In order to develop a better system for support of human sperm function in vitro, we conducted studies to evaluate whether reproductive tract cells are better than non-reproductive tract cells as an adjunt in that regard. METHODS Human spermatozoa were cocultured with Vero cells, with human oviduct cells and endometrial cells, and without cells (control) for either 1, 4, or 24 hr. Sperm motility was then analyzed with a computer-aided sperm analyzer (CASA-Hamiliton Thron, HTM IVOS Motility Analyzer). Aliquots of spermatozoa incubated for 24 hr were also stained with Hoechst 33258 and FITC-PNA to evaluate the status of acrosome in live cells. RESULTS Significant differences (P < 0.05) between the oviduct cell and the control groups after 24 hr were evident in the curvilinear velocity (VCL) (81.4 +/- 13.4 vs 60.0 +/- 14.1 microns/sec) and amplitude of lateral head displacement (ALH) (5.2 +/- 0.6 vs 4.1 +/- 0.5 microns). The incidence of acrosome reaction of live sperm was significantly higher in the endometrial cell group than in the controls (25.4 +/- 9.9 vs 6.6 +/- 2.4%; P < 0.001). CONCLUSIONS Coculture with human reproductive tract cells seems to improve some functional parameters of human spermatozoa. Coincubation with such cell lines, especially oviduct cells, might be a feasible approach to optimization of human spermatozoa for assisted fertilization using subfertile or frozen-thawed samples. We think coincubating human spermatozoa with a human reproductive tract cell line, especially oviduct cells, might be a feasible approach in preparing human spermatozoa for assisted fertilizatioin in subfertile and frozen-thawed semen samples.
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Lee WP, Lee CL, Lin HC. Glutathione S-transferase and glutathione peroxidase are essential in the early stage of adriamycin resistance before P-glycoprotein overexpression in HOB1 lymphoma cells. Cancer Chemother Pharmacol 1996; 38:45-51. [PMID: 8603451 DOI: 10.1007/s002800050446] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We have previously established Adriamycin-resistant HOB1 cell lines showing the multidrug resistance (MDR) phenotype. For further study, we analyzed the free-radical scavengers glutathione S-transferase (GST) and glutathione peroxidase (GPX) by enzyme assays and Northern blots. Three cell lines, HOB1/ADR0.1, HOB1/ADR1.0, and HOB1/ADR5.0, represented HOB1 cells resistant to 0.1, 1.0, and 5.0 microM Adriamycin, respectively. The mdr1 transcript was overexpressed in HOB1/ADR0.1 cells, and the amount of its expression reached a maximum between HOB1/ADR1.0 and HOB1/ADR5.0 cell lines. The increases in GST activity and GST-pi expression were observed only in high-level-resistant cell line (HOB1/ADR1.0 and HOB1/ADR5.0), which also showed increased GPX activity and expression. For investigation of the cytotoxic effect of Adriamycin on HOB1 cells prior to the mdr1 overexpression, an appropriate number of parental HOB1 cells were treated with 0.1 microM Adriamycin for 7 days, and the viable cells (HOB1/ADR) were isolated and subjected to analyses for mdr1, GST-pi, and GPX expression and for GST and GPX activity. In comparison with HOB1/ADR0.1 cells, HOB1/ADR cells did not show mdr1 overexpression but had significant increases in the activity and expression of GST and GPX. The current study suggests that in the early phase of Adriamycin treatment, GST and GPX are more important than P-glycoprotein for the development in HOB1 cells of resistance against Adriamycin.
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B, Member 1/biosynthesis
- ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics
- Antibiotics, Antineoplastic/pharmacology
- Base Sequence
- Blotting, Northern
- Cell Division/drug effects
- Doxorubicin/pharmacology
- Drug Resistance, Multiple/genetics
- Gene Expression Regulation, Enzymologic/drug effects
- Gene Expression Regulation, Enzymologic/genetics
- Glutathione Peroxidase/biosynthesis
- Glutathione Peroxidase/genetics
- Glutathione Transferase/biosynthesis
- Glutathione Transferase/genetics
- Humans
- Lymphoma/pathology
- Molecular Sequence Data
- Transcription, Genetic
- Tumor Cells, Cultured
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Huang HY, Lai YM, Lee CL, Chang MY, Chang SY, Soong YK. Improved sperm recovery rate with Percoll gradient method in intrauterine insemination. CHANGGENG YI XUE ZA ZHI 1996; 19:24-29. [PMID: 8935371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The purpose of this study was to compare the different sperm manipulation methods on the recovery rate of motile sperm that was collected to use in the intrauterine insemination. Three hundred and thirty-five IUI (intrauterine insemination) cycle from a total of 963 treatment cycles was performed for non-peritoneal factor infertility couples. The sperm separation methods were swim-up, swim-down and Percoll gradient (since Mar. 1992). We compared the different sperm preparation methods in normal and abnormal semen analysis group. Our results show that in the abnormal semen samples (oligospermic approximately, asthenospermic approximately), the Percoll gradient method is superior to the swim-up and swim-down methods on the recovery of a higher number of total, motile and active motile spermatozoa (p < 0.05), even though the sperm quality before preparation was rather poorer than the samples prepared by the other two methods. The pregnancy rate in both groups are not statistically significant. We conclude that the Percoll gradient is an improved method for semen manipulation as it allows greater recovery of sperm with higher motility in intrauterine insemination.
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Lee CL, Chung TL, Chiang CH, Lee WK, Liu MC. Mushroom poisoning in children: report of an accident. ZHONGHUA MINGUO XIAO ER KE YI XUE HUI ZA ZHI [JOURNAL]. ZHONGHUA MINGUO XIAO ER KE YI XUE HUI 1996; 37:133-4. [PMID: 8935413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
There were very few cases of mushroom poisoning every year in Taiwan and yet no fatal incident have been reported. A species named Amanita phalloides had high lethality rate (22-33%). Physicians should be aware of it's toxic property and be able to treat the patient in case of mushroom poisoning. However, mycologist sometimes might not distinguish edible from toxic mushroom so that educating people not to ingest wild mushroom is very important. We present 4 children with gastrointestinal syndrome after ingesting wild mushroom. We also introduce some basic approaches in treating mushroom poisoning in this paper.
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Lee CL, Lai YM, Soong YK. Management of urinary bladder injuries in laparoscopic assisted vaginal hysterectomy. Acta Obstet Gynecol Scand 1996; 75:174-7. [PMID: 8604607 DOI: 10.3109/00016349609033313] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND To illustrate our experience and evolution in management of urinary bladder injury in laparoscopically assisted vaginal hysterectomy. METHODS Four hundred and twenty-two women underwent laparoscopically assisted vaginal hysterectomy with or without adnexectomy during the period March 1991-September 1994. The indicators for hysterectomy included adenomyosis, myoma uteri, intractable menorrhagia, endometriosis and severe pelvic adhesion. There are six cases of urinary bladder injuries resulting from our 422 cases of laparoscopically assisted vaginal hysterectomy. RESULTS The first two cases of urinary bladder injuries were repaired through exploratory laparotomy. The third case was repaired through laparoscopic intracorporeal suture. The technique of the automatic linear stapler through laparoscopy was used in case 4. The last two cases were repaired vaginally. All these patients recovered well after primary repair with an indwelling catheter for five to seven days regardless of the method of repair. The operation time for repairing the injuries is shortest in vaginal approach. CONCLUSIONS The urinary bladder injury is one of the most common complications associated with laparoscopically assisted vaginal hysterectomy. Early detection and treatment enable complications to be overcome easily. As the laparoscopist acquires further experience in dealing with these complications, the urinary bladder injury may be managed laparoscopically. However, vaginal approach may be an easier way in dealing with this complication. Thus, most laparotomy or high technique laparoscopically repair could be avoided.
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Huang HY, Lee CL, Lai YM, Chang MY, Wang HS, Chang SY, Soong YK. The impact of the total motile sperm count on the success of intrauterine insemination with husband's spermatozoa. J Assist Reprod Genet 1996; 13:56-63. [PMID: 8825169 DOI: 10.1007/bf02068871] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
PURPOSE The purpose of this study was to evaluate the relationship between the total motile sperm count and the success of IUI treatment cycles with postwashed husband spermatozoa in couples with infertility in a large patient population. PATIENTS When 939 couples underwent 1375 cycles of IUI with varying etiologies of infertility which included male factor, endometriosis, tubal factor, ovulatory dysfunction, uterine factor, cervical factor, and unexplained infertility, the results were 207 pregnancies. RESULTS The overall pregnancy rate per cycle was 15.1% (207/1375). The total motile sperm count were significantly increased in the pregnant group than the nonpregnant group (38.7 x 10(6) versus 28.6 x 10(6); P < 0.001). There was a trend toward an increased success rate with increased total motile sperm count. Significance was reached when the total motile sperm count exceeded 5 x 10(6). Life table analysis was performed and the curve representing a cumulative chance of pregnancy calculated from our data reached 72%. CONCLUSIONS Our findings suggest that a final postwashed total motile sperm count used for IUI may be considered predictive of the success for pregnancy and allow couples to be informed of the chances of success.
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Soong YK, Chang FH, Lai YM, Lee CL, Chou HH. Results of modified laparoscopically assisted neovaginoplasty in 18 patients with congenital absence of vagina. Hum Reprod 1996; 11:200-3. [PMID: 8671186 DOI: 10.1093/oxfordjournals.humrep.a019019] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Construction of a neovagina using pelvic peritoneum via a laparoscopically assisted approach was used in 18 patients with congenital absence of the vagina. A better operative procedure is reported, which was modified from our preliminary technique, and the results of treatment are evaluated. Pelvic peritoneum was used for construction of a vagina, replacing a laparotomy by a minimally invasive laparoscopic approach. During follow-up, the advantages of our procedures are: (i) minimal likelihood of 'poor take' or later contraction because an autograft peritoneal epithelial line is used; (ii) minimal short and long term care is required; (iii) the technique is simple in experienced hands and has all the well-recognized benefits of minimal invasive surgery; (iv) the average length of neovagina is adequate and patency and depth can be maintained with minimal dilatation; (v) the neovagina, with epithelial lining resembling that of a normal vagina, facilitates comfortable sexual intercourse; (vi) the procedure is unaccompanied by dyspareunia or scarring, which are frequently associated with other techniques; (vii) less emotional stress and better cosmetic and economic benefits are noted.
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Lee CL, Chung TL. The trend of sudden infant death syndrome in Taiwan from 1984 to 1993. ZHONGHUA MINGUO XIAO ER KE YI XUE HUI ZA ZHI [JOURNAL]. ZHONGHUA MINGUO XIAO ER KE YI XUE HUI 1995; 36:431-3. [PMID: 8592930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We collected 1984 to 1993's health statistics to calculate the incidence and trend of SIDS in Taiwan. Deaths of SIDS were listed in the International Classification of Diseases (ICD) code 798.0. All infants under 1 year of age died of SIDS were included in our study. We found Taiwan was a low incidence area of SIDS. The incidences of SIDS from 1984 to 1993 were increased from 0.25 to 0.56 per 1000 live births. We also found the SIDS had inclining trend from 1984 to 1993. Whether the reason of inclining trend of SIDS in Taiwan is due to westernization of living style needs further exploration.
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Chang FH, Soong YK, Cheng PJ, Chou HH, Lee CL, Lai YM, Hwang FR, Chu KK. Laparoscopic repair of bowel herniation through previous cannula insertion sites. THE JOURNAL OF THE AMERICAN ASSOCIATION OF GYNECOLOGIC LAPAROSCOPISTS 1995; 2:489-92. [PMID: 9050610 DOI: 10.1016/s1074-3804(05)80078-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Operative laparoscopy frequently requires large cannulas below or above the umbilicus, which may result in unusual complications such as small bowel herniation through these insertion sites. Three women experienced small bowel herniation through cannula incision sites, either extraumbilically or paraumbilically, after major laparoscopic surgery. Two patients who had undergone laparoscopic myomectomy developed small bowel herniation through the 12-mm extraumbilical cannula site on postoperative days 7 and 8, respectively. In the first woman, the nontender, palpable, and reducible herniation healed spontaneously, with no episode of herniation during follow-up. The second patient required laparoscopic reduction of the herniated loop and repair of the fascial defect. The last woman had undergone laparoscopic-assisted vaginal hysterectomy and developed small bowel herniation through an unrecognized fascial defect paraumbilically 3 days postoperatively. Intended repair by laparoscopy was changed to laparotomy due to extensive and incarcerated bowel herniation.
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137
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Lai YM, Lee JD, Lee CL, Chen TC, Soong YK. An ectopic pregnancy embedded in the myometrium of a previous cesarean section scar. Acta Obstet Gynecol Scand 1995; 74:573-6. [PMID: 7618461 DOI: 10.3109/00016349509024394] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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138
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Wang CW, Lee CL, Soong YK. A comparison of hysterosalpingography and hysteroscopy in female infertility. ACTA ACUST UNITED AC 1995. [DOI: 10.1016/s1074-3804(05)80655-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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139
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Lee CL, Huang KG, Lai YM, Lai CH, Soong YK. Ureteral injury during laparoscopically assisted radical vaginal hysterectomy. Hum Reprod 1995; 10:2047-9. [PMID: 8567839 DOI: 10.1093/oxfordjournals.humrep.a136233] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
We report on a case of ureteral injury during laparoscopically radical hysterectomy to treat a patient with a stage IA2 carcinoma of the uterine cervix. The advantage of laparoscopically radical hysterectomy is the prevention of the identification and dissecting of the ureter from a vaginal approach, the main problem in the Schauta technique. However, ureteral injury may still occur while resecting the cardinal ligament without good visualization of the ureter during a vaginal procedure. Because the ureter was well identified and freed laparoscopically, a vaginal approach after uterine removal may be an option for treatment. Moreover, using the ureteral stent as a marker during a modified Schauta technique is helpful in the prevention of ureteral injury during laparoscopically assisted radical vaginal hysterectomy.
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Lee CL, Lai YM, Huang HY, Soong YK. Laparoscopic rescue after tubal anastomosis failure. Hum Reprod 1995; 10:1806-9. [PMID: 8582986 DOI: 10.1093/oxfordjournals.humrep.a136180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Laparoscopic rescue after tubal anastomosis failure is reported for the first time. The patient was a 33 year old woman sterilized by Pomeroy's method. Reconstruction of fertility was achieved by mini-laparotomy with isthmo-isthmic end-to-end anastomosis of bilateral tubes. Unfortunately, the patient did not become pregnant and tubal occlusion was diagnosed 6 months later by hysterosalpingography. Laparoscopic rescue with repeat isthmic-ampullary anastomosis and adhesiolysis was performed. Post-operatively, the patient had one menstruation and then achieved an intrauterine pregnancy. Instead of in-vitro fertilization/embryo transfer, laparoscopic rescue may be an alternative option for the patient with failed anastomosis.
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141
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Soong YK, Lee CL, Chu KK, Tsai FP. Role of laparoscopic assisted vaginal hysterectomy in gynecology. Int Surg 1995; 80:256-60. [PMID: 8775615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
One hundred and thirty laparoscopic assisted vaginal hysterectomies (LAVH) were performed at Chang Gung Memorial Hospital. All hysterectomies were for indications of the uterus, endometriosis, and extensive adhesions. Some of the patients also underwent concomitant procedures including unilateral or bilateral salping-oophorectomy, vaporization and/or excision of endometriosis, lysis and/or excision of adhesions. Kleppinger bipolar forceps were used for large vessel hemostasis and excision of adhesions in all the patients. CO2 laser was used for vaporization and excision of endometriosis. The complication rate was 10.0%. This included febric morbidity, intraoperative bladder injury, partial small bowel obstructions and thermal injury of the sigmoid colon. Four patients required laparotomy either to complete the procedure or to manage the complications. The mean blood loss was 160 ml and the mean hospital stay was 2.2 days. The mean operating time was 148 minutes and the mean age of the patients was 42.3 years. Two weeks after surgery, the majority of the patients were permitted to drive and resume normal nonstrenuous physical activity. The majority of the surgeries were videotaped. The study demonstrates that a hysterectomy can be safely performed laparoscopically by the well trained laparoscopic surgeon, resulted in reduced surgical morbidity, blood loss, postoperative discomfort and pain, shortened hospital stay and recovery.
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Huang HY, Chang MY, Lee CL, Lai YM, Chang SY, Soong YK. Parameters of semen analysis affecting the pregnancy rate of artificial insemination with husband's spermatozoa. CHANGGENG YI XUE ZA ZHI 1995; 18:109-14. [PMID: 7641101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The efficacy of intrauterine insemination with husband's semen (AIH) is well established for some types of infertility. Results that had been reported previously were Dwing difficult to assess owing to the low number of patients or treatment cycles as well as an inadequate definition of the indications in most cases. In this study, we report our experience with intrauterine insemination (IUI) using post-treated sperm suspension from husband's semen in the treatment of infertility. A total of 328 treatment cycles were completed from January to December in 1991. The indications for AIH/IUI were male infertility (130 cycles), unexplained infertility (87 cycles), sex selection (72 cycles) and anovulatory disorder (39 cycles). Sixty-eight pregnancies were achieved. The clinical usefulness of AIH/IUI with or without concomitant hMG regimens were established according to diagnostic subgroups. In our results, the cycle fecundity of pregnancy was higher in patients with ovulatory disturbance. The importance of sperm motility confirmed by our results that have compared by the serial sperm parameters. The motile sperm count may appear to be a highly consistent parameter that serves as a sensitive indicator of sperm function and correlation of successful pregnancy in our results. In conclusion, this study indicates that AIH with controlled ovarian hyperstimulation can result in higher viable pregnancy rate, and it is also a non-invasive and relatively easy procedure. We believe that this is a transient useful method for the treatment of non-organic infertility, prior to any attempt of aggressive assisted reproductive procedures.
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Chang FH, Chou HH, Lee CL, Cheng PJ, Wang CW, Soong YK. Extraumbilical insertion of the operative laparoscope in patients with extensive intraabdominal adhesions. THE JOURNAL OF THE AMERICAN ASSOCIATION OF GYNECOLOGIC LAPAROSCOPISTS 1995; 2:335-7. [PMID: 9050580 DOI: 10.1016/s1074-3804(05)80119-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In 12 patients who had known or suspected intraabdominal adhesions, we evaluated the benefit of using Palmer's point for inserting the Veress needle and primary cannula during laparoscopic adhesiolysis to prevent direct intestinal injury. After inserting the laparoscope through this point, four women were found to have extreme intestinal adhesions around the umbilical area, and intestinal or severe omental injury might occur if the cannulas were inserted directly through the umbilical fossa. The other eight patients had omentum, partial to severe, adherent to the anterior abdominal wall. No complication occurred during insertion of the Veress needle and primary cannula through Palmer's point. Nine patients had successful laparoscopic adhesiolysis and were discharged within 2 days. In the other three women the procedure was converted to laparotomy because of extensive intestinal adhesions (2 patients) and small bowel injury during laparoscopic adhesiolysis (1). Palmer's point can be considered a safe and good alternative site for inserting the Veress needle and primary cannula to lyse dense intestinal and extensive omental adhesions. This technique should provide the surgeon with wider visual angel and surgical field, thus making adhesiolysis much easier to perform.
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Wang CW, Lee CL, Soong YK. Bowel injury by the suction-irrigator during operative laparoscopy. THE JOURNAL OF THE AMERICAN ASSOCIATION OF GYNECOLOGIC LAPAROSCOPISTS 1995; 2:353-4. [PMID: 9050584 DOI: 10.1016/s1074-3804(05)80123-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Bowel injury is common during operative laparoscopy, yet injury by the suction-irrigator has never been reported to our knowledge. Any injury to the sigmoid colon by suction-irrigator occurred during intestinal retraction. Primary repair was performed through minilaparotomy incision. In addition to the potentially damaging effect of the instrument, a firm, distended, and unprepared bowel was a leading factor in this injury. We recommend that all patients have bowel preparation before operative laparoscopy, and that great care be taken for all surgical manipulations, even when employing traditionally atraumatic instruments.
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145
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Lee CL, Huang HC, Chiu SY, Lee YS, Pan TM. Latex agglutination test for detection of tetanus antitoxins. ZHONGHUA MINGUO WEI SHENG WU JI MIAN YI XUE ZA ZHI = CHINESE JOURNAL OF MICROBIOLOGY AND IMMUNOLOGY 1995; 28:151-6. [PMID: 9774994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
A rapid and easy method of slide agglutination test for the detection of human tetanus antitoxins was developed in this study. Testing reagents were prepared from carboxylated polystyrene latex particles with tetanus toxin by soluble carbodiimide. The test was performed on a glass slide with a drop of test sample and a drop of testing reagent. The agglutination reaction was usually completed within five minutes. Sensitivity of this test for tetanus antitoxins can be reached at 0.125 IU/ml. Therefore, the latex agglutination test can be used to determine the immune status of a patient in an emergency.
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Lee CL, Hrachovy RA, Smith KL, Frost JD, Swann JW. Tetanus toxin-induced seizures in infant rats and their effects on hippocampal excitability in adulthood. Brain Res 1995; 677:97-109. [PMID: 7606473 DOI: 10.1016/0006-8993(95)00127-c] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A new experimental model of developmental epilepsy is reported. Behavioral and EEG features of seizures produced by unilateral intrahippocampal injection of tetanus toxin in postnatal day 9-11 rats, are described. Within 24-72 h of tetanus toxin injection, rat pups developed frequent and often prolonged seizures which included combinations of repetitive wet dog shakes, and wild running-jumping seizures. Intrahippocampal and cortical surface EEG recordings showed that coincident with these behaviors, electrographic seizures occurred not only in the injected hippocampus, but also in the contralateral hippocampus and bilaterally in the neocortex. Analysis of the interictal EEG revealed multiple independent spike foci. One week following tetanus toxin injection, the number of seizures markedly decreased; however, interictal spiking persisted. After injection rats were allowed to mature some were observed to have unprovoked behavioral seizures and/or epileptiform EEG activity. Mature animals were also studied using in vitro slice techniques. Recordings from hippocampal slices demonstrated spontaneous epileptiform burst discharges in the majority of rats which had tetanus toxin induced seizures as infants. These events occurred in area CA3 and consisted of interictal spikes and intracellularly recorded paroxysmal depolarization shifts (PDSs). On rarer occasions, electrographic seizures were recorded. The use of the tetanus toxin model in developing rats may facilitate a better understanding of the unique features of epileptogenesis in the developing brain and the consequences early-life seizures have on brain maturation and the genesis of epileptic conditions in later life.
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147
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Lee CL, Soong YK. Laparoscopic hysterectomy: is dissecting the ureter necessary? Int Surg 1995; 80:167-9. [PMID: 8530236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Laparoscopic hysterectomy has been first reported by Reich et al. in 1989, which confirmed the possibility of laparoscopic hysterectomy being employed as a replacement of the vast majority of traditional abdominal hysterectomies. There are three critical points in laparoscopic hysterectomy. The most important critical point is to identify uterine arteries from the ureter in the paracervical area. Several ureteral injuries at operative laparoscopy have been reported. We performed two hundred and thirty laparoscopic hysterectomies during the period from March 1991 to October 1993. Sixty patients were later included in this study. Thirty of these applied the technique of dissecting the ureter at the initiation of laparoscopic hysterectomy. Most of the patients were discharged on the second postoperative day. Although dissecting the ureter at the beginning of the operation did not produce a significant discrepancy in operation time, blood loss, hospitalization day and ureter injury when compared with the control group, the uterine arteries, however, may be confidently desiccated once the path of the ureter near the uterosacral ligament is identified.
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Tsai FP, Cheng PJ, Lee CL, Soong YK, Chang MY. Major complications during laparoscopy-assisted vaginal hysterectomy--report of four cases and review of the literature. CHANGGENG YI XUE ZA ZHI 1995; 18:52-7. [PMID: 7767855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This paper presents four recent cases of complications resulting from of a total 130 cases of laparoscopy-assisted vaginal hysterectomies performed at Chang Gung Memorial Hospital from March 1991 till January 1993. These included two cases of bladder injury, one case of vessel laceration and one case of colon injury. In addition, the literature about complications occurring at laparoscopy are reviewed and classified. This paper will: 1. present precautionary measures for avoiding intraoperative complications; 2. describe management of complications.
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Chang FH, Lee CL, Soong YK, Jan YY. Combined laparoscopic hysterectomy and cholecystectomy--a case report. CHANGGENG YI XUE ZA ZHI 1995; 18:64-7. [PMID: 7767857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We present the first recorded case which received a combined laparoscopic hysterectomy, right salpingo-oophorectomy and cholecystectomy during one anesthetic period in Taiwan. This procedure was done to treat the coexisting benign lesions of the uterus, ovary, and the gall bladder. Postoperative pathological diagnoses was myoma, an ovarian hemorrhagic corpus leutum cyst, cholelithiasis, and cholecystitis. Estimated blood loss was less than 150 ml for the combined procedure. With the total operation time being 135 minutes. The patient recovered soon and could take a regular diet and walk without assistance 20 hours after operation. She discharged 4 days later and returned to work 5 days after discharge. We think for well trained laparoscopists, a cross-specialty cooperation between a gynecologist and a general surgeon to treat coexisting lesions of the uterus and the gall bladder is a safe, feasible, and beneficial procedure.
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Abstract
Ovarian preservation before abdominal irradiation may be recommended for young patients with various types of invasive cancer. The most common site for ovarian transposition is just below the iliac crest or posterolateral to the uterus. Here, we demonstrate laparoscopic ovariopexy with an automatic stapling device to transpose the ovaries to an uncommon site, i.e. lower anterolateral abdomen, in a patient with medulloblastoma prior to her receiving irradiation of the craniospinal axis. The anterolateral transposition of the ovary not only kept it away from the irradiated field but allowed it also to be shielded by the uterus. Thus, ovarian function could be well preserved.
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