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Chen Z, Contijoch F, McVeigh E. Regional Shortening From 4DCT Demonstrates High Sensitivity And Specificity For Detecting LV Wall Motion Abnormalities From Clinical Scans. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Supramanian PR, Granne I, Ohuma EO, Lim LN, McVeigh E, Venkatakrishnan R, Becker CM, Mittal M. Corrigendum. ICSI does not improve reproductive outcomes in autologous ovarian response cycles with non-male factor subfertility. Hum Reprod 2021; 36:1732-1735. [PMID: 33984122 DOI: 10.1093/humrep/deab043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- P R Supramanian
- Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - I Granne
- Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford OX3 9DU, UK.,Oxford Endometriosis CaRe Centre, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford OX3 9DU, UK.,Oxford Reproductive Medicine, The Manor Hospital, Oxford OX3 7RP, UK
| | - E O Ohuma
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, UK.,Centre for Global Child Health & Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Canada M5G 2L3
| | - L N Lim
- Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford OX3 9DU, UK.,Oxford Reproductive Medicine, The Manor Hospital, Oxford OX3 7RP, UK
| | - E McVeigh
- Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford OX3 9DU, UK.,Oxford Endometriosis CaRe Centre, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford OX3 9DU, UK.,Oxford Reproductive Medicine, The Manor Hospital, Oxford OX3 7RP, UK
| | - R Venkatakrishnan
- University Hospitals of Derby and Burton NHS Foundation Trust, Department of Obstetrics and Gynaecology, Derby DE22 3NE, UK
| | - C M Becker
- Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford OX3 9DU, UK.,Oxford Endometriosis CaRe Centre, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford OX3 9DU, UK.,Oxford Reproductive Medicine, The Manor Hospital, Oxford OX3 7RP, UK
| | - M Mittal
- Imperial College Healthcare NHS Trust, St Mary's Hospital, Department of Obstetrics and Gynaecology, London W2 1NY, UK
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Colvert G, Ortuño J, Chen M, Ledesma-Carbayo M, McVeigh E. 4DCT-derived Endocardial Left Ventricular Torsion Correlates With 2D MR Tagging-based Measurements In The Same Subjects. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Manohar A, Schluchter A, Contijoch F, McVeigh E. Anthropomorphic Dyssynchronous LV Phantom: A Framework To Investigate The Assessment Of LV Dyssynchrony Using 4DCT-SQUEEZ. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Severance L, Carter H, Contijoch F, McVeigh E. A Genetic Risk Score To Identify Young Individuals (aged 32-47) At Increased Risk Of Non-zero CAC. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Supramaniam PR, Granne I, Ohuma EO, Lim LN, McVeigh E, Venkatakrishnan R, Becker CM, Mittal M. ICSI does not improve reproductive outcomes in autologous ovarian response cycles with non-male factor subfertility. Hum Reprod 2020; 35:583-594. [DOI: 10.1093/humrep/dez301] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 12/12/2019] [Accepted: 12/18/2019] [Indexed: 12/27/2022] Open
Abstract
Abstract
STUDY QUESTION
Does the method of fertilisation improve reproductive outcomes in poor ovarian response (POR) cycles when compared to all other ovarian response categories in the absence of male factor subfertility?
SUMMARY ANSWER
ICSI does not confer any benefit in improving the clinical pregnancy or live birth (LB) outcome in autologous ovarian response cycles in the absence of male factor subfertility when compared to IVF.
WHAT IS KNOWN ALREADY
ICSI is associated with an improved outcome when compared to IVF in patients with severe male factor subfertility.
STUDY DESIGN, SIZE, DURATION
A retrospective study involving 1 376 454 ART cycles, of which 569 605 (41.4%) cycles fulfilled the inclusion and exclusion criteria for all autologous ovarian response categories: 272 433 (47.8%) IVF cycles and 297 172 (52.2%) ICSI cycles. Of these, the POR cohort represented 62 641 stimulated fresh cycles (11.0%): 33 436 (53.4%) IVF cycles and 29 205 (46.6%) ICSI cycles.
PARTICIPANTS/MATERIALS, SETTING, METHOD
All cycles recorded on the anonymised Human Fertilisation and Embryology Authority (HFEA) registry database between 1991 and 2016 were analysed. All fresh cycles with normal sperm parameters, performed after 1998 were included: frozen cycles, donor oocyte and sperm usage, intrauterine insemination cycles, preimplantation genetic testing (PGT) for aneuploidies (PGT-A), PGT for monogenic/single gene defects (PGT-M), PGT for chromosomal structural arrangements (PGT-SR) cycles, where the reason for stimulation was for storage and unstimulated cycles were excluded.
MAIN RESULTS AND THE ROLE OF CHANCE
ICSI did not confer any benefit in improving the LB outcome when compared to conventional IVF per treatment cycle (PTC), when adjusted for female age, number of previous ART treatment cycles, number of previous live births through ART, oocyte yield, stage of transfer, method of fertilisation and number of embryos transferred in the POR cohort (adjusted odds ratio [a OR] 1.03, 99.5% confidence interval [CI] 0.96–1.11, P = 0.261) and all autologous ovarian response categories (aOR 1.00, 99.5% CI 0.98–1.02, P = 0.900). The mean fertilisation rate was statistically lower for IVF treatment cycles (64.7%) when compared to ICSI treatment cycles (67.2%) in the POR cohort (mean difference −2.5%, 99.5% CI −3.3 to −1.6, P < 0.001). The failed fertilisation rate was marginally higher in IVF treatment cycles (17.3%, 95% binomial exact 16.9 to 17.7%) when compared to ICSI treatment cycles (17.0%, 95% binomial exact 16.6 to 17.4%); however, this did not reach statistical significance (P = 0.199). The results followed a similar trend when analysed for all autologous ovarian response categories with a higher rate of failed fertilisation in IVF treatment cycles (4.8%, 95% binomial exact 4.7 to 4.9%) when compared to ICSI treatment cycles (3.2%, 95% binomial exact 3.1 to 3.3%) (P < 0.001).
LIMITATIONS, REASONS FOR CAUTION
The quality of data is reliant on the reporting system. Furthermore, success rates through ART have improved since 1991, with an increased number of blastocyst-stage embryo transfers. The inability to link the treatment cycle to the individual patient meant that we were unable to calculate the cumulative LB outcome per patient.
WIDER IMPLICATIONS OF THE FINDINGS
This is the largest study to date which evaluates the impact of method of fertilisation in the POR patient and compares this to all autologous ovarian response categories. The results demonstrate that ICSI does not confer any benefit in improving reproductive outcomes in the absence of male factor subfertility, with no improvement seen in the clinical pregnancy or LB outcomes following a fresh treatment cycle.
STUDY FUNDING/COMPETING INTEREST(S)
The study received no funding. C.M.B. is a member of the independent data monitoring group for a clinical endometriosis trial by ObsEva. He is on the scientific advisory board for Myovant and medical advisory board for Flo Health. He has received research grants from Bayer AG, MDNA Life Sciences, Volition Rx and Roche Diagnostics as well as from Wellbeing of Women, Medical Research Council UK, the NIH, the UK National Institute for Health Research and the European Union. He is the current Chair of the Endometriosis Guideline Development Group for ESHRE and was a co-opted member of the Endometriosis Guideline Group by the UK National Institute for Health and Care Excellence (NICE). I.G. has received research grants from Bayer AG, Wellbeing of Women, the European Union and Finox.
TRIAL REGISTRATION NUMBER
Not applicable.
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Affiliation(s)
- P R Supramaniam
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
| | - I Granne
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
- Oxford Endometriosis CaRe Centre, Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford OX3 9DU, UK
- Oxford Reproductive Medicine, The Manor Hospital, Oxford OX3 7RP, UK
| | - E O Ohuma
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, UK
- Centre for Global Child Health & Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Canada M5G 2L3
| | - L N Lim
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
- Oxford Reproductive Medicine, The Manor Hospital, Oxford OX3 7RP, UK
| | - E McVeigh
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
- Oxford Endometriosis CaRe Centre, Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford OX3 9DU, UK
- Oxford Reproductive Medicine, The Manor Hospital, Oxford OX3 7RP, UK
| | - R Venkatakrishnan
- Department of Obstetrics and Gynaecology, University Hospitals of Derby and Burton NHS Foundation Trust, Derby DE22 3NE, UK
| | - C M Becker
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
- Oxford Endometriosis CaRe Centre, Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford OX3 9DU, UK
- Oxford Reproductive Medicine, The Manor Hospital, Oxford OX3 7RP, UK
| | - M Mittal
- Department of Obstetrics and Gynaecology, Wolfson Fertility Center, St Mary’s and Hammersmith Hospitals, Imperial College Healthcare NHS Trust, London W2 1NY, UK
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Supramaniam PR, Mittal M, Ohuma EO, Lim LN, McVeigh E, Granne I, Becker CM. Secondary sex ratio in assisted reproduction: an analysis of 1 376 454 treatment cycles performed in the UK. Hum Reprod Open 2019; 2019:hoz020. [PMID: 31598568 PMCID: PMC6778287 DOI: 10.1093/hropen/hoz020] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 06/29/2019] [Accepted: 07/10/2019] [Indexed: 12/12/2022] Open
Abstract
STUDY QUESTION Does ART impact the secondary sex ratio (SSR) when compared to natural conception? SUMMARY ANSWER IVF and ICSI as well as the stage of embryo transfer does impact the overall SSR. WHAT IS KNOWN ALREADY The World Health Organization quotes SSR for natural conception to range between 103 and 110 males per 100 female births. STUDY DESIGN SIZE DURATION A total of 1 376 454 ART cycles were identified, of which 1 002 698 (72.8%) cycles involved IVF or ICSI. Of these, 863 859 (85.2%) were fresh cycles and 124 654 (12.4%) were frozen cycles. Missing data were identified in 14 185 (1.4%) cycles. PARTICIPANTS/MATERIALS SETTING METHODS All cycles recorded in the anonymized UK Human Fertilisation and Embryology Authority (HFEA) registry database between 1991 and 2016 were analysed. All singleton live births were included, and multiple births were excluded to avoid duplication. MAIN RESULTS AND THE ROLE OF CHANCE The overall live birth rate per cycle for all IVF and ICSI treatments was 26.2% (n = 262 961), and the singleton live birth rate per cycle was 17.1% (n = 171 399). The overall SSR for this study was 104.0 males per 100 female births (binomial exact 95% CI: 103.1-105.0) for all IVF and ICSI cycles performed in the UK recorded through the HFEA. This was comparable to the overall SSR for England and Wales at 105.3 males per 100 female births (95% CI: 105.2-105.4) from 1991 to 2016 obtained from the Office of National Statistics database. Male predominance was seen with conventional insemination in fresh IVF treatment cycles (SSR 110.0 males per 100 female births; 95% CI: 108.6-111.5) when compared to micro-injection in fresh ICSI treatment cycles (SSR 97.8 males per 100 female births; 95% CI: 96.5-99.2; odds ratio (OR) 1.16, 95% CI 1.12-1.19, P < 0.0001), as well as with blastocyst stage embryo transfers (SSR 104.8 males per 100 female births; 95% CI: 103.5-106.2) when compared to a cleavage stage embryo transfer (SSR 101.2 males per 100 female births; 95% CI: 99.3-103.1; OR 1.03, 95% CI 1.01-1.06, P = 0.011) for all fertilization methods. LIMITATIONS REASONS FOR CAUTION The quality of the data relies on the reporting system. Furthermore, success rates through ART have improved since 1991, with an increased number of blastocyst stage embryo transfers. WIDER IMPLICATIONS OF THE FINDINGS This is the largest study to date evaluating the impact of ART on SSR. The results demonstrate that, overall, ART does have an impact on the SSR when assessed according to the method of fertilization (ICSI increased female births while IVF increased males). However, given the ratio of IVF to ICSI cycles at present with 60% of cycles from IVF and 40% from ICSI, the overall SSR for ART closely reflects the population SSR for, largely, natural conceptions in England and Wales. STUDY FUNDING/COMPETING INTERESTS The study received no funding. C.M.B. is a member of the independent data monitoring group for a clinical endometriosis trial by ObsEva. He is on the scientific advisory board for Myovant and medical advisory board for Flo Health. He has received research grants from Bayer AG, MDNA Life Sciences, Volition Rx and Roche Diagnostics as well as from Wellbeing of Women, Medical Research Council UK, the NIH, the UK National Institute for Health Research and the European Union. He is the current Chair of the Endometriosis Guideline Development Group for ESHRE and was a co-opted member of the Endometriosis Guideline Group by the UK National Institute for Health and Care Excellence (NICE). I.G. has received research grants from Wellbeing of Women, the European Union and Finox. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- P R Supramaniam
- Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | - M Mittal
- Imperial College Healthcare NHS Trust, St Mary's and Hammersmith Hospitals, London, UK
| | - E O Ohuma
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford OX3 7BN, UK.,Centre for Global Child Health & Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON M5G 2L3, Canada
| | - L N Lim
- Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | - E McVeigh
- Oxford Endometriosis CaRe Centre, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - I Granne
- Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.,Oxford Endometriosis CaRe Centre, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - C M Becker
- Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.,Oxford Endometriosis CaRe Centre, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
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Kim P, Contijoch F, Wong D, Ingle R, Hsiao A, Santos J, Kahn A, Pham M, McVeigh E, Adler E, Nguyen P. Stress Cardiac MRI for Evaluation of Nonspecific Allograft Dysfunction in the Transplanted Heart. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Zhang X, Sisniega A, Zbijewski W, Contijoch F, McVeigh E, Stayman J. TH-CD-206-12: Image-Based Motion Estimation for Plaque Visualization in Coronary Computed Tomography Angiography. Med Phys 2016. [DOI: 10.1118/1.4958193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Behar J, Behar J, Providência R, Cronbach P, Siddiqui S, Brough C, Ara F, Newham W, Ng F, Ayala-Paredes F, Withers K, Hayward C, Chin H, Fearn S, Omerod J, Gamble J, Foley P, Bostock J, Claridge S, Jackson T, Sohal M, Razavi R, Betts T, Herring N, Rinaldi C, Pourmorteza A, McVeigh E, Niederer S, Claridge S, Jackson T, Sohal M, Preston R, Carr-White G, Razavi R, Rajani R, Rinaldi C, Boveda S, Defaye P, Barra S, Babu G, Ang R, Algalarrondo V, Bouzeman A, Ahsan S, Deharo JC, Sporton S, Segal O, Klug D, Lambiase P, Sadoul N, Agarwal S, Piot O, Chow A, Périer M, Fauchier L, Babuty D, Lowe M, Leclercq C, Bordachar P, Marijon E, Wilson D, Panfilo D, Greenhut S, Stegemann B, Morgan J, Nicolson W, Li A, Behr E, Ng G, Raman G, Belchambers S, Rao A, Wright D, John I, Crockford C, Kaba R, Begg G, Tayebjee M, Leong K, Hu M, Kanapeckaite L, Roney C, Lim P, Harding S, Peters N, Varnava A, Kanagaratnam P, Roux JF, Badra M, White J, Lencioni M, Carolan-Rees G, Patrick H, Griffith M, Patel H, Spiesshoefer J, Morley-Smith A, Patel K, Rosen S, DiMario C, Lyon A, Cowie M. Devices & Sudden death. Europace 2015; 17:v10-v13. [PMCID: PMC4892105 DOI: 10.1093/europace/euv331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
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Fatum M, McVeigh E, Child T, Lakhoor K, Becker C. 3-D Laparoscopically-Assisted Percutaneous Oocyte Retrieval and Ovarian Tissue Harvesting for Fertility Cryopreservation. J Minim Invasive Gynecol 2014. [DOI: 10.1016/j.jmig.2014.08.754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Subira J, Child T, McVeigh E, Craig J, Turner K, Fatum M. Blastocyst expansion and inner cell mass grades are associated with clinical pregnancy in fresh single transfers. Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Fatum M, Ross C, Bergeron ME, Turner K, McVeigh E, Child T. Rescue in-vitro maturation in polycystic ovarian syndrome patients overresponding/underresponding to ovarian stimulation in in-vitro fertilization treatment: is it a viable option? Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.1130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Furuse M, Miyatake SI, Miyata T, Yoritsune E, Kawabata S, Kuroiwa T, Karajannis MA, Fisher MJ, Milla SS, Cohen KJ, Legault G, Wisoff JH, Harter DH, Hartnett E, Merkelson A, Bloom MC, Dhall G, Jones D, Korshunov A, Pfister S, Eberhart CG, Zagzag D, Allen JC, Chinot O, Wick W, Mason W, Henriksson R, Saran F, Nishikawa R, Hilton M, Abrey L, Cloughesy T, Field KM, Simes J, Nowak AK, Hovey E, Wheeler H, Cher L, Brown C, Livingstone A, Sawkins K, Rosenthal MA, McCrea HJ, Kesavabhotla K, Boockvar J, Kleinberg L, Blakeley J, Mikkelsen T, Stevens G, Ye X, Ryu S, Desideri S, Desai B, Giranda V, Grossman S, Badruddoja MA, Pazzi M, Stea B, Lefferts P, Contreras N, Wallen K, Shah R, Rance N, Schroeder K, Sanan A, Kut C, Raza S, Liang W, Abutaleb A, Xi J, Mavadia J, Ye X, Guerrero-Cazares H, McVeigh E, Li X, Quinones-Hinojosa A, Sloan AE, Reese J, Rogers LR, Embree H, Lazarus HM, Fung H, Kane D, Dropulic B, Gerson SL, Tsung GE, Green SD, Lai A, Green RM, Filka E, Cloughesy TF, Nghiemphu PL, Saito R, Yamashita Y, Sonoda Y, Kanamori M, Kumabe T, Tominaga T, Mohammadi AM, Chao ST, Peereboom DM, Barnett GH, Suh JH, Brewer C, Vogelbaum MA, Desjardins A, Peters KB, Herndon JE, Bailey LA, Alderson LM, Ranjan T, Sampson JH, Friedman AH, Bigner DD, Friedman HS, Vredenburgh JJ, Kaley TJ, Pentsova E, Omuro A, Mellinghoff I, Nolan C, Gavrilovic I, DeAngelis LM, Holland E, Lacouture ME, Ludwig E, Lassman AB, Shih KC, Bacha J, Brown DM, Garner WJ, Schwartz R, Burris HA, Shih K, Rosenblatt P, Chowdhary S, Weir A, Shepard G, Shastry M, Griner P, Hainsworth J, Sloan AE, Nock CJ, Kerstetter A, Supko J, Ye X, Barnholtz-Sloan JS, Miller R, Rich J, Takebe N, Prados M, Grossman S. CLIN-ONGOING CLINICAL TRIALS. Neuro Oncol 2012; 14:vi101-vi105. [PMCID: PMC3488786 DOI: 10.1093/neuonc/nos232] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023] Open
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Yang FH, Zhang B, Zhou DJ, Bie L, Tom MW, Drummond DC, Nicolaides T, Mueller S, Banerjee A, Park JW, Prados MD, James DC, Gupta N, Hashizume R, Strohbehn GW, Zhou J, Fu M, Patel TR, Piepmeier JM, Saltzman WM, Xie Q, Johnson J, Bradley R, Ascierto ML, Kang L, Koeman J, Marincola FM, Briggs M, Tanner K, Vande Woude GF, Tanaka S, Klofas LK, Wakimoto H, Borger DR, Iafrate AJ, Batchelor TT, Chi AS, Madhankumar AB, Slagle-Webb B, Rizk E, Harbaugh K, Connor JR, Sarkar G, Curran GL, Jenkins RB, Kurozumi K, Ichikawa T, Onishi M, Fujii K, Ishida J, Shimazu Y, Date I, Ebsworth K, Walters MJ, Ertl LS, Wang Y, Berahovich RD, Zhang P, Powers JP, Liu SC, Al Omran R, Sullivan TJ, Jaen JC, Brown M, Schall TJ, Yusuke N, Shimizu S, Shishido-Hara Y, Shiokawa Y, Nagane M, Wang J, Sai K, Chen FR, Chen ZP, Shi Z, Zhang J, Zhang K, Han L, Chen L, Qian X, Zhang A, Wang G, Jia Z, Pu P, Kang C, Kong LY, Doucette TA, Ferguson SD, Hachem J, Yang Y, Wei J, Priebe W, Fuller GN, Qiao W, Rao G, Heimberger AB, Chen PY, Ozawa T, Drummond D, Santos R, Torre JD, Ng C, Lepe EL, Butowski N, Prados M, Bankiewicz K, James CD, Cheng Z, Gong Y, Ma Y, Muller-Knapp S, Knapp S, Wang J, Fujii K, Kurozumi K, Ichikawa T, Onishi M, Shimazu Y, Ishida J, Antonio Chiocca E, Kaur B, Date I, Yu JS, Judkowski V, Bunying A, Ji J, Li Z, Bender J, Pinilla C, Srinivasan V, Dombovy-Johnson M, Carson-Walter E, Walter K, Xu Z, Popp B, Schlesinger D, Gray L, Sheehan J, Keir ST, Friedman HS, Bigner DD, Kut C, Tyler B, McVeigh E, Li X, Herzka D, Grossman S, Lasky JL, Wang Y, Panosyan E, Meisen WH, Hardcastle J, Wojton J, Wohleb E, Alvarez-Breckenridge C, Nowicki M, Godbout J, Kaur B, Lee SY, Slagle-Webb B, Sheehan JM, Connor JR, Yin S, Kaluz S, Devi SN, de Noronha R, Nicolaou KC, Van Meir EG, Lachowicz JE, Demeule M, Che C, Tripathy S, Jarvis S, Currie JC, Regina A, Nguyen T, Castaigne JP, Zielinska-Chomej K, Mohanty C, Viktorsson K, Lewensohn R, Driscoll JJ, Alsidawi S, Warnick RE, Rixe O, deCarvalho AC, Irtenkauf S, Hasselbach L, Xin H, Mikkelsen T, Sherman JH, Siu A, Volotskova O, Keidar M, Gibo DM, Dickinson P, Robertson J, Rossmeisl J, Debinski W, Nair S, Schmittling R, Boczkowski D, Archer G, Bigner DD, Sampson JH, Mitchell DA, Miller IS, Didier S, Murray DW, Issaivanan M, Coniglio SJ, Segall JE, Al-Abed Y, Symons M, Fotovati A, Hu K, Wakimoto H, Triscott J, Bacha J, Brown DM, Dunn SE, Daniels DJ, Peterson TE, Dietz AB, Knutson GJ, Parney IF, Diaz RJ, Golbourn B, Picard D, Smith C, Huang A, Rutka J, Saito N, Fu J, Yao J, Wang S, Koul D, Yung WKA, Fu J, Koul D, Yao J, Wang S, Yuan Y, Sulman EP, Colman H, Lang FF, Yung WKA, Slat EA, Herzog ED, Rubin JB, Brown M, Carminucci AS, Amendolara B, Leung R, Lei L, Canoll P, Bruce JN, Wojton JA, Chu Z, Kwon CH, Chow LM, Palascak M, Franco R, Bourdeau T, Thornton S, Qi X, Kaur B, Kitange GJ, Mladek AC, Su D, Carlson BL, Schroeder MA, Pokorny JL, Bakken KK, Gupta SK, Decker PA, Wu W, Sarkaria JN, Colman H, Oddou MP, Mollard A, Call LT, Vakayalapati H, Warner SL, Sharma S, Bearss DJ, Chen TC, Cho H, Wang W, Hofman FM, Flores CT, Snyder D, Sanchez-Perez L, Pham C, Friedman H, Bigner DD, Sampson JH, Mitchell DA, Woolf E, Abdelwahab MG, Turner G, Preul MC, Lynch A, Rho JM, Scheck AC, Salphati L, Heffron TP, Alicke B, Barck K, Carano RA, Cheong J, Greve J, Lee LB, Nishimura M, Pang J, Plise EG, Reslan HB, Zhang X, GOuld SG, Olivero AG, Phillips HS, Zadeh G, Jalali S, Voce D, Wei Z, Shijun K, Nikolai K, Josh W, Clayton C, Bakhtiar Y, Alkins R, Burgess A, Ganguly M, Wels W, Hynynen K, Li YM, Jun H, Daniel V, Walter HA, Nakashima H, Nguyen TT, Shalkh I, Goins WF, Chiocca EA, Pyko IV, Nakada M, Furuyama N, Lei T, Hayashi Y, Kawakami K, Minamoto T, Fedulau AS, Hamada JI. LAB-EXPERIMENTAL (PRE-CLINICAL) THERAPEUTICS AND PHARMACOLOGY. Neuro Oncol 2012; 14:vi25-vi37. [PMCID: PMC3488776 DOI: 10.1093/neuonc/nos222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023] Open
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Hu JCY, Seo BK, Neri QV, Rozenwaks Z, Palermo GD, Fields T, Neri QV, Monahan D, Rosenwaks Z, Palermo GD, Szkodziak P, Plewka K, Wozniak S, Czuczwar P, Mroczkowski A, Lorenzo Leon C, Hernandez J, Chinea Mendez E, Concepcion Lorenzo C, Sanabria Perez V, Puopolo M, Palumbo A, Toth B, Franz C, Montag M, Boing A, Strowitzki T, Nieuwland R, Griesinger G, Schultze-Mosgau A, Cordes T, Depenbusch M, Diedrich K, Vloeberghs V, Verheyen G, Camus M, Van de Velde H, Goossens A, Tournaye H, Coppola G, Di Caprio G, Wilding M, Ferraro P, Esposito G, Di Matteo L, Dale R, Coppola G, Dale B, Daoud S, Auger J, Wolf JP, Dulioust E, Lafuente R, Lopez G, Brassesco M, Hamad M, Montenarh M, Hammadeh M, Robles F, Magli MC, Crippa A, Pescatori E, Ferraretti AP, Gianaroli L, Zahiri M, Movahedin M, Mowla SJ, Noruzinia M, Crippa A, Ferraretti AP, Magli MC, Crivello AM, Robles F, Gianaroli L, Sermondade N, Dupont C, Hafhouf E, Cedrin-Durnerin I, Poncelet C, Benzacken B, Levy R, Sifer C, Ferfouri F, Boitrelle F, Clement P, Molina Gomes D, Bailly M, Selva J, Vialard F, Yaprak E, Basar M, Guzel E, Arda O, Irez T, Norambuena P, Krenkova P, Tuettelmann F, Kliesch S, Paulasova P, Stambergova A, Macek M, Macek M, Rivera R, Garrido-Gomez T, Galletero S, Meseguer M, Dominguez F, Garrido N, Mallidis C, Sanchez V, Weigeng L, Redmann K, Wistuba J, Gross P, Wuebbelling F, Fallnich C, Burger M, Kliesch S, Schlatt S, San Celestino Carchenilla M, Pacheco Castro A, Simon Sanjurjo P, Molinero Ballesteros A, Rubio Garcia S, Garcia Velasco JA, Macanovic B, Otasevic V, Korac A, Vucetic M, Garalejic E, Ivanovic Burmazovic I, Filipovic MR, Buzadzic B, Stancic A, Jankovic A, Velickovic K, Golic I, Markelic M, Korac B, Gosalvez J, Ruiz-Jorro M, Garcia-Ochoa C, Sachez-Martin P, Martinez-Moya M, Caballero P, Hasegawa N, Fukunaga N, Nagai R, Kitasaka H, Yoshimura T, Tamura F, Kato M, Nakayama K, Oono H, Kojima E, Yasue K, Watanabe H, Asano E, Hashiba Y, Asada Y, Das M, Al-Hathal N, San-Gabriel M, Phillips S, Kadoch IJ, Bissonnette F, Holzer H, Zini A, Zebitay AG, Irez T, Ocal P, Sahmay S, Karahuseyinoglu S, Usta T, Repping S, Silber S, Van Wely M, Datta A, Nayini K, Eapen A, Barlow S, Lockwood G, Tavares R, Baptista M, Publicover SJ, Ramalho-Santos J, Vaamonde D, Rodriguez I, Diaz A, Darr C, Chow V, Ma S, Smith R, Jeria F, Rivera J, Gabler F, Nicolai H, Cunha M, Viana P, Goncalves A, Silva J, Oliveira C, Teixeira da Silva J, Ferraz L, Madureira C, Doria S, Sousa M, Barros A, Herrero MB, Delbes G, Troueng E, Holzer H, Chan PTK, Vingris L, Setti AS, Braga DPAF, Figueira RCS, Iaconelli A, Borges E, Sargin Oruc A, Gulerman C, Zeyrek T, Yilmaz N, Tuzcuoglu D, Cicek N, Scarselli F, Terribile M, Franco G, Zavaglia D, Dente D, Zazzaro V, Riccio T, Minasi MG, Greco E, Cejudo-Roman A, Ravina CG, Candenas L, Gallardo-Castro M, Martin-Lozano D, Fernandez-Sanchez M, Pinto FM, Balasuriya A, Serhal P, Doshi A, Harper J, Romany L, Garrido N, Fernandez JL, Pellicer A, Meseguer M, Ribas-Maynou J, Garcia-Peiro A, Fernandez-Encinas A, Prada E, Jorda I, Cortes P, Llagostera M, Navarro J, Benet J, Kesici H, Cayli S, Erdemir F, Karaca Z, Aslan H, Karaca Z, Cayli S, Ocakli S, Kesici H, Erdemir F, Aslan H, Tas U, Ozdemir AA, Aktas RG, Tok OE, Ocakli S, Cayli S, Karaca Z, Erdemir F, Aslan H, Li S, Lu C, Hwu Y, Lee RK, Landaburu I, Gonzalvo MC, Clavero A, Ramirez JP, Pedrinaci S, Serrano M, Montero L, Carrillo S, Weiss J, Ortiz AP, Castilla JA, Sahin O, Bakircioglu E, Serdarogullari M, Bayram A, Yayla S, Ulug U, Tosun SB, Bahceci M, Aktas RG, Ozdemir AA, Tok OE, Yoon SY, Shin DH, Shin TE, Park EA, Won HJ, Kim YS, Lee WS, Yoon TK, Lee DR, Hattori H, Nakajo Y, Kyoya T, Kuchiki M, Kanto S, Kyono K, Park M, Park MR, Lim EJ, Lee WS, Yoon TK, Lee DR, Choi Y, Mitra A, Bhattacharya J, Kundu A, Mukhopadhaya D, Pal M, Enciso M, Alfarawati S, Wells D, Fernandez-Encinas A, Garcia-Peiro A, Ribas-Maynou J, Abad C, Amengual MJ, Navarro J, Benet J, Esmaeili V, Safiri M, Shahverdi AH, Alizadeh AR, Ebrahimi B, Brucculeri AM, Ruvolo G, Giovannelli L, Schillaci R, Cittadini E, Scaravelli G, Perino A, Cortes Gallego S, Gabriel Segovia A, Nunez Calonge R, Guijarro Ponce A, Ortega Lopez L, Caballero Peregrin P, Heindryckx B, Kashir J, Jones C, Mounce G, Ramadan WM, Lemmon B, De Sutter P, Parrington J, Turner K, Child T, McVeigh E, Coward K, Bakircioglu E, Ulug U, Tosun S, Serdarogullari M, Bayram A, Ciray N, Bahceci M, Saeidi S, Shapouri F, Hoseinifar H, Sabbaghian M, Pacey A, Aflatoonian R, Bosco L, Ruvolo G, Carrillo L, Pane A, Manno M, Roccheri MC, Cittadini E, Selles E, Garcia-Herrero S, Martinez JA, Munoz M, Meseguer M, Garrido N, Durmaz A, Dikmen N, Gunduz C, Tavmergen Goker E, Tavmergen E, Gozuacik D, Vatansever HS, Kara B, Calimlioglu N, Yasar P, Tavmergen E, Tavmergen Goker E, Semerci B, Baka M, Ozbilgin K, Karabulut A, Tekin A, Sabah B, Cottin V, Kottelat D, Fellmann M, Halm S, Rosenthaler E, Kisida T, Kojima F, Sakamoto T, Makutina VA, Balezin SL, Rosly OF, Slishkina TV, Hatzi E, Lazaros L, Xita N, Makrydimas G, Sofikitis N, Kaponis A, Stefos T, Zikopoulos K, Georgiou I, Zikopoulos K, Lazaros L, Xita N, Makrydimas G, Sofikitis N, Kaponis A, Stefos T, Hatzi E, Georgiou I, Georgiou I, Lazaros L, Xita N, Makrydimas G, Sofikitis N, Kaponis A, Stefos T, Hatzi E, Zikopoulos K, Hibi H, Ohori T, Sumitomo M, Asada Y, Anarte C, Calvo I, Domingo A, Presilla N, Aleman M, Bou R, Guardiola F, Agirregoikoa JA, De Pablo JL, Barrenetxea G, Zhylkova I, Feskov O, Feskova I, Zozulina O, Somova O, Nabi A, Khalili MA, Roudbari F, Parmegiani L, Cognigni GE, Bernardi S, Taraborrelli S, Troilo E, Ciampaglia W, Pocognoli P, Infante FE, Tabarelli de fatis C, Arnone A, Maccarini AM, Filicori M, Silva L, Oliveira JBA, Petersen CG, Mauri AL, Massaro FC, Cavagna M, Baruffi RLR, Franco JG, Fujii Y, Endou Y, Mtoyama H, Shokri S, Aitken RJ. ANDROLOGY. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.73] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Child T, Craig J, Turner K, McVeigh E, Fatum M, Gremeau AS. IVM for women with polycystic ovaries? A case-control study. Fertil Steril 2011. [DOI: 10.1016/j.fertnstert.2011.07.919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Trew G, Pistofidis G, Pados G, Lower A, Mettler L, Wallwiener D, Korell M, Pouly JL, Coccia ME, Audebert A, Nappi C, Schmidt E, McVeigh E, Landi S, Degueldre M, Konincxk P, Rimbach S, Chapron C, Dallay D, Röemer T, McConnachie A, Ford I, Crowe A, Knight A, Dizerega G, Dewilde R. Gynaecological endoscopic evaluation of 4% icodextrin solution: a European, multicentre, double-blind, randomized study of the efficacy and safety in the reduction of de novo adhesions after laparoscopic gynaecological surgery. Hum Reprod 2011; 26:2015-27. [PMID: 21632697 DOI: 10.1093/humrep/der135] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Gynaecological laparoscopic surgery outcomes can be compromised by the formation of de novo adhesions. This randomized, double-blind study was designed to assess the efficacy and safety of 4% icodextrin solution (Adept(®)) in the reduction of de novo adhesion incidence compared to lactated Ringer's solution (LRS). METHODS Patients undergoing laparoscopic surgery for removal of myomas or endometriotic cysts were treated with randomized solution as an intra-operative irrigant and 1l post-operative instillate. De novo adhesion incidence (number of sites with adhesions), severity and extent were independently scored at a second-look procedure and the efficacy of the two solutions compared. The effect of surgical covariates on adhesion formation was also investigated. Initial exploratory analysis of individual anatomical sites of clinical importance was progressed. RESULTS Of 498 patients randomized, 330 were evaluable (160 LRS--75% myomectomy/25% endometriotic cysts; 170 Adept--79% myomectomy/21% endometriotic cysts). At study completion, 76.2% LRS and 77.6% Adept had ≥ 1 de novo adhesion. The mean (SD) number of de novo adhesions was 2.58 (2.11) for Adept and 2.58 (2.38) for LRS. The treatment effect difference was not significant (P = 0.909). Assessment of surgical covariates identified significant influences on the mean number of de novo adhesions regardless of treatment, including surgery duration (P = 0.048), blood loss in myomectomy patients (P = 0.019), length of uterine incision in myomectomy patients (P < 0.001) and number of suture knots (P < 0.001). There were 15 adverse events considered treatment-related in the LRS patients (7.2%) and 18 in the Adept group (8.3%). Of 17 reported serious adverse events (9 LRS; 8 Adept) none were considered treatment-related. CONCLUSIONS The study confirmed the safety of Adept in laparoscopic surgery. The proportion of patients with de novo adhesion formation was considerably higher than previous literature suggested. Overall there was no evidence of a clinical effect but various surgical covariates including surgery duration, blood loss, number and size of incisions, suturing and number of knots were found to influence de novo adhesion formation. The study provides direction for future research into adhesion reduction strategies in site specific surgery.
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Affiliation(s)
- G Trew
- Reproductive Medicine and Surgery, Hammersmith and Queen Charlotte's Hospital, London W12 OHS, UK.
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Swanton A, Lighten A, Granne I, McVeigh E, Lavery S, Trew G, Talmor A, Raine-Fenning N, Jayaprakasan K, Child T. Do women with ovaries of polycystic morphology without any other features of PCOS benefit from short-term metformin co-treatment during IVF? A double-blind, placebo-controlled, randomized trial. Hum Reprod 2011; 26:2178-84. [DOI: 10.1093/humrep/der120] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Child T, Ross C, Pirello O, Pringle F, McVeigh E, Turner K. In-vitro maturation (IVM) of immature oocytes from unstimulated ovaries: results of the first 40 British cycles. Fertil Steril 2008. [DOI: 10.1016/j.fertnstert.2008.07.1636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Swanton A, McVeigh E, Lavery S, Trew G, Raine-Fenning N, Child T. Do women with polycystic ovaries but regular menstrual cycles benefit from metformin treatment during IVF? A double-blind, placebo-controlled randomized trial. Fertil Steril 2008. [DOI: 10.1016/j.fertnstert.2008.07.634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Slack A, Child T, Lindsey I, Kennedy S, Cunningham C, Mortensen N, Koninckx P, McVeigh E. Authors response to: Urological and colorectal complications following surgery for rectovaginal endometriosis. BJOG 2008. [DOI: 10.1111/j.1471-0528.2007.01641.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Slack A, Child T, Lindsey I, Kennedy S, Cunningham C, Mortensen N, Koninckx P, McVeigh E. Urological and colorectal complications following surgery for rectovaginal endometriosis. BJOG 2007; 114:1278-82. [PMID: 17877680 DOI: 10.1111/j.1471-0528.2007.01477.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To report the short- and medium-term complications of laparoscopic laser excisional surgery for rectovaginal endometriosis. DESIGN Retrospective cohort study. SETTING University teaching hospital, UK. POPULATION A total of 128 women with histologically confirmed rectovaginal endometriosis who underwent laparoscopic laser surgery between May 1999 and September 2006. METHODS Women were identified from operative database, and a case note review was performed. Data for surgical outcome and surgical complications were collected. MAIN OUTCOME MEASURES Rates of urinary tract and colorectal complications. RESULTS A total of 128 women underwent surgery. Of these, 32 required intraoperative closure of a rectal wall defect, including 3 segmental rectosigmoid resections. There were three rectovaginal fistulae and one ureterovaginal fistula. Ureteric damage occurred in two women, and five women suffered postoperative urinary retention. The risk of intraoperative bowel intervention was increased in women who complained of cyclical rectal bleeding. CONCLUSION Laparoscopic laser excision of rectovaginal endometriosis is a safe procedure with similar, if not lower, complication rates to other published surgical series.
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Affiliation(s)
- A Slack
- Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Oxford, UK
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Ciaccio E, Ashikaga H, Kaba R, Cervantes D, Hopenfeld B, Wit A, Garan H, Peters N, Coromilas J, McVeigh E. The location of the isthmus in reentrant ventricular tachycardia is correlated with the variation in infarct border zone thickness. J Electrocardiol 2006. [DOI: 10.1016/j.jelectrocard.2006.08.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Landi S, Ceccaroni M, Perutelli A, Allodi C, Barbieri F, Fiaccavento A, Ruffo G, McVeigh E, Zanolla L, Minelli L. Laparoscopic nerve-sparing complete excision of deep endometriosis: is it feasible? Hum Reprod 2006; 21:774-81. [PMID: 16449312 DOI: 10.1093/humrep/dei324] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Little is known about the morbidity associated with laparoscopic complete excision of endometriosis in terms of urinary, digestive and sexual function. METHODS We performed a prospective non-randomized study in 45 patients with laparoscopic complete excision of all detectable foci of endometriosis with segmental bowel resection using a non nerve-sparing technique (control group-group A n=20) and a nerve-sparing technique (case group-group B n=25). At initial gynaecological evaluation, and at follow-up details on dysmenorrhoea, pelvic pain, dyspareunia and dyschezia were evaluated using an interview-based questionnaire (10-point analogue rating scale: 0=absent, 10=unbearable). RESULTS The mean (+/-SD) follow-up period was 15.3+/-10 months (range, 8.8-23 months) for group A and 3.5+/-2.1 months (range, 0.3-5.2 months) for group B. In the immediate postoperative course, in group A three women required blood transfusion vs seven women in group B (P=0.003). The median time to resume the voiding function was significantly shorter in group B (12.5 vs 3.0 days; P<0.01). At the time of follow-up a higher proportion of patients in group B were 'very satisfied' than those in group A (87.7% vs 59.0%, P=0.013). CONCLUSIONS Laparoscopic nerve-sparing complete excision of endometriosis seems to be feasible and offers good results in terms of bladder morbidity reduction with apparently higher satisfaction than classical technique. Larger series with longer follow-up are needed to confirm our results.
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Affiliation(s)
- S Landi
- Department of Obstetrics and Gynecology, Ospedale Sacro Cuore, Via Don A.Sempreboni 5, 37024 Negrar (Verona), School of Medicine, University of Bologna, Italy
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Hovatta O, McVeigh E, Homburg R, Bogle S, Lass A. The Routine use of Follitropin Alfa (FbM) Pre-Filled Pen for Follicular Development for IVF. A Large Multinational Observational Study in Northern Europe. Fertil Steril 2005. [DOI: 10.1016/j.fertnstert.2005.07.787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jones C, Chamberlain P, McVeigh E. Personalized Embryo Transfer Policies in IVF: A Population-Based Analysis. Fertil Steril 2005. [DOI: 10.1016/j.fertnstert.2005.07.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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McVeigh E, Lass A. The routine use of a new formulation of follitropin alfa (FbM) for follicular development for IVF. A large multicenter observational study in the UK. Fertil Steril 2004. [DOI: 10.1016/j.fertnstert.2004.07.510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lass A, McVeigh E. Routine use of r-hFSH follitropin alfa filled-by-mass for follicular development for IVF: a large multicentre observational study in the UK. Reprod Biomed Online 2004; 9:604-10. [PMID: 15670403 DOI: 10.1016/s1472-6483(10)61768-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The technical advance of recombinant biotechnology to manufacture FSH has resulted in a biochemically pure FSH preparation with high batch-to-batch consistency. The protein content of recombinant human FSH (r-hFSH) can be reliably quantified in mass units by size exclusion high performance liquid chromatography (SE-HPLC) enabling r-hFSH follitropin alfa (Gonal-F) to be filled and released in the vial on the basis of mass with dose variability of only +/-2% [filled-by-mass (FbM)]. Observational studies have merit in addressing the effectiveness of a new product in routine clinical practice. This non-interventional study assessed r-hFSH follitropin alfa FbM for the multifollicular stimulation of patients undergoing assisted reproduction. A total of 1427 patients were recruited in 21 centres in the UK and the mean age was 34.3 years (+/-4.48, range 18-48). Of those who started treatment, 1388 (97.3%) received human chorionic gonadotrophin and 1330 (93.2%) underwent oocyte retrieval. A total of 1213 (85%) patients had embryo transfer and in the majority of recorded cases, most embryos replaced were graded as 1 or 2 (74.6%). The ongoing clinical pregnancy rate was 29.2% per cycle and 34.4% per embryo transfer. The routine use of r-hFSH follitropin alfa FbM in normal clinical practice in IVF has been demonstrated to be effective, safe and well received by patients.
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Affiliation(s)
- A Lass
- Serono Ltd, Feltham, Middlesex, London, UK.
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Garceau L, Henderson J, Davis LJ, Petrou S, Henderson LR, McVeigh E, Barlow DH, Davidson LL. Economic implications of assisted reproductive techniques: a systematic review. Hum Reprod 2002; 17:3090-109. [PMID: 12456608 DOI: 10.1093/humrep/17.12.3090] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Approximately one in six couples experiences problems with their fertility at some point in their reproductive lives. The economic implications of the use of assisted reproductive techniques require consideration. Herein, the health economics research in this area are critically appraised. METHODS Multiple strategies were used to identify relevant studies. Each title and abstract was independently reviewed by two members of the study team and categorized according to perceived relevance. The selected papers were then assessed for quality and data were extracted, converted to UK pounds sterling at 1999/2000 prices, tabulated and critically appraised. RESULTS A total of 2547 papers was identified through the searches; this resulted in 30 economic evaluations, 22 cost studies and five economic benefit studies that met the selection criteria. The quality of these studies was mixed; many failed to disaggregate costs, discount future costs or conduct sensitivity analyses. Consistent findings included the following: initiating treatment with intrauterine insemination appeared to be more cost-effective than IVF; vasectomy reversal appeared to be more cost-effective than ICSI; factors associated with poor prognosis decreased the cost-effectiveness of interventions. CONCLUSIONS The cost-effectiveness of different interventions should be considered when making decisions about treatment. Future economic appraisals of assisted reproductive techniques would benefit from more robust methodology than is evident in much of the published literature to date.
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Affiliation(s)
- L Garceau
- Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK
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Lenton E, Soltan A, Hewitt J, Thomson A, Davies W, Ashraf N, Sharma V, Jenner L, Ledger W, McVeigh E. Induction of ovulation in women undergoing assisted reproductive techniques: recombinant human FSH (follitropin alpha) versus highly purified urinary FSH (urofollitropin HP). Hum Reprod 2000; 15:1021-7. [PMID: 10783345 DOI: 10.1093/humrep/15.5.1021] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This multicentre, open, randomized, study compared the efficacy and safety of recombinant follicle stimulating hormone (rFSH; follitropin alpha) with highly purified urinary human FSH (uFSH; urofollitropin HP) in women undergoing ovulation induction for assisted reproductive techniques. Following long down-regulation with buserelin, patients received two ampoules of 75 IU (150 IU) s.c. rFSH or highly purified uFSH for 6 days, after which the dose could be increased until they fulfilled the criteria for human chorionic gonadotrophin (HCG) administration. Of 168 patients recruited, 155 received at least one dose of FSH, and 137 received HCG [68: rFSH (85%); 69: uFSH (92%)]. Following oocyte retrieval and fertilization, up to three embryos were replaced/patient and luteal support was given. The mean number of oocytes retrieved/patient was 10.2 +/- 6.0 for rFSH patients compared with 10.8 +/- 6.1 in the uFSH group (not significant). There was a trend towards fewer ampoules used (22.3 +/- 6.5 versus 24.3 +/- 6.5), higher pregnancy (44.3 versus 41.4%) and live birth rates (33.8 versus 26.7%), as well as a lower miscarriage rate (0.0 versus 16.7%) in favour of rFSH. However, no significant differences in efficacy parameters were recorded. Ovarian hyperstimulation syndrome occurred in 8.6% and 7.9% of rFSH and uFSH patients respectively. In conclusion, this protocol was effective in inducing multiple follicular development and high numbers of oocytes were retrieved with both drugs.
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Affiliation(s)
- E Lenton
- Sheffield Fertility Centre, Sheffield, S7 1RA, Reproductive Medicine Unit, Liverpool Women's Hospital, Liverpool L8 7SS, UK
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Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine condition of premenopausal women and has significant metabolic abnormalities that could have an impact after the menopause. Diabetes mellitus, hyperlipidemia and hyperinsulinemia could potentially affect health in this era of life. Endometrial cancer, due to unopposed estrogen action, is more common where progestins have not been given for menstrual dysfunction. Preventive management earlier in life will avoid postmenopausal problems in PCOS.
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Affiliation(s)
- R J Norman
- Reproductive Medicine Unit, Department of Obstetrics and Gynaecology, University of Adelaide, Australia
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Abstract
Methods for noninvasive tissue tracking and quantification of myocardial shortening with magnetic resonance imaging have been developed using presaturation tagging and velocity encoded phase maps. The concurrent development of rapid scanning techniques, such that a complete cine loop of a slice can be obtained in a breath-hold, has made the measurement of myocardial wall motion in patients a simple and reproducible examination. These methods make it possible to quantify the severity and extent of regional heart wall motion abnormalities both at rest and during stress.
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Affiliation(s)
- E McVeigh
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Abstract
Mechano-electrical feedback is studied by incorporating linear, instantaneously activating mechano-sensitive conductances into single cardiac cell models, as well as one- and two-dimensional cardiac network models. The models qualitatively reproduce effects of maintained mechanical stretch on experimentally measured action potential characteristics such as amplitude, maximum diastolic potential, peak upstroke velocity, and conduction velocity. Models are also used to simulate stretch-induced depolarizations, action potentials, and arrhythmias produced by pulsatile volume changes in left ventricle of dog. The mechano-sensitive conductance threshold for a stretch-induced action potential is closely related to the magnitude of the time-independent K+ current, IK1, which offsets inward mechano-sensitive current. Activation of mechano-sensitive conductances in small, spatially localized region of cells can evoke graded depolarizations, propagating ectopic beats, and if timed appropriately, spiral reentrant waves. Mechano-sensitive conductance changes required to evoke these responses are well within the physiologically plausible range. Results therefore indicate that many mechano-electrical feedback effects can be modeled using linear, instantaneously activating mechano-sensitive conductances. As an example of how stretch can occur in real human hearts, magnetic resonance images with saturation tagging are used to reconstruct the three-dimensional left ventricular wall motion. In patients with infarcts or recent ischemic events, "paradoxical deformation" is observed in that regions of myocardium are stretched rather than contracted during systole. In contrast, normal hearts contract uniformly with no stretch during systole. Paradoxical deformations in ischemic hearts may therefore present one possible substrate for the mechanically induced arrhythmias modeled above.
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Affiliation(s)
- J J Rice
- Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, 720 Rutland Ave., Baltimore, MD 21205, USA.
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Lass A, Skull J, McVeigh E, Margara R, Winston RM. Measurement of ovarian volume by transvaginal sonography before ovulation induction with human menopausal gonadotrophin for in-vitro fertilization can predict poor response. Hum Reprod 1997; 12:294-7. [PMID: 9070714 DOI: 10.1093/humrep/12.2.294] [Citation(s) in RCA: 162] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The study tests the hypothesis that small ovaries measured on transvaginal sonography (TVS) are associated with a poor response to ovulation induction by human menopausal gonadotrophin (HMG) for in-vitro fertilization (IVF). A total of 140 infertile patients with morphologically normal ovaries undergoing IVF was studied. The mean ovarian volume of each patient was measured on TVS before starting HMG. Subsequent routine IVF management was conducted without knowledge of the results of TVS. The mean ovarian volume was 6.3 cm3 (range 0.5-18.9, SD= 3.1). Patients (n = 17; group A) with small ovaries of < 3 cm3 (i.e. overall mean volume - 1 SD) were compared to patients (n = 123; group B) with ovaries > or = 3 cm3. Both groups were of similar age (mean 35.8 versus 34.4 years). Early basal FSH concentrations were increased in group A (9.5 versus 7.0 mIU/ml, P = 0.025). The cycle was abandoned before planned oocyte recovery in nine patients (52.8%) from group A and in 11 patients (8.9%) from group B because of poor response to ovulation induction (P < 0.001). Increased age and ovarian volume were associated independently with cancellation of the cycles. The remaining eight patients from group A who had oocytes retrieved required higher doses of HMG (87.5 versus 53.8 ampoules, P < 0.01), yielded fewer follicles (10.3 versus 14.5, P < 0.05) and fewer oocytes were recovered from them (6.8 versus 11.0, P < 0.05) compared with group B. There was no difference in the fertilization or pregnancy rates or the number of embryos available for transfer in either group. Our results indicate a strong association between ovarian volume and ovarian reserve. Small ovaries are associated with poor response to HMG and a very high cancellation rate during IVF. Assessment of ovarian size should be an integral part of infertility evaluation.
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Affiliation(s)
- A Lass
- Institute of Obstetrics and Gynaecology, Royal Postgraduate Medical School, Hammersmith Hospital, London, UK
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Dong SJ, MacGregor JH, Crawley AP, McVeigh E, Belenkie I, Smith ER, Tyberg JV, Beyar R. Left ventricular wall thickness and regional systolic function in patients with hypertrophic cardiomyopathy. A three-dimensional tagged magnetic resonance imaging study. Circulation 1994; 90:1200-9. [PMID: 8087929 PMCID: PMC2396316 DOI: 10.1161/01.cir.90.3.1200] [Citation(s) in RCA: 124] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Regional performance of the hypertrophied left ventricle (LV) in hypertrophic cardiomyopathy (HCM) is still incompletely characterized with studies variably reporting that the hypertrophied myocardium is hypokinetic, akinetic, or has normal function. Different imaging modalities (M-mode or two-dimensional echocardiography) and methods of analysis (fixed or floating frame of reference for wall motion analysis) yield different results. We assessed regional function in terms of systolic wall thickening and shortening and related these parameters to end-diastolic thickness using tagged magnetic resonance imaging and the three-dimensional volume-element approach. METHODS AND RESULTS In 17 patients with HCM and 6 healthy volunteers, four parallel short-axis images with 12 radial tags and two mutually orthogonal long-axis images with four parallel tags were obtained at end diastole and end systole. After the LV endocardial and epicardial borders were traced, three-dimensional volume elements were constructed by connecting two matched planar segments in two adjacent short-axis image planes, accounting for translation, twist, and long-axis shortening. A total of 72 such volume elements encompassed the entire LV. From each of these elements, end-diastolic thickness and systolic function (fractional thickening and circumferential shortening) were calculated. The average end-diastolic thickness was 15.8 +/- 4.2 mm in patients with HCM, which was significantly greater than that in healthy subjects (8.6 +/- 2.1 mm, P < .001). Fractional thickening was significantly less in patients with HCM than in healthy subjects (0.31 +/- 0.22 versus 0.56 +/- 0.23, P < .001). There was a highly significant inverse correlation between fractional thickening and end-diastolic thickness that was independent of the type of hypertrophy or age group. Similar inverse relations were observed between circumferential shortening and end-diastolic wall thickness. CONCLUSIONS The myocardium in patients with HCM is heterogeneously thickened and the fractional thickening and circumferential shortening of the abnormally thickened myocardium are reduced compared with healthy subjects. The decrease in fractional thickening and shortening is inversely related to the local thickness.
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Affiliation(s)
- S J Dong
- Department of Medicine, University of Calgary, Alberta, Canada
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Lima JA, Jeremy R, Guier W, Bouton S, Zerhouni EA, McVeigh E, Buchalter MB, Weisfeldt ML, Shapiro EP, Weiss JL. Accurate systolic wall thickening by nuclear magnetic resonance imaging with tissue tagging: correlation with sonomicrometers in normal and ischemic myocardium. J Am Coll Cardiol 1993; 21:1741-51. [PMID: 8496547 DOI: 10.1016/0735-1097(93)90397-j] [Citation(s) in RCA: 132] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVES This study examined whether the correlation of systolic wall thickening (%WT) by nuclear magnetic resonance (NMR) imaging with wall thickening by sonomicrometry (SM) is improved by using a three-dimensional volume element model of the left ventricular wall. BACKGROUND Left ventricular wall obliquity with respect to the imaging plane causes overestimation of wall thickness by planar imaging techniques. Wall thickness perpendicular to the endocardial surface can be accurately calculated by three-dimensional reconstruction of left ventricular wall segments. METHODS Sonomicrometers were placed transmurally in 11 dogs (left anterior descending artery territory) with an imaging marker, visible on NMR imaging, sewn to the epicardial crystal. Two adjacent NMR short-axis image planes were radially segmented by four perpendicular spin-saturated planes (tags), dividing the myocardium into eight volume elements, one of which contained the sonomicrometer crystal pair. Left ventricular thickness and thickening were calculated by four methods: 1) linear = distance between epicardium and endocardium at midpoint in the segment with the sonomicrometer; 2) planar = area of that segment divided by the mean of the endocardial and epicardial arc lengths; 3) biplanar = average of wall thicknesses calculated by the planar method from the segment with sonomicrometers and the corresponding segment located in the adjacent short-axis imaging plane; and 4) three-dimensional = volume of the element with the sonomicrometers divided by the mean of the endocardial and epicardial surface areas. RESULTS Regressions for all methods using pooled data from control periods and during ischemia: Linear %WT = 0.59 + 1.31 SM%WT (r = 0.71, SEE = 0.28, p < 0.0002) Planar %WT = 1.43 + 1.62 SM%WT (r = 0.87, SEE = 0.19, p < 0.0001) Biplanar %WT = 2.09 + 1.46 SM%WT (r = 0.90, SEE = 0.15, p < 0.0001) Three-dimensional %WT = 0.19 + 1.49 SM%WT (r = 0.95, SEE = 0.10, p < 0.0001) CONCLUSIONS Nuclear magnetic resonance imaging with tissue tagging allows accurate noninvasive assessment of systolic wall thickening. The three-dimensional volume element approach, by accounting for obliquity between the image plane and the left ventricular wall, provides the strongest correlation between NMR imaging and percent systolic wall thickening by sonomicrometer crystals.
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Affiliation(s)
- J A Lima
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland
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McKnight JA, McVeigh E, Biggart JD, Hayes JR. Lipoid pneumonia; an unsuspected diagnosis. Ulster Med J 1992; 61:198-201. [PMID: 1481315 PMCID: PMC2448948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Müller-Gärtner HW, Links JM, Prince JL, Bryan RN, McVeigh E, Leal JP, Davatzikos C, Frost JJ. Measurement of radiotracer concentration in brain gray matter using positron emission tomography: MRI-based correction for partial volume effects. J Cereb Blood Flow Metab 1992; 12:571-83. [PMID: 1618936 DOI: 10.1038/jcbfm.1992.81] [Citation(s) in RCA: 472] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Accuracy in in vivo quantitation of brain function with positron emission tomography (PET) has often been limited by partial volume effects. This limitation becomes prominent in studies of aging and degenerative brain diseases where partial volume effects vary with different degrees of atrophy. The present study describes how the actual gray matter (GM) tracer concentration can be estimated using an algorithm that relates the regional fraction of GM to partial volume effects. The regional fraction of GM was determined by magnetic resonance imaging (MRI). The procedure is designated as GM PET. In computer simulations and phantom studies, the GM PET algorithm permitted a 100% recovery of the actual tracer concentration in neocortical GM and hippocampus, irrespective of the GM volume. GM PET was applied in a test case of temporal lobe epilepsy revealing an increase in radiotracer activity in GM that was undetected in the PET image before correction for partial volume effects. In computer simulations, errors in the segmentation of GM and errors in registration of PET and MRI images resulted in less than 15% inaccuracy in the GM PET image. In conclusion, GM PET permits accurate determination of the actual radiotracer concentration in human brain GM in vivo. The method differentiates whether a change in the apparent radiotracer concentration reflects solely an alteration in GM volume or rather a change in radiotracer concentration per unit volume of GM.
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Affiliation(s)
- H W Müller-Gärtner
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
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41
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Tsukamoto H, Kang YS, Jones LC, Cova M, Herold CJ, McVeigh E, Hungerford DS, Zerhouni EA. Evaluation of marrow perfusion in the femoral head by dynamic magnetic resonance imaging. Effect of venous occlusion in a dog model. Invest Radiol 1992; 27:275-81. [PMID: 1601616 PMCID: PMC2396275 DOI: 10.1097/00004424-199204000-00002] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
RATIONALE AND OBJECTIVES There is a continuing need for a greater sensitivity of magnetic resonance imaging (MRI) in the diagnosis of avascular necrosis (AVN). Previously, it was demonstrated that a dynamic MRI method, with gadolinium-DTPA (Gd-DTPA) enhancement, can detect acute changes not seen on spin-echo images after arterial occlusion in a dog model. Because venous congestion appears to be a more directly relevant hemodynamic abnormality in a majority of clinical AVN cases, the authors extended the dynamic MRI technique to study changes in venous occlusion. METHODS Dynamic MRI of the proximal femur was performed in five adult dogs before and after unilateral ligation of common iliac and lateral circumflex veins. Sixteen sequential gradient-recalled pulse sequence (GRASS) images (time resolution = 45 mseconds, echo time = 9 mseconds, flip angle = 65 degrees) were obtained immediately after a bolus intravenous injection of 0.2 mmol/kg of Gd-DTPA. Simultaneous measurements of regional blood flow were made using the radioactive microsphere method. RESULTS After venous ligation, there was a 25% to 45% decrease in the degree of enhancement compared with preligation values on the ligated side. The decrease in cumulative enhancement (integrated over the entire time course) was statistically significant. The occlusion technique was verified by confirming a statistically significant decrease in blood flow determined by the microsphere method. CONCLUSIONS Dynamic Gd-DTPA-enhanced fast MRI technique can detect acute changes in bone marrow perfusion due to venous occlusion. This technique may have applications in the early detection of nontraumatic AVN.
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Affiliation(s)
- H Tsukamoto
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
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Cova M, Kang YS, Tsukamoto H, Jones LC, McVeigh E, Neff BL, Herold CJ, Scott WW, Hungerford DS, Zerhouni EA. Bone marrow perfusion evaluated with gadolinium-enhanced dynamic fast MR imaging in a dog model. Radiology 1991; 179:535-9. [PMID: 2014306 DOI: 10.1148/radiology.179.2.2014306] [Citation(s) in RCA: 84] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The authors studied, in a dog model, the feasibility of using gadolinium-enhanced dynamic magnetic resonance (MR) imaging to noninvasively monitor bone marrow perfusion of the proximal femur. With a gradient-recalled acquisition, sequential images of 10 hips in five healthy dogs were obtained for 14 minutes after an intravenous bolus injection of 0.2 mmol of gadopentetate dimeglumine per kilogram. The study was repeated after unilateral arterial embolization of major femoral vessels. Radiolabeled microspheres were injected before and after vessel occlusion. After unilateral embolization, statistically significant differences in enhancement were observed between embolized and control sides (eg, 31% vs 83% average peak enhancement in the femoral neck). There was a high correlation (r = .81 [average]) between the MR data and the microsphere blood flow measurements. The postembolization data indicate that contrast-enhanced fast MR imaging may allow early detection of abnormal bone marrow flow. This technique may be valuable in evaluating patients at risk for avascular necrosis of the femoral head, especially in posttraumatic cases.
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Affiliation(s)
- M Cova
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD 21205
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Abstract
A method is described for rapidly obtaining a multipoint estimate of T1 from a sample that is homogeneous over a few millimeters. An image of the longitudinal recovery curve is produced through the application of successive "pre-inversion" slices that are perpendicular to the imaging slice. These pre-inversion pulses are analogous to pre-saturation pulses, but they are much thinner and the tip angle is 180 degrees. The baseline for the recovery is measured from sections of the sample that have not been perturbed by the slice selective pre-inversion pulses. The existence of the baseline value and the lack of slice profile effects allows a quick T1 estimate (QT1) to be made with a simple linear regression algorithm. The QT1 values are found to correlate very well with T1 values measured with the scanner in "spectrometer' mode, for volumes as small as 5 x 5 x 5 mm. Possible applications are T1 estimates in homogeneous samples and tissues, and scouting the T1 range of a tissue to be measured with higher resolution volume localization techniques.
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Affiliation(s)
- E McVeigh
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
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